Post #4 How a Child May End Up in an Orphanage
Google tells us that orphanages were phased out by the 1930s in Canada. Google also showed me that in Russia orphanages are very much still to be found. For the city and region/oblast of Yaroslavl with a population of a million plus in the 1990s, I found a fairly current online list of 26 orphanages. The site is copyright from 2006 but as of 2024 is not available (http://adoptionknowhow.com/russia/orphanages/). Many were simply called “Baby House No.–” which is a “state residential institution for orphans and children without parental care, age 4 and under”. But others got specific. There were a couple of ‘Music and Artistic Education Baby’ houses. Then there were a couple of ‘Social and Rehabilitation Center for Minors’ orphanages. One was for children 3 to 18. There were a couple of ‘Sanatory [sic] Orphanages for Tuberculosis Children’. Others were for hard-of-hearing or deaf children. One was labelled ‘Agrarian Special Orphanage’. Other orphanages were labelled according the word ‘Type’. There is no explanation for the ones labelled ‘of the Type 7’ but those labelled ‘of the Type 8’ come with this piece, ‘for Mentally Defective Children’. Ten of the 26 orphanages in Yaroslavl carried the ‘of type 8’ plus ‘for Mentally Defective Children’ designation. If, as several articles I have found suggest, a high percentage of children in Russian orphanages are considered, at birth, or after time in an orphanage setting, to be ‘mentally defective’, what does the label refer to? Chapter Three (45-71) of Born For Love written by Maia Szalavitz and Dr. Bruce Perry offers a general picture of what to expect when a child spends his or her early childhood in an orphanage, for reasons generational, prenatal, environmental. There are always exceptions and progress is always being made but what I have read from a variety of sources would corroborate this chapter. Most children relegated/directed to orphanages will be diagnosed/deemed to have developmental delays mentally, physically, emotionally and socially.
OK, but do adoptors note this when starting a family unless consciously deciding to adopt a ‘special needs’ child? Parents cannot shut down at least a little bit of magical thinking. How many times have parents wondered at the evident genius in their child, all the while wondering how it was possible for “he or she certainly didn’t get it from me?” So maybe there is a way to hope that the disability label doesn’t actually apply to our child. And when adopting in countries such as Russia that magical thinking teases out slivers of hope that we have sidestepped developmental problems.
Several articles and policy papers (see Orphanage Risk Factors) talk of the attitude among more traditional Russian doctors that a baby with a birth ‘defect’ is going to be a problem for the mother so she is advised to turn her baby over to the state just after birth and sometimes without even seeing or holding the newborn. A Human Rights Watch paper noted, “Many parents face pressure from healthcare workers to relinquish children with disabilities to state care, including at birth. Human Rights Watch documented a number of cases in which medical staff claimed, falsely, that children with certain types of disabilities had no potential to develop intellectually or emotionally and would pose a burden with which parents will be unable to cope”. Maybe this is true, for Will Englund wrote a piece in the Washington Post called “Russia’s orphans: government takes custody of children when parents can’t cope”. His report on the issue of children in Russian orphanages:
The children are almost certain to have at least one disability. The disabilities can be congenital or related to alcohol consumption by the mother during pregnancy — or they have arisen because of the loss of emotional contact that comes with life in a state orphanage. “Every month in an institutional setting has a physical impact on the brain,” said Chuck Johnson, head of the National Council for Adoption, in an interview in Alexandria. “Every child will come with some developmental delays”.
But then, in a Human Rights Watch paper,
The experts reported that Russian psychological norms are based on very strict criteria. Apart from these norms, however, factors that in the West are considered as being simple medical risks, will, in Russia, be labelled as illnesses:
*Babies born to alcoholic parents or whose mothers suffered depression during pregnancy will be labelled encephalopathic and remain so until they come of age.
*Orphans will be classed as being mentally deficient.
*Children with a single physical malformation (a harelip or speech defect…) become subnormal in the eyes of Russian doctors.
Human Rights Watch also found that these early diagnostic practices interfere with a child’s right to full development and in certain cases, to life itself. Moreover, abundant information gathered in Russia indicated several crucial incentives behind ‘over-diagnosing’ that suggest violations of basic medical ethics.
According to a former charity worker who distributed assistance to impoverished baby houses and has traveled widely in Russia since 1991, one legacy of the Soviet medical bureaucracy encourages hospital staff to avoid any risk of sanctions for errors detected under their care.
For example, she recalled the case of a child she knew well who had a medical chart with a catalogue of conditions including oligophrenia and encephalopathy.
A doctor told me that they have to cover their butts. They could lose their job, so they write many diagnoses. And you know the penal system here. It’s a “better safe than sorry” system.
A second factor that encourages exaggerated diagnoses is the Russian law which, until recently, prohibited international adoption of “healthy” children. “The doctors in the system wanted the kids adopted, so they’d say that this child has a tumor and then “wink” at you”.
Reading NeuroTribes: the legacy of autism and the future of neurodiversity by Steve Silberman I could not help but see parallels between the labeling of disability in Russian orphanages with Silberman’s chapter on the disabled in Hitler’s Germany, “What Sister Viktorine Knew“(82 – 139). It is a nightmarish chapter.
Finally, a widely cited incentive for over-diagnosing is the extra financial subsidy and salary increment that the state grants to institutions that care for children with disabilities. The entitlement to these subsidies was confirmed by children’s rights activists as well as by staff of state institutions.
One volunteer who worked in a Moscow baby house for a year and a half recalled to Human Rights Watch,
Once, in a rare honest moment with the acting director, she told me, “We are considered as a medical facility because more than half our children are considered to have medical defects”. So they could finagle more money for the place.
Another baby house director told Human Rights Watch, however, that the subsidy does represent the greater burden shouldered by the staff in dealing with disabled children, even though the salary levels remain very low and do not attract specially trained personnel:
A pedagogue in a baby house who works here, for the Ministry of Health, will get a 20 percent higher salary than from another ministry. Yet what should we be talking about if the salary of a doctor is only $100 a month? Of course, all these places with “problematic kids” get higher pay because we have to deal with all the kids…. The name on the byline is Kathleen Hunt, who I assume was the reporter. The chapter is “The “Gilded Cage” of the Dom Rebenka: infancy to four years”, ( p.116 ) taken from Abandoned to the State: Cruelty and Neglect in Russian Orphanage (1998) written by Human Rights Watch.
These kids will enter adulthood, work their ways through life with a host of papers labelling them mentally defective like a life long albatross around their necks. And we come back to the question, aside from globally respected diagnoses, what do the labels really mean? And even with an appropriate diagnosis, what concrete prognosis does the label offer?
With no verification to the contrary, we assume that Yasik was sent to a baby house though he had turned four because, I think it was Julia who told us, Yasik was held at a home he was aging out of for the powers that were felt he was still adoptable. The largest number of children adopted out is from the baby houses. I guess there is no surprise there – it seems to me, we humans deeply believe in the wonder of having a baby as the picture-perfect way to establish a family and we just as deeply believe that we have the best chance of molding the little bitty baby into our likeness if the little bit comes to us ‘tabula rasa’. This belief system resists challenges to other options in ways that may be well below our conscious level of dealing with our lives.
In any case, when I look at what paper work we have, the orphanage name is Yaroslavl Orphanage. There is no such plain name on the listing I found so this was merely a sufficient name for the paperwork. We do not know what ‘Type’ it was. We do know there wasn’t enough land surrounding the building for it to be an ‘Agrarian Special’ orphanage; with ‘scruffy grass and bare spots, not far from lots of other buildings’, it was hardly worthy of the stimulation a playground should offer children. It put me in mind of how Tony describes the playground at his orphanage in 1930s Saskatchewan (A Canadian story of Adoption from the 1930s, Becoming Family). Inside, the orphanage looked quite small from what we could see in our very limited guided tour. We were taken via the straightest route to a receiving room. Inside we passed through a play room with a child-size piano which he must have played, so ….. maybe this was a ‘Music and Artistic’ Baby house. Yet, from the picture we have of the children assembled to wave good-bye to Yasik when we came to collect him into our family, there is at least one child with the markers for Down’s Syndrome so perhaps it was a “Type 8 ” home.
We were taken to the head person’s office, a sweet looking, grandmotherly woman who was a doctor. There was another woman at a desk who never once looked up at us, at least when I noticed. That is focus or loyalty to work or something. Was she now immune to these emotional tableaus about to unfold once again, or ? Yes, hindsight could suggest a wide range of possibilities; in the journal I was simply struck by her disinterest but so caught up in the emotions I was enjoying that I could not ask questions. Maybe she had a stiff neck.