title: Working with girls living on the streets in East Africa: professionals' experiences.
abstract: OBJECTIVE
  This paper reports a study elucidating the meaning of caring for girls of the street, as experienced by female staff members working with street children in Eastern Africa.
  
  
  BACKGROUND
  The phenomenon of children living on the streets is a global and escalating problem, and girls are presumed to be especially vulnerable. In East Africa, the traditional extended family system is rapidly breaking down and traditional gender values seem to remain. This was the context for investigating female carers' experience of caring for girls.
  
  
  METHODS
  Interviews were conducted with 37 project staff members working with children living on the streets in the framework of non-governmental organizations in Kenya, Uganda and Tanzania between 1997 and 1998. Transcribed text from female interviewees (n = 13) working with girls of the street was analysed using a phenomenological-hermeneutic approach.
  
  
  RESULTS
  The meaning of caring for girls of the street for female professional carers in East Africa was comprehensively understood as counselling the girls to integrate the past of their adverse life stories with their present identity. Counselling meant conveying visions for a possible re-direction of the life stories, from being a girl of the street into being an accepted family girl. Caring in this context meant being squeezed between ethical demands and gender values. Experiencing frustration and powerlessness was related to gender structures in society, having to fight the grip of street culture, and a lack of professional tools. Hope and satisfaction were related to success in changing the course of life stories of girls and to seeing possibilities for contributing to empowerment of girls and community members.
  
  
  CONCLUSIONS
  Gender issues are critical to care provided to girls of the street. Carers felt that they lacked relevant knowledge and support. Ethical aspects and gender issues in relation to professional care for vulnerable girls ought to be addressed in nursing education and practice, not only for developing countries, but also as a matter of global interest.
authors.affiliation: Department of Nursing, Umea University, Vardvetarhuset, Umea S-90187, Sweden. stefan.savenstedt@ltu.se
authors.forename: Stefan
authors.initials: S
authors.lastname: Savenstedt
authors.forename: Terttu
authors.initials: T
authors.lastname: Häggstrom
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000351:Africa, Eastern; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003153:Community Health Services / Q000379:methods*; D003376:Counseling / Q000379:methods; D003469:Culture; D005260:Female; D005783:Gender Identity; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D011369:Professional-Patient Relations; D019966:Substance-Related Disorders / Q000523:psychology; D035502:Trust / Q000523:psychology