In Africa, sisters lead the way to replace orphanages with family care

Decades of research has shown that children living in institutional care are extremely exposed to neglect, physical and sexual abuse. A lack of a stable relationships and interactions among children in institutions affect their foundations for brain development, resulting in poor mental health, academic failure, and increased chances of behavioral problems later in life, studies show.

Most African countries, including Uganda, Zambia and Kenya, have endorsed the U.N. Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the Child which recognizes that children should be raised in a safe and loving family or within a community to realize their full potential.

That's a key reason the international sisters' group UISG is encouraging congregations to end the placement of children in large institutions and instead support community-based, family-like alternatives.

During the launch of this global initiative Oct. 2, which was streamed online, religious orders of women and men were urged to join the initiative. "We understand that the family is the best place for a child to grow holistically," Sri Lankan Good Shepherd Sr. Niluka Perera, coordinator of Catholic Care for Children International, told participants. "Therefore, it is the responsibility of us who are committed to the care of vulnerable children to give the best place and environment for a child to grow."

Loreto Sr. Patricia Murray, executive secretary of the UISG, noted that there are at least 9,000 Catholic residential institutions or orphanages worldwide serving almost 5.5 million children. She urged religious institutions to learn from what others are doing in different countries to provide the best possible care for the vulnerable children.

"Catholic Care for Children functions well in three countries — Zambia, Uganda and Kenya. It's associated very closely with the conference of religious in each country, and we see that as a very good model," said Murray in an interview with Global Sisters report. "We can move our focus to supporting family life because we know that 80% of children are not orphans but have a living parent or a family structure, and that family structure can be helped to keep the child at home." UISG is carefully considering other countries where the model can be implemented, she said.

Poverty and family breakdown have contributed to the growth of institutional care, said Kathleen Mahoney, a program officer of GHR Foundation, which has "Children in Families" as one of its program areas. Through the respective religious associations, GHR has been providing funding in the three countries for the training of sisters in social work, case management and child care programs, and assisting in the transition from institutional to family care.

"GHR has a long history of working with Catholic sisters around the globe, and we really see them as tremendous spiritual and social asset for the world," she said. The social and spiritual aspects came together in Zambia and Uganda and recently in Kenya where "we really see sisters at the helm," she said. "Catholic Care for Children is a sister-led, charism-driven movement to improve care for children. We see real potential for this to grow."

Global Sisters Report reported from Uganda, Zambia and Kenya on the program models and how UISG is aiming to play a role in expanding these models to elsewhere in the world and trying to de-emphasize institutional care.

Uganda

The Catholic Care for Children's initial pilot project started in Uganda five years ago. The initiative began when the government of Uganda raised a red flag over poor quality of care in childcare institutes across the country, especially those run by the churches. The government threatened to close several children's homes, including those belonging to the religious sisters because of a lack of training to handle children, according to sisters interviewed for this article.

The East African nation had about 36 residential child care institutions in 1996, and now has an estimated 800 institutional care centers with around 150,000 children, according to available data published in 2019. Only 70 institutions are licensed by the Ugandan Ministry of Gender, Labor and Social Development, according to this report.

Catholic Care for Children in Uganda (CCCU) sought to reform child care institutes with the objective of ensuring a stable and secure family environment for every child. CCCU, which is an initiative of the Association of Religious in Uganda (ARU) and financially supported by GHR Foundation, began by training dozens of religious caregivers on the importance of family care rather than institutional care.

CCCU offered scholarships to more than 80 religious sisters in the areas of social work and social administration. A majority of the sisters attained a bachelor's degree in social work, some obtained master's degrees in social work, and others trained in a certificate course on protection of children. The sisters received their training at Makerere University in Uganda, in partnership with the Ministry of Gender, Labor and Social Development.

Sr. Mary Lunyolo, a member of Sisters of Mary of Kakamega, said the motive of training was to help the sisters with skills to support family reintegration, avert future family separation and finally end institutionalization within Uganda, a country of 44 million people.

"Many of the childcare institutes were run by sisters who had inadequate skills on institutional childcare," said Lunyolo. "But many of our sisters right now have received training in various aspects of childcare."

Lunyolo is the administrator of St. Kizito Babies Home, which was established in 1968 to care for babies whose mothers died during childbirth. It now serves as a short-term foster care and transition care center. Children are admitted awaiting return to the community so that they are adopted by other families, she said.

She said the home, which admits children from newborns to age 3, has been able to reintegrate 18 children, who are monitored in the community by sister caseworkers. Lunyolo estimated that thousands of children have been integrated with family members or adoptive families since the program began in various centers run by religious women in Uganda.

"The initiative is really working well because the community has bought into the idea," she said, noting that age levels and policies had to be changed. "Previously this home used to keep children up to 9 years, but now we strictly see them off within 3 years under the new policy." Sisters had been reintegrating dozens of children every week, she said, before the pandemic.

However, the COVID-19 pandemic and lockdown, has hampered the new policy of permanent unification in various centers across the country, Lunyolo said. The institution could not hold social meetings and trainings due to COVID-19 restrictions, which also hampered the ability to place children with foster parents.

"Sisters are not able to receive more children at their centers right now because they do not have the necessary check-up and isolation facilities," she said. "Visitors and parents are also not allowed to visit the centers for reintegration or adoption."

The reintegration process can have shortcomings that expose the child to more risk of abuse and neglect in the hands of the caregivers, especially relatives, said Lunyolo.

"Sometimes you find all is well, but sometimes you find there is a problem," said Lunyolo, clarifying that the majority of caregivers lack parenting skills or financial resources to care for the children. "Some of the resettled children hardly receive the parental care from the caregivers as majority of them often lack parenting skills or are economically handicapped." The region, which includes Mbale in the eastern part of Uganda, ranks almost double the country's poverty index, at 40% compared with the national average of 21.4%, according to the Uganda National household survey in 2016-17.

Sisters try to address such issues by providing startup kits, which include basic requirements such as food, clothing and bedding. In some cases, they offer income generating activities such as poultry keeping and livestock rearing. The institution also equips economically limited parents with skills such as hair dressing, tailoring and small business to boost their livelihood.

The home sensitizes parents and the community on child protection, which includes parenting skills training prior to the transition. The institution also makes follow up visits for two years to ascertain the welfare of the child. If conditions are not good, their intervention is limited to reporting to the probation officer, who by law reserves discretionary power to delay the unification or recall the child from the caregiver if the child is deemed to be unsafe. Where necessary, the institution links the children to partner non-governmental organizations for further support, said Rachael Weginga, a social worker attached to St. Kizito Babies Home.

Catholic Care for Children Institutes Uganda is emphasizing a holistic approach to transitional care, including family counseling and economic strengthening and parenting, aimed at ensuring that the family or foster care giver is ready to receive the child, based on the "do no harm" principle. "It is not about taking the child home," said Joseph Ssentongo, an official from the Kampala-based CCCU secretariat.

The Catholic Care initiative in Uganda now works with nearly 20 religious institutes operating 46 child care institutions with almost 2,000 children. The pilot program, which began in 2016 and ends in December 2021, is being implemented in three phases.

The first phase of the project started with CCCU assessing religious caregivers' skills and qualifications to run the institutional care. In its second phase, CCCU carried out research to find out whether religious sisters running the institutions were implementing the legal frameworks for child protection.

The results from the two phases revealed that there was greater need for training to be done on child protection so that sisters caring for children are able to carry out their duties with skills and qualifications required, said Lunyolo.

The issue of funding is also delaying the new model of permanent integration, Lunyolo said. The institutions still need support to care for children on a temporary basis, to identify caregivers and provide needed support and resettlement packages to families and foster parents. This has led the Association of Religious in Uganda to launch a CCCU Fundraising and Transitioning Donors program aimed at winning the hearts of donors to support the new model.

Brian Carroll, founder and chief executive officer of Markempa, company that provides empathy-based marketing services, is championing the donor transition program. The program seeks to address funding gaps that are choking transitional care in many Christian child care institutions.

"Early on, we discovered there was a significant need to establish fundraising basics for the Christian child care institutions that included doing consistent donor outreach to get new donors via phone, email, social media, and face-to-face," he said. More than 10 institutions have registered tremendous progress in one year, he said, to support the transition into community-based and family care.

Zambia

A three-year pilot program through the Zambia Association of Sisterhoods started in 2019 is reintegrating children from institutions into family and community care, building on practical experience from Uganda and research conducted earlier in Zambia.

The southern African nation had about 8,335 children living in institutional care, according to government data cited in a 2016 research report by Catholic Relief Services (CRS) and sponsored by the GHR Foundation. The children lived in 190 residential care facilities, with 40 being Catholic-affiliated.

The research looked in-depth at Catholic residential care facilities and what was needed to preserve families and promote alternative family-based care. Poverty — being unable to afford school fees or food — was the primary reason for placement in institutions, with the death of a parent as the second-most common reason, the research found. Plans for a Catholic Care for Children Zambia (CCCZ) program began in 2017 with the formal pilot project starting two years later.

Catholic Care for Children Zambia plans to integrate 60 children from institutional care to family care in the three-year pilot project period that ends in December 2021, according to Sr. Cecilia Nakambo, project coordinator for CCCZ. Two residential facilities were identified as initial sites for reintegration efforts, St. Martins Children's Home in the Lufwanyama district, and Lubatsi Home in Livingstone.

So far, 48 children have so far been reunited with their families from the two residential care facilities, Nakambo said. Notable signs of success include developing processes for proper documentation, planning and preparing the child to bond with its family, and engaging the family for the integration process, including identifying needed resources, she said. Resources can include food, school fees, clothing and transportation costs as most children come from rural areas.

Training of sisters and other caregivers in case management and counseling was particularly important. "We thought that a child could easily reunite with their family without proper assessment or investigations on whether they will easily be embraced back and even when they were not ready to be reintegrated," she said. The sisters also work with a government department to help find family members and reunite them with the children.

Catholic Care for Children Zambia aims to improve the wellbeing of children by continuing to provide counseling to family members of the 48 children and others who are reintegrated, in a second phase of the program after the pilot program ends in 2021. A review of the pilot project will determine if the reintegration program expands to include more children, Nakambo said.

Training is also being provided to caregivers within the two residential care facilities, she said. "We have carried out a number of trainings such as in case management, reintegration, trauma counseling, and basic qualification care for children which helps caregivers serve effectively, and how to protect and know a child's rights in a facility," said Nakambo, adding that much of the practical knowledge has been acquired from the initial project in Uganda.

As much as Care for Children Zambia favors the idea of child integration, the residential facilities produced notable members of Zambian society, including some senior government officials, she said, opting to not identify them to protect their privacy. However, the new method of reintegration with families has even greater likelihood of producing responsible members of society, she added.

"Through the help of GHR, we are carrying out this pilot activities and I can see that reintegration is possible in the new guidelines, as well as what is needed, how much, who is on board or its challenges among other factors," Nakambo said.

Recently, the CCCZ organized a counseling workshop for 35 children who are traumatized from various orphanages in Lusaka. Reintegration is key for children in orphanages to alleviate trauma, said Charity Shaba, the professional child counselor who led the workshop.

"We have managed to counsel children against the effects of mental stress, and most of them are now opening up and coming out of the trauma they had been going through," Shaba said.

The Zambia Association of Sisterhoods is doing a great job to spearhead the reintegration program because children have been living in various orphanages not knowing who they really are, and have been traumatized after being orphaned or abandoned by their parents, Shaba said.

"I feel the program will help children discover who they really are as individuals and find their own family identity. In the near future, I think we will have better family set ups because what they just know is their foster parents from the caregiver institutions and to them that is a normal way of life," she said.

Kenya

When the East African nation began taking steps in 2018 to reduce the number of children in institutional care, there were estimated 42,000 children in over 854 children's homes across the country.

The government announced a long-standing action plan towards deinstitutionalization of children. It also further placed a moratorium on the registration of institutions, revoking some of the licenses of adoption agencies.

The government's emphasis on deinstitutionalization helped spur research and discussion among sisters in 2018 about a Catholic Care for Children program in Kenya, which formally began a year later. One key aspect is to draw on the long-time experience of one of the local congregations in reintegrating children with families.

Since 1993, religious sisters at Kwetu Home of Peace, a rehabilitation center for street boys, has focused on tracing families of displaced children and preparing these children to return home.  Other institutional care centers, especially those run by the Catholic Church, also began following this model of reintegration.

The center, which is run by the Assumption of the Blessed Virgin Mary Sisters of Eldoret, accommodates homeless boys ages 8 to 14 who are rescued from the streets and slums in Nairobi and elsewhere and inducted into a process of reintegration. Three times a year, about 60 boys are taken into the program.

Sr. Hellen Simiyu, administrator of the center, said that using a scorecard during reintegration, sisters assess the family's needs and provide financial assistance as necessary. The center has reintegrated more than 4,500 children since 1993, with a long-term success rate of about 80%. To ensure that reintegration is successful, it is as vital to invest in families as it is in children, she said.

"We pick boys from the streets; after three weeks, we do home visiting and home tracing where we talk to parents and local leaders on the importance of accepting these children back to the families," said Simiyu. "Most of the boys we pick from the streets either have one parent or poor guardians who cannot take care of them; therefore, they end up on the streets."

Simiyu said that the model has been successful because of the strict adherence of all reintegration processes. They usually call the parents, an education officer from the government, and the area government official to ensure the safety of the child and for easy follow-up, she said.

Children should also be at the heart of reintegration efforts, she said. "Children should be listened to and involved in each stage of the process," she said, admitting that in some cases family reintegration fails because children returning to their families may not be in their best interests. "For children who don't have parents, we always get willing people from the church, others even volunteer from different institutions and they agree to support the child through foster parenthood."

Children interviewed said they are pleased with the model. Frank Kinuthia, 20, who now lives in a family unit after sisters from Kwetu Home of Peace found him a home seven years ago, said he was now doing better socially, emotionally and physically than when he was at the center.

"I'm happy to be in a family because I have learned to love and cherish every moment," said Kinuthia, who was taken in from the streets of Nairobi in 2009 after both parents died. The sisters found him a family among members of a parish after searching for several months. "It's a good feeling to have parents and siblings. They act as a role model. These parents will always encourage you to do good things and live in harmony with others."

Simiyu said the launching of Catholic Care for Children International will further implement this initiative for the sake of young children. "We are very happy with this initiative because it confirms what we have been doing," she said. "We are going to double our efforts to ensure every child has a normal life."

Sr. Winnie Mutuku who manages Upendo Street Children, a project run by the Daughters of Charity of St. Vincent de Paul in Kitale town in western Kenya, said she has already began championing  the importance of family care for children after learning the model from Kwetu Home of Peace and other Catholic affiliated centers.

"Since we began reintegration last year in March, we have reintegrated 46 children so far," she said, adding that now her center aims to restore dignity to the homeless children, educate them and reunite them with their respective families. "I am in total support of the UISG initiative to make sure that every child gets a home. It is the best way to go and also solution to many negative social effects that are currently affecting the youths."

Mutuku who won a presidential order of service award last year for feeding street children amid COVID-19, said her center hasn't reintegrated any children this year because they were still doing home tracing.The center rescues 20 to 30 children twice a year from the streets. They stay at the center for three to six months for rehabilitation before the process of reintegration begins, she said.

After reintegration, Mutuku said "we do a follow up at least for a year to ensure the safety and sustainability of the children just to ensure they don't go back to the streets,"

"When I see children in a loving home or with parents, my heart is at peace," she concluded. "I hope this noble initiative by UISG will be adopted by many more institutions even if they are not sister- or church-led."

Sr. Delvin Mukhwana, who is responsible for safeguarding and promoting quality care for children at the Association of Sisterhoods in Kenya (AOSK) and the project manager for Catholic Care for Children Kenya, told GSR that she was planning to reduce the number of children in residential care by holding workshops to bring in important community stakeholders to create family care models that include family reintegration, foster care, and domestic adoption.

The workshops for community members and the training of sisters from various congregations about the guidelines of transitional care began in July 2019, but have been more difficult to continue because of COVID-19 restrictions. The sisters do hold some virtual meetings to discuss the progress of reintegration.

"We are involving everyone in this process of reintegration. We are currently working with the institutions that have already begun this initiative by educating them on how they should proceed moving forward after reintegration," said Mukhwana, of the Assumption of the Blessed Virgin Mary Sisters of Eldoret. "We specifically educate them on the importance of family to the growth of a child."

*An earlier version of this story gave the wrong community.

[Gerald Matembu is a reporter in Uganda and Derrick Silimina is a reporter in Zambia.]