Ebola orphans need family care, not life in an orphanage
We can scarcely imagine the trauma in a young child’s life when their mother, or father, or both, die from a terrible disease. They can be left, bewildered and alone, often in busy hospitals full of strangers, many miles from home.
That’s what we are seeing in parts of West Africa which have been ravaged by Ebola. UNICEF has estimated that at least 3,700 children had lost one or both parents to the virus in Guinea, Liberia and Sierra Leone by the start of October – and that the numbers are growing.
The Ebola crisis raises a universal principle that we at Lumos understand all too well. Children thrown into adversity by crises and disasters need the support of their families and communities more than ever. Response to emergencies should not further harm children by separating them from their families and placing them in institutions or so-called “orphanages” which cannot give them the love, care and attention they need to prosper and grow.
This means that when crisis strikes, those in a position to help should do all they can to keep children in families – with blood relatives wherever possible.
It is part of the tragedy of orphanages in many parts of the world that the default reaction to a family in crisis – be it through poverty or inability to afford care for disabled children – has been to persuade parents to place vulnerable children in institutions, which cannot look after them like a family.
Sometimes, the crisis is man-made – arising from war and violence. In the summer, Lumos took part in a meeting of agencies and NGOs in Kiev, in Ukraine, to find ways of supporting brave organisations on the ground in strife-torn Eastern Ukraine in their work to prevent the breakdown of families – and the inevitable institutionalisation of yet more children - because of the violence.
Africa veterans will be familiar with the crises created by wars. Before joining Lumos I worked in Sudan, which suffered its share of strife and violence that had a devastating impact on the lives of children. Even in the midst of crisis, it was possible to ensure that children were kept with and reunited with families. This must be a humanitarian priority.
Ebola is, sadly, only the latest of many examples of the devastation of families by disease. HIV and AIDS have left a trail of human suffering, and have greatly affected children. So, too, did the Indian Ocean Tsunami, particularly in Sri Lanka, and devastating earthquakes in Haiti.
It is critical at these times that often-overwhelmed governments get the support they need to identify extended family support for children who lose parents. We admire the work of agencies providing guidance internationally and NGOs on the ground in West Africa – among them the Better care Network and the Child Protection Working Group on Ebola, as well as UNICEF and Save the Children - to help governments to achieve that aim. Local political will is important. The Liberian Government is reportedly strengthening the systems that allow social workers to track down extended family members.
The focal point is hospitals in Ebola-affected areas. This is where adults go to be treated and where, sadly, children can find themselves left in the hands of well-meaning but often over-stretched staff.
There are interagency guidelines for agencies working with children separated from parents and needing alternative care. The key is to ensure that the response of hospitals and health workers to crisis includes finding ways of keeping the children in families.
Agencies in Africa have vast experience and knowledge of good practice in this area, which they can share with local professionals. It includes simple steps such as ensuring children’s identities and family connections are accurately recorded, enabling health workers to find relatives.
The extended family is rightly celebrated in many African cultures and it is estimated that 80% of AIDS ‘orphans’ now live with extended families.
The challenge is to keep track of a child’s relatives in strife-torn areas where people may be dispersed over large distances. Nations such as Liberia, Sierra Leone and Guinea already have thousands of children in so-called orphanages – the majority of them not orphans, but separated from their families for reasons of poverty, disaster and war. Every effort should be made to prevent an increase in the numbers.
There is another challenge. Relatives capable of taking a child have to be supported, sometimes at a time of stress in their own lives. In some nations where Lumos works, child care professionals have to help family members and local communities overcome some entrenched cultural attitudes, particularly the belief that intellectually and physically disabled should be excluded from mainstream society in institutions.
In Africa, from what we read and hear, the challenge is starker. It is to persuade relatives and wider family members that the child of parents who have died from Ebola does not pose a threat to their health and safety
There is a 21-day incubation period after which, if the child shows no symptoms, they can be regarded as free of the virus. Agencies and NGOs on the ground can work with local professionals to engage with families to help them understand this.
Taking these steps to protect the child’s future is hard work. It requires close attention to detail and an assessment of the child’s background and needs by people struggling to cope with a devastating outbreak of disease. But everything we know about the ills of institutionalising children tells us that it is worth the effort.
Placing a child who has lost parents in a large, impersonal orphanage only compounds the harm they face in a traumatic period of their lives. Reuniting them, instead, with family members they know, trust and love will give them a chance of overcoming the trauma and continuing to grow and prosper.