18 July 2019

Towards systemic change: our work to reform child care in South Africa

In this blog, Hope and Homes for Children’s CEO Mark Waddington talks about his recent visit to South Africa where our team, thanks to the contribution of the partnership with UBS Optimus Allen & Overy, is doing a tremendous work in shifting the needle dramatically towards a reform of child care, and has developed an exceptional agreement with local authorities to reform their child protection systems.

On July 18, every year, “Nelson Mandela International Day” recognizes Mandela’s dedication to the service of humanity in conflict resolution, race relations, promotion and protection of human rights, gender equality and the rights of children and other vulnerable group.

 

“I have just returned from Johannesburg where our team is doing tremendous work with the support of companies like A&O and UBS through their foundation, UBS Optimus. We have shifted the needle dramatically toward creating a pathway for long term, sustainable reform that will save the lives of many children and significantly improve the lives of many more. In time, we will use this as a basis to drive improvements nationally.

What makes this so significant though is the success being delivered in spite of the scale of the challenges we face.I visited a number of communities with our team to try and get a handle on this.

“There’s a real danger that South Africa’s orphanage population might explode in number”

In one of the community we work in, on the outskirts of Johannesburg, two children were abducted and murdered last week. For their body parts. The practice of Muthi, is considered more potent in curing illness, endowing luck, or ensuring wealth when its artifices include parts of dead children.

But the threat does not stop there.

Recently, an infant was caught in the cross fire between gangs, and shot dead. Girls are being abducted for sex. Boys are being abducted for forced circumcision and then ransomed back to their parents, if they survive the procedure. Our team believe one in five boys this happens to dies of infection. Their bodies are rarely recovered.

The police are not trusted because they are often working alongside those involved in abducting the children. It is lucrative.

Teenage girls come under pressure to accept the advances of a “Blesser”, an older man who – for sex on demand – will contribute to the costs of school uniforms and food. The girls are often just discarded, especially when they are made pregnant. They are not allowed to use or don’t have access to contraception. Many of them also become infected with HIV AIDS.

The profound lack of security for children living in communities is common across South Africa.

Climate change is driving crop failure and chronic water shortages in many locations. When this is overlaid on already widespread rural poverty it drives the mass migration of people, especially young people, to the outskirts of the cities. Looking for work and opportunity they are dislocated from their families. This youth “bulge” in the demographic make-up of South Africa’s urban areas is in turn seeing rapid population growth alongside growing inequality. Tensions can approach boiling point.

All these factors collide to make abandonment of children, or giving a child up to the care system, commonplace. There is a real danger that South Africa’s orphanage population might explode in number. And all the evidence demonstrates how orphanages foster abuse and neglect, with often catastrophic outcomes for children.

The three orphanages Hope and Homes for Children and local authorities are working to close

Hope and Homes for Children is working with local authorities to close three orphanages, as a pioneering project to demonstrate how a combination of prevention and alternative family services can deliver far superior outcomes for children and their families.

And herein lies the hope.

We are partnering with the Bishop Simeon Trust, which has developed innovative approaches to working with young people. BST has a long standing relationship with this and many other communities, and has identified and supported locally based organisations to develop their work with young people to genuinely empower them, not only as agents of their own protection, but as influencers in their communities, and in ways that are making those communities safer and more secure. BST are also contributing funding for us to take on some of the staff they have trained so that their approach can be integrated into our prevention work, which is targeting the communities in which families are most vulnerable to breakdown and separation.

Empowering children to tell their own story: the use of video story-telling

One of the particularly innovative techniques developed by BST, in partnership with the University of Leeds, is the use of video. Young people are trained to make short films to articulate the reality of their circumstances, and the issues which concern them. Then through screenings they influence local leaders, influencers, service providers and the police.

During our visit to the community, a mixed group of young people – with the support of our team – were making a film on the streets of the community. Tabatha, aged 15, asked if they could use our car as a prop. They commenced to develop their story around the theme of how taxi drivers were sometimes involved in abductions, or sometimes aware of them, but also about how they might be persuaded to work as part of the community’s security network – its eyes and ears. This kind of thing enhances our prevention services, which are necessarily tailored to local community contexts. And by the way, who better is there to deal with the enormous complexity in different communities than those who live in them?

Tabetha explained how they intended to screen their latest film over the weekend and invite taxi drivers as well as social workers, community leaders and parents, and use it as the basis for an open discussion inspired and shaped by her and her friends.

There are a number of locally based organisations, one of which is called the Nigel Caring Community, that are helping with feeding and after school/homework support programmes. They provide a base for Tabetha and her friends, and they connect them to the social workers and police. We work closely with this organisation alongside BST.

And this is how the magic happens. In recognising that children are experts on their own childhood, and agents of their own care and protection, we are required to hear them, to be influenced by them and in ways that work for them. Video is one of those.

 

 

Tabetha and friends in full film production

Our team is connecting the dots by training social workers, ensuring they are involved and turn up to these kinds of screenings and meetings, obliging them to follow through on decisions taken with young people, helping them to build links to Early Childhood Development facilities in the community, and ensuring that they are putting the effort in to refer children and their families to the appropriate educational, health, welfare and employment programmes – which are available but which are so often not accessed. This is how family resilience is built. And it is from this that wider community capacity is strengthened to care for and protect children so that orphanages are no longer seen as an option. In fact, so that they become unacceptable.

One of the things to come out of this kind of work is a community Whatsapp group that enables children and parents to alert each other to potential security risks, such as an unfamiliar taxi driver driving around. This work is reaching 500 vulnerable children, which indirectly benefits their families too.

And if you want a view of how effective this kind of approach is – as just one example of the prevention work we are doing – take a look at this graph.

The three Children and Youth Care Centres (orphanages) we are closing are:

IGU = orphanage 1

STF = orphanage 2

DMT = orphanage 3

The effectiveness of prevention

Lourenza Foghill, Hope and Homes for Children’s Country Director in South Africa, describes this graph as a thing of beauty. She is right. It shows the very substantial reduction in the number of children being referred into the orphanages we are working with Provincial authorities to close. Being able to demonstrate the effectiveness of prevention – including its cost-effectiveness – has strengthened our position with the Gauteng Provincial government. Guateng is the most populous Province in South Africa, embracing both Johannesburg and Pretoria, and confines the largest number of children in orphanages – some 6,000 out of a national total of 21,000.

At the end of this month, we will be co-hosting an evidence summit with the Gauteng Government that will publicly establish their commitment to reforming child care across the entire Province using our work as proof of concept and best practice.

In parallel we are working with the judiciary to address their role in referring children into the care system and especially into orphanages, and persuading them to become more involved via community courts and arbitration to secure the support and involvement of absentee fathers in bringing up their children. This latter issue is particularly important.

I met Margaret during my visit, who was abandoned by her partner just over three years ago when she became pregnant. He had also passed on the HIV virus to her. She had no job, her relationship with her mother had broken down, and she had nowhere to live. When Margaret gave birth to Matthew, she was so desperate, so alone, that she approached a social worker to have Matthew take into care.

As too often happens, instead of putting the effort into connecting Margaret to the various services she is entitled to, the social worker took the path of least resistance and referred Matthew for confinement in one of the orphanages we are closing.

Our own social workers worked alongside the local authority social workers to advise and monitor, and step in when needed, to help Margaret rebuild her relationship with her Mum, get a job at a local supermarket, commit to the medication she needs to manage the HIV infection, and find accommodation. She was also supported with parenting classes. Matthew is now back with her, albeit after three years of unnecessary confinement in the orphanage.

And the news is good. When I went to visit Margaret and Matthew, the closeness between them, their playful and loving relationship, was palpable. The regular assessments that our social workers are overseeing have shown very significant improvements in the key metrics we monitor with Matthew, including his motor skills, language and socialisation capacity, his cognition and most of all, his well-being.

Here is another graph showing the progress our team have made in placing children like Matthew back with their families or in alternative forms of family care.

This second graph illustrates the challenges we are now facing within the system itself. There has been resistance among some local authority social workers to recruit train and support foster families, and many of the babies simply haven’t had information about their family circumstances recorded properly, or sometimes not at all. This makes tracing their families very difficult.

Nevertheless, we had a breakthrough earlier this year in persuading the Department for Social Development to require social workers to recruit and train five emergency foster families each. Our team has worked alongside the social workers to show them how to do this and to monitor progress. We are now seeing an improvement in the placement of children into loving families. In the meantime, and in parallel to supporting improvements in case management and the proper recording of information about children, we have also negotiated with hospitals to keep mothers and babies together for longerup to ten days at a time – so that where abandonment is a possibility the right services can be provided to either prevent it or find alternative family care.

You can imagine how complex this becomes.

For example, when you pour over the assessment charts for the children we have helped placed out of the orphanages and into families, we are consistently seeing an initial dip in the metrics we are monitoring before they recover and improve. The reason for this is the lack of willingness among local authority social workers to commit to post-placement support. So we are holding their toes to the fire. It’s important that they deliver this service and not us, otherwise there is no chance of us catalysing sustainable, systemic change, or of us enforcing accountability around quality. It is challenging work.

Lourenza, our Country Director, summed up this challenge clearly:

We have worked alongside the local authority social workers to embrace the concept of therapeutic work with the child-in-family, which has had excellent results in building resilience of both the child and family. Focused, targeted work and linkage to services, based on thorough needs assessments, and reassessment – which tracks impact – had to be done with the child and the family, prior to placing the child back into their family, to ensure a safe, sustainable and positive reunification. Getting the local authority social workers to do this has taken time. In fact, the result of the length of time and the care needed to ensure that local authority social workers understand and apply the process of working within the whole eco-system of a child, can be seen in the graph showing trend of Exits from institutions above. 

“This is how hope is born”

Over the coming weeks we have a number of events at community and Provincial level, and we are participating in national ones too. There is increasing attention on and commitment to child care reform and we are helping to lead the charge on it.

This is down to our incredible team in South Africa, who work smart and work hard in equal measure. And it is down to our partners like BST and the Nigel Caring Community, the Provincial authorities, and funding partners like UBS Optimus and A&O.

It is proof that with the right combination of commitment, the possibility of systemic change can become a reality.

And that is how hope is born.”