WEBVTT

00:00:01.144 --> 00:00:03.870
Across Europe and Central Asia,

00:00:03.870 --> 00:00:06.430
approximately one million children live in large

00:00:06.430 --> 00:00:10.528
residential institutions, usually known as orphanages.

00:00:10.528 --> 00:00:13.586
Most people imagine orphanages as a benign environment

00:00:13.586 --> 00:00:15.257
that care for children.

00:00:15.257 --> 00:00:18.488
Others know more about the living conditions there,

00:00:18.488 --> 00:00:20.940
but still think they're a necessary evil.

00:00:20.940 --> 00:00:24.337
After all, where else would we put all of those children

00:00:24.337 --> 00:00:26.488
who don't have any parents?

NOTE Paragraph

00:00:26.488 --> 00:00:29.955
But 60 years of research has demonstrated

00:00:29.955 --> 00:00:32.211
that separating children from their families

00:00:32.211 --> 00:00:34.563
and placing them in large institutions

00:00:34.563 --> 00:00:37.403
seriously harms their health and development,

00:00:37.403 --> 00:00:40.885
and this is particularly true for young babies.

00:00:40.885 --> 00:00:43.029
As we know, babies are born

00:00:43.029 --> 00:00:45.789
without their full muscle development,

00:00:45.789 --> 00:00:47.713
and that includes the brain.

00:00:47.713 --> 00:00:50.373
During the first three years of life, the brain grows

00:00:50.373 --> 00:00:53.143
to its full size, with most of that growth taking place

00:00:53.143 --> 00:00:55.763
in the first six months. The brain develops

00:00:55.763 --> 00:00:58.989
in response to experience and to stimulation.

00:00:58.989 --> 00:01:02.803
Every time a young baby learns something new --

00:01:02.803 --> 00:01:04.330
to focus its eyes,

00:01:04.330 --> 00:01:07.323
to mimic a movement or a facial expression,

00:01:07.323 --> 00:01:11.313
to pick something up, to form a word or to sit up --

00:01:11.313 --> 00:01:14.890
new synaptic connections are being built in the brain.

00:01:14.890 --> 00:01:18.989
New parents are astonished by the rapidity of this learning.

00:01:18.989 --> 00:01:23.897
They are quite rightly amazed and delighted by their children's cleverness.

00:01:23.897 --> 00:01:26.481
They communicate their delight to their children,

00:01:26.481 --> 00:01:28.202
who respond with smiles,

00:01:28.202 --> 00:01:32.604
and a desire to achieve more and to learn more.

00:01:32.604 --> 00:01:36.346
This forming of the powerful attachment between child and parent

00:01:36.346 --> 00:01:39.557
provides the building blocks for physical, social,

00:01:39.557 --> 00:01:43.067
language, cognitive and psychomotor development.

00:01:43.067 --> 00:01:47.281
It is the model for all future relationships with friends,

00:01:47.281 --> 00:01:50.522
with partners and with their own children.

00:01:50.522 --> 00:01:52.938
It happens so naturally in most families

00:01:52.938 --> 00:01:56.042
that we don't even notice it. Most of us are unaware

00:01:56.042 --> 00:01:59.472
of its importance to human development and, by extension,

00:01:59.472 --> 00:02:02.371
to the development of a healthy society.

00:02:02.371 --> 00:02:04.913
And it's only when it goes wrong that we start to realize

00:02:04.913 --> 00:02:07.922
the importance of families to children.

NOTE Paragraph

00:02:07.922 --> 00:02:11.858
In August, 1993, I had my first opportunity to witness

00:02:11.858 --> 00:02:16.016
on a massive scale the impact on children

00:02:16.016 --> 00:02:20.419
of institutionalization and the absence of parenting.

00:02:20.419 --> 00:02:22.856
Those of us who remember the newspaper reports

00:02:22.856 --> 00:02:26.110
that came out of Romania after the 1989 revolution

00:02:26.110 --> 00:02:30.531
will recall the horrors of the conditions in some of those institutions.

00:02:30.531 --> 00:02:33.290
I was asked to help the director of a large institution to

00:02:33.290 --> 00:02:37.253
help prevent the separation of children from their families.

00:02:37.253 --> 00:02:41.438
Housing 550 babies, this was Ceausescu's show orphanage,

00:02:41.438 --> 00:02:44.356
and so I'd been told the conditions were much better.

00:02:44.356 --> 00:02:46.806
Having worked with lots of young children, I expected

00:02:46.806 --> 00:02:49.422
the institution to be a riot of noise,

00:02:49.422 --> 00:02:51.285
but it was as silent as a convent.

00:02:51.285 --> 00:02:54.731
It was hard to believe there were any children there at all,

00:02:54.731 --> 00:02:57.367
yet the director showed me into room after room,

00:02:57.367 --> 00:03:00.382
each containing row upon row of cots,

00:03:00.382 --> 00:03:06.398
in each of which lay a child staring into space.

00:03:06.398 --> 00:03:10.048
In a room of 40 newborns, not one of them was crying.

00:03:10.048 --> 00:03:12.087
Yet I could see soiled nappies, and I could see

00:03:12.087 --> 00:03:13.659
that some of the children were distressed,

00:03:13.659 --> 00:03:17.504
but the only noise was a low, continuous moan.

00:03:17.504 --> 00:03:19.604
The head nurse told me proudly,

00:03:19.604 --> 00:03:22.825
"You see, our children are very well-behaved."

00:03:22.825 --> 00:03:25.568
Over the next few days, I began to realize

00:03:25.568 --> 00:03:27.631
that this quietness was not exceptional.

00:03:27.631 --> 00:03:31.404
The newly admitted babies would cry for the first few hours,

00:03:31.404 --> 00:03:33.393
but their demands were not met, and so eventually

00:03:33.393 --> 00:03:36.071
they learned not to bother. Within a few days,

00:03:36.071 --> 00:03:39.567
they were listless, lethargic, and staring into space

00:03:39.567 --> 00:03:41.393
like all the others.

NOTE Paragraph

00:03:41.393 --> 00:03:44.310
Over the years, many people and news reports

00:03:44.310 --> 00:03:46.481
have blamed the personnel in the institutions

00:03:46.481 --> 00:03:49.335
for the harm caused to the children, but often, one member

00:03:49.335 --> 00:03:53.902
of staff is caring for 10, 20, and even 40 children.

00:03:53.902 --> 00:03:57.964
Hence they have no option but to implement a regimented program.

00:03:57.964 --> 00:04:01.839
The children must be woken at 7 and fed at 7:30.

00:04:01.839 --> 00:04:04.351
At 8, their nappies must be changed, so a staff member

00:04:04.351 --> 00:04:07.716
may have only 30 minutes to feed 10 or 20 children.

00:04:07.716 --> 00:04:11.412
If a child soils its nappy at 8:30, he will have to wait

00:04:11.412 --> 00:04:14.371
several hours before it can be changed again.

00:04:14.371 --> 00:04:17.020
The child's daily contact with another human being

00:04:17.020 --> 00:04:21.488
is reduced to a few hurried minutes of feeding and changing,

00:04:21.488 --> 00:04:24.388
and otherwise their only stimulation is the ceiling,

00:04:24.388 --> 00:04:28.520
the walls or the bars of their cots.

NOTE Paragraph

00:04:28.520 --> 00:04:31.419
Since my first visit to Ceausescu's institution,

00:04:31.419 --> 00:04:34.552
I've seen hundreds of such places across 18 countries,

00:04:34.552 --> 00:04:37.344
from the Czech Republic to Sudan.

00:04:37.344 --> 00:04:40.328
Across all of these diverse lands and cultures,

00:04:40.328 --> 00:04:43.625
the institutions, and the child's journey through them,

00:04:43.625 --> 00:04:46.218
is depressingly similar.

00:04:46.218 --> 00:04:49.328
Lack of stimulation often leads to self-stimulating behaviors

00:04:49.328 --> 00:04:52.269
like hand-flapping, rocking back and forth,

00:04:52.269 --> 00:04:56.080
or aggression, and in some institutions, psychiatric drugs

00:04:56.080 --> 00:04:58.911
are used to control the behavior of these children,

00:04:58.911 --> 00:05:01.112
whilst in others, children are tied up to prevent them

00:05:01.112 --> 00:05:04.000
from harming themselves or others.

00:05:04.000 --> 00:05:06.492
These children are quickly labeled as having disabilities

00:05:06.492 --> 00:05:09.927
and transferred to another institution for children with disabilities.

00:05:09.927 --> 00:05:14.270
Most of these children will never leave the institution again.

00:05:14.270 --> 00:05:16.933
For those without disabilities, at age three,

00:05:16.933 --> 00:05:19.481
they're transferred to another institution, and at age seven,

00:05:19.481 --> 00:05:23.434
to yet another. Segregated according to age and gender,

00:05:23.434 --> 00:05:25.979
they are arbitrarily separated from their siblings,

00:05:25.979 --> 00:05:29.867
often without even a chance to say goodbye.

00:05:29.867 --> 00:05:32.645
There's rarely enough to eat. They are often hungry.

00:05:32.645 --> 00:05:35.355
The older children bully the little ones. They learn to

00:05:35.355 --> 00:05:38.704
survive. They learn to defend themselves, or they go under.

NOTE Paragraph

00:05:38.704 --> 00:05:42.264
When they leave the institution, they find it really difficult

00:05:42.264 --> 00:05:45.559
to cope and to integrate into society.

00:05:45.559 --> 00:05:48.808
In Moldova, young women raised in institutions

00:05:48.808 --> 00:05:52.816
are 10 times more likely to be trafficked than their peers,

00:05:52.816 --> 00:05:56.972
and a Russian study found that two years after leaving institutions,

00:05:56.972 --> 00:06:01.331
young adults, 20 percent of them had a criminal record,

00:06:01.331 --> 00:06:04.187
14 percent were involved in prostitution,

00:06:04.187 --> 00:06:08.751
and 10 percent had taken their own lives.

NOTE Paragraph

00:06:08.751 --> 00:06:11.632
But why are there so many orphans in Europe

00:06:11.632 --> 00:06:15.503
when there hasn't been a great deal of war or disaster in recent years?

00:06:15.503 --> 00:06:20.087
In fact, more than 95 percent of these children have living parents,

00:06:20.087 --> 00:06:22.076
and societies tend to blame these parents

00:06:22.076 --> 00:06:24.839
for abandoning these children, but research shows that

00:06:24.839 --> 00:06:27.960
most parents want their children, and that the primary drivers

00:06:27.960 --> 00:06:30.279
behind institutionalization

00:06:30.279 --> 00:06:34.476
are poverty, disability and ethnicity.

00:06:34.476 --> 00:06:37.575
Many countries have not developed inclusive schools,

00:06:37.575 --> 00:06:40.279
and so even children with a very mild disability

00:06:40.279 --> 00:06:42.855
are sent away to a residential special school,

00:06:42.855 --> 00:06:44.663
at age six or seven.

00:06:44.663 --> 00:06:48.797
The institution may be hundreds of miles away from the family home.

00:06:48.797 --> 00:06:51.521
If the family's poor, they find it difficult to visit,

00:06:51.521 --> 00:06:55.639
and gradually the relationship breaks down.

00:06:55.639 --> 00:06:58.942
Behind each of the million children in institutions,

00:06:58.942 --> 00:07:02.696
there is usually a story of parents who are desperate

00:07:02.696 --> 00:07:07.806
and feel they've run out of options, like Natalia in Moldova,

00:07:07.806 --> 00:07:10.199
who only had enough money to feed her baby,

00:07:10.199 --> 00:07:13.383
and so had to send her older son to the institution;

00:07:13.383 --> 00:07:16.423
or Desi, in Bulgaria, who looked after her four children

00:07:16.423 --> 00:07:19.052
at home until her husband died,

00:07:19.052 --> 00:07:21.295
but then she had to go out to work full time,

00:07:21.295 --> 00:07:23.442
and with no support, felt she had no option

00:07:23.442 --> 00:07:27.274
but to place a child with disabilities in an institution;

00:07:27.274 --> 00:07:30.428
or the countless young girls too terrified to tell their parents

00:07:30.428 --> 00:07:34.014
they're pregnant, who leave their babies in a hospital;

00:07:34.014 --> 00:07:36.746
or the new parents, the young couple who have

00:07:36.746 --> 00:07:41.252
just found out that their firstborn child has a disability,

00:07:41.252 --> 00:07:44.307
and instead of being provided with positive messages

00:07:44.307 --> 00:07:47.154
about their child's potential, are told by the doctors,

00:07:47.154 --> 00:07:50.210
"Forget her, leave her in the institution,

00:07:50.210 --> 00:07:53.730
go home and make a healthy one."

NOTE Paragraph

00:07:53.730 --> 00:07:57.262
This state of affairs is neither necessary nor is it inevitable.

00:07:57.262 --> 00:08:00.389
Every child has the right to a family, deserves

00:08:00.389 --> 00:08:04.220
and needs a family, and children are amazingly resilient.

00:08:04.220 --> 00:08:06.902
We find that if we get them out of institutions and into loving

00:08:06.902 --> 00:08:10.423
families early on, they recover their developmental delays,

00:08:10.423 --> 00:08:13.466
and go on to lead normal, happy lives.

00:08:13.466 --> 00:08:17.027
It's also much cheaper to provide support to families

00:08:17.027 --> 00:08:19.546
than it is to provide institutions.

00:08:19.546 --> 00:08:22.742
One study suggests that a family support service

00:08:22.742 --> 00:08:25.650
costs 10 percent of an institutional placement,

00:08:25.650 --> 00:08:27.914
whilst good quality foster care

00:08:27.914 --> 00:08:30.906
costs usually about 30 percent.

00:08:30.906 --> 00:08:33.954
If we spend less on these children but on the right services,

00:08:33.954 --> 00:08:37.906
we can take the savings and reinvest them in high quality

00:08:37.906 --> 00:08:42.555
residential care for those few children with extremely complex needs.

NOTE Paragraph

00:08:42.555 --> 00:08:47.092
Across Europe, a movement is growing to shift the focus

00:08:47.092 --> 00:08:49.928
and transfer the resources from large institutions

00:08:49.928 --> 00:08:53.888
that provide poor quality care to community-based services

00:08:53.888 --> 00:08:56.613
that protect children from harm and allow them to develop

00:08:56.613 --> 00:09:00.440
to their full potential. When I first started to work in Romania

00:09:00.440 --> 00:09:04.216
nearly 20 years ago, there were 200,000 children living

00:09:04.216 --> 00:09:07.777
in institutions, and more entering every day.

00:09:07.777 --> 00:09:10.088
Now, there are less than 10,000, and

00:09:10.088 --> 00:09:13.536
family support services are provided across the country.

00:09:13.536 --> 00:09:17.322
In Moldova, despite extreme poverty and the terrible effects

00:09:17.322 --> 00:09:20.314
of the global financial crisis, the numbers of children

00:09:20.314 --> 00:09:23.098
in institutions has reduced by more than 50 percent

00:09:23.098 --> 00:09:26.314
in the last five years, and the resources are being

00:09:26.314 --> 00:09:30.967
redistributed to family support services and inclusive schools.

00:09:30.967 --> 00:09:34.197
Many countries have developed national action plans for change.

00:09:34.197 --> 00:09:36.718
The European Commission and other major donors

00:09:36.718 --> 00:09:40.198
are finding ways to divert money from institutions

00:09:40.198 --> 00:09:43.194
towards family support, empowering communities

00:09:43.194 --> 00:09:45.923
to look after their own children.

NOTE Paragraph

00:09:45.923 --> 00:09:48.726
But there is still much to be done to end the systematic

00:09:48.726 --> 00:09:51.094
institutionalization of children.

00:09:51.094 --> 00:09:54.163
Awareness-raising is required at every level of society.

00:09:54.163 --> 00:09:57.687
People need to know the harm that institutions cause to children,

00:09:57.687 --> 00:10:00.647
and the better alternatives that exist.

00:10:00.647 --> 00:10:03.611
If we know people who are planning to support orphanages,

00:10:03.611 --> 00:10:07.653
we should convince them to support family services instead.

NOTE Paragraph

00:10:07.653 --> 00:10:10.915
Together, this is the one form of child abuse

00:10:10.915 --> 00:10:13.779
that we could eradicate in our lifetime.

NOTE Paragraph

00:10:13.779 --> 00:10:16.371
Thank you. (Applause)

NOTE Paragraph

00:10:16.371 --> 00:10:20.371
(Applause)