Blog - Children in institutions

Children in institutions

Bulgaria’s abandoned children- still waiting for the deinstitutionalisation

by Maria Sharkova

I spent almost a year in the children’s home in Mogilino as an interpreter and assistant of Kate Blewett during the filming of “Bulgaria’s abandoned children”, which was aired on the BBC in 2007. The time spent in that and other children’s homes in Bulgaria made me feel very strongly that:

- all institutions must be closed

- the staff, working in the institutes is also institutionalized and cannot be deinstitutionalized

- there are only two things children living with their families have that children in institutions don’t have – love and care.

After what I had seen and discovered during the work on the film, I could not stay indifferent and I made the decision to help the Bulgarian Abandoned Children’s Trust (TBACT) – the organization, created in UK after the film about Mogilino. Since then TBACT has focused its efforts on supporting a number of projects, which are a reflection of its analysis of the process of deinstitutionalisation in the country. The process is characterised by the following:

At present deinstitutionalisation has one main objective – to take the children out of the institutes and, partly, to develop the early intervention in order to close the entrance to the institutes. This is done through the use of four services: reintegration; adoption; foster care and Small group homes (SGH). It is notable that at present there is no monitoring of the outcomes for children, for example no one knows the: number of children, abandoned again after the reintegration or the number of those given up after fostering; there is no monitoring of the effect of the new service called “SGH”, either. Even where information is available about the number of children who have left an institution as a result of deinstitutionalisation during a certain period of time, there are still no data about the number of children who have been placed in that institution during the same period. In case when the ”entrance” to a specific institute was closed, by creating a “veto” of the acceptance of new children, there isn’t any sources of information about how many children have been accepted in the institutes, closer to the prohibited one. The statistic “speaks” for itself: according to the report, made by the State Agency for Child Protection (CPA), 20 children have been placed in homes for children with mental disabilities only during the first half of 2011 and 32 have been deinstitutionalized at the same time. What is not so easily seen behind these numbers is the fact that 5 out of 32 children have been moved to another institute, 7 died and 3 left the “home”, because they turned the age of 18, therefore those 15 cases cannot be considered as true deinstitutionalization (the figures for the rest of the institutes are the same). Those figures mean only one thing-20 children have been abandoned in the institutes during the first half of 2011 and 17 left the “homes”. In general, these figures speak of a deinstitutionalization that hasn’t taken place yet.

Therefore, the problem with the DI is to do with what happens outside the institutes. Let us look around us-the number of children with disabilities in mainstream education is extremely low, the schools and kinder gardens are inaccessible to them, the parents play the role of special teachers; There are no adequate technical and medical devices for children with disabilities, given according to the individual needs of each child (wheelchairs for children are not, included in the list of devices, provided by the Agency for social support for example), and the help for parents with children with disabilities is still regulated by the Act for social support.

There is a belief that if we want to close the homes, we just need to open enough day care centers for the children with disabilities and to create even more SGH. However, the good quality furniture there serves more to comfort our guilty consciousness than it is of any practical use for the children or their inclusion in society.

For example, the Report, published by ACP regarding the project “Childhood for everyone”, shows that the SGH will become the main service and alternative of the institutes. The plan foresees the building of 145 SGH around the country, where 85% of the children and 40% of the young adults with disabilities will be settled. As the SGH are considered as a temporary service, provided only if there aren’t any other ways for DI, those figures are startling and they demonstrate the conceptual weaknesses of the deinstitutionalisation plans of the agencies, responsible for the DI process in Bulgaria.

The same report recommends the building of a huge number of Day care centers for children with disabilities and Centers for social integration and rehabilitation.

Such services are again a way for segregation of the children with disabilities. We cannot expect to include the children with disabilities or to expect the families not to abandon their children, while we are constantly creating zones, centers or other forms of segregation. I am using the word “include”, instead of “integrate”, because the integration is accepted as a way to make the different people suiting the others, instead of accepting and understanding the difference. Policy makers find it difficult to accept or adopt such a direction of the DI process and this is, not because it is expensive, just the opposite-to create measures to stimulate the families to look after their children is far cheaper than to pay for a child, living in an institute. And we all know which approach is better for the children. It just doesn’t add up to focus solely on the well publicised closure of institutes (because otherwise the BBC will come to do another documentary?), without developing policies, directed to the families and creating inclusive environment for them.

Another problem is that the aim of the DI is to take the children “out” of the institutes, without providing adequate quality care “inside” for the children who still remain there. This tendency was observed by my British colleagues in 2008 and confirmed 4 years later by the Minister of health, who “suddenly discovered” the appalling conditions of the children in the Pleven baby home. It came crystal clear that while the Bulgarian government is demonstrating to the EU its unique capacity to close institutes, the children there are still…..dying. Actually, the Minister’s ‘discovery’ in Pleven came as no surprise to me – my only surprise was the Government’s reaction, which seemed to be oblivious to the fact that there had been many precedents in other institutions to the type of neglect and maltreatment occurring to that place. The organization I help, alerted the Ministry of Health and the CPA on two occassions during their meetings in 2011.* They triggered inspections of the institute. And obviously, no measures had been taken after that. The horrified face of the Minister demonstrates this.

Because of the total lack of care in the institutes, in 2008 TBACT decided to start supporting a programme in Pleven. TBACT had a policy not to fund any work that wasn’t going to be of direct benefit for the children, for example a new flooring for bedridden children; or a modern kitchen for babies who are being malnourished; or an air conditioner for children, who have never been taken out to breathe fresh air. The aim of the program was to provide a real, individual care and personal attention to a certain child, without investing in the institution itself. The program includes an everyday care, given to the children by the surrogate grannies (“BABAS”) and their job is to provide human contact to the children. The idea is to make the children feel they belong to someone; to be fed as much as they need; to hear their names; to talk to them. Our volunteers are busy and happy to do for free those things, which the staff is paid to do but would not do. TBACT added to those activities the help of a psychologist and rehabilitators, who work with the children and their babas.

The results came in a short period: the children started gaining weight, and some of them started walking, making noises, saying some words or even talking. The difference between the children, included in the program and those who don’t have their babas is also noticeable.**

But as much as those babas are remarkable for the children, this program can’t solve the problem and replace the need of a real deinstitutionalization-the support, given to the families, by creating a policy, aimed at the children and the families as the place, where the DI should happen.

* As a result of the signals, TBACT is banned and the volunteers are not allowed to help in Pleven, as well as the new babas.

** For more information regarding the projects of TBACT: www. Tbact.com

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