The dark side of orphanages

PIC: Pastor Ruth Kahawa

Her eyes welled up with tears. The pain in her voice was palpable. She was narrating the circumstances that led her to a difficult decision. 

The decision to let go of the orphans in an orphanage she run. Despite the heavy heart, she held onto faith that it was the best for their future.

"These children have been part of me, and it is like that part of me is going, but what keeps me strong is that this is the best for them, even if I love them so much," 
Ruth Kahawa narrated to a group of top African journalists at a workshop in Nairobi , Kenya, Caring for Vulnerable Children in a Fractured World.

It all started 22 years ago, 1996, when, daily, Kahawa, a pastor in Tororo district would meet starved children rummaging through the decomposing garbage for food. She was saddened. She would pick money from her bag and buy bananas for the little ones. Out of curiosity, she invited them to a restaurant, and over cups of tea, inquired how they had ended up on the streets.

"For the majority, greedy relatives had squandered their inheritance after their parents died," she recollects.

Consequently, shortly after, Smile Africa ministry, an organization taking care of orphans, was born. She started feeding the children on the verandah of her office. They were then 12 in number. Soon after, she confided in a friend who donated to her $5,000 (sh19m). She provided medical services as well. Before long, it was a fully-fledged orphanage.

Kahawa's heart was settled. The children had food, access to medical care, school and decent shelter.

Subsequently, she was surprised and confused when officials from the ministry of Gender, labour and social development told her that it was best for orphans to be raised from communities in families.

"The community abused these children, and now the officials are talking of taking them back?" she thought to herself.

It's not until 2013 when she was invited to a workshop on de institutionalization of children that learned that home is the best place for children to be raised.

"They showed us video clips of adults who had grown up in orphanages. One of them, a married father of three, said he had benefitted a lot from the orphanage, but from getting a good education, shelter, clothing et cetera but was hurt deeply whenever his children demanded to spend holidays with their grandparents, uncles and aunts. He had no known relatives and yet could not take them to the orphanage dormitories," she narrates.

She also recalls a clip of a young lady who painfully recounted that when her fiancé's family eagerly asked him who her relatives were, he had a hard time saying she had none, since she was raised in an orphanage.

"It's then that I realized that the children were better off in families, not the orphanage, even if I was providing all they needed," she says.

"We have been trained by Child's i foundation, a charity organisation for orphans, on how to trace the children's closest relatives and settle them back. This will take us about five years to find the relatives as well as foster families for children whose relatives we fail to trace. We have resettled 21 children so far."

Research shows home is best for orphans
Epaphrodite Nsabimana, the learning and research manager at Hope and Homes for children, a charity organisation based in the UK, that seeks to eliminate orphanages has three words to say about institutionalization of children; unwanted, damaging and unnecessary.

He notes that globally, about 8million children live in orphanages despite their demerits.

For starters, institutional care is more expensive per child compared to raising them in families.

Nsabimana explains, "Residential care facilities require staffing, salaries must be paid, buildings must be maintained et cetera"

The researcher continues that in South Africa, they found that keeping a child in institutional care was six times more expensive than keeping them in a family. Also in Tanzania, they found that the annual cost of keeping a child in an institution cost 1000usd, still six times cost of one child in a family.

What's more, the UK based Save the children organization found institutional care 10times more expensive in east and central Africa, in comparison to family care.

He further points out that there is low staff to children ratio for example 1 to 10 babies, probably around the same age, and it's difficult to be responsive to each one's individual needs.

"This makes it hard to form proper stable bonding that a child needs to develop in the early ages. One ten year old I met said that in her life she had had 10 mothers," he says.

Kahawa points out that in the orphanage, babies are fed for example at 10, whether they are hungry, at mid-day they are changed, whether you have soiled or not.

"They are on a routine because it makes it easy for the workers," she notes.

Eric Kubwimana, a 25-year-old man with direct experience of living in institutional care, in an orphanage in Rwanda following the 1994 genocide, says he once lived in a house of 45 children with 3 guardians working during different shifts.

 Kubwimana

"A mother can give birth to 12 children but not at the same time, so she can attend to their individual needs because they at different ages. Can an orphanage have guardians equal to number of children? Certainly not, because they would need money to pay them," he says.

Institutional care has also been blamed for delayed cognitive development, with the children scoring 20 points lower in IQ compared to the children in families. Often, the children raised in orphanages have lower self-esteem.

Other studies have found lower physical development for example in Malawi; there were more stunting issues and other chronic health problems defeating the purpose that people are attracted to orphanages for better health and nutrition conditions for orphans.

What's more, they are more vulnerable to abuse.
"In one orphanage, the manager told us that the children were living as brothers and sisters, yet when reintegration started it was found that some children were sexually abusing other community children," says Nsabimana.

"When we went back to the orphanage we found that 90 percent of the girls had been sexually abused. This was not reported anywhere because the institutional manager's son was involved in abusing the children."

He continues that a recent PhD thesis conducted by a Finnish student who inquired from orphans in Rwanda what they thought the best living environment was and they all said in a family.

He emphasizes that definitely, family care leads to better development outcomes.

How to effectively de-institutionalize
Nsabimana defines de institutionalization as the process of eliminating institutional care through the development of prevention family support services and family based alternative care. 

Pauline Kedogo of Save the Children, and also a steering committee member of the Association of Alternative Family Care of Children in Kenya says deinstitutionalization is a process and should not be sudden.

"You do not wake up today and close orphanages. You have taken care of them under that situation for a while. You have to prepare them; you have to prepare their care givers. The community also has to be prepared to take care of the children," Kedogo says.

"Closing the homes suddenly causes more damage. Emotional issues, psychological issues to deal with. We are counselling the children and caregivers," she says.

Nsabimana notes that Hope and Homes for children have developed a model to guide deinstitutionalization; engage with stakeholders, assessment of stakeholders involved, design and development of services and follow up support.

Government speaks out
The Ugandan Government believes that it is best for all children to grow up in families. Assistant commissioner for children James Kaboggoza explains why.

"We believe that the best place for a child to grow up is in a family, in a community setting. Many children are growing up separated from their families or orphaned, living in child care institutions."

He adds that if children grow up in institutions, they lose the meaning in their life. If they grow up in a family they learn how to love, they learn how to live with one another, their duties and become responsible citizens of tomorrow. They have a sense of belonging.

"We encourage Ugandan citizens to open their hearts and homes to children who have no families of their own and make a place for them within their own family," he advises.

The ministry of Gender, Labour and Social Development is engaging founders of orphanages countrywide with the aim of reviewing their operation hence the talks with various people running orphanages such as Kahawa.

What other countries are doing
In Africa, Rwanda is in the final lap of closing its orphanages and so far, 80 per cent of the children under institutional care in Rwanda have been reintegrated into either home-based care system.

As for Malawi, the government intends to close 400 orphanages and reintegrate the children into the community by the end of 2018.