“…….seeking but a moment’s rest among the long-forgotten haunts of childhood, and the resorts of yesterday; and dimly finding fear and horror everywhere….” 
–Charles Dickens Martin Chuzzlewit London,1843
Everyone knows poverty drives inequity. Here in Montenegro one of the ways we address this is by supporting dramatic expansion of pre-school education for the poorest 3-6year olds, who are currently 10 times less likely to attend which ensures worse life prospects and an inter-generational cycle of poverty.
But is childhood adversity: violence, neglect and dysfunctional parenting, also a driver of inequity?
152 years passed between Dicken’s writing Martin Chuzzlewit and the discovery of a neurobiological explanation of how and why broken childhoods haunt and destroy adult lives-even into old age.
The Adverse Childhood Experience (ACE) study, launched in 1995, continues to demonstrate in many countries huge inequity between adults who were affected by high levels of child abuse, neglect or dysfunctional parenting, and those who were not. High childhood adversity leads to markedly worse outcomes in health, education, employment and crime. It is much more prevalent than we thought and occurs across wealth quintiles.
In addition to being one of the world’s finest novelists, Charles Dickens also gave an authentic voice to those whose childhoods had been pulled apart by the desolate loneliness and crushing injustice of childhood adversity and inequity as he had experienced first-hand himself . As with Dickens, the passion of many UNICEF staff to tackle childhood inequity stems from our own childhood memories and in my case the experience of growing up in loveless institutional children’s homes has always been a major driver of my work.
At any given time across the region of CEE/CIS we have a million children in state care, a fact that will place them on a lifelong path of inequity.They come into state care because of childhood adversity or because they are abandoned, mainly into large-scale children’s homes. A placement in a children’s home is a secondary trauma for any child. It does not provide healthy attachment with an adult and this is particularly catastrophic for children under 5 when brain development is most active and dependent on consistent interaction with an adult.
Comparative brains scans as well as measurements of development-inhibiting cortisol levels between those in institutional care and those in strong families reveal a neurobiological inequity that will eventually translate into long term economic and social inequity.
A children’s home is a place where a child lives in a state of neglect – unequal not just in terms of poverty, but in terms of love, affection and attention. This is why 21 countries in our region have joined forces with the UN Human Rights Commission and UNICEF to eradicate placement of children under 3 in large scale institutions. In Montenegro there will be a complete end to placement of under 3s in state care by 2017. There is a similar campaign in Latin America where around 240,000 children live in state care.
The right to family life is being secured through stronger social work systems, which can keep families together, and promotion of fostering and other family based alternatives for children who cannot be cared for in the biological family. This has already yielded a 40% decrease in the number of children in institutional care in the past five years in Montenegro.
Children in state care are just the tip of the childhood adversity iceberg, the overwhelming majority of childhood adversity is suffered by children in families. We are thus working with health, education, justice and social work sectors to build systems which protect children and promote better parenting through pregnancy until adulthood. We work with government and women’s groups to break the taboo on childhood adversity-learning the lessons from similar efforts in the UK and Scandinavia a couple of decades ago. I recently did a TedX talk on this & was inundated with messages from Montenegrin adults who had been affected by childhood adversity and many had never told anybody. We launched the first study on child abuse in the parliament recently and next year we will launch and measure the impact of a public campaign on childhood violence and adversity. The aim is to reduce the space in which adversity is unreportable and invisible or even acceptable.
But how can we close the equity gap for adolescents whose lives have already been plagued by adversity?
Neuroscience may have taught us the bad news that when childhood adversity collides with adolescent brain development-it can put children on a lifelong negative trajectory : inequity, gangs, violence, but it has also taught us that the character and decision making skills required to prevent such a trajectory can be learnt thoughout childhood: grit, optimism, integrity and self-control for example . In collaboration with the Government, Birmingham University and ING, we are working with youngsters who have experienced high levels of adversity to teach these characteristics. We hope that this will help them to make better decisions , get back on track and close the equity gap between them and children from more stable backgrounds.
As international civil servants it is easier to talk about poverty than it is to talk about love. When we talk about adverse childhood experiences we are talking about love, a lack of love, or children being violated by those who should love them. We need to find ways of talking about childhood adversity as a major driver of inequity-despite the discomfort.
I would never want to lose sense of who I am and where I come from. Every month I join a group of young people who grew up in children’s homes in Montenegro and help them draw out their own potential to build better material and emotional future. I see my own reflection in their eyes and hope they will have a better tomorrow.
 Dickens, C. The Life and Adventures of Martin Chuzzlewit (1843), Chap. 25
 Tomalain C. Charles Dickens A Life 2011 Viking
Benjamin Perks is the UNICEF Representative in Montenegro