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Family Matters: a Study of Institutional Childcare in Central and Eastern Europe and the Former Soviet

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Family Matters: a Study of Institutional Childcare in Central and Eastern Europe and the Former Soviet Family matters: A study of institutional childcare in Central and Eastern Europe and the former Soviet Union 4 Bath Place, Rivington Street London EC2A 3DR Tel: 020 7749 2490 Fax: 020 7749 8339 Email: [email protected] Website: www.everychild.org.uk Registered charity number: 1089879 Registered Company: 4320643 EveryChild is an international non-governmental organisation that works worldwide to create safe and secure environments for children – giving them the chance of a better life. For more information about our work, please visit www.everychild.org.uk. vi The contents of this document may be freely reproduced or quoted, provided any reference is fully credited to EveryChild. Readers citing the document are asked to use the following form of words: Carter, Richard (2005), Family matters: a study of institutional childcare in Central and Eastern Europe and the former Soviet Union: London: EveryChild. Copyright © 2005 EveryChild ii CONTENTS Page Foreword vi Executive Summary 1 INTRODUCTION 4 CHAPTER 1 INSTITUTIONAL RESIDENTIAL CARE: THE HISTORICAL BACKGROUND AND CONTEXT The historical predisposition for residential care in the region 5 The experience since the collapse of the communist system 10 The adverse effects of institutional care 15 CHAPTER 2: THE CURRENT STATE OF INSTITUTIONAL CARE How many children are there in residential care? 18 Conditions in the institutions 27 How do these conditions violate the basic rights of the UNCRC? 29 Abuse in institutions 32 Why are children in residential care? 34 Entry into and exit from the system 41 CHAPTER 3: DEVELOPING FAMILY-BASED CARE A number of different approaches 47 Family-based care as a substitute for residential institutions 49 The barriers to implementing reform of the existing system 63 CHAPTER 4: DEVELOPING FAMILY-BASED CARE Conclusions 68 Emerging issues 68 The implications of reform of the existing system 71 o For governments 71 o For donors 74 o For NGOs 79 APPENDICES Appendix I: Nomenclature and terminology 81 Glossary and Abbreviations 81 Appendix II: Estimating numbers of children in institutions in 83 Central/Eastern Europe and the former Soviet Union Annex to Appendix II: Estimation of numbers of children in institutions in 88 the Russian Federation Appendix III: Resources on the Internet 106 Acknowledgements 94 References 95 iii List of Figures Page Figure 1 Rate of children aged 0-3 years in institutional care in selected countries: 10 Proportion per 10,000 in the population Figure 2 GDP per capita for seven groups of countries 11 Figure 3 The Great Depression, Argentina's 'Lost Decade' and the "Transition" 12 compared Figure 4 Changes in Human Development Index, 1998 – 2002 13 Figure 5 Per cent of households below the national subsistence minimum, Hungary 15 1992 Figure 6 Numbers of children (A) in residential care and (B) in the population, and (C) 21 the rate of residential care, all countries indexed (1989=2002) Figure 7 Rate of children in residential care (per 100,000 population aged 0-17), 22 Central and Eastern Europe Figure 8 Rate of children in residential care (per 100,000 population aged 0-17), South 22 Eastern Europe Figure 9 Rate of children in residential care (per 100,000 population aged 0-17), 23 western republics of the former Soviet Union Figure 10 Rate of children in residential care (per 100,000 population aged 0-17), South 23 Caucasus republics of the former Soviet Union Figure 11 Rate of children in residential care (per 100,000 population aged 0-17), 24 Central Asian republics of the former Soviet Union Figure 12 Reason for admission by three main reasons, Kyrgyzstan study 38 Figure 13 Poverty and family failure issues in 84 Romanian families 40 Figure 14 Total costs of providing for both institutional and family-based care during the 67 transitional reform period (notional figures) Figure 15 What happened to the 714 children helped by EveryChild Georgia between 73 2000 and 2005? Figure 16 Financing of Social services providers in Moldova 76 Figure 17 Schematic of the concept of childcare reform in Moldova 78 iv List of Tables Page Table 1 Total numbers and rates of children in residential care, all countries in central/ 20 eastern Europe and the former Soviet Union, 1989 to 2002, as calculated in the UNICEF TransMONEE database. Table 2 Seeking a better estimate of the numbers of children in residential care, 26 central/eastern Europe and the former Soviet Union Table 3 Reasons for admission to child care institutions, five countries in eastern Europe 37 and the former Soviet Union: per cent of all reasons given Table 4 Reasons for children being sent to institutions by broad type, Romania study 39 Table 5 Romania: recurrent cost analysis of alternative child welfare modalities 63 Table 6 Ukraine, Moldova and the Russian Federation: costs of different forms of care 64 Table 7 Costs of alternative care as a percentage of state residential care 65 Table II-1 Seeking a better estimate of the numbers of children in residential care, 85 Central/Eastern Europe and the former Soviet Union Table II-2 Official figures for children in institutional care, Russian Federation 88 Table II-3 Children and young people receiving care in various shelters and centres, 89 Russian Federation, 2003 Table II-4 A different estimate of the numbers of children in institutional care, Russian 91 Federation v FOREWORD The image of the executed bodies of Nicolae and Elena Ceauşescu on our television screens at the end of December 1989 was a powerful indication that their terrible regime in Romania was over. But this image was soon replaced in people’s minds by the horrific pictures of abandoned children in ‘orphanages’ – children who peered through the prison-like bars of their cots, rocked obsessively back and forth, and were dirty, malnourished and dressed in rags. These images were so stark that even now, 15 years later, the average person still associates Romania with orphaned children shut up in cages – whilst, at the same time, assuming that the problem had been solved. But in this report we show that, although some reforms have been effected, notably in Romania (largely as a result of pressure form the European Union), the problem of ‘abandoned’ children is a common one across the whole of Central and Eastern Europe and the former Soviet Union. Furthermore, the proportion of the region’s children in institutional care has actually increased over the past 15 years. The reasons for this are complex, but largely revolve around the catastrophic economic effects of the ‘transition’ to a market economy and the lack of any alternatives to institutional care. Because of this gap in childcare services, traditional family support networks are slowly breaking down. The state offers little support for vulnerable families and as a result, the decision to place a child in an institution is often the first, rather than the last, choice for desperate parents. This has inevitably led to increased pressure on state services, which provide little social welfare support to families in poverty, leading to more children at risk of abandonment. But, as our findings in this report reveal, the future does hold some hope. In particular, we argue that there are ready solutions – which we have successfully tested – to the region’s reliance on institutions as a form of childcare. By providing emotional and practical support to vulnerable families, we can help prevent infant abandonment or enable the reintegration of a child who is already in care back into their birth or extended family. Where this is not possible, family-based solutions, like foster care, are a cheaper, more effective and wholly better option for vulnerable children. With an estimated 1.3 million children living in institutional care in Central and Eastern Europe and the former Soviet Union, and the increasing number of children throughout the world at risk of entering institutional care, there is much work to be done. We urge leaders in childcare reform across the region to use the findings and recommendations in this report to guide and inform their decisions to effect positive change for these most vulnerable children. Anna Feuchtwang Chief Executive vi EXECUTIVE SUMMARY This report reviews the faltering progress made in childcare reform across Central and Eastern Europe (CEE) and the former Soviet Union (FSU) over the 15 years since the ‘orphanages’ of Romania were revealed to the world. We demonstrate that the overuse of institutional care is far more widespread than official statistics suggest; it remains a very serious problem, with damaging effects on children’s development. Many attempts at reform have been well meaning but misguided, and there is a serious danger that many view the overthrow of the communist system as sufficient evidence of reform in the region. These problems have far-reaching consequences: each generation of damaged children is likely to turn into a generation of damaged adults, perpetuating the problems far into the future. Although most of the evidence in this report is based on CEE and FSU, it is very important to stress that the problem of children in large residential institutions is not confined to that region. The escalating growth in HIV/AIDS in recent years, as well as the many ongoing violent conflicts in the world, has meant that there are many more children in the world without parents. For example, it is calculated that Ethiopia alone had an estimated 989,000 children orphaned by AIDS in 2001, a figure which will have increased to over 2,160,000 by 2010 (UNICEF 2003). With such numbers, it is hardly surprising that governments cannot cope, and are susceptible to suggestions that orphanages are the answer. If there is only one lesson to be drawn from this report, it is that the rest of the world must learn from the mistakes made in CEE and FSU, and avoid creating more large-scale orphanages.
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