Kelsey Nielsen, a 22 year old social work major at Temple University, pointed me to a post she had written about orphanages in Uganda. It kind of blew my mind in that it made me look at orphanages in developing nations in a new way. Kelsey spent 12 months in Uganda and started the Abide Family Center (feel free to donate!) alongside Megan Parker. I asked her to expand her post and write a guest post.
Patrick, a twenty year old, first time father, sits with his wife’s head in his lap. Their beautiful four month old baby boy lay sleeping next to them. Patrick sits silently listening to every breath his wife takes as she grips his hand tight to keep from screaming out in pain. This night spent on the cool dirt floor of their small one room home in the slums of Kampala, Uganda would strip Patrick of the two people he loved most. That night his wife died of an undetermined illness. Patrick worked in the quarry making just enough to pay rent and feed his family. He had little if any extra money all. He was unable to pay for transport to the closest hospital, let alone provide medical care.
The days after her passing, Patrick was not only faced with the loss of his wife, but with the uncertainty of how he would take care of his son. Christopher had been growing big and strong with his Mother’s love and breast milk packed with nutrients. To keep his son he would need money for formula and for the salary of a house girl who would watch Christopher while he worked during the day. He tried everything, but was left with few options. Hearing of Patrick’s situation, a neighbor directed him to an American working in a slum area nearby. The woman gladly admitted Christopher to her program. Patrick walked away from his son that day not knowing if or when he would ever get to bring him back home again.
If Patrick, a loving father who desired so deeply to raise his own son, had been living somewhere in the developed world, there would have been an entirely different outcome. If Patrick lived in a country with a progressive social welfare system in which the State worked to care for its most vulnerable citizens, he would have had access to programs that helped alleviate the increased economic strain that came with the death of his wife. Patrick would have potentially had access to government programs that subsidized food and housing costs, making it easier to provide for his son. These are not options for single-parents living in Uganda. Often times caregivers in their most vulnerable state seek assistance for their children and more often than not assistance comes in the form of institutional care models. Probation officers recommend OVC (orphans and other vulnerable children) to local babies’ homes and orphanages. After placement in an institution, there is little if any work being done to reunify the child with their immediate or extended family. Most commonly, when a child enters an orphanage they are forfeiting their right to grow up in their natural family. Family preservation models in the care of OVC are seldom implemented in the developing world, leaving at-risk families with extremely limited options.
The Dilemma: 4 out of 5 orphans have 1 or both parents living
Save the Children reports, “Lack of support to families and communities also results in large numbers of children ending up in potentially harmful institutions. 4 out of 5 of the estimated 8 million children currently living in care institutions, have one or both parents alive. With some support these parents would be able to continue to care for their child in their own home” (Family Strengthening and Support, 2010). In this policy brief, Save the Children acknowledges that not all families are able to care for and protect their children from harm. There are some families that even with the necessary assistance, would still fail to meet the critical developmental needs of their children. Therefore the unethical gap in care provided to OVC in the developing world I will be addressing are the services offered to at-risk caregivers by which the dominant and fundamental need is monetary.
The clear and upsetting gap between services for at-risk children and youth in the U.S. and the services offered to the developing world is one that must be acknowledged and critically analyzed in order to begin providing families overseas the same level of care offered to families here. In this paper I will question most directly why individuals from the developed world- individuals from countries with progressive social welfare systems, why we have decided it is okay to move backward and continue offering solutions that have been found ineffective and actually damaging in our own countries. There has been a clear movement away from institutional care in the United States, with a movement toward family preservation. However, we insist on offering the developed world this sub-par level of care that countless studies have proven damaging not only to children and families, but to entire communities and cultures.
In Philadelphia, families who DHS feels it necessary to separate are scheduled to be seen in court on multiple occasions. Individuals present at said hearings would most likely include: a judge, a child advocate, the child(ren), parents, other family members, a case worker, and a lawyer defending the parents. These court hearings are held to make sure all parties are doing their job. The judge wants to see evidence that there is a movement toward permanency for the child. If at all possible, it is in the form of reunification with the natural family. For a child to be released back into the care of the home they were removed from, the caregiver must take the necessary steps to make their home a safe place for that child.
Anyone at DHS would tell you that as often as they are referred to as “baby snatchers”, that is not what they are about. Not at all. The social workers, supervisors, and department heads all want to see children out of foster care and reunited with their biological family. They want to see caregivers making the necessary changes to help bring their children home. And it is in fact the case workers’ job to do everything in his or her power to make this possible. Whether it is providing transportation to NA meetings, helping the caregiver look for employment, or finding necessary mental health treatment- the caseworker serves as a broker and advocate for the caregiver.
Family preservation is at the center of the services DHS provides to their clients. Individuals and institutions working to address the needs of at-risk children in the U.S. have studied the effects of institutional care on children. They have understood that it is a child’s right to grow up with their natural family. They have realized that it is unethical to automatically write a caregiver off as unfit regardless of how a caseworker may feel about the situation initially. They have understood that it is entirely necessary to provide a caregiver with the tools to bring their children back home. Does it always work? Absolutely not. There are many parents who don’t take advantage of the services provided to them. They do not do their part in completing the steps to make reunification possible, and in this case the caregiver’s rights would be terminated. The point is, they are to be given every opportunity to make it possible for their children to return home. It is up to the caregiver to choose whether or not they will take responsibility and work with the case worker and the courts to meet the requirements for regaining custody of their children.
In Uganda at-risk families aren’t even presented with this choice. Just imagine how the number of children living in institutional care would decrease if instead of simply placing children in orphanages, we came alongside the parents and gave them a choice. What if we focused on empowering and helping link them up with the necessary resources to keep their children? We could prevent family separation in the first place.
In some cases there is a definite need to remove a child from the home; however there is a major difference between the care provided when this occurs. One of the major differences between orphanages and foster care as temporary solutions- when children are placed in foster care in the U.S. a social worker is working with their parents to help them regain custody. In Uganda when a child enters an orphanage, the orphanage is not working with the caregiver to help improve their situation- thus the orphanage becomes more of a long-term solution for these families.
When we measure services offered to at-risk families in the U.S. against what we fund and promote in Uganda there is a disparaging gap that should upset all of us. I don’t believe in satisfactory care. I believe in researching and educating ourselves before starting NGO’s in cultures SO vastly different from our own. I believe in offering the best care possible, whether it is in North Philadelphia or East Africa. Performing needs based assessments, studying evidence based/best practice models, and determining the cultural appropriateness of potential services and aid programs is critical. Because if you are not doing this, you are committing a serious disservice to the population you are serving. And you just might be doing more harm than good