01 Jun Why we need to shut down orphanages in Uzbekistan?
Illustration: Eldos Fazylbekov / Gazeta.uz
On 23 May Gazeta.uz conducted a poll titled ‘Do we need orphanages?’ among its readers in order to their attitudes towards orphanages and specialised institutions for children and those left without parental care. The results showed that most of the poll participants believe orphanages in Uzbekistan are necessary, even if they do not inspire confidence. I wrote an op-ed to debunk all the myths about the need for orphanages and provide its translation into English here.
The Uzbek society should remember what happened at the House of Mercy No. 1 in Margilan two years ago. At that time many people were extremely dissatisfied with the ‘unprecedentedly mild sentence’ for the orphanage employees, accused of sexual and physical abuse of children and theft of money of the institution.
As a result, the deputy director and other persons involved in the heinous crimes against children received long prison sentences. However, then only the guilty received punishment. Now it’s time to look at the root of the problem, which is the very existence of the orphanages.
The poll on the topic of orphanages, in which 2168 readers of Gazeta.uz took part, cannot be considered as representative. But its results are noteworthy, as it became apparent that child care issues were of concern to the public. Despite the lack of trust in orphanages, half of the respondents are still convinced of their necessity. At the same time, a third of respondents have a positive attitude towards them.
Only 5.7 per cent of respondents associate deinstitutionalisation with the closure of orphanages and other special institutions and 22 per cent of readers do not know what it is. Most of all, deinstitutionalisation is understood as the development of family forms of care and the transfer of children to families, as well as the development of family-type children’s towns.
Of course, we are all driven by good intentions and, perhaps, we see no alternative to the established system of institutionalised care for orphans and children left without parental care. But the road to hell is paved with good intentions.
Children belong to families, not orphanages
At a time when a blatant incident in the Margilan orphanage No. 1 caused a wide public outcry in Uzbekistan, I was taking a short course ‘A Short Introduction to Transforming Care’ by Lumos. Founded by Joan Rowling, the British author of famous Harry Potter books, the Lumos mission is to achieve that ‘by 2050, all children grow up in loving, nurturing, protective families.’ The international charity with the working experience in more than 12 countries around the world, including Moldova, Ukraine and Bulgaria, firmly believes that institutions are harmful to children in all circumstances.
Numerous scientific studies over the past 80 years show that institutionalisation negatively affects the health and development of children and increases the risk of violence against them in orphanages. Damage can be caused even when children’s institutions are equipped according to all requirements and are well funded.
Let’s look at the main reasons because of which we need to gradually abandon orphanages and develop alternative, family forms of care.
Reason #1: lack of attachment
To understand why orphanages are harmful to children, one must first understand what attachment is. American psychologist Vera Falberg has well explained this in her theory of attachment. When a child is born into the world, crying is the only means of communicating with the outside world. Every time the baby is hungry, wet, tired, when he is cold, something hurts him or he just feels lonely – he is crying. The cycle ‘arousal – relaxation’ (need – expression of protest – satisfaction of need – quiescence – new need) is repeated a thousand times in the first weeks and months of a child’s life.
Feeling the parent’s constant care, the children understand that they are under reliable protection and care. The cycle of attachment is repeated in all families, but we rarely understand the importance of this process for the development of children. In a full cycle, there is a strong relationship between self-esteem, cognitive development, and the child’s ability to learn. Only when this cycle is interrupted, we see the vital importance of a sense of attachment to an adult.
Now imagine a baby home, where there is often one carer for 5-20 children who changes every 8 hours. In such conditions, it is impossible to regularly meet the individual needs of each child in care and attention. As a result, children are fed, diapers are changed and they are bathed in accordance with the approved schedule. This means that children can lie in a wet bed, feel hunger or pain for several hours. Newborn children stop using crying as a means of communicating with adults because no one responds to it. Staying in an uncomfortable state for a long time, children cannot focus on studying the outside world.
Even if the management of the orphanage and carers will have warm feelings and professional attitude towards children, the cycle of attachment may be interrupted. Of course, one cannot deny the excessive work of many educators of orphanages, who often may experience professional burnout. But nothing can replace long-term family attachment.
Reason #2: lag behind in physical and mental development
In the 1950s, the Austro-American psychoanalyst Rene Spitz noted that children deprived of typical family life are physically underdeveloped and exhibit unusual self-stimulating behaviour, such as rocking their bodies, waving their arms, and other senseless obsessive movements. In 1952, Spitz made the film ‘Psychogenic Disease in Infancy‘ based on his research in institutions for orphans of World War II. The results showed that the separation of the infant from the mother and its early institutionalisation cause physical and mental retardation due to the lack of sensory and emotional stimulation of children – a pathology that he called children’s hospitalist.
Another scientific evidence of the serious harm of being in children’s homes to the mental development of children is the results of the study as part of the Bucharest Early Intervention Project in Romania in the 2000s. At that time for the first time, the random sampling method of 136 orphans aged 6–31 months was used – half of them were left in a group in an orphanage, and the rest were placed in foster care. The study periodically compared various aspects of the development of children in orphanages and a control group of children who had never been in an orphanage. Encephalograms (EEGs) were taken to measure the electrical activity of the children’s brain.
The two images above are from the Bucharest study and show a brain scan of two children. The image on the right shows an EEG of the brain of a child brought up in a family. There is a lot of neurological activity, especially in the direction of the front of the brain: the areas of red and orange are very active areas of the child’s brain. The image on the left is the brain of a child brought up in an institution. Blue and green colours indicate areas of lower activity. Studies have shown that the child lags behind in development by 1 month for every 3 months spent in the institution, and the longer the children remain in it, the greater the damage and the lower the chances of reducing the developmental lag.
Reason #3: high risk of violence
Many studies have shown that children of all ages in institutional settings are at greater risk of all forms of violence, including physical and sexual abuse, neglect and human trafficking or other forms of exploitation.
A study by the World Health Organization showed that children with disabilities are 3.7 times more likely to suffer from violence than children without disabilities. In this regard, the placement of children with disabilities in institutions also increases their vulnerability to violence. In boarding schools, children with communication difficulties (with hearing and speech impairments and learning disabilities) may have difficulty exposing the facts of violence against them.
The story of the disclosure of violence against children in the orphanage No. 1 in Margilan is still unclear – despite the fact that rumours of violence spread back in December 2017, the case was made public only in May 2018. It is practically impossible to conduct constant monitoring and supervision of what is happening in children’s institutions closed to the eyes of the public. Equipping the territory and premises of the Mehribonlik houses (orphanages), children’s towns and baby homes with video surveillance cameras is a superficial measure. The problem can be solved only by the development of family forms of care and foster family support services.
Reason #4: problems of adulthood
In addition to the harm caused in orphanages, institutionalisation often leads to problems of orphanage graduates in adulthood. A study conducted in Russia showed that for most graduates of orphanages, a sudden transition to adulthood can put them at risk of social exclusion, become homeless and unemployed, become criminals, and have mental health problems that can even lead to committing suicide.
As part of a study in Russia, the fate of about 15 thousand young people was studied after they left the institution. It was discovered that one in five had committed a crime; one in seven was involved in prostitution; one out of 10 committed suicide. All this is due to a lack of socialisation skills and problems with subsequent social adaptation.
Dependent behaviour is formed in children because much of what children do and decide on their own or with adults in families, for example, cooking, washing, buying food and clothing, etc., is done for them in orphanages. As a result, without the absence of independent living skills, they are released unprepared for independent life in society.
Reason #5: orphanages are too expensive
How much does our state spend on maintaining one child in an orphanage? For example, according to official data from the Ministry of Education of Russia, the government there spends from 1 million to 1,328 million rubles a year (143-190 million UZS) for each child in an orphanage.
According to unconfirmed reports, in Uzbekistan, the government spends about 10 million UZS (about 1,000 USD) per month on the maintenance of one child in an institution which includes a wage fund but without expenses for utilities and maintenance of the building of the orphanage. However, it is inappropriate to compare the financial and moral harm caused. Orphanages are too expensive for society because we are breaking the fates of the inmates of orphanages by disrupting their psyche and development in closed institutions.
Putting children in raising families would cost the budget much less taxpayer money if we, gradually abandoning orphanages, would direct the freed up human and financial resources to the development of professional guardianship and guardianship.
All of the above scientific evidence suggests that institutional institutions cause serious and irreparable harm to children. However, despite this, many people in Uzbekistan still believe that institutional care is a good option, even if it does not inspire confidence. Natural questions such as: ‘What about children with disabilities? Children living in extreme poverty? What to do with unscrupulous parents – leave their children with them?! What to do with street children who are difficult to bring up?’ Of course, all these questions come from good intentions, but let’s first dispel common myths.
Myth #1: only orphans live in orphanages
Data show that 80% of children in institutions around the world actually have one or both parents. Children who are full orphans, with the right support, can live with foster families or alternative family-based care.
Which parent will intentionally abandon his child? Such a desperate decision can be forced by difficult life circumstances, the deplorable socio-economic situation of the family, and labour migration. In most cases, parents are reluctant to put their children in boarding schools, and if they cannot provide decent living conditions for their children, they assume that they will be better taken care of in the orphanage.
Myth #2: orphanages are the safest places for children
Many believe that institutions are the safest places for some children to protect them from dysfunctional families and the dangerous environment created in them. Sometimes situations arise when a child is unsafe to live with his natural parents. But if we take children from families and put them in institutions, we also put them at high risk of further violence. With careful planning, family alternatives can be developed.
The transformation of large orphanages into small-sized ‘family-type children’s towns’ cannot be called a true family alternative. In such houses, no more than eight children of different sexes and ages can live in conditions as close as possible to home conditions, where they themselves can use household appliances. However, they still retain the institutional culture, and we cannot fully call this family-based care. In addition, the construction of such children’s towns can turn into a considerable amount of the state budget at a time when it is necessary to redirect existing resources to the development of family forms of care.
Myth #3: orphanages are needed for ‘difficult’ children
Many believe that children with disabilities and special care needs, as well as children with a difficult character (in other words, ‘children with increased needs’), can receive the necessary support only in institutional settings. Even at the birth of a child with learning disabilities, it is not uncommon that medical staff strongly recommend that parents transfer their newborn to a specialised institution. The persistent stigma and discrimination in society also contribute to this.
Weighing all the pros and cons, parents understand that in the current conditions of limited social and medical services for children with special needs as well as the underdevelopment of inclusive education, it is better to send their child to the institution. This is also facilitated by the inadequate social protection of children with disabilities with limited disability benefits since childhood, which are insufficient for proper care and development of the child.
As a result, according to the Ministry of Public Education, more than 20 thousand children, or about 70% of all children in institutions in Uzbekistan are children with disabilities.
However, with the right approach, inclusive education, social work and all the necessary services for such children can be developed and maintained at the mahalla (local neighbourhood or community) level, using resources redirected from the institutional system, and without separating children and their parents.
In order to understand what it feels like to be a child with cerebral palsy in a Soviet orphanage, I recommend reading Ruben Gallego’s autobiographical novel ‘White on Black’ and the book ‘Salty Childhood’ (Solyonoye Detstvo) of a graduate of the orphanage Alexander Gezalov, which has recently been translated into Uzbek. Gezalov suggests instead of using the word orphanage to use ‘detlom’ (instead of Russian word ‘detdom’ – orphanage) – a home where childhood breaks down and is amputated, and call the whole industry of institutionalisation of children as ‘Sirotprom’ (orphanage industry).
Myth #4: children in orphanages are under the reliable protection of the state
Today is June 1 – International Children’s Day. As in the past year, high-sounding statements will be made that children in orphanages and specialised institutions are under reliable protection and guardianship of the state. It may even be argued that conditions have been created in orphanages far exceed those in the family.
All this goes back to the Soviet past when the institutionalisation of children was associated with two main factors: the conscious need to improve the public perception of the Soviet state as a beneficent force providing the basic needs of all its citizens and a carefully built picture of the Soviet Union as a ‘healthy nation’ free of social problems.
Myth #5: orphanage tourism is a noble cause
If the orphanages harm children, then who are they useful for? It is not difficult for officials and large commercial companies to organise a holiday for orphans on New Year’s Day, give out gifts and take pictures with children with disabilities, and then publish the news as a social advertisement in the media. The orphanage is an excellent platform for one-time charity – both children are pleased and the reputation is improved.
Despite noble intentions, the sad truth is that visiting and volunteering at orpahanges contribute to the development of the Sirotprom, which separates children from their families and puts them at risk of abuse, neglect and violence. Last year, Lumos launched a three-year global campaign #HelpingNotHelping and J. K. Rowling urged all concerned people to stop orphanage tourism.
‘Today I am addressing youth with a speech: yes, volunteer, but plan carefully and thoughtfully. Your time and energy are precious: use them wisely and they will help change the world. Do not volunteer in orphanages. Instead, look at what is pushing children into childcare facilities and devote your time to projects that fight poverty or support communities with vital services,’ Joanne Rowling suggested.
The statement that the orphanage needs to be closed does not imply their closure overnight. First of all, it is necessary to develop social services that prevent family separation and provide a worthy alternative to children who cannot live with their natural families. Secondly, the gradual movement of children from institutions with the redirection of human and financial resources to family forms of care, which are better suited to their needs.
Most importantly, it is necessary not so much to deal with the consequences of orphanhood as to prevent it, strengthening the socio-economic situation of vulnerable families and promoting inclusive development. The choice is ours – continue to be proud of orphans who play football well, or look at the Square of Friendship of Peoples in Tashkent and take an example from the blacksmith’s family.