Thursday, June 5, 2014

Can family preservation programs and international adoption coexist at the same orphanage?

In loving memory of Abeli, Mwamini, and Maria.
(This post was first written last night).
Tonight I received a text from Reeds of Hopes manager in eastern DRC.  As I previously noted, he is traveling all over Eastern Congo to visit the school children supported by our program.  Some live in very remote locations that can only be reached by moto and/or by foot.  He is very committed to visiting these children and has been very moved by their stories, struggles and strength.  Earlier today he sent a text to say that he had had trouble with the moto, but had been helped by some men in one of the villages and was hoping to make it back to the orphanage today.  I waited anxiously to hear that he had arrived safely back at the orphanage.  When I finally heard from him, his text message was devastatingly straightforward:  "Today is not a good day for us because this morning Abeli died." Another baby had died at the orphanage.
Three babies over the past 3 1/2 weeks.
I am left wondering what to share, and what words to say.  These three children they mattered.  Their lives mattered. Every one of them was loved and wanted.  Every one of them was precious in the eyes of God and to their families and those that cared for them.  I loved these babies. I knew their faces and their names.  I have met some of them. 

This news forces me to ask some hard questions and to do some soul searching.  The babies at the orphanage are loved and not just by me or by the staff, but by their families.  They deserve our best efforts to keep them safe and healthy.  But the simple reality is that we don't run this orphanage.  We support it and help to fund it, but we have been prevented from doing much of the family reunification/support work we would like to do.  We have been able to work on making sure there is enough formula every month and hiring extra staff to care for the babies.  We work closely with the lead donor and founder, but otherwise we do not have a collaborative relationship with the other main donor.  

The orphanage is in Kaziba, a remote area in the mountains of eastern DRC.  It is removed from much of the insecurity that plagues other areas of eastern DRC.   Almost all of the children have living and known fathers, most of whom are extremely poor.  They all have lost their mothers.  Most of their families are from remote villages, and if they are employed at all, they work as farmers and miners. These fathers are desperate when they bring their babies to the orphanage, hoping that although their wives have died, their babies will not.  Almost all of these babies have siblings that live at home with their fathers or other family members.  The children have to leave the orphanage by 5-7 years old, though most have left before then to be reunited with their families.
Because they have families that intend to return for them when they leave them in the orphanages care, most of these babies are not eligible to be internationally adopted.  The Kaziba orphanage's role is the same as most of orphanages across Africa: to be a temporary place for families in desperate situations in a country where there are no safety nets to prevent families from falling apart when tragedy strikes. 
Tonight, the deaths of these three babies weigh heavily on my heart because I feel partially to blame for their deaths. Please bear with me here while I try to explain.  Just over four years ago, I visited the Kaziba orphanage for the first time.  I met the director and he immediately struck me as man that loved the children under his care.  He took meticulous care of them and worked well with the little resources he had.  They were in desperate need of support because they didn't have enough formula or resources and the children were starving and severely developmentally delayed.  We met those immediate needs, but instead sitting down and meeting with the families of the children in the orphanage, I suggested that he think about international adoption so they wouldn't be left in the orphanage.  I didn't even begin to consider that maybe they had families that loved them and wanted them.*  I share this part of my story here.   
Since that time, I have learned a lot about family reunification work.  As a result, I have stopped facilitating or helping directly with adoptions and I have advocated for a change of focus.   Instead of international adoption as a first resort, the focus should be on quality short-term emergency care with family preservation as the priority.  But through this process, I have learned something: its incredibly hard to move the focus away from international adoption when it is embedded in an orphanage.  Family support and reunification isn't well understood by most traditional aid organizations, and it can be complicated.  It requires a deep commitment to family preservation and the inherent dignity of all families in DRC.  It demands deep respect for Congolese fathers and their families.
It is much easier to fundraise for adoptions than for family support and reunification work (following the alternative care model) despite it being the right decision for most of the children.   At times,  I struggle with anger towards international adoption.  It seems that it takes away attention from those left in the orphanage the kids who wont be adopted.  The director's time is often consumed by all the needs of international adoptions: obtaining consents and proper documents, counseling birth families, escorting children and birth parents across the country, traveling internationally to visit adoptive families, and helping to fundraise for the organizations that facilitate adoptions.  These are important roles of the person who works as an adoption facilitator, but it raises some important questions.  Should this role be filled by the director of the orphanage himself whose actual job is the direct care of the children living in the orphanage?  Should someone that isnt in charge of the care of the orphanage perhaps fill this role?  Does this time-consuming work detract from spending time with birth families of the children that live in the orphanage and working towards getting the children home sooner?  Does this time spent away from the orphanage decrease the care of the children that are left living in the orphanage? 
I would argue that the children that live in the orphanage today need him more they need him the most.  And this is what international adoption can do at an orphanage if careful safeguards are not put into place: it takes the focus, drive, passion away from the children that need the most care and places it on the few that are to be adopted internationally, because international adoption consumes the resources and time of those that facilitate adoptions.  And maybe even more importantly, the money that comes to an orphanage (either through fees/compensation or donations of aid) with international adoption puts pressure on a fragile institution that combined with no safeguards to protect children from exploitation leave these same children even more vulnerable to abuse.  The director of an orphanage should never be in charge of facilitating adoptions; that role should be left for someone who isnt directly responsible for the daily care of the children.  I know that the director of the orphanage loves the kids who will not be adopted just as much as he loves those who will be or have been adopted.  He should not be forced to choose between caring for the children left in the orphanage and facilitating international adoptions.   Maybe these three children would have died even if the director had more time to be in the orphanage, overseeing their care.  But maybe they wouldn't have maybe they would have had more attention and focus and been treated earlier.  Maybe.  It's hard to know for sure, but these children deserve all of our efforts to prevent further deaths. 
What I do know for certain that over the past four years of our involvement at the orphanage, we have never had so many children die in such a short amount of time.  Any time this happens, we must ask hard questions and search our hearts.  
Where do I go from here?  I'm not sure, honestly.  We still don't run the orphanage. Unless there is clear agreement from all the different partners that donate to Kaziba, it is very difficult to move forward with a clear focus and cohesive plan.  If all parties don't strongly believe in quality short-term care focused on the end goal family reunification, then it is almost impossible to move forward together.  We can't all pull in different directions; the children will only suffer from such division. We have been in long discussions with some of the upper leadership of the orphanage to see if the vision and direction of Reeds of Hope still fits with the vision of the leadership of the orphanage.  We have been asking hard questions.  Ultimately, we must do right by the 46 babies and children that live every day at the Kaziba orphanage.  


Abeli, sick most of his life and in the hospital, 11 months old here


Taken the week before she died, from malaria


*If you are interested in reading an excellent paper on the  human rights implications (and potential violations) of offering international adoption before (or even at the same time) family reunification, family support, family preservation and alternative care, please go here: Intercountry Adoption and Poverty:  A Human Rights Analysis.  


Anonymous said...

Holly, thank you for your heart for the beautiful children of Congo and specifically this orphanage. Unfortunately, very few Americans understand the issues and needs of the Congolese. I appreciate you advocating for them. It is in this spirit, I ask the question does attacking others actively engaged in programs to serve and help the DRC children a productive use of time and energy? Though we likely share some differences in opinion, I’d love to see greater unity among the few Americans committed to Congo. Candidly, I don’t have the complete recipe to fix the complicated issues in DRC, but I have to imagine the strategy isn’t an “either / or” solution, rather “both/ and” solution. There are very few “absolutes” when dealing with Congo.

Is it really fair to insinuate that the recent and tragic loss of three beautiful children is even remotely linked to international adoption? It read like a divisive jab. You’ve lived DRC. The simple truth is there are over 4 million orphans with some estimates that 18% don’t live to their 5th birthday. International adoption is far from perfect, but it isn’t Congo’s main problem. These beautiful children that are forced into orphanages are merely the symptom of bigger issues. By actively fighting amongst ourselves over how to remedy symptoms we dilute resources and energy to address causes. Is the answer reunification, yes. Is the answer more financial resources and healthcare, yes. Does it likely involve some adoptions, I’d argue… yes.

I’ll end my comment the way I started it… thank you. I honestly appreciate your sincere care for the children of Congo. They deserve to be cared for, loved, and known. I’m confident that you’re efforts and advocacy have radically changed the lives of DRC children. Keep up the life changing work and stay positive.

scooping it up said...

thank you for your words, Holly. It is not a jab. You are right. And international adoption in ALL poor countries takes away focus from family preservation just by being a source of income to the country. Family reunification costs money to support them. Adoption brings in cash. They cannot peacefully co-exist. The corruption and greed takes over. Like in Ethiopia. Uganda, Ghana. DRC. You are heard, my friend.

Holly said...

Anon @ 1040pm. I'm not trying to insinuate anything. I'm directly saying that when a priority is placed on international adoption in an orphanage full of children with known families that could take care of them, there are direct negative consequences. As I said in my post. I don't know if the three babies would have died if the director had been present at the time. Maybe. Maybe not. It's impossible to know at this point. However, I think it is very appropriate to really examine in depth the circumstances at the orphanage when those three children died (four if you consider the child that died in March) and work hard to make sure that further preventable deaths do not occur. I don't consider that divisive at all. That should be what is done whenever there is a child death.

And it's not only about children dying. It's also about children lingering in orphanages for years when they have families that love them. That is also a great travesty.

I think that all partners at the orphanage (including that one that runs the adoptions) should come to the table and work together in a collaborate way to prevent further tragedies and to make sure the priorities are in line. Unfortunately, as I stated in the post one of the other main donors has not been willing to work together collaboratively.

Most of the children in the orphanage are there because of extreme poverty. I am not fighting with anyone, I am suggesting that only by working collaboratively together and putting our focus on family preservation, family reunification, family support while giving quality short term care to the children living at the orphanage will more deaths be prevented and more children be living with their families.

International adoption is something I support in general. It is not something I support in DRC at this time. When there is deep reform to the process, then perhaps it will be a viable option for some of the children at Kaziba but only after all other efforts at family preservation, reunification, support AND domestic adoption have been exhausted.

There are many examples of successful programs throughout Africa that prioritize family preservation projects. Please visit my page noted on the right bar.

Thank you for the comment.

Anonymous said...

I appreciate the dialogue. As you indicated, collaboration requires us to work together to achieve a shared goal. When the tasks are big, the obstacles persistent, and the resources limited… it makes teamwork tougher and all the more important. I respect your opinion. I actually agree that when possible reunification is ideal. Figuring out how to reverse the environment that was catalytic in the original displacement of the children will require the best minds to come together. Extreme poverty is a painful and complicated condition. For collaboration to be possible, all interested parties (myself included) need to remain humble and be open to compromise around strategy and tactics. Collaboration isn’t merely about having others fall into line with my ideas. I’ll continue to read about the strategy + programs you’re engaged in surrounding reunification. I believe we share a common goal of meeting the needs of these children.

Anonymous said...

It seems to me that IA is only a solution for a small number of children -- and it creates a whole wealth of other problems. Even organizations/agencies with the best of intentions can contribute (knowingly or unknowingly) to fraud and corruption. The incentives for orphanages change once IA becomes an option, because all of a sudden, the orphanage is financially rewarded for making kids available for IA. But the orphanage is not financially rewarded for prioritizing family reunification -- so which one does it choose? And what happens when the orphanage is opened up to agencies who aren't necessarily focused on ethics? Will family reunification even be an option at that point, when child finder fees of $1,500/child become available?

The same holds true in the U.S. -- I've watched Reeds of Hope and other organizations such as ReUnite Uganda struggle to raise relatively small amounts of money (such as $1,000) for non-IA options, while adoptive families raise more than $10,000 in a week towards their adoptions. There really needs to be a shift in focus away from IA as a "solution" to problems such as high child mortality rates.

Great post, Holly. It's a lot of food for thought.

kym said...

Thank you, Holly, for your post.

It's quite sad that these babies died. That shouldn't take away from how IA is still not the best option for many, especially unethical IA. Much of the problems with child protections can be alleviated WITHOUT IA. IA is still a drastic, sudden "solution". Charity and solidarity shouldn't be conditional on a baby exchange. That's NOT what's best for the baby. That is abuse of power, manipulation, and control.

An example for how IA should NOT be done (not DRC, but Sierra Leone). Twelve+ years for parents to be heard (because it might affect IA numbers). These are people's lives, not a fundraising fest. Until the adults can play fairly, they shouldn't be allowed to play. I wouldn't shed a tear if IA was banned. IA facilitators are clearly disrespectful of the human lives and families who are permanently affected, altered, and separated because of IA. Cultures lost, identities reassigned, genetic bewilderment, languages disrupted. AND justice ignored when confronted with the crimes committed - how is that charitable or in solidarity?

Anonymous said...

Powerful, valuable, challenging words here. Thank you for your heart and compassion for vulnerable children.

Anonymous said...

Thanks for this brave, brave post Holly.

I very much hope that you will keep speaking out and a fellow blogger wrote a great response to criticisms of your post:

The fact that infant mortality rates are appallingly high in DRC is NOT, in and of itself, a justification for IA in DRC. It's sad, it's awful, much needs to be done to stop 100% preventable child deaths... but IA won't fix the problem.

Infant mortality isn't just an issue in DRC... it's notable that the infant mortality rate right here at home in the US is APPALLINGLY high, relative to other developed countries - particularly for babies born to impoverished young women of color:

(Like, infant mortality rates more or less on par with Botswana).

I also, sadly, concur that it's probably not possible to simultaneously support family reunification and IA in DRC (or any developing country). There's just too much money (from PAPs/APs) and too little in the way of governance to keep in check.

Coercion is endemic in the US too -- matching PAPs to pregnant ladies, results in (not so) subtle coersion, as PAPs pay expenses, refer to the fetus as "our baby" and the pregnant lady as "our birthmom" (despite the fact that a woman isn't a birthmom til she's given birth AND relinquished her child; it's a vile term!). Go google "failed adoption" and you'll find way too many blogs where PAPs complain that they ponied up the cash and felt "cheated" if the first mom chose to parent).


I'd also like to point out to Anonymous that DRC has 4 million "SINGLE" orphans, i.e. kids with ONE living birthparent. In the US, we call them a "kid raised by a single mom" or "kid raised by a single dad".

melissa said...

It's sad, but sometimes parents can't afford to raise their children. Sometimes parents in the US can't ford to raise their children, and the children are raised by others. Just like we honor the wishes of US parents who for whatever reason choose not to parent, we should respect the wishes of parents in other countries who, for financial or other reasons choose not to parent.

Anonymous said...

Yes, absolutely! Keeping in mind that:

(1) a Congolese woman whose options are limited to relinquishing her beloved child so that he might live OR keeping him knowing that he will surely die because she cannot afford to feed him doesn't really have a choice at all.

It is absolutely unethical to let that woman give up her baby without offering a tiny bit of short-term assistance that might allow her to raise him.

(2) coercive adoption practices in the US ought to be minimized or eliminated. Good ways to start would include banning the matching of PAPs to pregnant ladies (she's not a "birthmom" til she gives birth AND relinquishes), allowing first moms six month to change their mind about relinquishing their child*, giving all adoptees access to their original birth certificates immediately (no questions asked, no making them wait until they turn 18 or 21) and making open adoption agreements legally enforceable (as they're presently not worth the paper they're printed on). Adult adoptees and first moms (Life of Von, Daily Bastardette, Land of a Gazillion Adoptees, etc) input regarding adoption reform would also be invaluable.

Last but not least, I would ban ALL fundraising for adoption -- this business of PAPs begging strangers on the internet for, like, $30k ought to be illegal. Period. (A woman relinquishing because she cannot afford to raise her baby... to some other woman who can't afford the kid either, not without sons short-term financial assistance is heartbreaking. And wrong. And ironic, in the most awful way).

* In NY, consumer protection laws give me 30-60 days to change my mind about a contract, such as switching to Sprint. Relinquishing a child is a MUCH more important decision that clearly requires a longer "change your mind" period.

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