Into the mix–orphanages not so bad??

The issue of what to do about the millions of children living out of parental care is politically charged–Ignore them? Undercount them? Insist on family reunification? Insist on adoption? Fudge the tough issues (like original family rights) with foster care? What about institutions/orphanages? Always bad? Sometimes okay? A new study from pediatric specialists from Duke University suggests that–gasp–certain kinds of orphanages may not be so bad, when they are structured in particular ways and embedded within the community….How to read this data? What does it mean for analysis of child welfare policy?

To me, the question is not so much the form as the substance. Does someone really really love you? Need you? Will they be there for you? Suffer with you? Commit to you, protect you, take care of you? This kind of consistent, deeply bonded commitment is the point, which is why I think foster care is a disastrous choice– in the former Soviet Union and elsewhere. I recognize that one can always find superb foster carers–and foster care is appropriate for certain children in certain situations…But as an institution–it is vastly inferior, in my view, to adoption. The Duke study seems to suggest that in Africa and South Asia, it may not be as good as certain…orphanages.

The Duke study, as other studies, should be read with nuance and caution. (Remember when the newspapers took the Bucharest Early Intervention data and blared out the misleading message–Foster care can be good for kids!!?) The authors of the Duke study make clear that they are not advocating that children live in institutions. They are urging caution as the UN and other bodies call for children to be moved out of institutions and into so-called “family based” options, like foster care….They are clearly excluding the former Soviet Union and Eastern Europe from their analysis, and accepting the fact that the Eastern European model of orphanages is inherently, well, bad.

See a report on the study here:

http://www.nytimes.com/2009/12/18/health/research/18child.html

More on the set of options facing all of us in a post to come soon….

From the NYT article:

“As for the African and Asian orphanages, the report in PLoS says, “Many institutions grew out of the community to meet the need of caring for the new wave of orphans and are a part of the community in a way that institutions in other regions and perhaps of the past were not.”

The pressure to move children quickly out of orphanages could endanger them, Dr. Whetten said, by sending them back to abusive or neglectful families.

“We’re not saying kids should be in institutions,” she emphasized. “We’re saying they’re not necessarily a bad option. We need to look at it as a feasible option for communities that are overwhelmed.””

The idea that foster care or even kinship care is automatically the most desirable option is an idiotic notion,  a point  I have been trying to make on this blog….One of my great fears is that the children now in institutions will, under unicef pressure, be moved into inferior foster care situations, and become so dispersed no one knows how they are doing or what their long term problems are….This will have certain political advantages in some nations–where out of sight is out of mind….And out of bad publicity…

To give one of the researchers the last word on this–

“‘The findings mean that there is peril in blanket generalizations about what is best for orphans, because there are good and bad versions of both orphanages and family homes,’ Dr. Whetten said.”

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