This study focused on the use of substances by street children in the city of Yaounde and their patterns of use. All the children found in the streets were male. The most commonly used substances were tobacco and cannabis and these were the same substances mostly responsible for dependence among these children.
The absence of girls among SCs of Yaounde contrast with the findings of Embleton & al in Kenya in 2013, where 15% of SCs were girls[11]; Joan S. & al in the USA, in the state of South Dakota, where low frequency run away were 46.9% female and high frequency run away were 51.75 female[4]; Shi-Heng Wang & al in Taiwan where adolescents who had run away only once and for one day or less were 48.1% female and those who had run for a longer time or more than once were 42.7% female[8]; Gwyther Rees in the UK where lifetime runaways were 10% among females and 8% for males [18]; Cumber and Tsoka-Gwegweni in 2015 in Yaoundé where 18.8% of SCs were girls. This difference can be explained by the construction of social housing specifically for girls in 2020 in Yaoundé. The absence of girls can also be explained by the exclusion in this study of SCs sites which are only active at night. These night sites are known for prostitution, making it more likely to have female SCs [1]. Once in the streets, one of the exit ways is marriage, which might be relatively more accessible to girls compared to boys. All these factors can be taken into account for the absence of girls in our sample.
The median (IQR) age of SCs was 16 (14–18) years, and they had spent an average of 3.5 (± 6.9) years in the streets. It can be estimated that the average age for joining the streets was 12.5 years old which is closed to the 12 years old average age for the onset of puberty among boys. This aligns with the current literature stipulating that puberty plays a role in the running away behavior because at this age, the child becomes more aware of the environment and the possibility to run away. However, because he lacks abstract thinking, he hardly perceive the risk of the streets [19].
The main reasons why they joined the streets were the quest for money 25.8% (41), delinquency 18.9% (30), unschooling 18.9% (30), and poverty 18.2% (29). These findings are different from those of the studies done in developed countries where the main determinant for joining the streets were child abuse and dysfunctional families[5, 6, 19]. Those who said that they joined the streets to get money, said that this had nothing to do with the level of wealth in the family. Meanwhile, it makes sense to think that all the reasons mentioned above are related to poverty[20]. Therefore, the difference observed in Yaounde might be the effect of poverty. None of them mentioned sexual abuse. This might be because it wasn't specifically asked.
Since they arrived in the streets, 60% of those children have used a substance. This is similar to the average 60% of substance use by SCs in developing countries identified in 2013 by Embleton & al. Meanwhile, in our findings, the proportions of substances taken are very different[6]. Meanwhile, this is very different from the 100% found by cumber and Tsoka-Gwegweni in 2015. This difference might be the result of the bias introduced by the snowball sampling. The site of Etoudi, where we included 17 SCs, is the only site where there was no substance use. The presence in that area of a koranic school where SCs are allowed to come and study, a mosque that is opened to SCs, and their general acceptance by the community of this area might be the possible contributors to that. The main reasons for using substances were imitation 50% (47), to get courage 19.1% (18), to get strength 14.9% (14), to reduce anxiety 13.8% (13), and pleasure 13.8% (13). This is similar to the findings of Ruby J. Martine in a Midwestern inner-city detention center in the USA whereby, teens said that they used substances to cope with their stressful lives both before and after joining the streets and as a way of socializing with peers[6].
Factors associated with substance use
The factors that are associated with the use of substances by these SCs within the three months before the interview were: the SCs’ site, age, level of education, time spent in the streets, source of income, number of living parents; joining the streets because of juvenile delinquency, poverty, or in a quest for money.
The SCs site can influence substance use by any means. The site of Gare voyageur is usually a landing site in the streets. This might lead to several street naïve and more submissive children, more likely to accept a proposition of substance use or still about to experience substance. As shown here and supported by the findings of Wang & al, longer stay in the streets is associated with a higher risk of substance use[8]. Different sites have different social support systems which may include, the relative acceptance of SCs by the community, availability of social support centers such as the one located in the site of Mfoundi and Gare voyageur. Children who join the street for money are likely to sell drugs to make money, thereby more likely to use drugs. Among SCs in Yaounde, there is a belief that some substances may help to perform better at more physically challenging jobs. This is how these jobs might motivate the use of a substance. Having one or both parents dead might lead to more adversity, thereby motivating the consumption of substances to cope with[6]. Juvenile delinquency and poverty are related[20].