Institutionalization at the Global Level

Institutionalization at the Global Level

The UN Sustainable Development Goals support the idea of a just, inclusive, and equitable society. However, many children face numerous disadvantages. Children residing outside family care are vulnerable. These children are susceptible to poverty, lack of educational opportunities, physical and sexual violence, and stigma (National Academies of Sciences, Engineering, and Medicine). The USAID and the Human Rights Watch estimate that about two to eight million children reside in institutions globally. A majority of these children are in Eastern Europe, Africa, Latin America, and Asia. The two bodies also raise concerns regarding the increasing number of children living in institutions. They link the increase to the rise of HIV/AIDS infections and a reduction in inter-country adoptions. The decline in these adoptions is due to corruption cases, inadequate monitoring, and profiteering cases. Most of these institutions have similar characteristics though some may vary depending on the region and country. A common characteristic of these institutions is inadequate physical environments. Children are placed in large groups with a number ranging between nine and above 16. Nonetheless, some wards accommodate 50 infants in one room (McCall). Similar aged children occupy the same rooms while those with disabilities kept in separate wards. The institutions also change caregivers frequently, making the children experience between 60 and 100 caregivers before clocking two years. Moreover, the interactions between the caregivers and the children are limited, responsive, and business-oriented with no parental warmth.

Institutionalized children across the world have almost similar characteristics. They develop poorly in all domains of life. Research indicates that these children register lower means in physical and mental development compared to parent-reared children (McCall). Furthermore, they exhibit specific behaviors uncommon among parent-reared children. These behaviors include self-simulation, such as rocking and head-banging, concentration problems, and indiscriminate friendliness. In some regions, these children have psychiatric problems. For instance, in Bucharest, the institutionalized children have a higher likelihood of developing psychiatric disorders by the time they are 54 months (McCall).

Some institutionalized children join normal families after spending several years and months in institutions. Most of these children transit to well-off and well-educated families in the US and Europe. The children demonstrate significant catch-up growth, especially in the mental and social domains. Nonetheless, the catch-up growth was limited in other areas such as memory and functioning (McCall). The limited growth could be due to the delayed and hindered development within the institutions. Furthermore, research indicates that children who leave institutionalized care at an early age display lower levels of development deficiencies compared to those who leave the institutions at advanced ages. Besides, the likelihood of long-term problems is high among severely-deficient institutions.

Theoretical Explanation of Deficient Development in Institutions

Various theories link institutionalized care with the deficient development of children. The attachment theory proposes that institutions fail to promote mothering and attachment relationships between the caregivers and the children (McCall). The idea of changing caregivers frequently limits the probability of the formation of such relationships. Consequently, the lack of attachment relationships results in limited ability in self-regulation. Lack of these relationships also denies the children experiences that facilitate normal development. For instance, infants spend most of their time lying face down or staring at the ceilings with minimum simulation. The changing caregivers also limit the interactions of these children with their caregivers due to the inconsistencies in the type of care offered by each caregiver. The care by the caregivers also limits interactions as it rarely involves the children.

The Chronic-stress theory gives a biological explanation to the long-term problems among institutionalized children. The theory proposes that these children live in extreme environments resulting in chronic stress (McCall). Institutional care is stressful for children because of the lack of warmth and consistency in care. Children who are sensitive to stress due to their genetic makeup, exhibit poor metabolism, poor production of antibodies, atypical development of the brain, poor physical growth, and poor behavioral control.

Global Policies on Child Welfare

The debate is ongoing on whether to improve the institutions or consider deinstitutionalization. Proponents of the deinstitutionalization claim that governments have to get rid of the institutionalization. They argue that family environments and better than the institution environment (National Academies of Sciences, Engineering, and Medicine). They also maintain that the idea of improving these institutions will shift the government’s attention and resources away from developing a family-setting system. Research supports these arguments. Research indicates that children living in family care with substantial risk are better than those residing in institutions. Although family care seeks to improve the development of the orphaned and abandoned children, the idea faces innumerable challenges. These challenges include cultural, historical, religious, and political and may complicate the process of adopting children. For instance, the political differences between the US and Russia resulted in a ban on adoptions by American citizens. This aspect makes it difficult for Americans to adopt Russian children even if they are willing.

Some countries provide incentives to individuals who consider adoption. Nonetheless, the process of using incentives is difficult as most countries are reluctant to consider this alternative. Though these countries understand that adoption is the best alternative, they are not willing to pay individuals who adopt children (National Academies of Sciences, Engineering, and Medicine). Furthermore, providing incentives may discourage couples from getting married as they are assured of financial incentives. The incentives may serve as a reward for getting children out of matrimony. Moreover, there is a possibility that the disabled and older children may be forced to stay in these institutions, as most individuals prefer the abled and young children.

Most countries still need time to implement deinstitutionalization fully and develop a family care system. Nonetheless, some countries have already made strides. For instance, Ukraine made an effort to deinstitutionalize and to develop family care (National Academies of Sciences, Engineering, and Medicine). In this case, the leadership of the country, including the president, supported the idea of deinstitutionalization. The leadership was dedicated to this idea and used various supportive policies and attractive incentives. Though the Ukrainian leadership supports adoption, some children still reside in institutions.

Institutionalization in Russia

The Russian government lacks clear data on disabled children and their whereabouts. Non-governmental organizations focused on supporting disabled children, estimates that about 45% of children in state institutions are disabled. The organization uses the Russian government data and statistics from the United Nations Children’s Fund and their observations to come up with the figure. Only about two to five percent of the total population of Russian children have disabilities, with about 30% of them living in state-run institutions. The country accounts for half of the children aged below three years living in these institutions. A 2010 UNICEF report records that Russia has the highest number of children under institutional care among ten countries (Human Rights Watch). Although the country has the highest rate, it also has the lowest level of poverty among the ten countries. The institutionalization in Russia has both the mainstream institutions and the institutions for the disabled. The mainstream institutions accommodate children without disabilities.

The Soviet Union considered abandoned and orphaned children as the building blocks for the Union. These children had no family structure, resided in communities, and received care and protection from the government. Nonetheless, instead of the government caring and protecting the children, it created an unhappy childhood for those children (Freeman, 2012). Consequently, the Soviet system of handling these children resulted in inequities that are present in the current Russian society. The place of these children in the soviet society was controversial, making institutionalization the only viable option for them.

History of Negative Perceptions towards Disability in Russia

The Soviet Union played a role in instilling the negative perception towards individuals with disabilities in the Russian Federation. At the 1980 Olympics in Moscow, a representative of the Soviet Union mentioned that the Union had no invalids (Philips). The representative used these words while responding to question by a journalist inquiring about whether the Union would take part in the Paralympic games. This denial of the existence of individuals with disabilities summarized the ideologies of exclusion in the Soviet Union. The denial also characterized the policies of disabilities under the socialism of the Soviet Union. Historically, the society in the former Soviet bloc made individuals with disabilities invisible and subjected these individuals to stigma. The Soviet Union captured these individuals under the unknown population category.

Individuals with Disabilities in the Pre-Soviet Period

During the pre-Soviet era, individuals lived a village-based life guided by the Orthodox Church. During this period, individuals with disabilities interacted freely with other people and participated in various activities such as the weaving of baskets, embroidering, and sewing (Philips). Other individuals with disabilities strolled around the churches and were closely associated with the clergy and religious culture. This association earned them respect among ordinary citizens. The main caregivers of the disabled were the church, family members, and elites. The Tsarist state, in early 1700, identified and regulated the lives of the disabled. Tsar’s government required individuals with mental disabilities to get certification from the Senate. Although the certification excused from state service, it also limited their rights to property and marriage. In late 1700, Catherine’s reign developed the asylums for accommodating individuals with mental disabilities (Philips). By the 19th century, the position of the disabled had changed with the erosion of community support systems. Scholars attribute this erosion to urbanization and industrialization. Institutionalization became evident in the late 19th century and early 20th century, with an increase in a number of institutions for the disabled (Philips).

Disability during the Soviet Period

The word “invalid” changed meaning after the establishment of the Soviet Union. Previously, the Tsarist state used the word to describe a warrior. However, the Soviet Union used the word to describe individuals with no capacity to work (Philips). This definition was the basis of policies regarding disability in the Union. The Union required citizens to participate in paid labor to illustrate their social usefulness. Unlike other countries that used the individual-tragic approach, the Union used the functional approach based on an individual’s usefulness to Soviet society. The Soviet state developed home for the invalids and divided the disabled into three categories based on their capacity to work.

Disability in post-World War II

This period witnessed the formulation of most disability policies in the Soviet Union. WWII resulted in a large number of disabled individuals forcing the Union to develop models to deal with the war invalids. The Union felt that it was vital to support the war invalids to avoid rebels (Philips). The Union denied the existence of undesirable effects of the war by excluding the war invalids from the elucidations of the war. Consequently, people turned away from the invalids and were ashamed of them. This action was the cornerstone of the current perception of Russians towards the disabled.

During the 20th century, social isolation characterized the disability policy despite the fact that the war invalids were approximately 2.6 million and about 8% of the Soviet army (Philips). The Union utilized the functional approach to maintain social control. In the mid-1900s, the state dispersed the disabled veterans from Moscow and other cities to settlements in rural regions, making institutionalization a common thing for the disabled. The state created the internaty to accommodate young children up to the age of 16 (Philips). Afterward, the state would transfer them to internaty for adults. Although the goal for the internaty was to create a home-like environment, it created a perception that the society had no social problems. The internaty institutions housed elements with a blemish.

Effects of Institutionalization

Institutionalization has serious effects on the physical, psychological, and emotional development of children. The characteristics of institutionalized care include large groups, lack of specialist training among caregivers, unstable and cold caregiver-child relationships, overcrowding, insufficient resources, and unresponsive care. UNICEF and other international organizations discourage governments in Asia and Eastern Europe to stop institutionalization of children below the age of three. The state’s institutions offer minimum care and fail to provide educational opportunities for children with disabilities (Sycheva and Wesolowsky). Some officials of these institutions claim that the state uses institutions to keep the disabled as they wait to die.

Institutionalized care contributes significantly to depreciation in brain growth, low IQs, physical underdevelopment, and decreased social abilities. Moreover, it also limits the ability of children leading a normal life later in life. Institutionalized care uses a specific routine, making it difficult for children to adjust to normal life. This care limits the life experiences of these children to the routine of the institutions making older children, 16 years and above, behave like six-year-old children (Sycheva and Wesolowsky). Limited life experiences in the institutions set the children in panic mode whenever they encounter anything unusual.

Life in the institutions robs the children of their potential. A significant portion of the disabled children in the institutions has living parents. The institutions are isolated geographically to isolate the children and cut links between the children and their blood families. Institutions also discourage parents from visiting their children. The neglect and isolation rob the children of their potential. The children undergo physical torture, such as being tied to various pieces of furniture, affecting their psychomotor abilities (Mazzarino). For instance, human rights activists claim that a big number of these children forget how to walk after being confined for months and years.

Reducing Adverse Effects of Institutionalization and Alternatives

Both chronic-stress and attachment theories relate to the long-term problems of the care given in the institutions. The two theories suggest that improving caregiving can help reduce the long-term effects. Moreover, governments to provide secure attachments. The St. Petersburg and the US intervention yielded positive results. The intervention adopted two options (McCall). The first option focused on training caregivers and encouraging them to practice the typical parental style when handling the children. The training intervention encouraged the caregivers to be engaged with the children, follow the children’s lead, offer contingently-responsive interactions, and engage in reciprocal conversation. The second option focused on changing the institutional environment to facilitate caregiver-child relationships and create a family-like setting (McCall). The structural changes include reducing the group sizes to about six children, reduce the number of caregivers responsible for individual groups, end the periodic transitions, integrate groups according to age and disability status, and introduce family hours and monitoring systems.

Reforming the state institutions is necessary for the well-being of the institutionalized children. There is a need for the Russian Federation to consider working with outsiders and volunteers. The outsiders should ensure that these children attend normal schools outside the institutions (Whewell). This way, the children will learn to interact with other people other than their usual caregivers. They learn to live ordinary life outside the institutions. This will help them develop both their psychological and social skills.

The Russian Federation should consider designing and implementing support systems that will encourage families in Russia to adopt disabled children. Although Russians have started considering adoption, following the US ban, most families prefer normal young children leaving the disabled in the institutions. The government should consider breaking the profitability system and corruption within these institutions. Reports indicate that the institutions receive as much as 1.5m roubles annually for each child (Whewell). Officials of the institutions are keen on retaining this money by complicating the adoption process. The institutionalized system uses members of parliament to paralyzes the transition process from the institutions to family care through corrupted bureaucracies.

The Russia Federation should consider the ConventionConvention on the Rights of the Child (CRC) and ensure that children have a right to form and express their views freely. Under this ConventionConvention, the Federation also has the responsibility of ensuring that all children are safe. In this case, the government needs to implement systems that help in reporting maltreatment cases. The government also should follow the guidelines under the ConventionConvention on the Rights of Persons with Disabilities (CRPD) to protect all children with disabilities against any form of mistreatment.

Recommendations and Conclusion

The paper recommends that the government should consider awareness campaigns to change the perceptions of the public towards institutionalized and disabled children. This action may encourage more Russians to adopt these children enabling the children to get family care. The paper proposes that the government should ensure that the institutionalized children attend normal schools with other children under the family care to ensure the successful development of their social skills. Moreover, there is a need for the Russian Federation to train the caregivers, employ specialists, and equip the institutions with proper medical equipment to equip the disabled with the necessary skills and make them independent.