Orphanages are not the solution

Back in 2016 I wrote a blog about why Save the Children doesn’t support volunteering in orphanages and why we are concerned about the growing trend in voluntourism.

I talked about why we are worried about untrained volunteers having access to extremely vulnerable children and how the demand for this kind of volunteering contributes to the harmful practice of building and funding orphanages. Today, I want to delve a bit deeper into the problem of orphanages, how this negatively impacts children’s attachment and development, and tell you more about what Save the Children and others are doing to support solutions that bring about real change in the lives of children and communities.

I urge you to take part in the Better Care Network’s campaign called ‘The Love you Give’ – which challenges the concept of caring and urges young people not to volunteer in an orphanage. Please watch this powerful video from perspectives of Kenyans who grew up in orphanages.

The Problem: Fundamentally the wrong model of care
Over the last two decades there has been a lot of attention and research on how the brain develops. Our brain has more neurons in it before we reach the age of three than at any other time in our lives. We connect these neurons through a process of what is often referred to as “serve and return”. When a young child babbles or cries, the caregiver responds with eye contact, speaking, and comforting the child. When caregivers are sensitive and responsive to a child’s needs, they create an environment which strengthens the connections in the brain. This is how we learn to talk, that we are important, that we are loved, and that we can depend on others. Because this relationship is both expected and essential, the absence of secure and responsive caregiver poses a serious threat to children’s development and long-term wellbeing.

If the caregiver’s responses are unreliable, inappropriate, or absent, the child does not get the stimulation he or she needs to develop physically, emotionally and socially. Not only does the brain not receive positive stimulation, but the body’s stress response is activated, flooding the brain with harmful stress hormones.

These early interactions fundamentally shape how we view the world throughout our lives. Do you believe that you are worthy of love? Are the people you care about going to leave? This is all unconsciously set from a very young age and can be very difficult to unravel later in life.

In addition, orphanages separate children from their extended family and community. In many countries in which we work, your family is your safety net. They are the ones that broker marriage, help when you are unemployed, give you status in society, and entitle you to a birth certificate. Your family is your health insurance and your pension all in one and orphanages strip away this extensive protective network.

Probably one of the most famous studies on the effects on orphanage care on children is the Bucharest Early Intervention Study, a longitudinal study which started in Romania in 2000 and continues to follow children. They found that growing up in orphanages leads to profound deficits and delays in cognitive and social-emotional development and greater risks of psychiatric disorders. On average, for every three months that a child was in an institution, he or she lost one month of development compared to a child in foster care.

Importantly this study was not looking at terrible orphanages and terrible foster care, it was looking at high quality versions of both. A subsequent study in 2004 based on 32 European Countries lead the Council of Europe to conclude “Considering the risk of harm in terms of attachment disorder, developmental delays and neural atrophy in the developing brain, no child under the age of three should be placed in residential care without a parent or primary caregiver.”

Regardless of how wonderful an orphanage looks, how clean the facilities are, and how qualified and approachable the staff members are, it simply cannot provide the same one-to-one support that a family, in its many different forms, can.

Good versus bad orphanages
I often get questions from well-intentioned supporters who say, “I know that orphanages can be bad, and I saw the pictures of the orphanages in Romania, but the orphanage I support is nothing like that. I support a good orphanage.” Unfortunately, regardless of the amount of money put into an orphanage – no matter how clean, how many materials, or how much training and support the staff receive – the model of care is fundamentally flawed. An orphanage cannot provide the kind of one-on-one individual focus of a family, created around love, acceptance and safety. Institutional care is based on group with revolving caregivers, set routines, and a fixed end date.

There is a substantial body of evidence that made the United Kingdom, United States, Australia and many other countries transition from institutional care to family-based care and yet we continue to support this antiquated model abroad.

If the problem isn’t the absence of parents, then let’s address the real problem
The first step is prevention. It’s important to remember that the majority of children are not being placed in orphanages because they are being abused or have no other place to live, but instead they are placed due to poverty or because of a lack of access to education in their own community. In the studies that we’ve conducted, we’ve found between 80-90% of children have at least one living parent. So why do we continue to put money into orphanages when they are expensive, delay young children’s development, separate children from their families, and don’t address the underlying problems children and their families are facing?

If the problem is poverty, we need to put funding into services that helps vulnerable families access money through social protection programming, livelihoods, and other economic support. If the problem is access to education and the hidden costs involved in sending children to school (like transport costs and uniforms), we need to support communities, national, and local governments to improve access to school. If the problem is violence in the home, then we need to put money into creating a strong social service workforce to intervene and alternative family-based care which is culturally appropriate.

Several people commented on my last blog that they would continue to support orphanages until a better safety net for children exists, but this just perpetuates the problem with money and support flowing to the wrong places. Supporting orphanages creates more “orphans”. In countries like Nepal and Cambodia, the majority of orphanages are located in tourist destinations. This is not based on what’s best for children, or the places of most need, but is specifically supplying a demand to tourists. Volunteering and supporting orphanages simply perpetuates the problem.

What is Save the Children doing about this issue?
Save the Children works closely with national and local governments to regulate child care institutions, strengthen families, and work on the underlying cause of separation. We also work to set up alternative systems of quality care including support to kinship carers and foster care. To see more information on our work, please click on the links: Indonesia, Cambodia, Zambia, and Eastern Europe. We continue to conduct research to identify the underlying causes of family separation, the best and most protective forms of family-based care based on the context, and respond with family tracing and reunification in emergencies in South Sudan.

What Governments are doing to address this problem
At the DFID-convened Disability Summit in July of 2018, the UK Secretary of State for International Development stated “The UK government recognises that institutionalisation harms children’s physical, emotional and psychological development. Children with disabilities are often the first to be placed in institutions, the last to leave institutional care and often end up being forgotten by society. The UK Government will work towards the long-term process of deinstitutionalisation.”

The Indonesian Government created National Standards of Care for Child Welfare Institutions in 2011 and recently passed legislation that clearly outlines that institutionalisation should be the last resort for children and officially recognises social work as a profession.

The Ugandan government is closing down unregistered orphanages that are deemed unsafe.

In 2014 the Kenyan Government created Guidelines for the Alternative Family Care of Children in Kenya and in 2018 placed a moratorium on the construction of new child care institutions.

The Rwandan Government has committed to ending the institutionalisation of all children by 2020. And many more Governments are moving in this direction.

It’s time to think more ethically about volunteering
Many travel and tourism companies are no longer offering orphanage volunteer trips. To find out more about who they are, visit the ReThink Orphanages webpage. And yet, well-intentioned volunteers are still supporting orphanages. Save the Children co-leads ReThink Orphanages, a coalition of agencies from travel and tourism, faith-based organisations, and the education sector to change the way that we continue to fund and support orphanages. In 2018 ReThink Orphanages won a silver medal in the World Travel Market Responsible Tourism Awards for our work in communicating responsible tourism in Australia.

What can you do to be part of the solution?
Before you travel, start by thinking about how you can support community initiatives that strengthen families. Use our 10-point volunteering checklist to help guide your search for ethical options. Make sure there are background checks. Consider whether you would be able to do the same activity in your own country. If you can’t, for example walk in off the street and volunteer to help vulnerable children in the UK, why is okay to do this in another country? Be a conscious consumer. Don’t be afraid to ask difficult questions and learn about the locations in which you’re traveling. Don’t forget to consider volunteering in your own community at home. While there are many needs overseas, there are also numerous opportunities for helping those in need at home.

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  • Jean Darveau

    The link to “Bucharest Early Intervention Study” is not valid :-/

  • Rebecca Smith

    Dear Jean, Thank you for pointing this out. I have amended the link and it should be working now. Please do let us know if you are still having problems accessing it.