1. Street Children and Orphans in Eastern Europe Tatiana Balachova, Ph.D. Barbara Bonner, Ph.D. University of Oklahoma Health Sciences Center Sheldon Levy, Ph.D. Brown University

2. Categories of Children Who are Not in Parental Care n n Street/homeless children (UNICEF, 1986) – –Children on the street – –Children of the street n n Children in substitute care – –Institutionalized children

3. Definition of Street Children n n "Any girl or boy for whom the street …has become his or her habitual abode and/or source of livelihood, and who is inadequately protected, supervised, or directed by responsible adults." (Ortiz et al., 1992)

4. Background prior Perestroika n n No Street Children in Developed Soviet Societies n n State is taking excellent care of orphans n n No recognition of physical/sexual child abuse n n Severe child neglect recognized n n Data on negative issues were closed n n State control on parents response to a childs needs n n Medical care provided for all children by the state n n National newborn home visitation programs

5. Care for Orphans and Street Children in Soviet Union n n Police Collection and Distribution Departments (Priemnic-Raspredelitel) in big cities n n Babys home (Dom Rebyenka) state orphanages for infants age 0-4 n n Childrens home (Dyetskii Dom or Internat) state orphanages/institutions for children age 5- 17 n n Boarding institution (Spets-Internat (Psychoneurological Internat) for physically or mentally disabled children age 5-17

6. Impact of the Transition n n Greater democracy and freedom n n Economic impact – –fall in wages and family income /37% of Russians income below living wage (Russian minister of Labor and Social Development report to the Duma/Parlament, Oct. 2000) – –rising unemployment – –extremes of income inequality >>>>Poverty Over 160 million people or 40% of the region population live in poverty (European Childrens Trust, Oct. 11, 2000) n n 50 million of them children – –40 million of these children live in the former Soviet Union

7. Impact of the Transition n n Loss of social safety network n n Health crisis – –increase in mortality rates / nearly 25% of the population will not reach the age of 60 (European Childrens Trust, October 11, 2000) – –poor health – –disruption of health care system n n Education (schools and day care) – –lack of resources – –falling enrollment and attendance

8. Number of Street Children n n Romania – –Estimated up to 20,000 street children in Romania (beginning of 1999, 5.2 million children age 0-17 in Romania) n n Russia – –Estimated from 1 to 4 million street children – –Estimated 50,000 children run away from their homes every year (beginning of 1999, 34.9 million children age 0-17 in Russia)

9. Dynamics of the Numbers n n Russia - number of registered orphans between 1993 and 1997 increased by 30% - number residing in institutions increased by 35% - children in foster families (mostly relatives) 46% - number adopted was consistent, increased by 2% n n Romania – –Abandonment of children in state institutions has increased between 1990 and 1995 by 26 percent (Child Hope)

10. Street Children, Children in Shelters and Institutions: Who are They? n n 90-95 % of children in orphanages are social orphans who have a living parent (UNICEF, 1997) n n 98 % children in shelters have a living parent (Balachova, 1994)

11. Factors that Drive Children Away from Home: Alcohol Abuse n n Most children in shelters reported parents alcohol abuse (Balachova, 1994) n n Most children in state-run institutions had a parent who was either alcoholic or had legal problems with authorities (Gribanova, 1988) n n 82 % of alcoholic fathers were found to be aggressive (verbally threatening and physically violent) toward their children (Christov & Toteva, 1989)

12. Factors that Drive Children Away from Home: Physical Abuse and Neglect n n 92% of street children reported that they had run away from their families or institutions because of physical or other abuse (Jhumki Basu, 1998) n n Preschool enrolment rates dropped between 1989 and 1999 by 10% in Russia, 21% in Ukraine, 15% in Albania, and 29% in Moldova (UNISEF report, 8, 2001) n n 5% of primary school students in Russia are out of school (UNISEF Report, 1999)

13. Children in State-Run Institutions n n Children in institutions are at significant risk of premature death (Ministry of Labor and Social Development) – –With higher death rates in Internats for mentally disabled children (UNICEF) n n Approximately 30% of children in special institutions for disabled die before they reach age 18 (Ukraine, 1996, Human Rights Watch)

14. Children in State-Run Institutions n n Mortality rate is due in part to crowding, poor hygiene, and low standards of care (UNICEF) n n Many children are at increased risk from their underlying conditions n n The incidence of malnutrition disorders, rickets, and anemia increased in Infants Homes by 75% respectively between 1989-1994 (UNICEF)

15. Children in State-Run Institutions n n From 5 to 7 times more likely to have behavioral, cognitive, and communication problems than children in general population n n 65% have mental retardation or learning problems (Shipitsina, Ivanov, & Vinogradova, 1997)

16. Children in State-Run Institutions: Outcomes On graduation from a state institution for mentally disabled at age 18 n n 18.3% became vagrants n n 10% involved in crime n n 10% committed suicide (Alternative Report on the Convention on the Rights of the Child, October 1998)

17. Elements of New System n n Shelters and social-rehabilitation centers have sprung up to provide a more humanistic system n n Alternatives to institutional care are in their infancy – –foster care – –family group homes – –family reunification programs

18. Recommendations Primary Prevention n n Public education to increase awareness of child abuse and neglect, and to alter public attitudes toward orphans n n Parenting programs for parents n n Training for primary health care & child care professionals n n Reestablish after school & community programs

19. Recommendations Secondary Prevention n n Services for children with special needs & their families n n Services for single parents, multiple children families, and other families at risk n n Early intervention for families of alcoholics and drug addicts

20. Recommendations Tertiary Prevention n n Services for street children with interventions on different levels – –street work – –shelters – –foster families n n Establishing of child abuse reporting and investigation system n n System of short- and long- term substitute care with respect of childrens needs/rights & deinstitutionalization n n Training on CAN for staff at institutions/shelters

21. Policy Recommendations Development of child protection laws & procedures – –Definition of child abuse & neglect – –Reporting laws – –Punishment for offenders – –Protection for victims – –Investigation procedures – –Mandatory treatment services