Why Family-Based Solutions

Awareness and understanding about the need for family-based solutions for vulnerable children, and the obstacles along the way

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When it is no longer in the category of ‘these children are lacking so much’, but rather in the category of: ‘how do any of the children survive?’:

https://familybasedsolutions.org/2018/12/11/state-run-vs-private-run-institutions/

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Children with Disabilities

A five-year-old girl, who weighs 6kg and spend 20-22 hours a day in a baby crib that is a bit too small for her, at an adoption centre where she has lived for over 4 years now. All because she has cerebral palsy.

Today is the International Day of Persons with Disabilities. A good time to take a moment to look at the situation of children with disabilities in institutions. Unfortunately it is not a pretty one.

In many countries, worldwide, children with disabilities make up a substantial part of children in institutions. In quite a few countries, they are even the majority. As more and more countries become aware of the need for deinstitutionalisation and for the move towards family-based care, unfortunately the proportion of children with disabilities in institutions increases, because they are often overlooked and left out of the transition arrangements.

There are a variety of reasons why children with disabilities end up in institutions, and many of them can be solved by redirecting funds or awareness raising. One reason, which was discussed in the podcast on Abandonment (which you can find HERE), is parents lacking the money to pay for the medical costs needed to keep the child alive and well. A second reason is a lack of community services, like access to therapists and mobility aids, without which it can become very hard to care for the child as she grows older. A third reason is lack of access to education, with many mainstream schools refusing to accept children with special needs and special education not being available locally, sending the child to a far away institution may seem like the only way to make sure she gets an education. A fourth reason is improper advice from doctors. When a doctor tells a parent that the child is unable to live in their care or that the child will never know them, or that the child will be better off and happier in an institution, parents will tend to feel forced to take their advice. A fifth reason is stigma. In many cultures, a child with a disability is seen as a curse, as a witch, as proof of incest, or as proof of demonic possession. This can create an enormous pressure on parents to get rid of the child and can make life – for both the parents and the child – in the community unlivable. Or parents may fear for the child’s life, if their neighbours or relatives are determined to kill the ‘threat’ in their midst.

In all these cases, the parents will see no other option, and possibly no other way to keep the child alive, than to abandon her or place her in an institution.

And then there are the institutions… Children with disabilities who end op in institutions, are very often there for the rest of their lives. In some cases children and adults with disabilities are placed in the same institution, and even in the same room, making the children even more vulnerable to abuse than they would have already been. And living conditions of children with disabilities are almost always far worse than those of other children in institutions.

As has been mentioned numerous times now, institutions struggle, and fail, to take care of children’s essential basic needs. When a child has these essential basic needs, but also special needs, she has no hope of remotely adequate care in an institution. Although some institutions for children with disabilities are really run with the very best of intentions, with a determination to give the children a better life than they would have in the outside world where the stigma is so great, only very, very few institutions for children with disabilities are run by people who have any kind of knowledge or training of the kind of care that is needed to meet both the essential basic needs and the special needs of these children. The result is that they do not come close to meeting any of the children’s needs.

Children with disabilities often spend most – or even all – of their time in their beds, sometimes tied down in them. Or they are tied into a chair of some sort and left to sit there all day. Hygiene conditions are often lacking, particularly when the children get bigger and it becomes harder to carry them around and bathe them properly. With one caregiver looking after many children, it is a challenge to just keep up with all the nappy changes that need to be done. Let alone there being any hope of assistance in play, or teaching children self-care skills.

In many institutions, children die young, usually due to neglect and/or lack of medical help. People running the institutions come to see it as inevitable, a normal course of events, that these children do not reach adulthood, even though the cause of death is not their disability. And so it becomes a self-fulfilling prophecy: death is expected, less is being done to prevent is, so death comes sooner.

On this ‘world disability day’ we need to remember that children with disabilities are children. That they have a lot to give, that they have great potential to grow and learn. And that they deserve our respect, our care and our love. They deserve family-based solutions.

Please share this post, to help make more people aware.

https://familybasedsolutions.org/2018/12/03/children-with-disabilities/

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Additional Risks of Institutionalisation

In previous blogs, we have looked at children being pulled out of their families to fill ‘orphanages’ to cater to the voluntourism industry and the orphanage industry (HERE and HERE). We have looked at ways children are exploited both knowingly and unknowingly in institutions (HERE). And we have looked at how their growth, health and brain development, as well as their chances of successful independent adult lives is put on the line by not having their essential basic needs met for many years (HERE). That seems like too much to handle already, and it really is.

Unfortunately there is more. When children live in institutions, they are much, much more vulnerable to abuse than children are in general.

Instances of physical abuse and sexual abuse are much higher for institutionalised children than for those living in families. I am leaving out emotional and psychological abuse here, because considering essential basic needs are never met in institutions, that can simply be said to be inherent in the system.

I have read various reports claiming that as much as 40% of children in institutions have experienced physical abuse. When I compare that with what I have come across myself over the past 12 years, that seems like a laughingly low percentage. Personally, I have not encountered an institution caring for children over 3 years old where beatings were not the predominant form of disciplining. Quite frankly, I would be surprised if as many as 10-15% of children over 3 years old in institutions had NOT experienced physical abuse. This is not just based on what I have seen happen myself, the marks (and permanent disabilities as a result) that I have seen on the children and the behaviour from children that clearly points to experience of physical abuse. I also gather it from the reactions I get from pretty much all adults involved in the institutions when I start training sessions on non-violent discipline methods.

On almost all occasions am I told outright – and if no one says anything, I can still see it on their faces – that I don’t understand, that it is part of the culture here, that these children are different and that nothing else works here. I have gotten all but laughed out of the room on various occasions for thinking that my ‘weak’ disciplining techniques of natural consequences and ‘time-out’, combined with fairness, consistency and following through would actually be effective. The astonishment when I would model the techniques with the children and very quickly have more authority over them than those using threats and beatings was very real. In one case, while they had to admit that I did have a lot more ‘control’ over the large group of teenagers, they still did not believe that it was down to the things I had mentioned in the training, they felt there had to be some other secret ingredient I had not told them about.

It is this disbelief in the possibility of anything other than beatings being effective as a method of disciplining, more than anything else, that has me convinced that far, far more than 40% of children in institutions are subjected to physical punishment. And usually physical punishment takes far more serious forms than just a slap with a hand or a slipper.

Apart from physical abuse, sexual abuse is a very serious risk for institutionalised children. And the risk comes at them from very many sides. Children may be sexually abused by their caregivers or other staff in the institutions, they may be abused by other children, and in places where there is no child safeguarding in place to speak of and children are allowed to leave with volunteers or other visitors unsupervised, they may be abused by those visitors too.

Because children are afraid to or unable to speak out about what is happening, they make easy victims. And children with disabilities are even more at risk than other children. There seems to be a myth going around that children with disabilities are less likely to be sexually abused, because the are ‘less attractive’. But sexual abuse of children has nothing to do with attraction and everything with power. Because children with disabilities are even less able to stand up for themselves or to communicate what has happened to them, the perpetrators feel safe abusing them.

Children are put at extra risk of sexual abuse by other beneficiaries of the institutions when small children are placed together with teenagers or even adults. Something that is particularly common for children with disabilities.

Children with intellectual disabilities in particular are set up to be abused in many situations. One thing that plays into this is that either caregivers do not realise that while a teenager with an intellectual disability to a certain extend will always have the mind of a child, this does not mean that his body will not develop into that of a man, with all the urges brought on by the hormones raging through his body. And whether or not they do realise, caregivers do not usually want to acknowledge topics like sex, so they prefer to ignore the situation, instead of teaching the teenager about acceptable and unacceptable behaviour in a developmentally appropriate way. This leads to situations where a group of teenage boys with intellectual disabilities get locked in a dorm for the night, with no supervision. And during the day time the results of the previous night’s rapes become apparent in the weaker, less capable boys. Or situations where teenage boys and girls are not separated and the rapes result in pregnancies.

One more risk to be mentioned here, is that of child trafficking. Children who live in institutions are much more at risk of being targeted by traffickers than children in families. In some countries it is generally known that dozens, and in some cases even hundreds, of children disappear from childcare institutions every year, never to be heard from again.

So, if for no other reason – and we have already seen that there are many other reasons – children should not be put in institutions to protect them from the serious risks of physical and sexual abuse, and of trafficking.

Please share this post, to help make more people aware.

https://familybasedsolutions.org/2018/11/30/additional-risk-of-institutionalisation/#more-223

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The Real Cost of Institutionalisation

When you start talking about the need to move away from institutional childcare, towards family-based care, you are often confronted with the argument: ‘it is too expensive, we cannot afford to move way from institutions’. It is a very persistent myth that institutional childcare is the most efficient, cost-effective way to care for children without parental care.

Since these days the best way to convince anyone of your point of view is to come with a financial argument, let’s have a look at the real cost of institutionalisation, not just in the moment, but in the long run.

In fact, research has shown again, and again, that caring for a child in an institutional setting is 6-20 times more expensive than funding things like family support and community services that will allow the child to stay with their own family, foster care and almost all forms of small group home care (the only exception is good specialised small group home care for children with very complicated special needs, this is more expensive than regular institutional care; but here it is not a comparison between two equivalent options: in regular institutional care the child would barely hang on to life, or die, while in good specialised small group home care he can thrive).

Interestingly enough, this is almost always as far as the argument is taken: looking at the cost of the moment, of caring for the child. While I agree it is already a pretty good argument to say that you could provide better care, with better outcomes, for 6-20 times less money, there is a wider argument to be made, which I think should not be ignored.

In a previous blog (which you can find HERE) we have looked at what institutionalisation does to children. We established that there are very severe, permanent consequences to institutionalisation. These consequences, which lead to young adults not being able to cope in the outside world, come with a cost to society, and that cost should logically also be taken into account when talking about the cost of institutionalisation.

Young adults who come out of institutions being 10x more likely to end up in prostitution, 40x more likely to end up with a criminal record and 500x more likely to commit suicide, plus an overall greater chance of ending up living in the street, has a societal cost. Money needs to be put into the police and justice system, the prison system and the hospital system to deal with these things.

Added to that is the fact that someone who has grown up without having had their essential needs met, without being nurtured and without having had the chance to form attachments, will struggle very much to raise their own children if they have them. Their brain is not wired to know how to give their child what they were never given themselves. This means that when adults who were institutionalised themselves as children have their own children, they are very likely to need a lot of support from social services to be able to cope. And even with that support, they may not be able to manage and may have their children removed from them for the protection of the children.

This turns the problem not only into an expensive one, but also into a generational one. Particularly if the next generation of children is also put into an institution, instead of in family-based care. It becomes a self-perpetuating cycle.

So, while a cost for care that is higher by 6-20 times is already excessive, even when looking only at the financial side of things, the cost is in fact a lot higher than that. And that is not even taking into account the cost of human suffering that is connected to it.

https://familybasedsolutions.org/2018/11/27/the-real-cost-of-institutionalisation/#more-208

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Survival of the Fittest

In any institution I have visited, where children have lived for many years, in different countries across the world, I am told the same thing: ‘These children are badly behaved, rebellious, ungrateful, disrespectful and disobedient’. I am told this as if they are exceptional, particularly bad children. And I am asked to ‘make them behave better’.

It breaks my heart whenever I am told this, because the behaviour seen in these children is the natural and inevitable result of being raised without attention, affection, a chance to form attachments, proper stimulation and positive role models. As mentioned in the previous blog (which you find HERE), when essential basic needs are not met, brain development does not occur as it should and this causes problems. But also, very simply, there is no supervision or guidance for the children.

There is nothing inherently wrong with these children. It is a reaction to their circumstances. If you were to switch some children from your family with those from the institution at a young age and raise them in reversed positions, then the children from your family in the institution would be showing the problematic behaviour and the children who were taken into your family would be considered well-mannered and well-behaved. Any child put in an institution for years will either turn out the way described, or will not survive.

Children whose essential basic needs are not met, will try to fight to have their needs met. Their brain is programmed to do this, because it is essential for survival and proper development. So, for example, if positive attention is not available, then the child will discover quite quickly that negative attention is much easier to get. And for brain development negative attention – even in the form of beatings – is considered preferable to no attention at all. Not meeting a child’s essential basic needs is inviting difficult behaviour.

Apart from that, however, there is also the fact that in most institutions there are very few caregivers taking care of very many children. This means that there is going to be a lack of supervision and guidance. When children are left to their own devices most of the time, they will become aware that they have to solve things for themselves and they will do so in their own way.

This is problematic, because children are still learning about rules for culturally and socially acceptable behaviour and are still struggling to understand them. This means that they do not yet have a proper sense of morality. They are not immoral (meaning to have a twisted sense of morality), but they are amoral (meaning they do not yet know what is morally right or wrong). Being amoral, their decision making process is not based on what is culturally or socially acceptable. And in most children the urge to help those weaker than them is not well developed yet. Instead, their brain is programmed for one thing: survival. They are driven by the motivation of ‘what do I need or want?’

This is a healthy survival strategy that exists in all children, and that is usually tempered in its results by the supervision and guidance from adults. When the adult supervision is absent, it leads to a situation of ‘survival of the fittest’. Through physical fights and bullying children will determine who is the strongest and who has the biggest say. Children who end up at the bottom of this hierarchy can expect to be bullied, abused in various ways and generally lead a life of fear.

This is unfortunate and it is very painful to see in real life. But as mentioned before, it is not a sign of ‘badness’ in the children. The children are simply reacting to the situation they find themselves in. All they are trying to do is to stay alive.

https://familybasedsolutions.org/2018/11/23/survival-of-the-fittest/

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What Institutionalisation Does to Children

Many people consider institutionalisation of children not ideal, but still preferable to the alternatives. This is very unfortunate, and ultimately dangerous. Because it is one of the things that leads to institutionalisation. The reason why many people think institutionalisation is not so bad, is because they think that children’s basic needs are covered when they are put in an institution: they get food, clothes, shelter, they can wash themselves and most of the time they will get education too. The problem is that this covers only half of the basic needs. It covers what I tend to call the child’s practical needs, but not all of their physical and practically none of their psychological needs, which are just as urgent.

What I call a child’s basic essential needs, include the practical needs mentioned above, as well as the need for attention, stimulation, affectionate physical contact and the opportunity to form attachments. Many people, even those who are highly educated, are not aware of the devastating effects of not having these needs met. We are all aware that children like getting attention and like to be held, but these things are often seen as a luxury. They really are no such thing.

Children who chronically do not get enough affectionate physical contact, will not just be less happy, there will be a physiological reaction: they will produce less growth hormone and their immune system will become less active. This means that the children will get sick more often than children in families and that illnesses are more likely to become very serious. And their growth will be stunted. When you walk into an ‘orphanage’ you will always be struck by how much smaller these children are than children of the same age in the community in the same area. Plus lack of growth hormone can delay puberty and proper development of the body. Worst of all, for babies the physiological effect is even stronger, their immune system can shut down completely. Babies who do not get held, will die.

Attention and stimulation are essential for proper brain development. A baby is born with a certain number of neural pathways and connections and is primed to create more, based on the experiences she has. If she spends her days lying in bed, without any stimulation and very little human interaction, the brain does not get signals to create new neural pathways. And the brain, being very efficient, will even destroy existing pathways if they are not used, to make room for other, more useful ones. Pathways that are not so beneficial may be made in the brain of a child whose needs are not met, a child who learns that no one will come when you cry, that your hunger and discomfort are ignored, will experience toxic stress, which has a strong, negative effect on brain development.

At age ten the foundation of our brain is laid, after that, you build on that, but you cannot improve the foundation further. So if pathways have not been build or have been destroyed, then you will just have to do without them. This way you can end up with a foundation with serious holes in it, meaning that whatever you end up building on that foundation cannot stand strong. Research has shown that children who have grown up in an institution from a young age, have a brain capacity 20-30% smaller than that of children in families in the same area. This is brain-matter that is simply not there.

And then there is the need for attachment. When a baby is born in a family, she learns how to bond with people and form attachments, simply by making her needs known and having them met most of the time. By spending time interacting with her parents and wider family. By learning that she can depend on certain people being there to take care of her and to help her when she is in trouble or discomfort. Throughout this process neural pathways grow in her brain, which allow her to form attachments and relationships, of all kinds, later in life. Without even realising that she had to learn how to do this, early on.

In institutions, there is usually little or no opportunity for forming attachments and learning how to go about that. There are few caregivers and many children. The turn-over of caregivers tends to be high and children are moved around, so children learn they cannot depend on  individuals being there for them. And because of this lack of opportunity to bond, the child does not develop the parts of the brain that help her form attachments as she grows older. This can leave her unable to form any kind of relationship in later life: working relationship, friendship, romantic relationship or even a bond with her own children if she has them. It leads to a variety of attachment disorders, such as indiscriminate attachment disorder, disorganised attachment, or reactive attachment disorder. All of which can involve seriously challenging behaviour.

Attachment is also essential in things like learning to regulate your own emotions and behaviour and in learning about empathy. A child needs a trusted adult, whom she has bonded with, to gradually make her aware of how to deal with her own emotions and outbursts, and of the fact that other people also have feelings and that these feelings are affected by her behaviour. Without attachment, it becomes much harder to learn this. And if you have not been able to learn about this, you could end up becoming a danger to your environment.

Apart from this basic, fundamental brain development, there is another layer to what institutionalisation does to children. Children living in institutions tend to live large cut off from the outside world. They just live inside the institution. This means that they do not have the opportunity, like children in family, to observe the way regular, everyday life works for adults in the community. Children in a family see their parents interacting with neighbours, with family members, with shop keepers, with religious leaders and through these observations, and through being taken along to the market and to someone else’s house, they learn how the world works, what is expected from men and from women and from people with your position in society. This allows the child to gradually absorb what she needs to know, over the course of 15-20 years, to prepare her for independent adult life.

Children who grow up in institutions do not have that opportunity. When they are shown the gates once they turn 18 years old, they have no idea how the world works, where you should go to buy things affordably, how to find a place to live and a job, how to interact correctly with people of different background. This is why research has shown that children who grew up in institutions are more likely to end up living in the street. They are 10x more likely than children from families to end up in prostitution, 40x more likely to end up with a criminal record and 500x more likely to commit suicide.

This is not because when they leave the institution they think ‘I’m going to become a prostitute’ or because they think ‘I’m going to steal a car’. When they leave the institution they think ‘now life begins!’, ‘now I have freedom’. Only to find out very soon that they are unable to cope with life on their own out in the community. They are vulnerable to people taking advantage of them and they have no other options. The combination of the improper brain development and the lack of preparation for what it means to live out in the community leaves them unable to keep standing.

https://familybasedsolutions.org/2018/11/20/what-institutionalisation-does-to-children/

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Exploiting Children

In previous blogs mention has already been made of gross forms of exploitation of children, it comes in the form of the orphanage-industry (as you can read HERE and HERE), illegal adoption and forced labour or begging. These things are relatively easy to recognise and condemn. However, children who live in ‘orphanages’ and other institutions tend to be exploited in more ways. And the scary thing is that those who exploit them, do not always know that that is what they are doing.

‘Orphanages’ and other institutions are forever struggling to find the money needed to fund all of their operation cost. Regardless of whether the people running the institution are skimming money off the top or whether they are diligently putting every penny into the care of the children, there is never enough money. This means that finding donors and getting more donations, is always one of the main priorities.

The problem is that often times, even in places where an institution is run with great integrity and the children’s well-being firmly is a central focal point, the need for more funds and for keeping donors happy blinds people to the cost it comes at for the children.

It seems like such a little thing, allowing a big donor to go into the children’s dorm – breaching their privacy and sense of having a place to themselves – to see how they live, while giving a tour of the place; asking one of the children to recite a poem, a prayer or to sing a song for a visitor; telling the donors about the harrowing background of the child before she came to the institution. Just ‘little things’. But they are ‘little things’ with a big impact on the child’s sense of worth and dignity. And they do not happen once, they happen day in, day out. Giving the children – not incorrectly – the impression that they are not so much at home, as they are at the disposal of any visitor for their entertainment.

Once the ‘little things’ have become part of everyday life, going almost unnoticed by the adults in charge, they can also start growing, getting further out of hand. Having the children who sing so beautifully stay home from school, so that they can perform for the VIP guests that are coming during the day. Allowing a group of visitors not only to enter a dorm, but to crowd around a child who is lying on her bed feeling miserable and stripped down to her underwear to try to cool down her high fever. Making a child show the visitors the scars from her abusive past, to go with the story of her rescue. All of this is blatant exploitation and is degrading to the children.

It may feel far fetched, but nothing I have described here is anything I haven’t personally seen happen. And there are ways of exploitation that I can pretty much guarantee you have seen happen at some point as well. Remember a cute photo of an ‘orphan’ on social media, with either having the child say, or having the text accompany it, something to the extent of: ‘Hello, I am Tamara, please sponsor me so that I can eat and continue to go to school.’ Although this girl was not sent out into the street to hold her hand up, she is being made to beg. It may not feel exactly the same, but in essence it is.

One more reason why children need to be taken out of institutions and be raised in families: to stop their constant exploitation in order to raise funds. And if you ever find yourself in a situation where someone offers to make children perform for you, to lead you into their private spaces or to tell you their story of woe (especially when the child is right there), politely decline to take part in this. It can be done, I have done it. Do not be a part of this.

https://familybasedsolutions.org/2018/11/16/exploiting-children/

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Introducing the Podcasts

I am very excited that in the quest to raise awareness about various topics surrounding alternative care and institutionalisation, this website has expanded by adding a podcast series. You can find the first podcast HERE.

The idea of the podcasts is first of all to attract people who are more interested in listening to what I have to say, while getting on with their day, rather than having to read is. However, the podcasts will not simply be me saying the same things that I have been writing.

The basic message will be similar: helping people understand the impact of certain aspects of institutionalisation and the kind of alternatives that are available and more beneficial. However, the approach will be different. While the blogs contain mostly theoretical information, explaining in generally issues of child psychology or market mechanisms, for example, the podcasts will be very concrete. The idea is for the podcast to compliment the blogs, by telling real life stories that actually happened to illustrate the theoretical points that I have been making in the blogs.

This week’s podcast is mostly an introduction and an explanation of what you can expect from the series going forward. From next week the stories themselves can be found on the podcast page.

Feel free to let me know what you think of either the blogs or the podcasts in the comments. And if you have questions or requests for subjects to be included, so let me know.

https://familybasedsolutions.org/2018/11/13/introducing-the-podcasts/#more-262

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What Is a Residential Childcare Institution?

It is often called an ‘orphanage’, even though most of the children living in it are not orphans. Or it is called a children’s home, while it cannot really be called a true home to the children, when their essential basic needs are not met. The most accurate word to use is residential childcare institution, but this is quite a mouthful. And as it turns out, even when you use the most accurate description, there is still a lot of room for confusion, because this term is used for a large variety of things.

Many different set ups are referred to as residential childcare institutions. For example, while in Western Europe orphanages no longer exist, when you look at the alternative care statistics or when you read the reports submitted to the Committee on the Rights of the Child, you see that there are references to ‘residential care’ for children. In Western Europe, residential care refers to small group homes. It is a form of alternative care used for children with complicated special needs or behavioural difficulties, who are unable to live with their own family or a foster family. Because these small group homes are not real family settings, they are categorised as residential care. However, an attempt is  made to make these group homes as family-like as possible. By having no more than  – usually – 8 children in one group, more often teenagers than younger children, cared for by dedicated caregivers (so not different people all the time), and usually the children live in a regular house in the community, so that they are able to take part in regular, everyday life.

This is in stark contrast to what is referred to as residential institutions in for example former-Soviet countries. There a residential institution may have a capacity of 100-500 children. These children often live in large buildings away from the community, without the freedom to leave the grounds. The life inside these residential institutions is usually strictly regimented, with very little room for individual choice or identity. And while these institutions often employ quite a large staff, very few of that staff are actually involved in the care of the children. Meaning that the children get little or no attention, stimulation, affectionate physical contact or opportunity to form attachments.

These are the two extremes of the wide range of institutions called residential childcare institutions. And in between can be found pretty much any conceivable  nuance, under the same name. And that is not even taking into account the institutions that call themselves something else, but really are the same thing. Just to create more confusion for those who are trying to get an overview.

In various countries there are boarding schools, which when you look closer turns out to be an enormous grey area, when it comes to institutional care. To a certain extend all boarding schools provide institutional care, in that the children are not cared for by their parents much of the time. However, children who go home every weekend or at all school holidays still have a strong connection to their families and have the essential basic needs that are not met in an institution met at home, for the most part.

However, there are also boarding schools, in some countries, where children only go home once a year, or not even that. So, while they call themselves boarding schools, they are in fact residential childcare institutions, because the child has no other caregivers than the ones at the boarding school. Especially boarding schools where some children do go home and others do not, make it very hard to get accurate figures on how many children are in fact without parental care.

While the scale and the quality of care of residential childcare institutions (under whatever name) varies enormously, there is one constant: children who grow up in residential childcare institutions do not do as well as children who grow up in a family situation. Children who grow up in small group homes do much, much better than children who grow up in a large scale institution, however, they still do worse than children who grow up in foster care.

So, while ‘residential childcare institution’ can mean a wide range of things, the priority should always be to avoid putting children in them. Children need family-based solutions!

https://familybasedsolutions.org/2018/11/09/what-is-a-residential-childcare-institution/

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I Have a Birthday, Therefore I Am!

Today is my birthday. When you are in your fifth decade, this does not hold all that much significance anymore. It is nice to get friendly wishes, but other than that it is just another day, one filled with work and the drive to get more done for the children.

The situation is very different for children who live in institutions. Generally speaking birthdays and becoming older are more important to children than they are to adults. But for children who live in institutions there is more to a birthday than that. Their birthday and the absence of any celebration have an important impact on their sense of worth and their identity.

In most cases, children living in institutions live as a tiny part of a big crowd. The way institutions are managed is not to look at the individual needs of the children or at their identity, but rather the aim is to operate as a well-oiled, smooth running machine. The children are like items rolling past on a conveyor belt. In this situation it is easy to start feeling lost and worthless. A child’s identity disappears like a drop in the ocean of children around them.

Every day consists of wearing the clothes you are told to wear, not ones you get to decide on yourself; going around in the hairstyle you were given; waking up in a large dorm room between the other children; washing in the large washing facility between the other children; eating your meals between all the other children; getting on the school bus with all the other children, etc. It never ends. You are never just you, you are always one of the group, and are almost always addressed as such, unless you are in big trouble for doing something wrong.

Birthdays form a part of this. Your birthday, the day you came out into the world, and your age are parts of you, of who you are, of your identity. Yet in many institutions birthdays are not celebrated. Or, if they are it is often done once a year for everyone or once a month for everyone who had their birthday that month. From a management perspective, this is understandable, especially in places where more than 100 children are cared for, the birthday celebrations would be almost constant. However, from the child’s psychological perspective it is very damaging. This, again, reduces the child to being a part of the big group and takes away the significance of the special day.

In a home for more than 250 children, visitors and volunteers who come more than once are constantly confronted by children asking them ‘what is my name?’ The children want confirmation that the visitor knows who they are individually, that they are being seen. Children will also inform visitors of their birthdays, especially if the birthday is coming up in the next month. The child knows that there will not be a celebration or a present, they just want to share this little bit of their identity, of their me-ness with the visitor. To emphasise that they are a person, an individual, they let visitors know: I have a birthday!

https://familybasedsolutions.org/2018/11/07/i-have-a-birthday-therefore-i-am/

[whyfamilybasedsolutions-blog]

“Intellectual Disability Among Children Everywhere”

This week the latest manual, the fourth in the series ‘Children Everywhere’, has come out. Originally it was written for the NGO Orphanage Projects, giving advice to people running institutions on how to provide  better care to children with intellectual disabilities. The writing and publishing of a manual does not happen in the space of a day or a week, so it was written well before any plans of folding Orphanage Projects and starting Why Family-Based Solutions occurred to me.

This does not mean that the book is no longer relevant, however.   First of all, are there still many, many institutions caring for children with intellectual disabilities, without necessarily being quite aware of the needs of these children. But secondly, although written for institutional situations, the manual can play an important role in family-based solutions too.

I sincerely hope that the institutionalisation of children with disabilities will come to an end sooner rather than later, and that with increased community services, parental support and inclusive education far more children with disabilities will be cared for by their families. However, there will continue to be a need for some alternative care for children with complex special needs, and particularly for those with severe and profound intellectual disabilities.

To make sure these children get the care they need, just handing them over to a random foster family will not be good enough. Foster families and small group home caregivers need to be given specialised training to make sure that they are aware of the needs of the children and of how to meet them. This is where ‘Intellectual Disabilities Among Children Everywhere’ can play an important role, as a training manual.

The manual consists of three parts. In Part 1, an explanation is given of what is meant by ‘intellectual disability’, and of the physical and behavioural issues that you are likely to encounter, how to deal with them and how to help children become as independent as possible. It also includes a chapter on effective disciplining, without using corporal punishment. In Part 2, conditions regularly associated with intellectual disabilities, such as cerebral palsy, Down’s syndrome, autism, seizure disorders and mental health problems, are discussed. And in Part 3 of the book, structures of management and set up of institutions are discussed, necessary therapies, as well as the kind of training needed for caregivers and the advice to consider moving to family-based solutions.

If you are interested, you can order the manual HERE.

https://familybasedsolutions.org/2018/11/05/intellectual-disability-among-children-everywhere/

[whyfamilybasedsolutions-blog]

How Did Orphanages Spread?

A lot of people think that residential childcare institutions, or ‘orphanages’, are an unavoidable part of life. They think that it is the only way to provide care for children without parents and for children whose parents are unable to care for them. So, it follows, that all countries must have them and that they have been around for as long as settled community living, as we know it, has been in existence. This kind of thinking is illustrated by the headline: “Rwanda Wants to Become Africa’s First Orphanage-Free Country: Here’s How”. While Rwanda’s aim to be orphanage-free is laudable, they will not be the first country.

Residential childcare institutions are not universal and they certainly are not the only or the best way to provide care to children without parental care. So let’s have a look at how ‘orphanages’ became so widespread and how widespread they are.

Institutional care for the vulnerable, whether it be orphans, the poor or the elderly, are not a natural part of society. While I have not done an in depth study into the subject, I am reasonably certain that the beginning of orphanages is connected to Catholicism (at that time just known as ‘Christianity’ in Europe), and its spread to wider Christianity. This makes sense, because Catholicism introduced the institutionalisation of adults in monasteries and convents. In turn, the people living in monasteries and convents would sometimes take in those in society who did not have anyone to care for them, including children.

In time, this went from a few individuals among the nuns or friars, to having special orphanages, run by the nuns or the friars. With more babies also being brought in because of the greater grip that Christian morality developed on society, leading to a stigma on unwed motherhood, which in turn led to unwed mothers finding themselves forced to abandon their babies in order to still be able to keep their place in the community.

Once Christianity broke up into a number of different schools of thought, non-Catholic faiths did not go in for monastic life, but they did continue the tradition of running orphanages – and condemning birth outside of wedlock. As greater parts of the world were being discovered, Christians of a wide variety of backgrounds traveled across the world as missionaries. Introducing far away people not only the Bible, but also the European education system and to residential institutional childcare: orphanages.

Although today you can find ‘orphanages’ in almost all countries in the world – with many of them run by Muslim, Jewish, Hindu or Buddhist faith-based organisations – I do believe it is by and large a European, Christian export product.

In most countries in the world, until ‘orphanages’ were introduced children who did not have parents or whose parents were incapable of caring for them, would be absorbed and taken care of by their extended family or community. These networks were close knit and provided a safety net for those struggling to cope.

In some countries this is still the case. Of the 13 independent island nations in the Pacific Ocean only Fiji and Samoa have residential institutional childcare – on a small scale. Cook Islands, Kiribati, Marshall Islands, the Federated States of Micronesia, Nauru, Niue, Palau, Solomon Islands, Tuvalu, Tonga and Vanuatu still rely on their extended family structure to take care of vulnerable children, often with some help of government supported community services.

So, it can be done, protect children without institutions. Either by strengthening the traditional communities, or by providing modern alternatives – about which more in another blog.

https://familybasedsolutions.org/2018/11/01/how-did-orphanages-spread/#more-191

[whyfamilybasedsolutions-blog]

Who Ends Up in Institutions?

In the course of my research work for the ‘world list’ it has become clear to me that the reasons why children end up in alternative care, and particularly in institutions, are surprisingly similar across many countries. It also became apparent that there is a big difference between why children in high income countries are in alternative care and why children in other countries are in alternative care.  

Earlier this month I promised  a blog  on the reasons why children end up in institutions, why they are abandoned. Here is that blog.

In non-high income countries, overwhelmingly the main reasons why children end up being separated from their parents – with or without the parents’ consent – and placed in alternative care – most often in institutions – are poverty, lack of access to education, and disability.

Here is a bit from How to Help, Not Harm, which illustrates what tends to happen: “Parents do not look for a way to get rid of their child, they look for a way to help their child, to save their child. The problem occurs when while looking for help, they find none. When there are no services available or affordable that allow them to provide their child with what she needs. When for a while it seems like there is no answer and nothing can be done, and then… a solution presents itself. And it is that solution, which presents itself at that moment of desperation when no other solution can be found, that makes everything so much worse. […]The solution to hand your child over to an ‘orphanage’ where she will have her belly full all the time, getting several meals a day, thinking that now she will be able to grow up strong and healthy. Believing the doctor or community elder who says, against everything your instincts tell you, that your handicapped child will be better off and happier in a children’s home. Not wanting to let go of your child, even though she has special needs, but loving her so much that you give her up so that she will be able to survive and get the most out of life, in a children’s home.”

Almost all parents want to take care of their own children. They are okay with that being hard, they are okay with making sacrifices. However, what they want even more than taking care of their own children, is for their children to have good lives. If circumstances make it impossible for parents to take care of their children, they are willing to make the sacrifice of giving them up for what they believe is the best interest of the child.

This means that when healthcare is inaccessible or unaffordable, the parents of a child with a serious illness or disability may feel forced to give up the child in the hope that it will save her life. When educational facilities are unaffordable, not available or refuse to accept a child with a disability or with a marginalised ethnic or religious background, parents may feel their child will only be able to escape their desperate circumstances by getting an education and the only way for the child to get an education is to put her in an institution. The parent who worries that their child might die of starvation or cold, believes that they are doing a good thing by handing their child over to an institution.

These are decisions made out of desperation and love. They are decisions that should be completely unnecessary. In a later blog, we will look more closely at the cost of institutionalisation, but I can already disclose here, that if the money put into institutional care was invested into social security and community support service projects instead, people would not need to face these kinds of decisions.

This is illustrated by the contrast of reasons for entering alternative care between high-income countries and other countries. In high-income countries the main reasons for being taken into alternative care (which almost always means family-based care) are children removed from their families because of situations of serious neglect or abuse, and older children with severe behavioural problems who form a danger to themselves or their surroundings. In other words, children are only separated from their families for their protection.

It is rather heart wrenching to realise that although many, many children in non-high-income countries end up in alternative care, and the majority of them in institutions, extremely few of them were separated from their parents for their own safety. So aside from the large group of children in institutions who should not be there at all, these countries also are home to a group of children who are still with their parents, but are not safe there.

There will always be a small group of children who need alternative care because they are not safe in their own family. However, a lot can be done to work with the family first to ensure that it becomes a safe place for the child to be. And if this is not possible, an assessment needs to be made to weigh off whether the inevitable trauma that is caused by taking a child away from her parents is less than the trauma that would be caused by leaving the child with her parents.

It is time to start providing parents with the support that will enable them to take care of their own children, as most of them could dearly love to do. As well as to make sure that children who are genuinely not safe with their parents, are given the protection they need in alternative, family-based settings.

https://familybasedsolutions.org/2018/10/29/who-ends-up-in-institutions/#more-189

[whyfamilybasedsolutions-blog]

How Child Trafficking Is Related to ‘Orphanages’

Today, on 16 October 2018, NGOs across the world are joining forces in a global trafficking campaign to raise awareness of the scale, the roots and the consequences of human and child trafficking. Unfortunately, child trafficking is a subject that is extremely relevant to anyone involved in institutional residential childcare. So, in this blog, I will describe some of the ways in which the two are connected.

Child trafficking is defined as: the recruitment, transportation, transfer of control over, harbouring and/or receipt of a child for the purpose of exploitation. Trafficking of children can happen between countries, but also within countries. When we talk about the horrors of trafficking, we mean more than just the movement of children from their family situation to a different destination, we also talk about what happens at the other end: sexual exploitation, forced labour, forced begging, and conditions of slavery.

All of these things sound horrendous, but most people do not make the connection with the notion of ‘orphanages’ and residential institutional childcare. In reality, there are many ways in which these things are connected. Some ways are more obvious than others.

Let’s start with the most obvious way: the orphanage industry. This has been brought up in previous blogs, but cannot be left out here. The orphanage industry refers to institutions that call themselves orphanages that have been opened with the purpose of receiving money from foreign (and sometimes also domestic) donors and from visiting volunteers. The children in these ‘orphanages’ almost all have at least one living parent. They were often brought to the ‘orphanage’ by child-finders or child-recruiters, who go to extremely poor families and persuade them that their child will have a better future – receiving food, education and healthcare – if he or she is placed in the ‘orphanage’. In some cases, when persuasion does not work, coercion or threats are used instead.

Once children are in the ‘orphanage’, they will not receive the amazing care that was promised. Most of the money from foreign donations will flow into the pockets of the people running the ‘orphanage’, little of it will reach the children. In fact, in some places, people have realised that when the children are in very bad shape – badly dressed, malnourished – foreign donors tend to give more money. So the children are purposefully kept in that state. This is a blatant form of child trafficking.

Another form that is hard to deny or ignore is that of illegal adoption. Situations like where parents believe they are putting their children in a boarding school to get an education, but when they come back to collect the children, they find there is no trace to be found of them. With increasingly strict laws and regulations surrounding adoption, for the protection of the children, people who find it hard to adopt through official channels look for other ways. And when there are buyers, it will never be long before sellers emerge. In countries like Nepal and Guatemala, a moratorium has been placed on all inter-country adoption when it became apparent that these kinds of practices were wide-spread. However, they still take place in other countries.

Other situations that put residential institutional childcare within the definition of child trafficking may be less visible, but no less true. While children are not always placed in institutions with the express purpose of exploiting them, in practice that may still be what happens. For example, when children who grow up in a Buddhist monastery or in a Talibeh are made to go out on the street to beg for food or money. There is no problem with adults renouncing possessions or choosing to live only on what is provided, but to send children out to beg because of this is exploitation.

When proper child safeguarding policies are not in place and enforced, which is the case in many places where volunteers are welcomed to spend time with the children in ‘orphanages’, this can put the children at extreme risk. This will be taken as an opportunity by predators looking to sexually exploit children, a common occurrence. In some countries, children are known to have disappeared from ‘orphanages’ in astonishing numbers. Child traffickers are glad to take advantage of the lack of supervision and of the vulnerability of the children to make a profit.

Sometimes a situation can start in a grey area and gradually get out of control. For example, it is important for children’s development to give them the chance to help around the house in a limited way and to do small chores, to help them prepare for the day when they need to stand on their own two feet. However, this is not the same as making the children completely responsible for all the cooking and cleaning, and often even the care of the younger children. When you get to that – and many ‘orphanages’ do – you have moved away from helping the child develop necessary skills and have reached child labour and exploitation. And in some places, unfortunately, it is pushed even further, to where the children are forced to work in the field or are explicitly offered for sexual exploitation.

As you see, there are many, many ways in which the problem of child trafficking is not just connected but intertwined with ‘orphanages’ and residential institutional childcare. If we are serious in our claim to want to put an end to child trafficking, then we have to put an end to the institutionalisation of children too. It has become abundantly clear over the past decades that children cannot be sufficiently protected against trafficking when they are in institutions.

https://familybasedsolutions.org/2018/10/16/how-child-trafficking-is-related-to-orphanages/

[whyfamilybasedsolutions-blog]

Don’t Take My Word for It

Recently, Lumos has held a major event in the US. Lumos is a London-based organisation that for the past 13 years has worked very hard and gained increasing momentum to achieve global deinstitutionalisation. And now they have released a video that was taken at that event.

In the summer of 2017, I had the privilege of attending Lumos’ ‘Introduction to Deinstitutionalisation’. For four days I was able to exchange experiences and have discussions with a variety of representatives of major international organisations involved in child protection and of several government bodies from across the world. As well as increasing my knowledge and understanding of various details of how to make sure deinstitutionalisation is done responsibly.

Lumos is passionate and knowledgeable about many of the same things that I stand for and write and talk about. This is why I feel that this video provides the perfect opportunity to allow you to hear about it from someone else. Don’t take my word for it: listen to J.K. Rowling the founder and Georgette Mulheir the CEO of Lumos explaining to Whoopi Goldberg what is at stake.

The owner of the video does not allow it to be embedded by others. But you can click here to watch it on YouTube. Believe me, it is worth it.

https://familybasedsolutions.org/2018/10/08/dont-take-my-word-for-it/#more-155

[whyfamilybasedsolutions-blog]

Learning the Lesson and Providing Real Help: Indonesia

In the past days, the news has been full of accounts about the terrible earthquake and tsunami that hit the Indonesian island of Sulawesi on 28 September. A major disaster with a confirmed death toll of many hundreds and rising daily, with some people saying it may well reach thousands. Help will be needed for people to start to rebuild their lives. And many children will likely be separated from their parents and other relatives, either permanently or temporarily.

This brings back to mind the situation in Indonesia when a massive tsunami struck in December 2004. And it rings major warning bells: what happened in the aftermath of the 2004 tsunami must not be repeated this time, for the sake of the children.

After the 2004 tsunami ‘orphanages’ and residential childcare institutions popped out of the ground like mushrooms, in Indonesia. Some where run by people who really thought that the children had nowhere else to go and needed to be taken in to be kept off the street, some where run by people who realised that a lot of foreign money was going to come in, to help the most vulnerable, and that being in charge of an ‘orphanage’ was an effective way of getting a cut of that money.

In either case, not much of an effort was made to try to locate relatives of children to return them to their families, or to find ways to place children in other family-like situations, while they were waiting to be reunited with their families. In some cases, there was no need to go look for families, because the families themselves would come to offer the children at ‘orphanages’. The tsunami had ruined their business, their source of income, their homes, and they did not know how to feed their children. No alternatives were available to these parents, who just wanted their child to have the best chance of survival.

The thing is that in 2005 international NGOs were able to trace the families for the vast majority of the children they came in contact with. So, in fact, most of these children did have relatives to look after them, they were just temporarily separated by the chaos. And instead of taking children away from their families to feed them, it is entirely possible – and much cheaper – to feed the children IN their families.

What keeps running through my mind on seeing the reporting on the current tsunami, is that we need to learn the lessons from what happened in 2004-2005 and we need to learn them fast. Otherwise there are likely to be hundreds of children who end up being separated from their families for far longer than is necessary and in less than ideal circumstances.

So, by all means, please do give to help the people of Sulawesi rebuild their lives again after this disaster. However, do so with consideration of what kind of aid will be of help and what kind of aid will end up causing harm.

Do not go over there to start a new ‘orphanage’, do not send money to people running ‘orphanages’ or other residential childcare institutions, because that will only end up harming the children. Instead, give money or (if you have the skills and expertise) go over and start up a building programme, to make sure that people and particularly families will have a safe place to live again. Give money to programmes providing food for those how experience serious food insecurity. Give money to organisations like the International Red Cross/Red Crescent that organise tracing of families, to make sure children get to return to their family. Support micro-finance projects that help people get back on their feet, and restart their businesses, so that they can start to provide for themselves and their families again.

These are all constructive ways to make a positive difference for the people and particularly for the children of Sulawesi. Supporting having children put in institutions is not. Think about it and do the right thing!

https://familybasedsolutions.org/2018/09/30/learning-the-lesson-and-providing-real-help-indonesia/

[fywchildrights-blog]

History of the Children’s Rights Movement

The Children’s Rights Movement did not take form until the 19th and 20th century after the industrialization of not only the United States but the rest of the world. With the rise and jobs and the opportunity to finally make an income, families sent there children at young ages to work in unimaginable conditions in factories that were not even stable for adults to work in. After the notice of a rise in risk for children working in these horrific conditions France became one of the first countries to pass laws to protect children in the work force. The country also granted rights for protection of there health, social and judicial fields (humanium.) After the world transforming into an industrialized phenomenon the outbreak of world domination took over the lives of children. During both World War I and II laws were enacted to help keep children safe from the unfortunate events that war brought upon there lives. After the formation of the League of Nations in 1924 they adopted the Geneva Declaration on the Rights of Child which only last for a short period of time until the Second World War; in which after that the United Nations adopted the Universal Declaration of Human Rights (“History of Children’s Human Rights.”)

The most impactful moment in the course of the Children’s Rights Movement was the draft of the Convention on the Right of the Child in 1989 and was then passed in 1990. After periods of distress and long years of children not being protected the world decided to take a stand and fight for our children. The Convention on the Right of the Child declared that any person under the age of 18 was considered to be a child, and strived to protect, respect and not be discriminative of its religion or race ("Convention on the Rights of the Child.”) The declaration of the Convention on the Right of the Child changed the way the world perceived children.It gave them a voice and the ability to to contribute to the society they live in as well as people no longer viewing them as helpless and weak (“The History of Children’s Rights: Whose Story?”) The Children’s Rights Movement though has not stopped ever since its success with the passing of the Convention of the Right of the Child, instead it has broaden its wings to help starving children, children in foster care, those with learning disabilities and has inspired many other movements that work to help protect our children and provide them with the proper care they nurture.