Family Matters a Study of Institutional Childcare in Central and Eastern Europe and the Former Soviet Union by Richard Carter
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FAMILY MATTERS A STUDY OF INSTITUTIONAL CHILDCARE IN CENTRAL AND EASTERN EUROPE AND THE FORMER SOVIET UNION BY RICHARD CARTER If you would like to receive the full version of this report, please contact us on 020 7749 2490 or visit www.everychild.org.uk/reports.php 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 Copyright © 2005 EveryChild FAMILY MATTERS A STUDY OF INSTITUTIONAL CHILDCARE IN CENTRAL AND EASTERN EUROPE AND THE FORMER SOVIET UNION ACKNOWLEDGEMENTS GLOSSARY AND ABBREVIATIONS Many people have helped to provide material for CIS Commonwealth of Independent States ECOHOST European Centre on Health of Societies in Transition this report and there is not sufficient space to thank ERRC European Roma Rights Centre them all. However, I would particularly like to FRCCF Fundatia Român˘a pentru Copii Comunitate s¸i Familie (Romania) mention Peter Evans, who contributed to Chapter 4, Geographical groupings: the following groupings are used in this report for what used to be and Jo Rogers and Larissa Bouchelnikova of referred to as the Communist Bloc: EveryChild Russia, who provided invaluable a) Central Europe (CE): Poland, the Czech Republic, Slovakia, Hungary and Slovenia. b) South East Europe (SEE): Romania, Bulgaria and Albania, plus (sometimes) Macedonia material on the numbers of children in institutional and Croatia; but consistent and reliable data on the states of former Yugoslavia are so care in Russia. sparse that the latter two are often not included, and Bosnia/Herzegovina and Serbia/Montenegro not at all. I am also grateful to the EveryChild country c) Central and Eastern Europe (CEE): states in (a) and (b) above. directors and staff in South East Europe and the d) Baltic states: Estonia, Latvia and Lithuania. former Soviet Union for all the help, comments and e) Western former Soviet Union: Belarus, Moldova, the Russian Federation and Ukraine. case study material they provided. Jon Barrett, f) Transcaucasus or South Caucasus: Armenia, Azerbaijan and Georgia. Laura Boone, Paul Dimmick, Myra Green and Ian g) Central Asia (CA): Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan. h) The Commonwealth of Independent States (CIS): states in (e), (f) and (g). Sparks also provided very helpful comments – i) The former Soviet Union (FSU): states in (d) (e), (f) and (g). I hope I have done justice to their contributions j) Central and Eastern Europe and the former Soviet Union (often referred to simply as and, indeed to all the others I have received. ‘the region’): states in (c), (d), (e), (f) and (g). Thanks are also due to Bragi Gu∂brandsson for early sight of the Council of Europe report on HRW Human Rights Watch IHF International Helsinki Federation for Human Rights children at risk and in care (Gu∂brandsson 2004). ILO International Labour Organisation Special thank yous must also go to Lisa and IOM International Organisation for Migration NGO Non-governmental organisation Katie Harker for their excellent and insightful edit OSI Open Society Institute of this summary report, and to Tyra Castelino OSCE Organisation for Security and Cooperation in Europe for overseeing the overall production. UNCRC United Nations Convention on the Rights of the Child Richard Carter Family matters: a study of institutional childcare in Central and Eastern Europe and the former Soviet Union has been kindly sponsored by Burson-Marsteller Brussels. www.burson-marstellar.be Some names and details may have been changed in order to protect the identity of the children, families and communities we work with. Design and artwork: www.wave.coop Printed by Dunnsprint on 50% TCF recycled paper Photo credits : Barry Cawston, Chloe Hall, Omnik Krikorian and David Levene. 2 Acknowledgements FIGURES FI 2 Glossary and abbreviations FIGURE 1 Numbers of children (A) in institutional care and (B) 16 4 Foreword in the population, and (C) the rate of institutional care, all 6 Executive summary countries indexed (1989-2002) FIGURE 2 Reason for admission by three main reasons, 20 9 INTRODUCTION Kyrgyzstan study CONTENTS FIGURE 3 Poverty and family failure issues in 21 84 Romanian families 10 CHAPTER 1 : INSTITUTIONAL CARE : THE HISTORICAL BACKGROUND AND CONTEXT FIGURE 4 Total costs of providing for both institutional and 35 family-based care during the transitional reform period ■ The historical predisposition for institutional (notional figures) care in the region ■ The experience since the collapse TABLES of the communist system TABLE 1 Total numbers and rates of children in institutional 16 ■ The adverse effects of institutional care care, all countries in Central/Eastern Europe and the former Soviet Union, 1989 to 2002, as calculated in the 14 CHAPTER 2 : THE CURRENT STATE OF UNICEF TransMONEE database INSTITUTIONAL CARE TABLE 2 A better estimate of the numbers of children in 17 institutional care, Central/Eastern Europe and the former ■ How many children are in institutional care? Soviet Union ■ Conditions in the institutions TABLE 3 Reasons for admission to childcare institutions, 20 FAMILY ■ Why are children in institutional care? five countries in Eastern Europe and the former ■ Entry into and exit from the system Soviet Union: % of all reasons given TABLE 4 Romania: recurrent cost analysis of alternative 33 24 CHAPTER 3 : DEVELOPING FAMILY-BASED CARE child welfare modalities ■ A number of different approaches to TABLE 5 Ukraine, Moldova and Russia: costs of different 34 family-based care forms of care MATTERS ■ Family-based care as a substitute for residential institutions CASE STUDIES ■ Prevention CASE STUDY 1 How institutional care figures in Bulgaria 15 ■ The barriers to implementing reform fell at the stroke of a pen of the existing system CASE STUDY 2 Social and living conditions for children 18 living in Internat No.2, L’viv 36 CHAPTER 4 : CONCLUSIONS AND RECOMMENDATIONS CASE STUDY 3 A simplistic assessment of a child’s needs 22 ■ Key conclusions CASE STUDY 4 Development delay worsened by lack of therapy 23 ■ EveryChild recommendations CASE STUDY 5 A family in crisis 26 For governments CASE STUDY 6 Kinship care 27 For donors CASE STUDY 7 Two sisters reunited 28 For non-governmental organisations CASE STUDY 8 Adoption of an abandoned child 29 41 REFERENCES CASE STUDY 9 Small support makes a world of difference 30 CASE STUDY 10 Respite care as a step towards reintegration 31 CASE STUDY 11 Support for a young single mother 32 4 FOREWORD 5 The image of the executed Children who peered through the prison-like bars But, as our findings in this report reveal, the of their cots, rocked obsessively back and forth, future does hold some hope. In particular, we bodies of Nicolae and and were dirty, malnourished and dressed in argue that there are ready solutions – which we Elena Ceaus¸escu on our rags. These images were so stark that even now, have successfully tested – to the region’s television screens at the 15 years later, the average person still associates reliance on institutions as a form of childcare. Romania with orphaned children shut up in By providing emotional and practical support to end of December 1989 was cages – whilst, at the same time, assuming that vulnerable families, we can help prevent infant a powerful indication that the problem has been solved. abandonment or enable the reintegration of a their terrible regime in child who is already in care back into their birth But in this report we show that, although some or extended family. Where this is not possible, Romania was over. But this reforms have been effected, notably in family-based solutions, like foster care, are a image was soon replaced in Romania (largely as a result of pressure from the cheaper, more effective and wholly better people’s minds by the horrific European Union), the problem of ‘abandoned’ option for vulnerable children. children is a common one across the whole of pictures of abandoned Central and Eastern Europe and the former With an estimated 1.3 million children living in children in ‘orphanages’. Soviet Union. Furthermore, the proportion of the institutional care in Central and Eastern Europe region’s children in institutional care has actually and the former Soviet Union, and an increasing increased over the past 15 years. The reasons for number of children throughout the world at risk this are complex, but largely revolve around the of entering institutional care, there is much work catastrophic economic effects of the ‘transition’ to be done. to a market economy and the lack of any alternatives to institutional care. We urge leaders in childcare reform across the region to use the findings and recommendations Because of this gap in childcare services, in this report to guide and inform their decisions traditional family support networks are slowly to effect positive change for these most breaking down. The state offers little support for vulnerable children. 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 Anna Feuchtwang social welfare support to families in poverty, Chief Executive leading to more children at risk of abandonment. EveryChild 6 EXECUTIVE SUMMARY 7 This report reviews the faltering progress made in childcare reform across Central and Eastern Europe and the former Soviet Union over the 15 years since the ‘orphanages’ of Romania were revealed to the world. We demonstrate that the overuse of institutional Our research highlights a number of important 3. Orphanages remain in CEE and FSU, and their care is far more widespread than official statistics revelations, which are explored in detail in this use is increasing in other parts of the world.