Tag: Uganda

Training changing lives of children in Uganda

Written by on June 19, 2014 in Featured Posts, Voices from the Field with 18 Comments

A sometimes mind-blowing firsthand account of an ambitious attempt to improve the care of orphaned and vulnerable children in Uganda.

It started in a cramped government office in Kampala

There are at least 50,000 children in residential care in the Uganda, a huge number by any standard. Uganda has been called the NGO capital of the world, and while some of these organizations are doing tremendous work, in 2011 it was just a handful of us gathered in a cramped government office in Kampala to talk about alternative care for children outside of parental care. Alternative care refers to practices designed to keep children, as much as possible, in families and communities rather than putting them in residential care. That first day we had no handle on who was doing what, why, and where.

Three years later and we have made significant progress, and I give the government immense credit for being passionate and pushing for change! The result was “The Alternative Care Framework,” guidelines for working with children outside of parental care with a strong emphasis on family preservation and reintegration of children back into families. These guidelines have potential to improve the lives of children and families throughout Uganda. The challenge is to get organizations to know and follow the guidelines, and to make them aware when the changes are working.

Mark Riley meeting with an adoption review panel in Kampala, Uganda

Meeting with an adoption review panel in Kampala, Uganda

Why change?

While developing the Alternative Care Framework, we looked at child care facilities in Uganda. We knew the number had increased exponentially in the previous ten years, but beyond that too little was known. How many existed? What services did they offer? How well (or poorly) were they run? Why were so many children going into residential care? What we learned was more startling that we anticipated (summary of the results). Child care institutions have become the default solution for children outside of parental care with worrying trends as to why children end up in care in the first place. Here are some troubling facts we learned about those institutions:

  • Over 80% of child care institutions do not have a child protection policy
  • Over 85% of children in such institutions have known parents and family members
  • Less than 25% of institutions make any attempts to trace the families of the children in their care and/or engage with family members
  • Over 50% of institutions have unacceptable care standards with poor infrastructure, sanitation, diet, accommodation, health provisions, and supervision
  • Less than 30 child care institutions are currently legally licensed and recognised by the government

What we saw was in sharp contrast with internationally accepted best practices which prioritize community and family-based alternative care and specifically state that residential care should be a temporary and last resort.

Educating care providers

posterStarting in August, 2013, the government (working with SUNRISE OVC, a USAID program run by AIDS Alliance), conducted workshops in each region of Uganda to connect with practitioners and explain the Alternative Care Framework. We developed the training materials with support from UNICEF. The main topics were family preservation, child resettlement and reintegration, and family-based alternative care. The workshops were a huge opportunity to engage with stakeholders at all levels, including working directly with care-providers.

More than two hundred care providers and about fifty district workers attended. All told it was a fantastic mutual learning experience.

Boarding schools and pitfalls

Besides training participants, we also asked questions. One session explored why children end up in institutional care in the first place. In every region of the country, participants said one of the biggest reasons children are placed in orphanages is for access to the free services, and they acknowledged that nearly all the children in their facilities have known families.

We debated whether many “orphanages” could be more accurately identified as free boarding schools. (In the words of one director: “I couldn’t get funding for my boarding school unless I packaged it as an orphanage.”) Ironically, some good private schools which have been forced to close because of the “free” education funded by western donors, so the amazing Ugandan entrepreneurial spirit is being squashed by NGO’s thinking they are helping.

Even worse, we realized that less vulnerable parents are often able to admit their children into the higher quality institutions with the best services, whereas the most vulnerable parents, who perhaps truly need support, are more likely put their children in the nearest and lowest quality institutions. One such mother was so desperate, having found out she was HIV positive and losing her job in the same week, that she took her child to the most easily accessible residential care facility—after being referred there by a nurse who was on the orphanage’s payroll. The standards there were appalling, and since it had an international adoption program, her child was put up for international adoption. So in the midst of tremendous trauma she nearly lost her son who she loved. THANKFULLY, someone was tipped off (by the potential adoptive family actually), saw some glaring inconsistencies, and raised the alarm. The mother was eventually reunited with her son after a lengthy process of wresting the boy from the clutches of the orphanage and adoption agency.

That was in 2012 and her life has been transformed. Now she is happy, healthy and financially independent due to the interventions, education, and support she received.

Fulfilling needs or filling beds

The participants also confessed that children often end up in institutions simply “because they exist.” Interestingly, communities that do not have orphanages, including some of the poorest in Uganda with high rates of HIV infection and poverty, tend to have lower rates of child abandonment compared to similar communities that do have orphanages. Not surprisingly, participants pointed out many of the obvious reasons why children are separated from their families: emergencies, the death of a parent, extreme poverty, and child protection issues. We explored these and began to think about alternatives. For example, we looked at ways to address poverty rather than allowing poverty to split families apart. We also challenged participants about the justice of removing a child from his or her home due to abuse but doing nothing about bringing the abuser to justice.

A government worker noted we often have things backwards. Children are removed from society while the perpetrators of crimes against them go free. She argued that government and institutions should work together to ensure children can stay safely in their own communities and to remove those committing crimes against them. An incredible admission by some institutions was that they are under constant pressure from donors to “fill the available beds.” Empty beds equal no child sponsorships. For such institutions, the vision of the donor is a driving factor even above the best interests of the children and their families.

Positive and negative responses

Some institutions did not take the workshops seriously. One well known home for babies in Kampala sent their gardener claiming to be a social worker. In my view, those who took the workshops least seriously were the organisations with active international adoption programs. This confirms what many of us suspect: organisations focused on international adoption do not seriously pursue resettlement and other domestic solutions despite evidence that these solutions are effective and in line with government policy.

The SAFE Campaign calls for the preservation of Ugandan families and communities

SAFE Campaign materials calling for the preservation of Ugandan families and communities

But there were encouraging responses as well. One organisation in Jinja that has undertaken many international adoptions decided to abandon their international adoption program. They felt their integrity had become increasingly compromised by agency after agency continually offering ‘rewards’ and ‘partnerships’ in return for providing them with children. (Receiving money or donations as a part of any adoption process is illegal in Uganda, so you will be hard pressed to get any organization to admit doing it.) They have now thrown their full weight and vision behind the alternative care framework.

Another organisation in Hoima fully embraced the new framework. When we sat down and explored the financial implications of keeping 60 children for 18 years versus resettling them in family-based care, the director was literally “blown away.” He realized that he could support nearly 1,000 children in family-based care for the same cost as raising just 60 children in his residential facility. Another organisation decided to reduce the number of children in residential care and invest in more community-based support for families: vocational skills training, livelihood support, family counselling, and referral services. These activities strengthen families and help keep them together.

One of the greatest achievements of the workshops was the commitment to work better together that many organisations gave to the government staff. There was a needed realignment of organisations back to the local government officials as opposed to being dictated by their donors. A Probation and Social Welfare Officer from the north of Uganda eloquently expressed her feelings about the workshops this way.

We have sadly allowed Child Care Institutions too much power and they have become the default solution for children. But we know children thrive better in families, and most of the children in institutions have families. We need to get children back into families, and institutions need to change their models to support families not their own institutions. These workshops have helped communicate this message and explicitly outlined government policy and best practices. Now there are no excuses.

Ugandan childcare workers

Ugandan childcare workers

Time to respond

From a ragged beginning transformation is slowly coming to Uganda, and those of us who begun this journey and others who joined along the way are committed to making the alternative care “movement” work. Today we have an increasing number of organisations delivering high quality resettlement, family-based alternative care, and other services that support families and keep them together.

Despite limited resources, Ugandans and the government of Uganda are proving they can lead for change, and key partners such as UNICEF and USAID are providing assistance to inform and educate the care providers and organizations that need to get on board. A number of other programmes are starting in 2014 to support the alternative care framework. Terre des Hommes Netherlands are about to launch a significant programme that could impact 1000’s of children’s lives and create a blueprint for the rest of Uganda and beyond.

I am under no illusions. We have a long way to go, and the government needs to get tougher with organizations that are not meeting standards or following the child care policy. But as we say in Uganda: “Hope never runs dry!” And now the river is rising. Donors and child care organizations – this is your time to stand up and be counted or be left behind!

When institutions get it right

Written by on June 19, 2014 in Featured Posts, Voices from the Field with 0 Comments

This inspiring story of working with childcare institutions in Uganda to resettle children and prevent family separation will encourage you and surprise you. We really can see changes that improve the lives of children and families even in the most vulnerable situations.


teddy-and-sonTeddy and David are the newest residents in Emergency Housing at Abide Family Center. They were referred by a local orphanage whose director has decided to partner with us. Our shared goal is to keep children out of the orphanage and with their own families as often as possible.

I help run Abide Family Center, a NGO working on family preservation located in Bugembe in Jinja, Uganda. Someone told me recently that Jinja has the highest number of orphanages per capita in the world, which didn’t surprise me. My own impression is that I hear about a new orphanage being started almost every week.

Jinja is a nice place to live. We’re two hours from Kampala, Uganda’s capital. We live between lush, rolling green hills and the source of the Nile River on the shores of Lake Victoria (and it’s seriously beautiful). You can go to the pool, sip a latte in a café, and “rescue” poor children from poor families by placing them in a state-of-the-art orphanage in the afternoon—all in a day’s “work!”

I have, in the past, treated orphanages as the enemy. Our most common hashtag on social media is #FamiliesNOTorphanages, because we believe all children deserve a family and that no orphanage should ever be considered as the first option or as a substitute for a family.

While I still believe we need to fight for every child to have the love, support, care and protection only a family can provide, I have become a lot slower to alienate potential partners and a lot more willing to listen to where folks running orphanages are coming from. I have had my own views challenged and I have come to realize that there are many people who run childcare institutions who are doing it right.
When we developed our program, we decided to focus on more than just family preservation services. We wanted to be part of building a larger system with child protection and best practices are at the forefront. We did not want to empower just any needy family we came across, but we strategically targeted families with children who were at-risk of being placed in orphanages. We wanted to help vulnerable yet loving parents support their families and stay together.

Unlikely Partners?

We realized that to effectively keep children out of orphanages, the best people to partner with are the very ones I would have written off a few years ago: folks running childcare institutions.
We see a change among many childcare institutions here. Increasingly orphanage directors and staff are recognizing that residential care should not be the default option for vulnerable children and that children should only be placed in their care as a last resort.

We are seeing more childcare institutions developing preventative services and/or referring children to other appropriate organizations. Some orphanages are starting resettlement programs and treating residential care as a temporary, transitional space until better, more permanent solutions are found.

Celebrating Six

I want to highlight six specific child care institutions and celebrate the desire I see in each of them to serve the best interests of children. They give me hope that more orphanages will get on board for the change that is coming. They encourage me to believe we will continue to see gains in child welfare and child protection even in regions and situations where orphanages are being most misused and overused. In no way do these examples include all the childcare institutions doing it right; they are simply a few examples to shine a light on the progress being made.

1) Child’s i Foundation

One of our closest partners and allies in the fight for best practice for orphans and vulnerable children is a childcare institution. Child’s i Foundation has a Babies’ Home in Kampala called Malaika. They also have a social work training program (where we send our own social workers), and they run an ongoing campaign called Ugandans Adopt. The Ugandans Adopt campaign is promoting domestic adoption for Ugandan children who cannot stay with their biological families.

Malaika Babies’ Home is unique due to the average length of time babies remain in their care. When a child is abandoned and referred to them by local authorities, social workers from Malaika are in the field within 48 hours searching for relatives and investigating the child’s case. More than half of the children referred to Malaika are resettled within their own extended families. Only when children cannot be resettled, then the Child’s i staff work relentlessly to get each child adopted by a loving Ugandan family. Child’s i Foundation really embodies what Uganda’s Alternative Care Framework is all about, working to address each vulnerable child’s unique needs for care and services. On a side note, advocates for international adoption seldom mention the good news that Ugandans are successfully adopting Ugandan babies into loving homes!

2) Amani Baby Cottage

My Co-Director and I started off as volunteers at Amani Baby Cottage, which is also located in Jinja. The Director of Amani put much experience and care into developing a model organization. Amani has consistently fought for each child’s best interests, whether reunification or adoption. This is a childcare institution working hard so that children may be raised in families. They treat their Babies’ Home as a transitional facility while they search for a better, permanent option for every child. Amani allowed us to learn from them in the areas of resettlement and family preservation, and they partner with us by sending prevention and resettlement cases.

We trust Amani to refer a child there if needed. We had to do this for a preservation case we were working on. Our staff worked hard to keep the baby and mother together, but it became clear that no amount of good social work or services could keep this child in her own family. Although we like to focus on successes, it’s important to talk about those times when we work hard to preserve a family and it still doesn’t work. This can happen anywhere in the world, so we can’t leave such setbacks out of the conversation. We believe in following a best practices framework, which means valuing and having a place for all alternative care solutions as long as they are being used appropriately.

3) Ekisa Ministries

Ekisa is an excellent home for children with disabilities located here in Jinja. Although Ekisa has a residential care facility, they pour much of their time and energy into community and family support. Ekisa works to keep children with disabilities in their own families whenever possible, supporting and equipping families so they can raise their own children. I always tell them that they have one of the hardest jobs I know, working to promote family preservation for children facing serious stigmas and barriers that threaten to tear their families apart. Ekisa is actively working to tear down the barriers and reeducate people in order to remove the stigmas. Ekisa could very easily keep all of their children in residential care, rationalizing it with the legitimate challenges the children face at home and the greater access to medical services the children would have in their care. Instead, they have chosen to walk side-by-side with the families, lifting them up as capable of caring for their children.

4) Arise & Shine

Arise and Shine is a babies’ home in Jinja that refers both prevention and resettlement cases to us. Arise and Shine offers family preservation services, however, some cases are more complicated and they have asked us to help with those. They are also treating their facility as a last resort for children who truly cannot remain in their families.

One case stands out to me. A young mother came to their gate wanting to place her two daughters in their care. This young mom had just gotten a job as a house girl for a wealthier family. They told her she could have the job, but she could not bring her daughters with her. Having had no source of income for quite some time, she was desperate. She went to Arise and Shine looking for a solution so she could work. Countless children are in orphanages for similar reasons. But the director referred her to us. She and her girls moved into our Emergency Housing for two months while she enrolled in our business and parenting classes and got back on her feet.

5) Baby Watoto

Watoto is one of the largest childcare institutions in Uganda. We happened to be attending a workshop in Kampala that some Watoto social workers were attending. After hearing about our programs, one of the social workers pulled me aside and asked if she could make a referral to us. There was a teenage mother of triplets whose three girls had been placed in Watato’s home for babies in Kampala. This mother frequently visited her girls, and the social worker could see that she loved them but was unable to provide for them. We had one of our social workers do an assessment and coordinate with the Watoto social worker to create a transition plan. The young mother was given the chance to raise her own girls because the social worker chose to focus on her strengths and her potential rather than her poverty.

It would have been easy, in another orphanage, with a different social worker, for the girls to remain in institutional care or even be adopted internationally. This was a young single mother living in poverty. Many would have automatically set the odds against her. Instead, Watoto chose to view her as capable and as the best and first option for the long-term care of her girls. Since making this initial referral, Watoto has continued to send us both prevention and resettlement cases.

6) Sonrise Babies’ Home

Sonrise is our newest orphanage partner. Sonrise called us about a young single mother who was struggling to keep herself and her son safe. She approached the Babies’ Home to see if they would take her two month old baby boy. When the director asked her how she would be able to sleep at night without her son, she began to cry. (So many children are dropped off at orphanages by mothers in tears.) The orphanage Director realized this mom very much loved her son. She was just in a very desperate situation. When I went with two of my social workers to perform an assessment for this mother, I also with the director, and we solidified a partnership. She told us that she believes there needs to be “Many more Abides in Uganda, not more orphanages.”

I wish more people listened to us in the field before opening childcare institutions. Even the people running orphanages are starting to admit we don’t need more of them, and that we must increase efforts to support vulnerable families before they give up their children to orphanages or adoption.

All six of these childcare institutions “get it” or are on their way there. They are working to do what is best for orphaned or otherwise vulnerable children in Uganda. They remind me of the importance of working together so we can build up systems that protect children. Alienating orphanages and painting them all with a broad brush is not helpful. Truly, for each of the good ones, there are many more that are poorly run and misguided. For my sanity and the sake of optimism, I am going to choose to celebrate those who “get it” and hope others will catch on as donors become aware and standards are raised.