A NEW HOME FOR ORPHANAGES? New research suggests that children, at least in less wealthy nations, do just as well in orphanages as homes with one biological parent, findings that might make room in international policy debate for more home-grown institutions. Image: ISTOCKPHOTO/VARDHAN
Orphanages linger in the popular imagination as unnatural relics, places from which neglected children need to be quickly rescued. And many international organizations and policymakers have made it a priority to reduce the role of these institutions, trying to place kids into family settings as quickly as possible.
But children in orphanages in less wealthy countries appear to be doing just as well as their orphaned or abandoned counterparts who live in private homes—even those living with family members—according to a new study that examined the well-being of some 3,000 children in five countries. "Health, emotional and cognitive function, and physical growth were no worse for institution-living [children]," the study authors report in a new paper published online Thursday in the journal PLoS ONE. They found, in fact, that "the institution-based children scored higher on intellectual functioning and memory and had fewer social and emotional difficulties."
With some 143 million orphaned or abandoned children worldwide—and tens of thousands more projected to be orphaned by AIDS and other diseases in the next year—a fresh look at the orphanage issue might be coming in the nick of time for many kids, especially where foster or adoptive families are in short supply.
The new findings are "going to be uncomfortable for many people—or at least unconventional," says Richard McKenzie an economics professor at the University of California, Irvine, who was familiar with but did not contribute to the study. The researchers take a "hit [at] the Dickensian imagery," he says, noting the timeworn tale of Oliver Twist, which he calls a "dramatization"—even for the 19th century. To be sure, previous research has found that young children who have been neglected in massive eastern European nurseries exhibit early developmental and even hormonal differences compared with their noninstitutionalized peers, but the six- to 12-year-old children in the new study—many of whom had been in institutions since early childhood and infancy—appeared to be doing relatively well.
What makes the results even more poignant, says McKenzie, is that by design "the study is biased against institutional care." Children with just one dead parent are technically considered orphans (those who have lost both parents are considered "double-orphans"). So, a child whose father has died but still lives with his or her mother and extended family is still classified as an orphan and should, theoretically, have a better outcome. "You would think kids in the care of strangers to be worse off than those in the care of kin," he says. But McKenzie, who has studied the alumni of orphanages in the U.S.—and was an orphan himself, growing up in the Barium Springs Home for Children, an orphanage in North Carolina—says that the conclusion of the paper "doesn't surprise me as much as it might others."
Before embarking on the study (which was conducted in Cambodia, Ethiopia, India, Kenya and Tanzania), the researchers themselves expected children in institutional settings to measure up poorly to their adopted counterparts. But even before all the data were in, the researchers began to suspect that their assumptions were wrong, says lead study author Kathryn Whetten, director of the Center for Public Health Policy at the Duke Global Health Institute in Durham, N.C.
"The stereotype that many of us in the U.S. and Europe have of an institution is not what is being set up in less wealthy nations," Whetten says. "It's not like what we've seen in Romania or Annie or anything like that." Many of the orphanages the researchers visited were grassroots projects, "being set up by local pastors or local couples that really loved kids," Whetten explains. "What people do not realize is that this [institution] is our community response," a medical student from Uganda who had been orphaned told the researchers.
On average, these facilities had 25 to 30 children and were largely staffed by people who stayed on the premises and received little outside pay—people who treated their caregiver roles as more than a workaday job.