Tied to a moped, this 13-year-old girl is forced to trudge after her grandfather as he gathers rubbish to recycle on the streets of China.

Jiang Manqi’s family cannot afford to seek medical help to treat the teenager’s epilepsy, so she is tied to a moped so her relative can look after her.

Abandoned by her parents, denied access to schools and too poor to receive care, this is the only option Manqi has.

The only way grandfather Jiang Shulin has to keep her close to him is to tie her to his electric trike.

In a bid to make her more comfortable and lessen her humiliation, he has constructed a specially adapted payload area at the back where she can sleep.

He said he had not other option but to make her do this for her own safety: ‘It breaks my heart but what else can I do? Her parents have abandoned her and I am all the family she has,’ he told CEN.

‘She is better when she can get some medicine from the hospital but I can’t afford that so we have to get by the best we can.

‘The rope keeps her from wandering about or falling into the traffic. It’s all I can afford,’ he added.

In 2010 pictures revealed how migrant workers were forced to leave their children tethered to window bars – with only a rope as a means of keeping them safe.

Unable to afford even the most rudimentary child care, the parents have to bring their youngsters to work with them in a factory in Jiaxing in the south east of the country where the parents toil for ten hours a day.

The youngsters are taken to the shop floor, where anxious parents use lengths of rubber to tie the children to iron bars on the windows.

And there they are left – safe from traffickers or thieves, but with absolutely nothing to do other than watch mother or father work and shuffle as far as the rubber rope allows them.

The pictures, taken in Zhejiang province, recalled the heart-breaking plight of Jingdan, a two-year-old boy chained to a lamp post in Beijing in February 2010.

His father Chen Chuanliu works as an unlicensed rickshaw cyclist, taking fares all over the city, while the boy’s disabled mother collects rubbish at the roadside. Like the children in the factory he was tethered to prevent him from wandering off.

Concerned passers-by spotted Jingdan outside a shopping mall who then reported his father to the authorities, who ordered him to remove the chain.