Institutional Care.PDF

Courtesy UNICEF Pakistan

National Commission for Child Welfare & Development Ministry of Social Welfare & Special Education Government of Pakistan

Supported by SAVE the Children UK October 2007

FOREWORD...... 4

EXECUTIVE SUMMARY...... 6

1. INTRODUCTION...... 8

1.1 Background...... 8
1.2 Assessment Objectives:...... 9
1.3 Assessment Design:...... 9

1.3.1 Sampling:...... 10

1.3.2 Literature Review:...... 11
1.4 Methodology & Tools:...... 12
1.5 Pre-testing:...... 13
1.6 Data Entry & Compilation:...... 14
1.7 Report Preparation...... 14
1.8 Limitations of the Assessment...... 14
1.9 Constraints...... 14

2. INTERNATIONAL GUIDELINES & NATIONAL COMMITMENTS...... 15

2.1 Family-Based Care of Children...... 15
2.2 Draft UN Guidelines for Residential Care...... 16
2.3 Pakistan and the CRC...... 17
2.3 Children in Residential Care...... 18
2.5 Laws and Policies for Care of Vulnerable Children...... 19

3. CHILDREN IN GOVERNMENT INSTITUTIONS...... 20

3.1 Types of Government Institutions...... 20
3.2. Organizational Aspect...... 21
3.2.1 Staff Capacity...... 21
3.3 Physical Environment...... 22
3.3.1 Space for the Children:...... 23
3.3.2 Provisions for the Children...... 24
3.4 Child Care and...... 25

Development...... 25

4.4 Child Protection:...... 29

4. CHILDREN IN PRIVATE INSTITUTIONS...... 32

4.1 Orphans and Orphanages...... 32
4.2 Organizational Aspect...... 34
4.2.1 Staff Capacity...... 35
4.3 Physical Environment...... 35
4.3.1 Space for the Children:...... 36
4.3.2 Provisions for the Children...... 37
4.4 Child Care and Development...... 38
4.5 Child Protection...... 42

5. CHILDREN IN MADRASSAHS...... 45

5.1 Introduction to Madrassahs...... 45
5.2 Organizational Aspect...... 47

5.2.1 Staff Capacity:...... 49
5.3 Physical Environment...... 49
5.3.1 Space for Children:...... 50
5.3.2 Provisions for Children...... 51
5.4 Child Care and Development...... 52
5.5 Child Protection...... 54

6. GIRLS’ INSTITUTIONS...... 56

6.1 A Glace at the Situation of Girls in Pakistan...... 56
6.2 Organizational Aspect...... 58
6.2.1 Staff Capacity...... 59
6.3 Physical Environment...... 59
6.3.1 Space for Girls:...... 60
6.3.2 Provisions for Girls...... 60
6.4 Girl-Child Care and Development...... 61
6.5 Girl-Child Protection:...... 63

7. A CALL FOR FAMILY-BASED-COMMUNITY-BASED CARE...... 65

7.1 Why Institutions are not the Place for Children...... 65
7.2 What Choices do Families Have...... 66
7.3 De-Institutionalization...... 67
7.4 Principles of Family Integrity...... 68
7.5 Temporary Institutional Care...... 69
7.6 Recommendations...... 69

ANNEX 1: QUESTIONNAIRE...... 72

ANNEX 2: CONSULTATIONS WITH STAFF...... 77

ANNEX 3: CONSULTATIONS WITH CHILDREN...... 79

ANNEX 4: GLOSSARY OF TERMS...... 83

ANNEX 5: GLOBAL INDICATORS FOR FORMAL CARE...... 84

FOREWORD

Since the Earthquake Emergency in Pakistan (8th October 2005), there has been a growing concern with Children without parental care. The Vulnerability Assessment which was carried out by the National Commission for Child Welfare and Development (NCCWD), Ministry of Social Welfare, in collaboration with UNICEF and UNFPA, provided a figure of 40,000 orphans in those areas, but it was also revealed that majority of those orphans did not become orphans as a result of the earthquake, but they were orphaned before the earthquake. The information was significant because it brought home the fact that many orphans are out there who are almost invisible, without the special care and protection that is their right by way of their special vulnerable situation. The NCCWD started focusing more on OVC (Orphans and Vulnerable Children) in its programme. With support from UNICEF, a Strategy document on Family-Community-Based-Care-System For Children was approved, and Service Standards for Residential Child Care Institutions in Pakistan were drafted. With Save the Children UK, it set out on a series of activities with the objective of creating the mechanisms which would provide care and protection to Children without Parental Care. The current Assessment is one of those activities.

In Pakistan some children are placed in institutions because their primary caregivers – that is their parents have died. But there are many children in institutions for other reasons, either because they parents have separated or divorced, and the single mother or father cannot take care of children; or out of sheer poverty which constraints the parents to take care of their children. Many children run away from homes because of domestic or school violence, and end up on the streets from where they end up in Institutions deprived of liberty, because of have come in conflict with the law.

The Convention on the Rights of the Child recognizes the family as the natural environment for the development and well-being of children, that parents have the primary responsibility for the upbringing of the child, and that the child has, the right to be cared for by his or her parents. For those children who are deprived of their family environment or it is not in their best interests to remain in that environment, then the Convention expects the appropriate use of substitute care for such children. However placement in Institutional care is to be used as a measure of last resort. The rights of the child are to be effectively protected in all such cases, including the right to protection from discrimination, neglect and abuse; the right to develop his or her personality, talents and abilities to their fullest potential; and the right to have a say in decisions affecting the child’s life, including the right to participate in decisions relating to his or her living conditions in the institutions.

The current assessment looks at the situation of children in various kinds of institutions ranging from detention centers and shelters where children are deprived

of liberty to Madrassahs and Orphanages. It serves as the basic, foundational, and qualitative information source for future researches and studies on the subject. The Assessment gives rise to some questions: what is the balance between state responsibility and parental responsibility when the parents are in no way capable of fulfilling the rights of their children; where are the girls without parental care if there are fewer institutions for girls as compared to boys; can the extended family’s role be formalized; do the small private orphanages herald the small-group “homes” at the community level, that are foreseen; will the Government shift resources from residential care to alternative solution, etc?

We would like to thank all the individuals, organizations and government offices that contributed to the development of this Assessment. In particular we would like first like to thank all the Children in the Institutions who so keenly participated and contributed to the consultations. We would like to thank the Management staff and the Carers in all the institutions both private and Government who provided useful and pertinent information. We would like to thank the team of DELTA Consultants who diligently worked on the Assessment, and had to patiently go through several revisions to bring it to its present form. Finally we would like to thank UNICEF, particularly Dr. Riffat Sardar, who reviewed the final draft and provided her technical guidance and expertise.

We hope all those Institutions providing residential care to children, all the Government, International, non-Governmental, and civil society organizations concerned with orphans and vulnerable children, will find the Assessment useful and use to build programmes to fulfill the needs and rights of orphan and vulnerable children.

Mr. Rasool Bakhsh Baluch Ms. Madeline Wright

Secretary Country Director

Ministry of Social Welfare & Special EducationSave the Children UK Federal Government of Pakistan Pakistan

EXECUTIVE SUMMARY

It is now widely recognized that children without parental care are at a higher risk of discrimination, inadequate care, abuse and exploitation. Preference for family- based care is emphasized frequently in the Convention for the Rights of the Child due to the emotional, social, and developmental benefits for children to grow up in a family environment. Pakistan has signed and ratified the Convention on the Rights of the Child, and is committed to uphold the principles enshrined in the CRC for protection of children of Pakistan. At the national or provincial levels, there is no comprehensive legislation for the protection of children without parental care. There are several laws that deal with one or another aspect of children without parental care. The Government started focusing on Orphaned and Vulnerable Children (OVC), after the Earthquake emergency in 2006, which brought to highlight, 40,000 orphans, most of whom reported that they were orphaned before the earthquake. Recently the National Commission for Child Welfare and Development (NCCWD) drafted a Policy for the Orphans and Vulnerable Children in the Earthquake Affected Areas. Though the extended-family system is still quite strong in Pakistan, the responsibility of caring for relative children puts extra burden on poor families. The families living in abject poverty are forced to send the additional relative orphaned children to orphanages or to Madrassas. Many parents, who simply cannot take care of their children, also send their own children to such Institutions in hope of better care.

The Assessment was carried out in a variety of Institutions: Government supported remand home/shelters for children in conflict with the law; Government and Private Orphanages, and Government and Private Madrassahs. The children in the Government institutes are the unfortunate children who are deprived of family- based care. Comparatively, the Government institutions are well-regulated and have developed organizational systems and processes, which in turn bring tighter control and bureaucratic rigidity. The children though well-fed, are denied the life that a normal child would be living. Most of the children in conflict with the law have been on the streets, and experienced the risks and dangers of living on the street; the question arises, are they better off in the institutions? In Private Institutions the picture was some what different as compared to government institutions and Madrassahs. Most of the Private Institutions emphasized on child care, which was indicated through the ample supply of provisions for children and comparatively better physical environment. However discrimination, corporal punishment and harassment exist even in some of the sophisticated private orphanages. The official figures estimate 13,000 Madrassahs all over the country. There are a total of 1.5 million children enrolled in the Madrassahs all over the country. Contrary to common belief that parents send children to Madrassah because of poverty, the consultations with children enrolled in Madrassahs revealed that poverty or religiosity are not be the only reasons for children being in Madrassahs. Many children end up in Madrassahs because of poor academic achievements in schools.

70% of the Madrassahs visited were resource poor without any secure funding flows, compounded by deficient management systems. In Madrassahs, as there is nothing much to offer and there is nothing much to choose from therefore the children have to follow what ever they are told. The care and development opportunities provided to children residing in Madrassahs were the least satisfactory as compared to the Government and Private Institutions. In order to include the gender aspect to the Assessment, it was decided to include Girls institutions also in the scope of the Assessment. There are very few girls Institutions as compared to boys Institutions. Girls’ institutions were very well protected and in most cases seemed like impenetrable fortresses. Generally the Girls Institutes fared better than boys’ institutes in allowing freedom of expression and in respecting the right of girls to privacy. The girls in Madrassahs were less confident than the girls in Orphanages. Girls were not playing sports in any of the Institution. Most of the recreational activities were indoors, even when playgrounds existed. Unlike the boys Institutions, protection issues such as discrimination, verbal abuse and physical or sexual abuse was not reported in the Girls Institutions. Vocational training especially sewing and stitching was part of every institution’s program. The Carers did not seem to exert extra control over the girls, giving the reason that the girls are anyway very obedient and docile, and a behavior learned early on in life because of the lower status of girls generally in society.

Children living in Institutions are deprived of a family environment. They receive less stimulation, individual attention and love. Most of these children are isolated from the outside world. Most of them suffer from corporal punishment; even when in grief and pain their voices are not heard. Though sexual abuse was not reported, yet there is a real danger and risk of sexual abuse, because of the isolation from the outside world. Children do not have access to appropriate medical care, nor is there any culture of keeping health records. Some basic and/or primary education is provided in most institutions, but can it ensure to prepare them for the challenges of adult life? Majority of the Carers were not trained in child care, and most of them had never heard about CRC. The monitoring and supervision of institutions is very weak. In short the institutional care violates the very principles of the CRC as well as many of its articles.

There is the need to move towards a process of de-institutionalization, by replacing large institutions with small group “homes” for children in their own communities. Govt. should have a national policy on Alternative Care, which treats Temporary Institutional Care as a measure of last resort, recommending Family-Based- Community-Based Care for the child without parental care. There is also the need to make rules for Alternative Care and set up regulatory bodies to regulate Alternative Care. The recommendations made in the Assessment if adopted will pave the way for fulfilling the rights of children without parental care, and would go a long way in protecting children from neglect, discrimination, violence, abuse and exploitation.

TABLE OF CONTENTS

FOREWORD

EXECUTIVE SUMMARY