Eastern Europe

Once the region with the highest rate of placing children in orphanages, Eastern Europe is now the epicenter of the movement to empty them.

In Moldova, Europe’s poorest country, the orphanage population has dropped from 11,000 to 2,000 since 2011 as international charities work with the government to close orphanages, reunite children with parents and establish foster-care services, Hope and Homes for Children says. A similar effort in Georgia has reduced the number of state-run orphanages from 50 to two, now accommodating about 75 children rather than 5,000 in 2005, UNICEF says.

Bulgaria has won praise for focusing its reforms on children with disabilities, finding family-style care for all who had been in state institutions. Overall, the population of Bulgaria’s state-run orphanages has dropped from about 7,500 in 2010 to less than 1,200 today, coinciding with a tenfold increase in the number of foster families who now care for more than 2,400 children, UNICEF says.

In sheer numbers, Romania is the region’s paramount success story — especially in light of the Ceausescu era abuses.

As in Bulgaria, Romania’s reforms have been aided by tens of millions of dollars in European Union funds as the EU assimilated the two former Warsaw Pact nations. Agencies such as Hope and Homes for Children have helped place children with foster families or in smaller homes where they can enjoy outings, birthday celebrations and a normal education.

Stefan Darabus, Hope and Homes’ regional director, says Romania’s next big challenge is to keep vulnerable families together, which benefits the children and costs the state far less than an orphanage placement.

One of the old-style orphanages still operating in Bucharest, called Robin Hood, is due to close next year. Children who can’t be reunited with their families or placed in foster care will move into state-supervised family-style homes.

Among them is 20-yearold Cristina. At Robin Hood since 2009, she was smiling one recent morning before starting a new life in one of those homes.

“I’m happy I am moving to a house where there’s a garden and dogs,” said Cristina, whose intellectual disabilities prevent her from giving informed consent to use her full name.

Elena Ionita, Robin Hood’s director, says the youths living there have deep-rooted problems.

“We give them their needs — food, shelter — but in no way can we supplement the one-on-one care that a foster parent could give,” she said.

In Russia, child-welfare reforms have been slower.

After a 2014 Human Rights Watch report documented cases of children with disabilities being illtreated in state-run orphanages, the government put in place policies to help disabled children remain with their families or be placed in family-style settings — but progress has been limited.

According to Russian officials, the number of children without parents or guardians has declined almost 50 percent in recent years, from about 126,000 in 2011 to 66,000 in 2016. But recent data indicates only a few hundred are placed with foster families each year, and there’s been no major surge in adoptions.

Historically, Russia’s orphanage system has been tightly controlled by the government. Now, an orphanage outside state control has been set up to care for children with severe disabilities: St. Sophia’s, run by the Russian Orthodox Church in a residential Moscow neighborhood.

In the past, few Russian families adopted children with conditions such as Down syndrome or cerebral palsy, but St. Sophia’s has been able to place at least three such children in adoptive homes.

Unlike state-run orphanages, where many children might share one bedroom, they are divided into groups of five or six at St. Sophia’s, each living in an airy, apartment-like space.

“It used to be one room for 25 people — now it looks more like small families,” said St. Sophia’s director, Svetlana Babintseva.

In China, orphanages mostly house children abandoned by their families because of serious medical issues.

Families faced with high medical costs — as well as rules that long restricted couples to one, and now two, children — sometimes feel they have no choice but to abandon such children, particularly if they live in poor rural areas.

Following reports of babies left in fields and garbage dumps and even flushed down toilets, China experimented in 2011 with opening “baby hatches” attached to orphanages to provide desperate parents a safe place to leave children they couldn’t care for. But many programs have since been suspended after being inundated with hundreds of children.

Orphanage conditions have improved over the past decade, but funding is a challenge because most children require specialized medical treatment.

China is now promoting the care of such children in family settings. By late last year, there were 460,000 orphans and abandoned children in China — about 373,000 cared for through foster care or adoption, and 88,000 in orphanages, according to official statistics.

Still, the number of adoptions in China has steadily fallen, from 44,260 in 2009 to 18,736 last year.

Robin Hill, chief executive of New Hope Foundation, a charity that provides medical treatment for babies with deformities, said the Chinese government is seeking to place children in foster care with families living near orphanages or within the facilities themselves.

In India, the government estimates there are 20 million orphans and abandoned children, but only a small fraction have no living parents.

Some orphanages run by religious groups and nonprofits undergo government inspections to ensure standards are met. However, there are hundreds of unregulated privately run institutions, and reports surface periodically that children in some of them suffer maltreatment and sex abuse.

Nepal has been plagued by multiple orphanage-related problems.

In 2015, after an earthquake killed nearly 9,000 people, a UNICEF report decried an upsurge in cases of children “deliberately separated from their families and placed in orphanages so they can be used to attract donors.”

Since then, the government has been urged to reunite abandoned children with their parents or extended family. But the current number of children in orphanages — about 15,000 — is down only slightly from UNICEF’s estimate of 16,000 before the earthquake.