Orphan Care: An Introduction

This collection aims to cast light on the social work profession and its care for orphans in middle and low income nations. Four countries are profiled in this work, and the focus in each portrayal is the work done by professionals as well as the socio-political context of this work in the area of care for orphaned children. As will be argued later, both our international perspective and our understanding of the needs and care of orphans around the world are limited in the English language social work literature. This work represents an attempt to address these limitations. I whole-heartedly embrace Watts’ urgent call,

“International and comparative social work and social welfare have some catching up to do…In order to seek answers, we need to recognize we have much to learn from each other. We have much to learn about how social work is practiced in countries different from our own. We have much to learn about the similarities and the differences in social work in various countries. Our learning about its many facets and expressions can challenge our own interpretations of reality and our own truth claims and move us to new ways of thinking and new ways of understanding” (1997, p. 5).

Shortly after social work’s inception as a profession in the early twentieth century, an international dimension to the profession emerged. In 1928, 3,000 representatives from 40 different countries met at the First International Conference of Social Work, and collaborations begun there led to the eventual development of the International Federation of Social Work in 1956 and the International Association of Schools of Social Work in 1954 (IASSW 2008; IFSW 2008). Notable professionals from the past, such as Jane Addams, and present, such as Katherine Kendall, have foregrounded the international role of the field. Today there is a resurgence of efforts to facilitate and encourage the circulation of a global social work understanding and knowledge-base.

While individual leaders in the U.S. have been active in international social work, the field in the U.S. as a whole does not exhibit an international perspective. The widespread introduction of internationalization and issues of globalization into the social work literature and education is a relatively new event in the U.S. The past ten years has witnessed an increase of reference to events and issues in other countries and the interconnectedness of peoples around the world. Introductory social work books now have sections devoted to an international perspective, with some carrying the theme throughout (see for example van Wormer 2006). According to Healy (2001), while many schools of social work in the U.S. offer international and comparative content, such coursework is far from being institutionalized. Cross-cultural contact is also becoming incorporated into curricula. Cornelius and Greif (2005) found that 20% of master’s programs offer some opportunity for international study abroad, intercountry faculty exchanges, or international research collaboration. Some of the leading authors in the field characterize this increasing focus on international issues as a reaction to globalization while citing the continuing localistic orientation of the field. Midgley (1990) offers a critique of the localism of social work practice and research. That the profession in the U.S. lacks an international perspective may be reflective of both our cultural tendency towards isolationism and an autistic orientation of practitioners and researchers. This inward focus both as a culture and a profession is being challenged by a few global pioneers in the field.

Despite the increasing attention to internationalization in the field in the U.S., “few would claim that the international dimension in social work is adequate or that there is sufficient information about social work in different societies. … Thus, social workers have limited, if any, exposure to programs or practice beyond the boundaries of their own countries” (Hokenstad, Khinduka and Midgley 1992, p. 2). “The literature on social work as a profession in different countries is surprisingly limited. … There is clearly an urgent need to document social work practice in different societies so that social workers can have a better understanding of their profession in other parts of the world” (Midgley 1992, p. 17). Others have a more serious perspective on social work’s need to get global. Nagy and Falk (2000) announce that an international perspective in social work education is important for “….the survival of the profession, meaning that social work depends on knowledge and influences gained from other societies” (p. 50).

These leaders in the field agree that much more information on other countries is vital for social work as a science-based profession. They share a sentiment regarding the advancement of the discipline that warns our scientific and practical isolationism limits our understanding of and potential contribution to the amelioration of social problems that effect individuals and communities at both the local and global levels. These voices lead the charge in calling for a vitalization of international knowledge and awareness for American social workers. I agree this is a valuable goal, but I am cautious about the path we take on this venture. We have much to gather and learn, but as will be argued below, to do so solely from an authoritative position could be unfortunate for our understanding of social problems and social work in other cultures.

Influenced by postmodern theory, several practice theories suggest that we have much to learn from clients. The feminist perspective (Hare-Mustin 1978) and the narrative approach (White and Epston 1990) encourage us to seek the client’s view on a given situation and to honor the client’s voice. The impact that these approaches has had on practice are profound, as seen with the embracement of empowerment and self-determination as key principles in the field. These postmodern approaches hold the notion of “client as the expert” as a central component in the therapeutic relationship. A practitioner working from one of these perspectives not only values the client’s construction of the situation, but acknowledges the client’s position of authority regarding the purpose and direction of the intervention. To this, the social worker who works from a postmodern perspective does not see herself as the expert and does not dictate the goals for the intervention. Rather, she joins with the client, helps to enunciate the client’s position, and collaborates with the client in sharpening her coping skills. These approaches utilize the concept of voice, beginning with whose version of the story is told is critical toward understanding. Thus, social workers who use a postmodern approach value the client’s version of events.

Drawing from this perspective for our understanding of other cultures, we can employ the same value to the views of persons indigenous to a particular cultural group or society. Anthropologists term this the “emic” or insider perspective, wherein information about a particular group is gathered from one or more group members (Pike 1967). In this way, behaviors, events, or structures in the culture are included and defined from a cultural perspective. It appears that the English language social work literature has not been as influenced by this predilection. Despite the fact that social work is taught in at least 100 countries (Garber 1997), in a review of articles published from 1977 to 1996 in 33 core social work journals in the U.S., Cetingok (1999) reports fewer than 7% of contributors were from outside the U.S. Similarly, in a later study of articles published from 1999 to 2001 in the top seven social work journals in the U.S., Greif (2004) found that slightly fewer than 10% were from foreign contributors. The major social work journals that target an American audience, then, gather about 90% of their articles from U.S.-based authors.

To hear about social work in other countries from indigenous scholars rather than having the knowledge produced by a cultural outsider is a primary goal that I hoped to achieve with this collection. In this collection, the contributors, the editor excluded, are from non-western countries and all are writing about one shared social problem. The contributors describe the problem, services, and needs of orphans from their emic perspective. The focus on non-western countries is two-fold: First, relatively little information is available on social work in these regions of the world. Midgley (1990) persuasively argues that international social work has been “unidirectional,” with westerners “exporting” knowledge and practices to non-western nations. He forwards that we must seek information from “Third World” (sic) countries in order for us to learn from them. Although this position was put forth 15 years ago, the situation has not changed significantly. In their separate reviews of U.S. social work journals, Cetingok (1999) and Greif (2004) found the majority (over 60 %) of foreign contributors were from just three western countries. If one includes Israel as “western,” the representation of contributors from western countries bounces to over 85% (Cetingok 1999) and 95% (Greif 2004). The total foreign contributions by westerners may be even greater, since only the countries with the largest contributions are reported in the articles. The second major impetus for focusing on non-western countries is the regions within which they lie are particularly impacted by the central topic of orphans, albeit having very different rates of orphaning and varying levels of care effectiveness. A complexity of applying this perspective results from a discrepancy in the data and information available on orphans in each of the countries. All of the authors utilize their country’s official statistics, each of which is far below the United Nations’ figures. I present the international figures in this article, and the country authors report their state’s data.

Every society has in place some system for which to care for its parentless children. While the type of systems may at times vary, a signifying feature is the level of formal institutional or governmental involvement in the care of children. Those with little governmental involvement (and often, support) rely more heavily upon traditional kinship or community care. As will be presented in the readings, this tendency has become problematic, especially when large-scale societal economic and health crises overwhelm traditional supports. When entire communities are crippled, as occurs in epidemics and wars, children may be left without care, leaving them to survive on the streets (UNICEF/ISS 2004). Of great concern as well, is the lack of oversight of traditional support systems that may place some children at risk for exploitation, such as the practice of caretakers’ denying orphaned children food until their biological children have eaten or the practice of “grabbing,” that is, the taking of property by relatives after the death of a parent that robs children of their, often meager, inheritance (Family Health International 2003; UNICEF/ISS 2004). To address such deficiencies in the system, many non-western countries are developing policies and programs to address the growing problem of orphaning. Conversely, highly bureaucratized countries like the U.S. and the former Soviet states rely more on formal institutions and structures to assess and care for orphaned children. But as we have seen in countries like the U.S. and Great Britain, over-involvement by government has often overlooked kin and community supports (UNICEF/ISS, 2004), and it is only within the last 10 years that we have seen a resurgence of efforts to nurture those primary and secondary support systems.

The plight of orphaned children throughout the world is grave. There are an estimated 2 million children in Europe and the U.S. who are without parental care (UNICEF/ISS 2004). In other regions of the globe, the numbers are alarming. The following discussion is informed by a joint report by UNAIDS, UNICEF and USAID (2004) on orphans in three regions: Sub-Saharan Africa, Asia, and Latin America and the Caribbean. (The report defines orphans to include maternal orphans, those who have lost their mother; paternal orphans, those who have lost their father; and double orphans, those who have lost both mother and father.). There are over 140 million orphaned children throughout the world, with the vast majority from Asia (87.6 million) and Sub-Saharan Africa (43.4 million). The rate of orphaning has been decreasing in Asia and Latin America in the past ten years, but the numbers remain high due to natural increases in population. Sub-Saharan Africa is unique here in that its orphan rate has been increasing, largely due to the AIDS pandemic (that is, 28% of all orphans are orphaned because of AIDS). The orphan population in Sub-Saharan Africa has increased by over 50% since 1990 and over 12% of all children there are now orphans.

The circumstances of orphanhood vary by country and region of the world. War, famine, disease, and economic circumstances are the leading primary causes of orphanhood. Asia and Africa have been particularly hard hit by the HIV/AIDS pandemic (and the global maldistribution of antiretroviral medications), and it is the leading single cause of orphanhood in Africa (UNICEF 2001). Much of the recent work on the topic of orphanhood has been stimulated by the urgent situation in Africa, where over 80% of orphans who have lost parents due to AIDS live (UNICEF 2003). While children’s needs vary by circumstances, the report Children on the Brink (UNAIDS/UNICEF/USAID 2004) identifies a number of critical areas affecting orphans:

Despite the enormity of the problem, the subject of orphans has received comparatively little attention in the English language social work literature. In a search of the social work abstracts from 1977 to 2007, only 43 articles published dealt with orphans. Only 12 of the 43 were focused on children from middle to low income nations. Although, 6 of these 12 articles were published in the past 7 years, we still have some catching up to do on the topic as it affects economically disadvantaged nations.  [1] Similarly, books published on the topic of orphans in the past 20 years are few. A search of publications in the past 30 years revealed only 17 books and reports, and another 8 with some coverage, on the current orphan population.  [2] Notable among these is Tolfree’s (1995) Roots and Roofs which explores the care of institutionalized children in more than a dozen countries throughout the “developing world.” The dearth of information in the social work literature leaves us with a narrow view of the magnitude of the problem and with little understanding of what challenges are present and resources utilized by social workers in these countries. To the extent we know anything about the world’s orphan population, it is due to the work of the United Nations, particularly UNICEF, the World Bank, as well as several notable NGOs such as Family Health International and International Social Services. Of course, several social workers have been involved with the UN and as representatives of various organizations in collaborative efforts to study and advocate on behalf of orphaned children.

The social workers and other professionals who work with orphans in direct services, program development, or management do so in the larger context of global rights for children. Since the adoption of the Universal Declaration of Human Rights of 1948, the first international human rights document, the world community has struggled to cast a protective net over marginalized, exploited, and victimized groups, including children. Since the Declaration, six universal human rights treaties have been initiated, and the treaty aimed specifically at children is the 1989 Convention on the Rights of the Child, or the CRC. The CRC enjoyed the swiftest passage and is the most widely adopted of the treaties, with only two states – Somalia and the United States yet to ratify it (Lopatka 2007). The CRC contains 54 articles which are to be viewed within the lens of its four key principles pertaining to the rights of children: non-discrimination; the best interests of the child; right to life, survival and development; and, respect for the views of the child (Committee on the Rights of a Child 2003). The CRC is the core international document articulating the global rights of children and the responsibilities and obligations of states toward protecting and upholding those rights. Some of the key provisions that pertain to orphans in the CRC are the right to supervised care (article 3), the right to a family and an identity (article 8), the right to remain with family (article 9), the right to a review of their care (article 25), the right to an education (article 28), and the right to care that meets basic needs (article 27). In addition, Article 20 is explicit in the responsibility that governments hold for orphaned children, “a child temporarily or permanently deprived of his or her family environment, or in whose own best interests cannot be allowed to remain in that environment, shall be entitled to special protection and assistance provided by the State.” Since the implementation of the CRC, the international community has engaged in additional efforts to assure the safety and well-being of children. The UN held the 1990 World Summit for Children, with over 150 countries in attendance and in 2002 held a Special Session on children (UNICEF 2001). These efforts were to focus world attention upon the serious conditions, such as child trafficking, hunger, and child labor, still faced by children throughout the world and to build upon states’ efforts to continue their commitment to children’s rights as designated in the CRC.

Drawing from these previous efforts and concluding that orphans were at special risk, the Committee on the Rights of a Child issued a Recommendation in 2004 (37th session), which was reiterated in their Day of Discussion of 2005, that advised the adoption of guidelines for standards of care for children without parental care (OHCR 2008). The NGO Working Group on Children without Parental Care drafted a set of guidelines, which they submitted along with 45 other organizations who submitted statements, to the Day of Discussion. The NGO Working Group’s (2006) recommendations include the following: the prevention of removal of children from family care by providing families with necessary supports and eradicating or minimizing the structural factors, such as poverty, impacting orphanhood; the facilitation of a range of culturally appropriate options regarding the care and support of parentless children, including foster and kinship care; and the enumeration of requirements for practices in care provision. These guidelines were submitted to the UN’s Office of the High Commissioner for Human Rights, which is yet to make a determination regarding the form and timeline of a proposal of international standards of care, if any, to the general assembly.

As discussed, the profession’s organized involvement in disseminating research, promoting best practices, and advocating for orphans has been limited. However, IFSW did issue a statement urging further attention to the orphan issue for the Day of Discussion. Oddly, though, IFSW has issued policy statements on a number of important global concerns, e.g., human trafficking and HIV/AIDS, but nothing on the orphan problem. Over 140 million children in the world demand that the social work profession be more centrally involved in raising public awareness. That is not to say that social workers in the most affected countries are not involved in orphan care. As we shall see in the selections here, social workers play a role, and in some countries, a central role, in addressing the needs of orphaned children.

The collection presented here is a paradigmatic case study of orphan care. Thus, the countries presented in this volume do not offer a representative sample of the world’s orphan population, but rather are lower income nations managing a significant subpopulation of orphaned children. The focus on low- and moderate- income countries is an attempt to capture the array of programs and services offered and the orientation of social workers, to the extent they are involved in care, toward the problem of orphaning in a variety of social contexts. As lower income nations, they no doubt face tremendous obstacles in care delivery. The issue of orphanhood is intricately connected to the problem of poverty. Lower income nations tend to have higher rates of orphaning, and within a given nation, children from the lower stratum are at greater risk for orphanhood. Thus, classification of country by income is a convenient way to conceive of both international and intranational well-being. The discussion that follows is based upon the World Bank’s (2008) system of classification and supporting data (see Table 1). The highest income countries tend to be western nations, most are capitalistic and democratic, and all have a high standard of living, and a very high ranking on the Human Development Index (HDI). HDI combines factors such as infant mortality and literacy rates. Most of the highest income nations would also more appropriately be termed post-industrialized societies, as their economies have moved away from production to service and technology and have a small percentage of their population involved in agricultural production. (The oil-rich nations in the Middle East challenge this grouping and are often characterized in a separate category from other nations.). Among the middle and low income countries is a great variance in their level of industrialization, political structure, standard of living, and HDI. The simplest statement that can be made is they have a lower standard of living and rank low on HDI and have less urbanization, industrialization and democratization than the high income countries. None of the middle or low income countries could be considered a post-industrialized nation. Botswana seems to defy this, with a large percentage of the population involved in service occupations (45%), but it has a large rural population and its extreme poverty rate is very high, with 50% of the population falling in this category.

Table 1: Classification of Countries

The contributors describe, from their informed, emic position, their country’s orientation towards orphans and orphan care, as well as their country’s social work orientation. While there are differences among them, there are also common issues and practices. The final paper from Tatek Abebe in this collection offers a lens through which to view the commonalities, forwarding that the etiology of orphanhood can be understood in terms of historical and contemporary global relations. From the perspective that this is a structurally constructed problem, Abebe argues that solutions must also be large-scale, global, and comprehensive.

From a localist perspective, our task in this edition is to understand and present the role of social work in addressing the needs of orphans in each of the selected countries. Our key task is to present the nature and extent of the problem and the cultural responses toward defining the problem and addressing the needs and care of the orphan population. That is, to better understand the challenges, knowledge, and skills of our social work colleagues across the globe. From a global perspective, our goal is to understand the commonalities and distinctions of orphan care and social work’s role in it so that the profession can engage an international voice with the purpose of fulfilling the field’s mission:

“The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work” (IFSW 2000).

To initiate efforts to evaluate the extent to which we uphold this mission for orphans, we offer these portraits of the experiences of four countries. We hope this work will add to a critical understanding of the profession’s involvement, and the gaps of that involvement, in the lives and care of the world’s orphans.

Cetingok, M. 1999: Contributions of foreign-based authors to selected social work journals in the United States, in: Journal of Sociology and Social Welfare, 4, pp.47-59.

Committee on the Rights of the Child 2003: General Comment No. 5. Retrieved online March 5, 2008 from < http://www.unhchr.ch/tbs/doc.nsf/(symbol)/CRC.GC.2003.5.En >

Cornelius, L.J. and Greif, G.L. 2005: Schools of social work and the nature of their foreign collaborations, in: International Social Work, 6, pp.823-833.

Family Health International 2003: Voices from the Community: The impact of HIV/AIDS on the Lives of Orphaned Children and their Guardians. NY: FHI.

Garber, R. 1997: Social work education in an international context: Current trends and future directions, in: Hokenstad, M.C. and Midgley, J. (eds.): Issues in international social work: Global challenges for a new century. Washington, D.C.: NASW Press, pp.159-171.

Greif, G. L. 2004: How international is the social work knowledge base?, in: Social Work, 3, pp.514-516.

Hare-Mustin, R.T. 1978: A feminist approach to family therapy, in: Family Process, 2, pp.181–194.

Healy, L. M. 2001: International social work: Professional action in an interdependent world. NY: Oxford University Press.

Hokenstad, M.C., Khinduka, S. K. and Midgley, J. 1992: The world of international social work, in: Hokenstad, M.C., Khinduka, S.K. and Midgley, J. (eds.): Profiles in international social work. Washington, DC: NASW Press, pp. 1-11.

International Association of Schools of Social work.2008: History. Retrieved March 3, 2008 from < http://www.iassw-aiets.org/ >

International Federation of Social Work 2000: Definition of Social Work. Retrieved March 3, 2008 from < http://www.ifsw.org/en/p38000208.html >

International Federation of Social Work 2008: History. Retrieved March 3, 2008 from < http://www.ifsw.org/en/p38000040.html >

Lopatka, A. 2007: Introduction, in: United Nations Office of the High Commissioner for Human Rights and Save the Children Sweden (SCS) (eds.): Legislative History of the Convention on the rights of the child. New York and Geneva: United Nations, pp.xxxvii-xliii.

Midgley, J. 1990: International social work: Learning from the third world, in: Social Work, 4, pp.295-301.

Midgley, J. 1992: The challenge of international social work, in: Hokenstad, M.C., Khinduka, S.K. and Midgley, J. (eds.): Profiles in international social work. Washington, DC: NASW Press, pp.13-27.

Nagy, G. and Falk, D. 2000: Dilemmas in international and cross-cultural social work education, in: International Social Work, 1, pp.49-60.

NGO Working Group on Children without Parental Care 2006: Development of International Standards for the Protection of Children Deprived of Parental Care. International Conference, Bucharest, 2 and 3 of February 2006.

Office of the United Nations High Commissioner for Human Rights (OHCR) 2008: Fact Sheet No.10 (Rev.1): The Rights of the Child. Retrieved March 20, 2008 from < http://www.unhchr.ch/html/menu6/2/fs10.htm >

Pike, K.L. 1967: Language in relation to a unified theory of the structure of human behavior. (2nd ed.). The Hague: Mouton.

Tolfree, D. 1995: Roofs and roots: The care of separated children in the developing world. Aldershot, England: Arena/Ashgate Publishing.

United Nations 1989: Convention on the Rights of the Child. Retrieved January 15, 2008 from < http://www.unhchr.ch/html/menu3/b/k2crc.htm >

United Nations Global Development Network, UNDP 2007/2008: Indicators by Tables. Retrieved March 3, 2008 from < http://hdrstats.undp.org/indicators/indicators_table.cfm >

UN Committee on the Rights of the Child 2003: Thirty-fourth session, 19 September-3 October 2003. GENERAL COMMENT No. 5.

UNAIDS/UNICEF/USAID 2004: Children on the Brink: A Joint Report of New Orphan Estimates and a Framework for Action. NY: UNAIDS/UNICEF/USAID.

UNICEF 2001: We the Children: Meeting the Promises of the World Summit for Children. NY: UNICEF.

UNICEF 2003: Africa’s Orphaned Generations. NY: UNICEF.

UNICEF 2005: State of the World’s Children 2006. NY: UNICEF.

UNICEF and International Social Service 2004: Improving protection for children left without parental care: A call for international standards. NY: UNICEF.

van Wormer, K. 2006: Introduction to social welfare and social work: The U.S. in global perspective. Belmont, CA: Thompson Brooks/Cole.

Watts, T.D. 1997: An introduction to the world of social work, in: Mayadas, N.S., Watts, T.D. and Elliott, D. (eds.): International handbook on social work theory and practice. Westport, CT: Greenwood Press, pp.1-5.

White, M. and Epston, D. 1990: Narrative means to therapeutic ends. NY: Norton.

Worell, J. and Remer, P. 2003: Feminist perspectives in therapy: Empowering diverse women. NY: John Wiley & Sons, Inc.

World Bank 2008: Data and Statistics: Country Groups. Retrieved January 10, 2008 from < http://go.worldbank.org/D7SN0B8YU0 >

Author´s Address:
Ass Prof. Jo Daugherty Bailey
BSW Program Director
University of Houston-Downtown
Department of Social Sciences
One Main Street
USA-Houston, Texas, 77002
United States
Tel: ++1 713 226 5245
Email: baileyj@uhd.edu