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Across Europe and Central Asia,

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approximately one million children live in large

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residential institutions, usually known as orphanages.

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Most people imagine orphanages as a benign environment

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that care for children.

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Others know more about the living conditions there,

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but still think they're a necessary evil.

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

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who don't have any parents?

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But 60 years of research has demonstrated

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that separating children from their families

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and placing them in large institutions

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seriously harms their health and development,

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and this is particularly true for young babies.

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As we know, babies are born

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without their full muscle development,

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and that includes the brain.

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During the first three years of life, the brain grows

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

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in the first six months. The brain develops

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in response to experience and to stimulation.

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Every time a young baby learns something new --

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to focus its eyes,

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to mimic a movement or a facial expression,

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

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new synaptic connections are being built in the brain.

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New parents are astonished by the rapidity of this learning.

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

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They communicate their delight to their children,

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who respond with smiles,

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and a desire to achieve more and to learn more.

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This forming of the powerful attachment between child and parent

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provides the building blocks for physical, social,

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language, cognitive and psychomotor development.

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It is the model for all future relationships with friends,

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with partners and with their own children.

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It happens so naturally in most families

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

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of its importance to human development and, by extension,

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to the development of a healthy society.

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

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the importance of families to children.

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

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on a massive scale the impact on children

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of institutionalization and the absence of parenting.

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Those of us who remember the newspaper reports

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that came out of Romania after the 1989 revolution

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

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

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help prevent the separation of children from their families.

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

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

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Having worked with lots of young children, I expected

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the institution to be a riot of noise,

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but it was as silent as a convent.

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

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yet the director showed me into room after room,

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each containing row upon row of cots,

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in each of which lay a child staring into space.

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

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Yet I could see soiled nappies, and I could see

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that some of the children were distressed,

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but the only noise was a low, continuous moan.

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The head nurse told me proudly,

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

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Over the next few days, I began to realize

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that this quietness was not exceptional.

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

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but their demands were not met, and so eventually

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they learned not to bother. Within a few days,

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they were listless, lethargic, and staring into space

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like all the others.

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Over the years, many people and news reports

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have blamed the personnel in the institutions

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

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

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

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

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

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

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

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several hours before it can be changed again.

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The child's daily contact with another human being

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

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and otherwise their only stimulation is the ceiling,

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the walls or the bars of their cots.

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Since my first visit to Ceausescu's institution,

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

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from the Czech Republic to Sudan.

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Across all of these diverse lands and cultures,

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

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is depressingly similar.

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Lack of stimulation often leads to self-stimulating behaviors

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like hand-flapping, rocking back and forth,

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or aggression, and in some institutions, psychiatric drugs

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are used to control the behavior of these children,

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whilst in others, children are tied up to prevent them

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from harming themselves or others.

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These children are quickly labeled as having disabilities

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and transferred to another institution for children with disabilities.

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Most of these children will never leave the institution again.

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For those without disabilities, at age three,

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

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to yet another. Segregated according to age and gender,

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they are arbitrarily separated from their siblings,

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often without even a chance to say goodbye.

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

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The older children bully the little ones. They learn to

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

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When they leave the institution, they find it really difficult

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to cope and to integrate into society.

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In Moldova, young women raised in institutions

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

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

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

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14 percent were involved in prostitution,

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and 10 percent had taken their own lives.

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But why are there so many orphans in Europe

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

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

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and societies tend to blame these parents

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for abandoning these children, but research shows that

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most parents want their children, and that the primary drivers

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behind institutionalization

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are poverty, disability and ethnicity.

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Many countries have not developed inclusive schools,

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and so even children with a very mild disability

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are sent away to a residential special school,

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at age six or seven.

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

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

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and gradually the relationship breaks down.

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Behind each of the million children in institutions,

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there is usually a story of parents who are desperate

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

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who only had enough money to feed her baby,

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

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

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at home until her husband died,

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

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and with no support, felt she had no option

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but to place a child with disabilities in an institution;

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or the countless young girls too terrified to tell their parents

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

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or the new parents, the young couple who have

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just found out that their firstborn child has a disability,

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and instead of being provided with positive messages

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

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"Forget her, leave her in the institution,

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go home and make a healthy one."

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

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Every child has the right to a family, deserves

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and needs a family, and children are amazingly resilient.

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

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families early on, they recover their developmental delays,

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and go on to lead normal, happy lives.

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It's also much cheaper to provide support to families

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than it is to provide institutions.

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One study suggests that a family support service

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costs 10 percent of an institutional placement,

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whilst good quality foster care

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costs usually about 30 percent.

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

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we can take the savings and reinvest them in high quality

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residential care for those few children with extremely complex needs.

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Across Europe, a movement is growing to shift the focus

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and transfer the resources from large institutions

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that provide poor quality care to community-based services

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that protect children from harm and allow them to develop

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

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

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in institutions, and more entering every day.

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Now, there are less than 10,000, and

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family support services are provided across the country.

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In Moldova, despite extreme poverty and the terrible effects

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of the global financial crisis, the numbers of children

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in institutions has reduced by more than 50 percent

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in the last five years, and the resources are being

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redistributed to family support services and inclusive schools.

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Many countries have developed national action plans for change.

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The European Commission and other major donors

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are finding ways to divert money from institutions

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towards family support, empowering communities

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to look after their own children.

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

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institutionalization of children.

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Awareness-raising is required at every level of society.

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

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and the better alternatives that exist.

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If we know people who are planning to support orphanages,

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we should convince them to support family services instead.

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Together, this is the one form of child abuse

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that we could eradicate in our lifetime.

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Thank you. (Applause)

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(Applause)