Bulgaria launched a process of deinstitutionalisation in 2010, shamed into action by the media (as demonstrated by Kate Blewett’s ‘Bulgaria’s Abandoned Children’) over the horrific conditions endured by disabled children in isolated institutions. The children were victims of a policy whereby parents were advised to give them to the state, which then hid them away. By the beginning of 2016, all 24 old-type institutions for children with disabilities had been closed and 1,470 children and young people with disabilities were living in small homes (p. 29) built with more than EUR 100 million from EU funds.
The elements and the extent of the reforms have been a key focus of our work at the European Social Network (ESN). In our report ‘Investing in children’s services’, we assessed the organisation of children’s services in 14 European countries, including Bulgaria, with a focus on child protection services. As a follow-up to this work, I recently visited some of the newly built small homes and met with social services directors and government representatives to discuss progress in implementing the reforms and the future challenges.
Ms Minka Yovcheva, social services director in the Municipality of Sofia argued that the changes had yielded immediate results with children already gaining height and weight thanks to an improvement in eating practices. They had also significantly developed their communication and independence skills, she said. This view was shared by Svetlana Slaveva, director of the Vassil Levski and Hristo Botev homes, two of the centres built to house up to 12 children each to replace the isolated institutions where children were once held.
Ms Slaveva spoke of children unable to move, depressive, afraid to use a lift or to go outside. She told me the story of a girl who used to spend all her time motionless in a foetal position at the institution where she lived. “When she came here, she could not walk. It took us several months to teach her but now she is able to move, has started to speak and grab things”. The 12 children who live here are supported by an integrated team of 13 professionals in each home, including social workers, nurses, doctors, speech and mobility therapists. Like most family homes, these centres are focused around the kitchen, and are a significant improvement. However, there are some indicators of concern.
Ms Yovcheva explained that there were difficulties in hiring and retaining staff. In some cases, staff leave after being trained as it is difficult to convince practitioners to stay in a profession with hard working conditions and low salaries. Mr Lazar Lazarov, Bulgaria’s current Deputy Minister of Labour and Social Policy, said the process of deinstitutionalisation marked “a step forward” but conceded that “it is not just a process of building homes but also improving the quality of care, which can only happen in stages”.
Prejudices exist and the practice of doctors telling parents to abandon disabled children continues. Moreover, one of the problems when it comes to abandoning these children is not only the attitude of doctors but also that of the parents and relatives who grew up with prejudices towards disability. Ms Slaveva explained that only one family keeps regularly in touch with their child at the Levski and Botev homes.
In the words of Mr Lazar Lazarov, “no disabled child who has parents should be in a children’s home”. However, a concerted effort is necessary to make this happen. Ms Ofelia Kaneva, who chairs the National Agency for Child Protection, speaks of the need to recognise that child protection is not only the responsibility of social services and must be shared across sectors, not least to ease the burden for child protection social workers who manage on average 285 cases each.
Looking towards the future, prevention is key. That is why Mr Lazarov emphasises that in the second phase of the process of closing down institutions, the focus will be placed on supporting families to prevent child abandonment and on further developing integrated teams of social, health and education professionals to support parents and children in a more holistic way.
A second focus of reform will be on the sustainability of the investment made so far to ensure that as children turn 18, they are supported in their transition to adulthood in monitored centres, where young people have a mentor to support them in finding a job and are taught life and social skills.
Finally, Ms Yovcheva spoke of the need to reinforce fostering for children with disabilities. Whilst she is proud that there are currently 47 families in Sofia fostering 67 children, only two of them are children with disabilities. Therefore, there needs to be increased social awareness to overcome the stigma rooted in the past, and improve support in order to encourage more families to provide a loving environment for disadvantaged children.