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  • Translator: Joseph Geni Reviewer: Morton Bast

  • Across Europe and Central Asia,

  • approximately one million children live in large

  • residential institutions, usually known as orphanages.

  • Most people imagine orphanages as a benign environment

  • that care for children.

  • Others know more about the living conditions there,

  • but still think they're a necessary evil.

  • After all, where else would we put all of those children

  • who don't have any parents?

  • But 60 years of research has demonstrated

  • that separating children from their families

  • and placing them in large institutions

  • seriously harms their health and development,

  • and this is particularly true for young babies.

  • As we know, babies are born

  • without their full muscle development,

  • and that includes the brain.

  • During the first three years of life, the brain grows

  • to its full size, with most of that growth taking place

  • in the first six months. The brain develops

  • in response to experience and to stimulation.

  • Every time a young baby learns something new --

  • to focus its eyes,

  • to mimic a movement or a facial expression,

  • to pick something up, to form a word or to sit up --

  • new synaptic connections are being built in the brain.

  • New parents are astonished by the rapidity of this learning.

  • They are quite rightly amazed and delighted by their children's cleverness.

  • They communicate their delight to their children,

  • who respond with smiles,

  • and a desire to achieve more and to learn more.

  • This forming of the powerful attachment between child and parent

  • provides the building blocks for physical, social,

  • language, cognitive and psychomotor development.

  • It is the model for all future relationships with friends,

  • with partners and with their own children.

  • It happens so naturally in most families

  • that we don't even notice it. Most of us are unaware

  • of its importance to human development and, by extension,

  • to the development of a healthy society.

  • And it's only when it goes wrong that we start to realize

  • the importance of families to children.

  • In August, 1993, I had my first opportunity to witness

  • on a massive scale the impact on children

  • of institutionalization and the absence of parenting.

  • Those of us who remember the newspaper reports

  • that came out of Romania after the 1989 revolution

  • will recall the horrors of the conditions in some of those institutions.

  • I was asked to help the director of a large institution to

  • help prevent the separation of children from their families.

  • Housing 550 babies, this was Ceausescu's show orphanage,

  • and so I'd been told the conditions were much better.

  • Having worked with lots of young children, I expected

  • the institution to be a riot of noise,

  • but it was as silent as a convent.

  • It was hard to believe there were any children there at all,

  • yet the director showed me into room after room,

  • each containing row upon row of cots,

  • in each of which lay a child staring into space.

  • In a room of 40 newborns, not one of them was crying.

  • Yet I could see soiled nappies, and I could see

  • that some of the children were distressed,

  • but the only noise was a low, continuous moan.

  • The head nurse told me proudly,

  • "You see, our children are very well-behaved."

  • Over the next few days, I began to realize

  • that this quietness was not exceptional.

  • The newly admitted babies would cry for the first few hours,

  • but their demands were not met, and so eventually

  • they learned not to bother. Within a few days,

  • they were listless, lethargic, and staring into space

  • like all the others.

  • Over the years, many people and news reports

  • have blamed the personnel in the institutions

  • for the harm caused to the children, but often, one member

  • of staff is caring for 10, 20, and even 40 children.

  • Hence they have no option but to implement a regimented program.

  • The children must be woken at 7 and fed at 7:30.

  • At 8, their nappies must be changed, so a staff member

  • may have only 30 minutes to feed 10 or 20 children.

  • If a child soils its nappy at 8:30, he will have to wait

  • several hours before it can be changed again.

  • The child's daily contact with another human being

  • is reduced to a few hurried minutes of feeding and changing,

  • and otherwise their only stimulation is the ceiling,

  • the walls or the bars of their cots.

  • Since my first visit to Ceausescu's institution,

  • I've seen hundreds of such places across 18 countries,

  • from the Czech Republic to Sudan.

  • Across all of these diverse lands and cultures,

  • the institutions, and the child's journey through them,

  • is depressingly similar.

  • Lack of stimulation often leads to self-stimulating behaviors

  • like hand-flapping, rocking back and forth,

  • or aggression, and in some institutions, psychiatric drugs

  • are used to control the behavior of these children,

  • whilst in others, children are tied up to prevent them

  • from harming themselves or others.

  • These children are quickly labeled as having disabilities

  • and transferred to another institution for children with disabilities.

  • Most of these children will never leave the institution again.

  • For those without disabilities, at age three,

  • they're transferred to another institution, and at age seven,

  • to yet another. Segregated according to age and gender,

  • they are arbitrarily separated from their siblings,

  • often without even a chance to say goodbye.

  • There's rarely enough to eat. They are often hungry.

  • The older children bully the little ones. They learn to

  • survive. They learn to defend themselves, or they go under.

  • When they leave the institution, they find it really difficult

  • to cope and to integrate into society.

  • In Moldova, young women raised in institutions

  • are 10 times more likely to be trafficked than their peers,

  • and a Russian study found that two years after leaving institutions,

  • young adults, 20 percent of them had a criminal record,

  • 14 percent were involved in prostitution,

  • and 10 percent had taken their own lives.

  • But why are there so many orphans in Europe

  • when there hasn't been a great deal of war or disaster in recent years?

  • In fact, more than 95 percent of these children have living parents,

  • and societies tend to blame these parents

  • for abandoning these children, but research shows that

  • most parents want their children, and that the primary drivers

  • behind institutionalization

  • are poverty, disability and ethnicity.

  • Many countries have not developed inclusive schools,

  • and so even children with a very mild disability

  • are sent away to a residential special school,

  • at age six or seven.

  • The institution may be hundreds of miles away from the family home.

  • If the family's poor, they find it difficult to visit,

  • and gradually the relationship breaks down.

  • Behind each of the million children in institutions,

  • there is usually a story of parents who are desperate

  • and feel they've run out of options, like Natalia in Moldova,

  • who only had enough money to feed her baby,

  • and so had to send her older son to the institution;

  • or Desi, in Bulgaria, who looked after her four children

  • at home until her husband died,

  • but then she had to go out to work full time,

  • and with no support, felt she had no option

  • but to place a child with disabilities in an institution;

  • or the countless young girls too terrified to tell their parents

  • they're pregnant, who leave their babies in a hospital;

  • or the new parents, the young couple who have

  • just found out that their firstborn child has a disability,

  • and instead of being provided with positive messages

  • about their child's potential, are told by the doctors,

  • "Forget her, leave her in the institution,

  • go home and make a healthy one."

  • This state of affairs is neither necessary nor is it inevitable.

  • Every child has the right to a family, deserves

  • and needs a family, and children are amazingly resilient.

  • We find that if we get them out of institutions and into loving

  • families early on, they recover their developmental delays,

  • and go on to lead normal, happy lives.

  • It's also much cheaper to provide support to families

  • than it is to provide institutions.

  • One study suggests that a family support service

  • costs 10 percent of an institutional placement,

  • whilst good quality foster care

  • costs usually about 30 percent.

  • If we spend less on these children but on the right services,

  • we can take the savings and reinvest them in high quality

  • residential care for those few children with extremely complex needs.

  • Across Europe, a movement is growing to shift the focus

  • and transfer the resources from large institutions

  • that provide poor quality care to community-based services

  • that protect children from harm and allow them to develop

  • to their full potential. When I first started to work in Romania

  • nearly 20 years ago, there were 200,000 children living

  • in institutions, and more entering every day.

  • Now, there are less than 10,000, and

  • family support services are provided across the country.

  • In Moldova, despite extreme poverty and the terrible effects

  • of the global financial crisis, the numbers of children

  • in institutions has reduced by more than 50 percent

  • in the last five years, and the resources are being

  • redistributed to family support services and inclusive schools.

  • Many countries have developed national action plans for change.

  • The European Commission and other major donors

  • are finding ways to divert money from institutions

  • towards family support, empowering communities

  • to look after their own children.

  • But there is still much to be done to end the systematic

  • institutionalization of children.

  • Awareness-raising is required at every level of society.

  • People need to know the harm that institutions cause to children,

  • and the better alternatives that exist.

  • If we know people who are planning to support orphanages,

  • we should convince them to support family services instead.

  • Together, this is the one form of child abuse

  • that we could eradicate in our lifetime.

  • Thank you. (Applause)

  • (Applause)

Translator: Joseph Geni Reviewer: Morton Bast

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