Orphan Care in China

China is a communist, centralized country with a population of 1.3 billion. Since the founding of the People’s Republic of China in 1949, the central government has controlled resources in order to promote the industrialization of the country. The planned economy was the mainstream for the country and the urban, industrial development was prioritized, then a number of policies were implemented for the benefit of workers and urban people. Among them was the policy of the registered system, which divided Chinese citizens into urban and rural populations, labeling people as either work unit employees or farmland peasants. The division of citizens into two groups indicated the establishment of a binary social structure. In order to control costs, salaries for employees were low and stable for a very long time. As a control and compensation for the low salaries, the government provided a number of tangible supports to the employees, such as medical care, food allocation, housing, education, employment, pension, labor protection, and marriage and maternal protection. Due to the fact that welfare provision was closely related to the status of being employed, the employees largely relied on their work units, and gradually, the welfare system evolved into work unit welfare, and hence the welfare of occupation, which means welfare is attached to the occupation one is having (Li and Wang 2007). Therefore, the welfare system in the planned economy enlarged the differences between urban and rural peoples in China, with urbanites receiving more than their rural counterparts, which was described by some scholars as an urban-rural binary and discriminatory welfare system (Guo and Lin 1990). Under this system, urban residents were included while only rural residents who were poor from unexpected sufferings or events were included (Li 2007). The social welfare system was featured as social relief and government control, targeting the childless elderly, orphans, and people with disabilities (Su 2007).

Since economic reform and the transition from a planned economy to a market economy, the traditional state-work unit structure has been broken. In the urban areas, more and more workers have lost their jobs and were thus separated from their work units and means of support. The state did not provide any social welfare to help workers cope with unemployment. In rural areas, the breakdown of the collective economy worsened the situation for rural people, leaving them unprotected and marginalized from the welfare system (Leung 1995).

In order to cope with the situation, the government decided to implement a new welfare structure. The government will provide all of the expenses for social welfare, establish a social welfare system which can serve all the citizens, including all the rural and urban people, and encourage the development of market-oriented welfare institutions (Su 2007). In its implementation, difficulties have emerged, such as insufficient social welfare legislation, lack of funding, contradictions between the demand and the need, and the lack of systematic administration in social welfare (Li 2007; Li and Wang, 2007). With the breakdown of the centralized welfare system in China, more and more NGOs and different governmental departments have assumed responsibility for the of delivery welfare services to people in need (Li 2007; Sun and Lu, 2007).

In China, the definition of orphans has changed over time and the legal definition is not as clear as the international one. For instance, on Aug. 1, 1992, the Ministry of Civil Affairs released an announcement as a part of the Law of Adoption, indicating that orphans referred to children under 14, whose both parents were dead. On March 29, 2006, another document, “Suggestions on Enhancing the Assistance Work for Orphans,” issued by Ministry of Civil Affairs jointly with 14 ministries of the central government, stated that orphans are those under 18 who had lost their parents through death or abandonment and are unsupported by others. Under this, there are two major kinds of orphans: actual orphans and form orphans. “Actual orphans” are the children whose parents have died or have been missing for more than four years. They are easy to be recognized. “Form orphans” are those who have one or more parent living, but they are not protected or looked after by their parents due to abandonment, poverty or imprisonment. In reality, there remains confusion in defining who are included in official definitions of orphanhood (Cheng 2003).

On Sept. 29, 2005, the first national survey on the situation of orphans in China conducted by the Ministry of Civil Affairs was released to the public. The findings indicated that there are 573,000 orphans under 18 years of age. The data describes the distribution and social support to this group. The majority, 86.3% or 495,000, are living in rural areas. Four provinces account for 30% of the total: 50,000 are in Henan province and more than 40,000 are in Hunan, Anhui and Jiangxi provinces. In these four provinces, 95% of the orphans are living in rural areas (Shang 2005). The findings also show that over half are receiving national systematic support, among them 53,000 are granted the urban minimum living allowance, 125,000 receive the rural five protection allowance  [1] , and 116,000 are supported by the rural poverty allowance. The amount of the allowance varies in different areas, as the rural and uban allowance varies and different areas have different standards for the allowance. It ranges from 60 yuan (RMB) in very poor rural areas to 390 yuan (RMB) in Beijing. Still, there are 200,000 orphans not protected or covered by the national systematic support or relief (Shang 2005).

Interestingly, UNICEF indicates that the number of orphans in China is over 21 million (UNICEF News). It seems that there is a big discrepancy between the national and international figures on Chinese orphans. While there is not published data to account for this discrepancy, one possible reason may be that the two different definitions of orphans. In contrast to the legal definition in Chinese law discussed above, according to UNICEF, an orphan is a child under 18 who has lost one or both parents, lives in a household with an adult death in the past 12 months, or who lives outside family care. Comparing these two definitions, it is clear that the national one is limited, and the international one is broader.

The targeted groups of child welfare service in China are mainly the dependent, homeless children who are orphans, abandoned children, children with disabilities and runaway children. Since 1949, there have been three periods of development of child protection policies in China.

The first stage was from 1949-1978. During this period, service delivery was organized by the government on different levels in the form of institutionalization. On the basis of the previous institutions set up by the regional Guomindang government, the Communist government established caring homes for orphans. According to data by the Ministry of Civil Affairs, during 1949-1954, there were 666 welfare institutions caring for the elderly and orphans, with 25,960 orphans living in them. At the beginning of the 1960s, as a result of food shortages and disasters, the population of orphans and abandoned children increased, and institutionalized care grew. In 1962, there were 772 child welfare homes, accommodating 65182 orphans (Bai and Wu, 1996). During the cultural revolution, a large number of child welfare homes were closed down, so by the end of 1978, there were only 49 child welfare homes with 3665 children (National Statistics Bureau 1985). Due to the closing of the homes, more and more dependent and homeless children became street kids. The central features for this stage are as follows: 1) institutionalized care was more relief and accommodation and more political than welfare; 2) the service quality was relatively poor, meeting only the basic needs of the orphans, and focusing on political education while neglecting educational and psychological needs, and 3) the funding was provided mainly by the government, with the state covering all the expenses of the child welfare homes (Wang 2007).

The second stage was from 1979 to the early 1990s and was a period of primary reform of child welfare care. First, the number of child welfare homes increased sharply. From 1979-1992, 15 new child welfare homes were set up and 2500 more orphans were taken in (National Statistics Bureau 1994). The second change was the inclusion of runaway children by the welfare homes. The third change was a transition from relief to welfare and the inclusion of education and a development orientation in terms of service delivery within the institutions (Cheng 2003). The last change was a move to multiple funding sources for child welfare homes; in addition to state funding, more stakeholders became involved in funding service delivery, such as foreign foundations and individual donors (Wang 2007).

The third stage began in the early 1990s and continues to the present. This is a period of comprehensive reform for the child welfare system. From 1999 to 2004, the numbers of child welfare homes and residents almost doubled (National Statistics Bureau 1994). With the increasing development of the child welfare system, problems became apparent, such as the separation of orphans from the mainstream educational system, decreased attention to the psychological and mental development of the children, interruption of children’s socialization and development of social skills, and poor quality of service provided within the institutions, insufficient funding, and abuse cases by the workers (Zhang 2003; Human Rights Watch 1996). Another change during this period is that the central government enacted policies regarding the right to protection for children and social welfare for orphans and children with disabilities, such as, the enactment of the Law of Adoption and the establishment of guidelines for work with orphans and children with disabilities by the central government. Recent efforts have been on promoting relative caring and foster homes supplemental to child welfare homes (Wang 2007). This current environment will be the focus of discussion in the following sections.

There is no official data on the exact numbers of children abandoned by their parents annually. However, there is some data that can be referenced for understanding how seriously the situation is. At the end of the 1980s, the Ministry of Civil Affairs declared that the number of abandoned children accommodated by the state-owned child welfare homes was between 5,000 and 6,000, and the numbers increased to 66,000 by the end of 1999, among the abandoned children, the majority were girls or babies with disabilities (Ministry of Civil Affairs 2006). The numbers of abandoned children was increasing sharply between 1999 to 2003, and according to data released by the Ministry of Civil Affairs, the number in child welfare homes, both state-owned, or privately owned, rose from 45,000 to 54,000 and then to 78000 in 2005(Ministry of Civil Affairs 2006).

It is clear that there are more and more children abandoned by their biological parents, and they form the majority of the residents in child welfare homes in China (Ministry of Civil Affairs 2006). Most of the mentally and physically healthy children will be adopted by adults inside and outside China. Those who suffer from diseases or disabilities tend to stay in the homes for the rest of their lives, and they lack the opportunity to go school or interact with people in the community. Studies on children growing up in child welfare homes indicate that they lack a sense of safety and intimacy, are less confident in social participation (Gao and Yang 2007; Cheng 2003), and tend to be lonely, self-centered and lack a sense of security (Zhu and Cai 2007). These outcomes have the potential for creating more problems in adulthood, such as difficulty securing employment and marriage (Xu 2007; Gao and Yang 2007).

As for the causes of abandonment, research has shown that there are two primary reasons. Many scholars find that the government’s one-child policy was the single most significant cause of child abandonment in the 1990s (Johnson 1996; Johnson et al. 1998). According to this policy, married couples are allowed to have only one child, while rural couples can have a second chance if their first child is a girl. Since having a son is important for elder care in rural families, couples whose second child is a girl may choose to abandon her in hopes to try again for a son (Chan, Liu and Zhang 1997), while the situation in urban areas is better due to the fact that urban people have been strictly constrained by the work unit in family planning, and enjoy better welfare support for the elderly (Cheung 1998). The other major cause for abandonment is related to the economic situation of poor families and the inadequate social welfare coverage for these families. In many cases, due to poverty, the family cannot afford maternal checkups and care, which may result in a child with medical needs. When a child is born with a disability or serious disease, they are too poor to afford proper medical care and treatment, so they may abandon their medically needy infant in either a hospital or near a child welfare home, hoping someone will take care of the child (Cheung 1998; Xu 2007).

AIDS is creating a new kind of orphan in China. The phenomenon came to catch the public attention by the end of 1990s. In China, the term “AIDS orphan” refers to a child under the age of 15 whose parent, or parents, has died as a result of the AIDS virus. According to UN-AIDS estimates, by the end of 2005, there were 15 million AIDS orphan in the world and by 2010 that number will rise to 25 million. According to UNICEF, there are 78,000 AIDS orphans in China, and by 2010, that number will increase to 260,000 (Qian, Bi and Lu 2007). The main cause for so many AIDS victims are infection of the blood supplies, primarily in areas like Henan, Hubei and Anhui, while in some other areas, it results from drug addiction and unsafe sexual practices (Xu, et al. 2007). The major difficulties AIDS orphans face include emotional suffering from the loss of parents, lack of financial support resulting in poverty, discrimination by the community, vulnerability of being affected by HIV, and poor access to social services (Huang and Yang 2007). As a new phenomenon, there is insufficient policy support and regulation for the welfare of this group, and as a result, there is a care gap for AIDS orphans in the current service delivery system.

In the current orphan service system, another new kind of orphan is emerging. The public attention to this group resulted from two main sources, the first of which are juvenile criminal officials. Many reports indicate that many juvenile criminals are coming from families with one or both parents in jail (郭欣 2006; 陶健 2006). Another source of information is the educational systems. Researchers have found the basic rights for these children are not properly protected and many children drop out of school after their parents are jailed, while some run away from home and become street urchins and thus become targets for gangs and recruited to criminal activity (Zheng 2006). In 2005, there were 1.56 million prisoners in jail, 30% (close to 1/2 million) have dependent children, with the total number of the dependent children for these prisoners over 0.6 million (Chen 2005). This is a huge group, much more than the previous two types. These children are in a vulnerable situation, as they have to rely on themselves and are not a targeted population served by civil affairs departments or the department of justice for assistance (Zheng 2006).

Orphanage service used to be monopolized by the government in the sole form of institutionalization, i.e. the orphanage homes. However, as the reform deepens, more forms of service such as kinship care and foster care are being offered. All of these currently constitute orphanage services in China.

Orphanage service has the longest history and plays the main role in service for orphans in China; the service is funded by the government and forms the basic function of the civil affairs departments in local areas. There are some privately run homes, which are complementary to the government-run orphanage homes. For instance, in Beijing, there are 83 privately-run welfare homes, among them, 77 are for the elderly and 6 for the children (Beijing Civil Affairs Bureau 2006).

A typical orphanage home is organized as an affiliation to the department of civil affairs in the local government. Administratively each orphanage has a director and two or three vice directors in charge of different affairs. There are several offices including an office of primary education, office of rehabilitation, office of students, and office of treatment. The building houses facilities for feeding and playing, sleeping, education, and rehabilitation and medical treatment, and the number of therapists, teachers, doctors and nurses employed are based on the numbers of beds.

There is a screening and review procedure for taking in any new orphans, the agency needs to verify the identity of newcomers, ensuring that they exactly meet the requirements of the agency. Basically, the main goal for service is to meet the basic needs of the children, i.e. food, clothing, and shelter. Services also include education, in which formal schooling may take place within the institution or outside it, depending on accessibility to the community and the home’s resources. For children with diseases and disabilities, the home provides resources to treat their medical needs and sets up rehabilitation plans for them.

Rehabilitation services include music therapy, directive education and language training to help the children improve their physical functioning. For formal education, the home will send the children to nearby schools, so that they have the opportunity for contact with the outside world. For medical treatment, the home provides treatment to the disabled and ill children, and also basic prevention for healthy children. Meanwhile, the home also searches for some alternative care, such as foster care inside and outside the agency, combining institutionalized care with family care (Feng 2004).

The features of this kind of service can be summarized as follows:
The agency is in charge of fundraising, determining admission procedures, identifying new residents, recruiting new staff, and providing daily care. As a government agency, the ultimate goals for orphanage homes are to accommodate homeless children, and function as social control to make the society stable. The emphasis is on taking in as many orphans as possible, and settling them, while less on improving quality of service. The institution focuses on providing standard service, which at times may result in the neglect of the diverse needs of children. Orphanage homes stress the institution-centered model, i.e. service delivery happens in the institutional setting. The agencies gain sufficient funding and resources from the government and society to maintain the home to operate, meanwhile they must obey and follow the government instructions and administration. There are some advantages of this type of service that make them the cornerstone of orphanage service in China. They serve as the vehicle of social control, as a return, the funding and staff are stable, the benefits and working conditions are relatively preferable, and professional promotion is ensured. The disadvantages range from poor quality of service and poorly trained staff (Xu 2007) to the institutionalized working model that emphasizes administration rather than service, which fails to meet the diverse needs of children (Wang 2007; Xu 2006).

The concept of foster care was imported from western countries (Xu 2006). In the early 1990s, the idea of the foster family was introduced into China as a supplement to the government run, institutionalized care for the orphans. Foster care in China refers to caring for orphans in a temporary family, in a natural family setting, as studies find institutionalized care limit the mental, social and psychological development of orphans (Wang 2007; Xu 2006). Currently, almost half of orphanage homes have initiated foster care for their residents (Wang 2007). Gradually, foster care has evolved as a valuable form of care for orphans.

There are two kinds of foster care, one is foster care inside the agency and the other is outside the agency. Foster care inside the agency refers to staff from the agency establishing a family with several children, providing a family environment. It aims at providing a more individualized and better service to the children. The other form is to recruit parents outside the agency to form a family with several children. After training, the parents play their roles as father and mother in their home setting, and provide daily care for the children as family members. Many studies indicate that foster family care provides a better service and stronger chance for the children to grow healthily (Wang 2007; Xu 2006). Some families develop close, intimate relationships among family members (Wang, 2007). However, compared to orphanage homes, the foster system lacks sufficient resources such as trained and skilled professionals and access to facilities. Therefore, it is hard to ensure a level of rehabilitation and educational equality offered in orphanage homes (Wang 2007).

Service for the AIDS orphans appeared in the late 1990s, as the illness became more prevalent and the number of families impacted increased. There are several models development in service delivery. To sum up there are three main models.

Henan province is one of the focal places where AIDS infection rates are high, and consequently, AIDS orphans need support. The provincial government takes the major responsibility of care for these orphans. Three ways of caring were developed: 1) foster family. 2) adoption, and 3) institutionalized care. Foster family refers to the care taken by the kinships or families that can help to care for these orphans, the local government will pay the family a fixed sum of allowance to cover the child’s living expenses. The allowance varies in different places in the province. Meanwhile, the local government encourages people to legally adopt these orphans. According to the official data, from 1996-2004, 55,000 Chinese orphans had been adopted by American families, and 5,500 by Canadian families (Si 2006). For those who do not have a foster family, the local government will arrange for them to live in the orphanage homes and share the institutionalized care. The service provided focuses on the daily life caring and financial support. The minimum requirement is to keep the basic living standard for these orphans so that they are not homeless.

In Yunnan, AIDS infection results more from drug addiction. Apart from foster family and institutional care, the local government has applied four ways to assist the AIDS orphans. First is to provide a minimum living allowance to the urban orphans, and regular relief for rural orphans, which may range from 60 yuan (RMB) to 390 yuan (RMB) monthly. Second is to conduct joint projects with civil organizations and international charitable agencies to provide relief help to these orphans, such as education and emotional support. The third is to negate all school fees for the orphans to ensure their education. The last one is to establish a resettlement center for assisting AIDS orphans in the city. The center provides residence to these orphans, is in charge of collecting data regarding the number of orphans in the area, provide training for the staff working with AIDS orphans, encourage and guide people to adopt orphans, supervise the foster families to provide better care for the orphans, and direct the township level and street office level government to work on assisting AIDS orphans. The center serves to integrate resources in the area and to monitor the process of service delivery.

In Hubei in the past several years, the local government explored a community-based model to care for AIDS orphans. The model relies mainly on the kinship family and financially depends on the government and individual enterprises’ funding and community care. These AIDS orphans are taken care by their kinship families, the local government provides all the living allowance to the foster families, and the local businesses contribute funds to help subsidize the support. Meanwhile, great efforts have been made on community acceptance and care for these orphans so that they can interact and integrate into the whole communities. This model has been identified as the best one for orphans to be integrated into the community supported by the public and the local government (Huang and Yang 2007).

As mentioned above, children with parents in jail also face a number of difficulties, but there are no regulations or policies addressing their needs. However, there are some NGOs providing services to some of these children in need.

One of the famous one is the sun village in Beijing. Sun Village was set up in 2000, mainly providing service to the children with parents in jail. It is self fundraising and offers institutionalized care for these children during the absence of their parents, to ensure that their rights for education and care are protected. There are four departments in the village, the department of administration, fundraising and development, children management and property management. There are eight staff working here in charge of the daily operation, fundraising, public education, advocacy, promotion, education and monitoring. There are more than 130 children aged between 3 months to 18 years old living there. All the children will go to school in the nearby community, the Village provides all the service free of charge, including schooling, clothing and daily needs. The children will visit their parents in jail three to four times a year, the Village will cover all the expenses. Within the Village, there is a small clinic, with a full time doctor, and a counselor providing psychological counseling to the children. As of now, the Village has branches in Xian, Xinxiang and Longxian accommodating more than 200 children (Xu 2007).

In review of the services delivered to orphans in China, a number of barriers and problems in terms of policy-making, implementation, and service delivery can be identified.

From our previous discussion, a number of policy gaps are apparent. China has ratified the Children Rights Convention, and the Chinese government developed its agenda for child development. Still, operational regulations and policy regarding implementation of the Children Rights Convention within the Chinese context are lacking. In 2006, the government exacted “Instructions on strengthening work on assisting orphan and disabled children,” providing a basic framework for orphan care. The instruction was the first policy on orphanage care since the economic reform in the 1990s, demonstrating the active stance of the government in orphan care. It states the goals for orphan care as comprehensive development, clarifies the identification of different kinds of orphans, ensures the systematic construction of orphan care, claims to be open to all social forces to be involved in orphan care, and demands more professionalization for care work. Theoretically, the instruction is an ideal policy to regulate orphan care.

Unfortunately, there are no operational guidelines that can be applied to the practice. For instance, how to deal with other institutions in helping children with parents in jail? Who takes up the main responsibility to look after the AIDS orphans who are infected, the health department or civil affairs department? Who is responsible for supervising and monitoring the service quality by GOs and NGOs? How can the service deliverers be professionalized? What are the standards of service quality for orphans? What can be done to guarantee the quality of service in the agencies and in the foster families? To the extent these questions remain unanswered, there is still much to be done in policy advocacy in this field.

Some scholars have found that in present day orphanage homes, there remain some major issues impacting care. First of all, institutionalized care may be harmful to children’s healthy development. The institution is a centralized and closed system, it limits children’s connections with the outside world, and cannot provide intimate, family care. To some extent, it interrupts the socialization process for the children (Zhu et al. 2007). Secondly, there are some internal problems in the operational process within the institutions: 1) the majority of the staff in orphanage homes are recruited from society, without any requirement for professional credentials, knowledge, or skills. For many homes, there are no therapists, psychological counselors or social workers (Zhu et al. 2007; Xu 2006; Wang 2007); 2) according to the statistics from Ministry of Civil Affairs, the ratio of staff to residents in orphanage homes varies from 1:2.99 to 1: 4.18, much higher than that of 1:1.5 in many western such as Japan and UK (National Statistics Bureau 2006); and 3) staff frequently turn over, making services and care inconsistent. Also, reports of abuse and neglect of the children by staff illustrate a problem of both management and oversight in these homes (Wang 2007; Zhu et al. 2007; Human Rights Watch 1996). Thirdly, the cost for maintaining the homes is high. The current orphanage homes accommodate more than 60,000 orphans, with 160,000 staff (Ministry of Civil Affairs 2001). To maintain such a large structure incurs large expenses. The major funds for the orphanage homes come from the government. From 1990 to1996, local governments invested 5.15 billion in orphanage homes and the central government invested 7.4 billion (State Council News Office 1996). Despite this large investment, it is still financially difficult for the orphanage homes to meet their expenses, as the costs for care provision rises, particularly for rehabilitation and medical treatment (Wang 2007; Zhu et al. 2007). Therefore, it is crucial to explore some new models to care for the orphans in China.

Foster care has its issues too. One is that quality control for foster care is weak with a lack of monitoring of care by professionals so that services lack effective oversight and incidents of abuse have happened, such as some cases reported in foreign mass media (Shang and Xu 2003). Another issue is that the foster system lacks access to rehabilitation facilities and skilled professionals, which may affect the physical rehabilitation of the children (Wang 2007). These issues, if unchecked, will hinder the further development of foster care in China.