Ukraine’s invisible children: the urgency of care reform

Coverage of the conflict in Ukraine has been a stark reminder of the pace and extent to which war turns lives upside down. The terrifying experience of conflict sees people turning to loved ones and places that are familiar and comforting. Children are no different.

And yet, even before the war in Ukraine started on 24 February, for over 100,000 Ukrainian children the familiar wasn’t a family environment, but an institution.

You may remember the horrific images of institutions in Romania in the 1990s that captivated the attention of Europe and resulted in unified calls for significant care reform. While many Eastern European countries have significantly reformed their childcare systems, Ukraine lagged behind. It has one of the largest systems of institutionalisation of children in Europe, with a large proportion of children with disabilities. This culture of institutionalism has been driven by factors including financial challenges for families, the inability of parents to care for a child and a need for reform of child protection systems.

But change is possible. In Romania, there were also over 100,000 children growing up in institutions in 1998. Twenty years later, that number had dropped to 6,632 children in 185 institutions. Organisations such as Hope and Homes for Children, Lumos, Disability Rights International and Changing the Way We Care work to drive change in support of family-based alternatives while advocating for system reform.

Decades of work on deinstitutionalisation has shown that effective reintegration is gradual, planned and supported. Otherwise, children may still be at significant risk of being placed in unsafe and inappropriate care. However, on 19 March, reports from the Ministry of Social Policy indicated that 30,582 children from these institutions were returned to the care of parents and other guardians following the eruption of conflict across the country. While this might seem like good news, there are significant implications for children sent back in haste and without preparation, having spent years in institutional care. Lack of access to supportive services, tackling developmental delays, effective support for attachment disorders, and addressing families’ own mental health and wellbeing are just a few of the issues that need to be tackled. Measures to address the reasons the child was placed in an institution in the first place are also key, as well as strengthening the child protection system in Ukraine to ensure no other children become institutionalised. Behind these numbers are children, each with an individual story – one that always includes a complex combination of risk and resilience.

Where and how are they now?

Questions remain on where these children have ended up and how they are doing. While there are anecdotal accounts, these children are all but invisible within the humanitarian system and its response. This is echoed by Halyna Postoliuk, director of Hope and Homes for Children Ukraine:

The loss of financial opportunities and logistical connections has led to job cuts, wages cuts and rising unemployment. Fewer families with children can provide for themselves. The situation of families who had survived based on state social payments, remains critical, as the regularity of social payments has not been fully restored yet and prices are rising rapidly. […] There is virtually no place to remove children. There is a catastrophic shortage of [emergency foster carers] in the region. Institutions do not work. The situation is really getting worse.

These children may not have been home in many years. They and their caregivers will need help to meet their needs and connect with a network for ongoing support. Additionally, estimates vary on the number of children with disabilities in Ukraine, but it is thought that a significant number of them had been institutionalised. The holistic support both children with disabilities and their caregivers desperately need can only be provided if the humanitarian community and government work together to ensure their basic needs are met and they have access to inclusive education, safe transport, housing, quality health care, protection and psychosocial support, as well as rehabilitative services when needed.

The question for the humanitarian community and government to grapple with is how to address the immediate and longer-term protection needs of these children and their families, given the lack of information and therefore understanding of their whereabouts and needs.

Working together – sustainable humanitarian response and life-saving systems

While humanitarian actors build knowledge of the circumstances of children as the situation evolves, an opportunity exists to support Ukrainian authorities to lead reform of the institutional care system to support family-based care for children, and reduce their risk of being re-institutionalised. Inter-agency coalitions such as the Ukraine Children’s Care Group and coordination mechanisms like the Unaccompanied and Separated Children Task Force provide crucial space for United Nations agencies, humanitarian and development actors and local organisations to reinforce these efforts.

The European Union (EU) has a significant role to play in supporting this transition. In particular, in the context of Ukraine’s recently granted status as an EU membership candidate, the country will need to undertake significant reforms to meet the acquis communautaire, an ensemble of baseline standards (including in the field of social rights) with which each European member state must comply. This is, in itself, an unprecedented incentive to profoundly change the country’s inadequate childcare and protection systems for the better.

The humanitarian and development communities must support the most vulnerable families and children – wherever in Ukraine they might be. This will help prevent vulnerable children falling into the care system and minimise the risk of a new institution-based care system being re-established. The work to rebuild a childcare and protection system that leaves no one behind must start now.

What should this response look like?

Many families in need of help live in remote villages, where public transport runs at best twice a day (and sometimes once or twice a week). No one will leave children alone at home, and it is not possible to take everyone to go all together, because the ticket price sometimes reaches more than 100UAH [around $2.90].The possibilities of our organisation in this sense are unique, because we can quickly respond even to a phone call from a family, and within a few hours – to deliver the package, or even send it by Nova Poshta [a widespread postal and cargo company in Ukraine], if the need is urgent and the family lives far away.

– Yana Polishko, social work specialist, Dnipropetrovsk region, Hope and Homes for Children Ukraine

The humanitarian response should not just focus on bringing in international capacity. While the humanitarian community has a role in filling gaps, the generous support from donors must be channelled into strengthening Ukraine’s child protection systems towards a government- and locally led approach.

We need a humanitarian response that supports the existing child protection system to identify, monitor, support, and refer children to additional services when required. This includes harmonised case management procedures and close coordination with, and between, government ministries, so that children and their families don’t fall through the cracks. Currently there are residential care institutions managed by the Ministry of Health, Ministry of Education and Ministry of Social Affairs. Importantly, the system should enable children’s participation and agency over decisions that affect them.

The response must include a trained and supported social welfare workforce that meets with individual children and their caregivers, providing psychosocial support, addressing concerns and connecting them to services. This includes social workers, psychosocial support workers and experts in disabilities. Childcare and protection workers must be recognised by donors, governments and all humanitarian actors as essential front-line emergency responders.

Families and caregivers will also need services such as financial support and parenting programmes, and access to health care, psychosocial support, education and livelihoods opportunities – no matter where they have been displaced or how their lives have been uprooted.

In May, we started working on setting up counselling centres, mobile teams and mobile local spots for organising work with children. In order to introduce the work of mobile teams, in-patient counselling points and places of organising children’s leisure in the Kyiv region and Kyiv, we have prepared relevant materials on the content of work, case management and documenting that will help professionals to identify the needs of children and their families and provide them with the most necessary help.

– Nadiya Tatarchuk, programme director, Hope and Homes for Children Ukraine

These interventions can sow the seeds for a future system in Ukraine that builds on the considerable advocacy from the child rights and disability rights communities and UNICEF in recent years and the momentum behind actions since the conflict erupted.

Transforming the care system

Much remains unknown about the situation of children who have returned to families from institutions and the types of support they will need. However, there is undoubtedly a role the humanitarian community can play to support these families and ensure the future does not include a life of re-institutionalisation. For humanitarian action to tackle this challenge, it must focus on transforming the childcare system in Ukraine and work closely with development agencies that have been focused on this for decades, redirecting how residential care is perceived and used, in partnership with the government and with long-term, sustainable development in mind.

Advocacy efforts will continue within the humanitarian system to support a cross-border monitoring system that will facilitate the tracking and supporting of children from institutional care as well as efforts in parallel within Ukraine as it progresses its candidacy to enter the European Union.

It cannot happen overnight, but by taking this approach we can support what development agencies working on care reform have been trying to address for years and ensure thousands of children can grow up safe and protected in family-based care.

Amanda Brydon is Head of Child Protection Policy and Advocacy and Rebecca Smith is Head of Programmes, Child Protection at Save the Children. Nolan Quigley is Global Advocacy Advisor and Marie Raverdeau is EU Advocacy Officer at Hope and Homes for Children.   

The authors are grateful to Lauren Murray, Regional Child Protection Adviser, Save the Children, Ukraine Crisis Response, for her review and to Nadiya Tatarchuk from Hope and Homes for Children Ukraine for her input.