For many countries in the English-speaking Caribbean, Child Month is celebrated in May. Reading about some of the local activities being held to celebrate Child Month, led me into thinking what kind of world I want my daughter to live in; and what must be done to help to shape such a world. The UN Convention on the Rights of the Child goes a far way towards helping us to craft spaces in which our children can meet their fullest potential. It outlines children's basic human rights: the right to survival; to develop to the fullest; to protection from harmful influences, abuse and exploitation; and to participate fully in family, cultural and social life. Looking over these four core rights however, I am blown away by how they are being challenged at the most fundamental levels.

In 2001, an ILO/IPEC (International Labour Association/International Programme on the Elimination of Child Labour) funded project, in collaboration with governments across the region, sought to unearth some of the hidden truths regarding child labour. One of the themes that arose was the existence of commercial sex exploitation of children (PDF). The study found cases of children as young as 10 years old being sexually exploited for commercial gain: working as prostitutes; being hired out to tourists; and working in "go-go" clubs and massage parlours. For large numbers of children, sexuality has become not only a tool of survival, but also a weapon for their exploitation.

Children's vulnerability in the area of commercial sex work is exacerbated by a number of socioeconomic factors. Unstable economies; premature departure from school; poverty; weakened family support systems; the tourism industry and the related demand for sex; and cultural patterns that may place some children in the role of income earners, all act as contributing factors to young people's entry into sex work. Research has also highlighted the presence of other "pull" factors such as the desire to rebel; the fulfillment of sexual desires; and peer pressure. Gender also plays a key role as "girl-children" are particularly at risk, although significant numbers of boys were also found to be active in commercial sex work.

Children's participation in commercial sex work brings with it some particularly troublesome concerns in the areas of sexual and reproductive health.

Given the predominantly hidden nature of sex work (particularly that involving underage children), this vulnerable group is not easily accessible to people outside of their "communities." What this means in practical terms is that they are not easily provided with health care information or care that could help them to protect, and possibly save, their lives. This is compounded by the fact that children's participation in sexual activity, particularly as a source of income, is not only a taboo issue, but an illegal one, thus adding a further level of secrecy and obscurity to their activities; and likely contributing to their unwillingness to discuss the issue. Adults who may be in some way involved in the children's activities are also unwilling to participate in efforts to provide the children with sexual education or care, because it could be seen as an admission of guilt.

Additionally, low levels of education and emotional immaturity pose particularly troubling challenges in the provision of health care, given the ages of the members of this group. This challenge is further aggravated by the unwillingness of some health care workers and staff in pharmacies and shops to provide young people—in particular the obviously younger ones—with the sexual education and/or prophylactics that could save their lives. As one adolescent sex worker noted: "One stink woman once tell me that I was too young. I told her to f— off and went somewhere else."

The participation of children in commercial sex work poses a direct threat to their human rights. According to local research, children in this group are ten times more likely to contract an STI (sexually transmitted infection), thus putting them at increased risk for contracting HIV, and endangering their survival. In addition, children engaged in sex work are likely to discontinue their education, thereby decreasing their income earning abilities outside of illegal activities, and reinforcing the cycle of poverty.

There is an urgent need for policies and programmes that meet the needs of this vulnerable group. Such programmes must include the children themselves in the planning and implementation if they are to truly meet their needs. Community-based programmes and counselling must be aimed not only at providing unbiased health care, but to re-educate children already involved in sex work. Self-esteem building components and skills training are also necessary to dissuade entry into sex work.

Failure to create policies and programmes based on the challenges faced by this at-risk group will undermine their ability for survival. It's as simple and as scary as that.