OPINION: A Response to “Children’s Homes: The Nanny State” | The Economist

Editor’s Note: In our September 2013 newsletter, we solicited responses from our readers regarding three articles recently published in The Economist, The Washington Post and the Huffington Post, which discuss the deinstitutionalization of orphanages. Below is a response by Kyle Hamilton (MTS), Editor of OVC Wellbeing’s “News & Opinion Blog,” to The Economist article, “Children’s homes: the nanny state” (published August 17, 2013).

The author of “Children’s homes: the nanny state” argues that orphanages should be shut down because: “big institutions are poisonous”; “orphanages can prevent children living with what family they have”; and “institutions are costly.” In developing these arguments, the author misuses information and cites inadequate sources in supporting their assertions.

First, the article makes broad generalizations about orphanages without providing sufficient evidence. The author describes poor conditions orphans encounter in big institutions like Sarata Noua orphanage and Chisinau Municipal Institution for Babies in Moldova and implies that 2 million children are living in large, “poisonous” institutions like these orphanages without citing a source to undergird this claim. Yes, there have been and continue to be large orphanages that neglect children. Yet, in reality, not all orphanages or residential institutions are big and not all orphanages are the same. Instead, orphanages around the world are marked by diversity: orphanages employ a wide variety of models in caring for children, including family-style homes, and orphanages do not automatically result in the same outcomes for children. On the one hand, some orphanages, for a variety of reasons, neglect children or worse, resulting in array of developmental delays, malnutrition, etc. On the other hand, some orphanages are able to provide children with loving and nurturing environments.

Second, the article also misuses information and does not use adequate sources to substantiate its arguments. Secondary sources are used without examining the original study. For example, this article cites a report produced by the Better Care Network in order to claim that “for every three months that a child stays in an institution he or she loses one month of development.” Yet, it’s unclear how the Better Care Network arrived at this conclusion, as the three resources cited makes no such claim. Fortunately, however, one of the sources cited in the Better Care Network report did lead me to the author of the original claim. In their study of children from eastern Europe living in hospitals or orphanages, “International Adoptions: Implications for Early Intervention,” Dana Johnson and Kathryn Dole argue, “[o]verall , children fell behind 1 month of linear growth [weight-by-length] for each 3.4 months in the orphanage.” Clearly this study indicates that the specific demographic examined falls outside the normal range for growth (weight-by-height), but the author of “Children’s homes” fails to perform due diligence in making their argument. The author not only cited an inadequate source, but also employs this statistic in order to make a broad claim that exceeds the conclusions of the original study by Johnson and Dole. While the original study is describing “growth” (weight-by-height) among children with the average age of 28 months from Eastern Europe, the author of “Children’s homes” distorts this information by asserting a broad claim about the “development” of a child of any age residing in any orphanage. In short, The Economist article misrepresents the claims and limitations of the original study.

Additionally, “the nanny state” article argues that up to 90% of children living in orphanages around the world have living parents, citing Georgette Mulheir, Chief Executive at Lumos, an organization that promotes deinstituionalization. I am sure that Ms. Mulheir is an intelligent person, but she is not an authoritative source. Again, the article makes another sweeping, global claim without citing an adequate source. Nevertheless, even if most children living in orphanages have living parents, this does not mean that these parents are able or suitable caregivers. Moreover, the author fails to consider the counter factual: where would these kids have been had they not been in the orphanage? And correspondingly, what would the development of these children have been like if these children were not in orphanages, but on the streets or being used for forced labor, etc.?

“The nanny state” article argues, “institutions cost between six and ten times as much as supporting a child within a family.” This claim is difficult to assess and would require further investigation. Do the studies use the same measures and standards of care when calculating their cost? Is the cost of the institutions per child compared to the minimum standard of care in those same communities?

Finally, “the nanny state” article fails to engage the NIH-funded Positive Outcomes for Orphans (POFO) and the OSCAR Health and Wellbeing studies which challenge the article’s narrative.