Sunday, February 7, 2010

Orphanages Versus Community Based Care

Given the numbers of orphaned, abandoned and otherwise needy children in developing countries such as Kenya, the issue of whether institutional or community based care is preferable is a difficult one. There are badly run institutions and well run ones. But there are also children who face their greatest dangers in their own homes, from their parents or from their carers. From what I can see in Kenya, social services often don't get involved in cases where things go wrong, either in institutions or in community care settings.

A study with a large sample size published a couple of months ago looked at both types of care, comparing cognitive functioning, emotion, behavior, physical health, and growth. The conclusion was that community care is not better and that, for some indicators, institutions are better. The authors of the study advise against aiming to transfer as many children as possible to some kind of community care setting. This is good advice if the children are in a well run institution or if an adequate level of community care can not be guaranteed.

However, the organisation I am working with, Ribbon of Hope, does not advocate merely keeping a child in their community. We advocate for children to be cared for with the support of other people in the community, in addition to their carer or carers. We would like to see children receive any state support to which they are entitled. And we would like to help provide their carer with the means to provide for the child.

Many children in institutions have one living parent and many more have close relatives who are living. But there are also children who may not have any close relatives or whose relatives are unknown and untraceable. So I wouldn't argue that there is no need for institutions to care for children.

But there are institutions that have been set up with the express aim of making money. I don't know how many of these bogus orphanages there are compared to legitimate orphanages. I just know that several bogus orphanages have been set up in the immediate area around Nakuru. There are also institutions that cannot cope with the number of children they are trying to provide for and conditions for the children, and even the staff, are terrible.

The only well run orphanages I have seen receive very large sums of money from benefactors. It's right that institutions providing for children receive large amounts of money, of course, but most institutions are not able to attract enough money and the children can suffer as a result. Keeping children in an institution usually costs a lot more than providing assistance for them to live in a family setting. Therefore, there may be a good case for more children being raised in a family setting when that is feasible.

In addition, many of these well run orphanages are funded by private donations and are at least partly administrated by foreigners. This is not a bad thing in itself but it does suggest a lack of sustainability and a high degree of dependency. It can be difficult enough for local people to confirm that children presented to them are really orphans but for non-local people it can be impossible. Some people see orphanages as an opportunity to cut their own costs by sending one or more of their children there and claiming the children belong to a deceased relative.

So the stark dichotomy between institutions and community care for orphans is not helpful. Both settings have their advantages and disadvantages. It is quite true that institutions should not aim to transfer as many children as possible to community care. But I think there should be fewer orphanages and far more children should be cared for in a well supported environment. Some of the money available, both state, donor and private, could better be used to provide families with everything they need to give a good home to children who have been orphaned, abandoned or are otherwise in need of care. The study in question is a good one, with a sound methodology, but I don't think it took into account the scenario where the carer is actively supported in providing care.

Incidentally, people often ask about how you can tell whether an orphanage is legitimate or not. They even ask the same question about charities, philanthropic organisations, philanthropists, NGOs, CBOs and the like. I don't have a list of things but the Information in Context blog gives advice on this and other matters. The only rule of thumb I have at the moment is that when people or organisations seem to obsess about numbers, size and quantities, to the exclusion of all other criteria, this can indicate that they are more interested in raising money than in changing things for the better. That always makes me suspicious.


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