The success of the Harry Potter books has taken me to places that I never, in my most optimistic daydreams, visualized myself. If you had told me twenty years ago that I would one day stand in the Oval Office, I would have advised you to change your medication, and my disbelief would have been no less extreme if you had prophesied a trip to Buckingham Palace, or 10 Downing Street, or a fake hillock in the opening ceremony of the 2012 Olympics.
Yet I really did go to those places, and I remember them all like cinematic stills, as though they happened to somebody else.
My visit to the foreign orphanage was not supposed to be upsetting, or not as far as the staff was concerned. The woman in charge beamed as the three year olds swarmed around the strange visitor, eager for her attention. Those children neither knew nor cared about Harry Potter. All they craved was affection. We could not speak each other’s language, but that did not deter the little girl with the shaven head. She crawled into my lap and beamed up at me. If you have ever had a totally unfamiliar toddler cling to you in the evident hope that you might simply take them away with you, you will probably understand what it felt like to detach her fingers and leave. As I pretended to listen to the white-coated carer walking beside me, I remembered the horrifying statistics on the numbers of children who are trafficked from such institutions. That three-year old would have clung to absolutely anybody for a smile and a hug.
Another day, another children’s institution and I was shown into a room full of totally silent babies. They had learned that crying brought no comfort and their lack of interest in eye contact was eerie. The photographer wanted me to smile; I wanted to cry. My worst memories, though, are of the vast impersonal children’s home in Eastern Europe where I saw three children with severe cerebral palsy sharing a single bed. They were tube fed, washed and otherwise totally ignored. An English-speaking nurse confided in me that another young disabled girl in her care kept asking for her mother. When the little girl’s pleas became too much, the nurse would leave work and telephone the ward, pretending to be the mother who had been convinced that no contact was in the best interests of a child who was begging for her.
The names ‘orphanage’ and ‘care home’ often conjure up benign images. People donate money willingly and generously, believing that the children living in such institutions have been rescued from a life barely worth living. This, I have learned after ten years of reading research papers and talking to experts in the field, is an idea predicated on lack of knowledge about the reality of what institutionalization does to a child, and about the real reasons that children find themselves in care homes.
80% of the eight million children living in orphanages and institutions worldwide are not orphans. They have at least one living parent, and that parent usually wants to care for them personally. To those of us fortunate enough to grow up in the privileged First World, it might seem inconceivable that a parent would voluntarily give up the care of their child to an institution. We take for granted the medical and welfare systems that support the care of children at home. Institutions spring up where no such systems exist, where there is cultural discrimination against disability, where conflicts and disasters have destroyed livelihoods and – by far the largest driver of institutionalisation – where parents are so poor that they fear the only way to save their child from starvation is to place them in residential care.
Ten years ago, after those first dreadful experiences of visiting orphanages, I made contact with several experts in the field of deinstitutionalization. This led me to found Lumos, an international non-profit organization. Its aim is to help countries reform childcare and protection systems, moving from building orphanages towards systems that help families to stay together.
It has now been proven that loving adult engagement with a young child helps strengthen neural electrical connections in the brain, shaping its development. Brain scans visibly demonstrate the dramatic difference between the brain development of children who have had loving one-to-one care from an adult, and those who have been raised without it. A key failing of orphanages is that shift rosters and low ratios of adults to children cannot ensure the close, sustained adult attention children need to grow and prosper. Institutionalized children are more frequently sick than the wider population and at far greater risk of mental illness and impairment. As adults, they are many times more likely to use drugs, to engage in prostitution and to commit suicide, than those raised in families.
Those who emerge from institutions place a never-ending economic burden on societies, yet ironically, institutionalization itself is very expensive. It is far more cost-effective to provide foster and adoption services and community-based health and welfare systems. Yet orphanages often assert an economic ‘pull factor,’ attracting funding, frequently from abroad, which increases societal pressure on families to give up their children.
The good news is that this is an entirely solvable problem. Lumos has spent 10 years working in Europe, where institutionalization of children was a major concern, especially in formerly Communist countries. There can be a vested interest in keeping institutions running, as the workers fear the loss of their own livelihoods. Lumos’s answer is retraining employees as community-based health and social workers. Institutional buildings can be repurposed to house community services.
Encouragingly, a ‘tipping point’ has now been achieved: most countries in that region have plans to end institutionalization. Furthermore, the US government and the European Union are taking a lead in changing the way foreign assistance is delivered, to move the focus onto protecting and supporting families.
The United Nations post-2015 Sustainable Development Goals, with their focus on ‘Leaving No One Behind’, offer the global community a once-in-a-lifetime opportunity to end the institutionalisation of children around the world. Lumos will work hard to make sure the SDGs really do make an impact on the lives of millions of children living outside of families in institutions and orphanages.
Outside of Europe, meanwhile, the numbers of children in so-called orphanages continues to rise in other areas. Lumos USA has now begun work in the Latin America and Caribbean region. We have started in Haiti, where approximately 30,000 children are currently living in almost entirely privately funded orphanages. Once again, we find the familiar ratio of 80% non-orphans, and recognize the driving force of poverty.
Lumos has a single, simple goal: to end the institutionalization of children worldwide by 2050. This is ambitious, but achievable. It is also essential. Eight million voiceless children are currently suffering globally under a system that, according to all credible research, is indefensible. We owe them far, far better. We owe them families."
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