Across Europe and Central Asia, approximately one million children live in large residential institutions, usually known as orphanages. Most people imagine orphanages as a benign environment that care for children. Others know more about the living conditions there, but still think they're a necessary evil. After all, where else would we put all of those children who don't have any parents?
在歐洲和中亞 大約有一百萬名孩童 住在大型收容機構,通常稱為孤兒院 大部份的人想像中的孤兒院 是可以照顧孩童的優良環境 其他人雖然了解孤兒院的居住環境 仍然認為孤兒院的存在是必要之惡 否則,我們還能將那些失去父母親的小孩 安置在哪裡呢?
But 60 years of research has demonstrated that separating children from their families and placing them in large institutions seriously harms their health and development, and this is particularly true for young babies. As we know, babies are born without their full muscle development, and that includes the brain. During the first three years of life, the brain grows to its full size, with most of that growth taking place in the first six months. The brain develops in response to experience and to stimulation. Every time a young baby learns something new -- to focus its eyes, to mimic a movement or a facial expression, to pick something up, to form a word or to sit up -- new synaptic connections are being built in the brain. New parents are astonished by the rapidity of this learning. They are quite rightly amazed and delighted by their children's cleverness. They communicate their delight to their children, who respond with smiles, and a desire to achieve more and to learn more. This forming of the powerful attachment between child and parent provides the building blocks for physical, social, language, cognitive and psychomotor development. It is the model for all future relationships with friends, with partners and with their own children. It happens so naturally in most families that we don't even notice it. Most of us are unaware of its importance to human development and, by extension, to the development of a healthy society. And it's only when it goes wrong that we start to realize the importance of families to children.
經過六十年的研究 發現讓小孩與原生家庭分開 並把他們安置在大型收容機構 會嚴重影響他們的健康與發展 對嬰兒來說更為嚴重 就我們所知 嬰兒出生時肌肉和大腦 都尚未發展完全 在三歲以前,大腦會發育至完整的大小 在六個月大前,則會完成大部份的成長 大腦就能夠對體驗和刺激 做出反應 每一次新生兒學習新的事物 --比如雙眼對焦 模仿一個動作或是臉部表情 撿起東西、學習單字、或是坐下-- 大腦中會產生新的聯結 新手家長對這樣快速地學習感到驚訝 他們會對孩子的聰穎感到吃驚與開心 他們會向孩子表達出喜悅 孩子露出笑容 並且期待學會與完成更多事情 在父母與孩子之間強大的連結過程 幫助了肢體、社交、語言、認知 以及心理性肌肉運動的發展 這是未來與朋友、夥伴以及與他們自己的小孩 的人際互動範本 這件事很自然地在大部份的家庭中發生 以致於我們從未察覺 其對人類發展以及延伸出來 對健康社會發展的重要性 直到事情開始發生狀況 我們才開始懂得家庭對孩童的重要性
In August, 1993, I had my first opportunity to witness on a massive scale the impact on children of institutionalization and the absence of parenting. Those of us who remember the newspaper reports that came out of Romania after the 1989 revolution will recall the horrors of the conditions in some of those institutions. I was asked to help the director of a large institution to help prevent the separation of children from their families. Housing 550 babies, this was Ceausescu's show orphanage, and so I'd been told the conditions were much better. Having worked with lots of young children, I expected the institution to be a riot of noise, but it was as silent as a convent. It was hard to believe there were any children there at all, yet the director showed me into room after room, each containing row upon row of cots, in each of which lay a child staring into space. In a room of 40 newborns, not one of them was crying. Yet I could see soiled nappies, and I could see that some of the children were distressed, but the only noise was a low, continuous moan. The head nurse told me proudly, "You see, our children are very well-behaved." Over the next few days, I began to realize that this quietness was not exceptional. The newly admitted babies would cry for the first few hours, but their demands were not met, and so eventually they learned not to bother. Within a few days, they were listless, lethargic, and staring into space like all the others.
在1993年八月時 我有了第一次的機會見證 機構化與缺少養育對孩童的重大影響 我們之中有些人還記得 1989年羅馬尼亞革命後的新聞報導 都會回想起在某些收容機構裡的恐怖狀況 我被邀請去幫助大型機構的主管 協助他們預防孩童與家庭分離 壽西斯古的示範孤兒院目前照顧550名嬰孩 他們告訴我這樣的情況已經改善很多了 我有許多和幼童工作的經驗 因此在我的預期中 機構應該會有很多的噪音 但這裡卻靜得像修道院 很難相信這裡面居然有小孩 主管帶我走過一間又一間的宿舍 每一間裡面有好幾排的小床 每一張床上都躺著一個凝視著空氣的孩子 在一間有40名新生兒的房間裡 沒有一個孩子在哭 我可以看到有已經髒了的尿布 還有一些難過的孩童 然而唯一聽得見的噪音 只是不間斷的低沉呻吟聲 護理長驕傲地告訴我: 「你看,我們的小孩都很有教養。」 在之後的幾天裡 我開始了解 這樣的寧靜並不奇怪 新進的孩子也許會在前幾個小時哭 但是他們的需求並未被滿足 最後他們就學會了不吵人 幾天內,他們就會變得無精打采、成天昏睡 然後變得和其他人一樣都凝視著空氣
Over the years, many people and news reports have blamed the personnel in the institutions for the harm caused to the children, but often, one member of staff is caring for 10, 20, and even 40 children. Hence they have no option but to implement a regimented program. The children must be woken at 7 and fed at 7:30. At 8, their nappies must be changed, so a staff member may have only 30 minutes to feed 10 or 20 children. If a child soils its nappy at 8:30, he will have to wait several hours before it can be changed again. The child's daily contact with another human being is reduced to a few hurried minutes of feeding and changing, and otherwise their only stimulation is the ceiling, the walls or the bars of their cots.
歷年來,許多民眾和新聞報導 指責機構裡的工作人員 因為他們傷害了孩子 但是通常一名職員得照顧10個、20個 甚至是40名孩童 因此他們別無他法,只能將工作標準化 七點要叫孩子起床、七點半要餵食 八點一到,他們的尿布就得換了 所以一名員工只有半小時 來餵飽十個或二十個孩子 如果一個孩子在八點半時弄髒了尿布 他得等上好幾個小時才能換上乾淨的尿布 孩子與其他人的日常接觸 被減少到只有在餵食和換尿布時的匆促幾分鐘 否則他們唯一的刺激 就只有天花板、牆壁或是小床的橫板
Since my first visit to Ceausescu's institution, I've seen hundreds of such places across 18 countries, from the Czech Republic to Sudan. Across all of these diverse lands and cultures, the institutions, and the child's journey through them, is depressingly similar. Lack of stimulation often leads to self-stimulating behaviors like hand-flapping, rocking back and forth, or aggression, and in some institutions, psychiatric drugs are used to control the behavior of these children, whilst in others, children are tied up to prevent them from harming themselves or others. These children are quickly labeled as having disabilities and transferred to another institution for children with disabilities. Most of these children will never leave the institution again. For those without disabilities, at age three, they're transferred to another institution, and at age seven, to yet another. Segregated according to age and gender, they are arbitrarily separated from their siblings, often without even a chance to say goodbye. There's rarely enough to eat. They are often hungry. The older children bully the little ones. They learn to survive. They learn to defend themselves, or they go under.
自從我第一次抵達壽西斯古的機構後 我已去了上百個類似的地方 從捷克到蘇丹等十八個國家 在這些不同的地方、文化、機構 以及孩子在這之間的旅程 遺憾地都很雷同 缺乏刺激通常會造成自我刺激行為 像是拍手、前後搖晃或是侵略行為 在某些機構中,精神疾病的藥物 被用來控制這些孩子的行為 在其它情況時 為了避免孩子傷害自己或是其他人 孩子會被綁起來 這些孩子很快地會被貼上身心障礙者的標籤 然後被轉介到另一家 服務身心障礙孩童的機構 大部份這樣的孩子都不會再次離開所屬的機構 然而,對於沒有身心障礙的孩子 滿三歲時,他們會被轉到另一間機構 七歲時,再轉到另一間 他們會被依照年齡和性別來隔離 他們被迫和兄弟姊妹分離 而且通常連道別的機會都沒有 他們很少吃得飽 通常都處在飢餓的狀態 年長的孩子會覇凌年幼的孩子 他們學著生存、保護自己 否則他們的性命就會不保
When they leave the institution, they find it really difficult to cope and to integrate into society. In Moldova, young women raised in institutions are 10 times more likely to be trafficked than their peers, and a Russian study found that two years after leaving institutions, young adults, 20 percent of them had a criminal record, 14 percent were involved in prostitution, and 10 percent had taken their own lives.
當他們離開機構 會發現難以適應、融入社會 在摩爾多瓦 機構裡長大的年輕的女性 被販賣的機率是同儕的十倍 一份俄國的報告指出,青少年離開機構兩年後 其中有百分之二十的人有犯罪紀錄 百分之十四的人從事性交易 百分之十的人自殺了
But why are there so many orphans in Europe when there hasn't been a great deal of war or disaster in recent years? In fact, more than 95 percent of these children have living parents, and societies tend to blame these parents for abandoning these children, but research shows that most parents want their children, and that the primary drivers behind institutionalization are poverty, disability and ethnicity. Many countries have not developed inclusive schools, and so even children with a very mild disability are sent away to a residential special school, at age six or seven. The institution may be hundreds of miles away from the family home. If the family's poor, they find it difficult to visit, and gradually the relationship breaks down. Behind each of the million children in institutions, there is usually a story of parents who are desperate and feel they've run out of options, like Natalia in Moldova, who only had enough money to feed her baby, and so had to send her older son to the institution; or Desi, in Bulgaria, who looked after her four children at home until her husband died, but then she had to go out to work full time, and with no support, felt she had no option but to place a child with disabilities in an institution; or the countless young girls too terrified to tell their parents they're pregnant, who leave their babies in a hospital; or the new parents, the young couple who have just found out that their firstborn child has a disability, and instead of being provided with positive messages about their child's potential, are told by the doctors, "Forget her, leave her in the institution, go home and make a healthy one."
但是為什麼這幾年沒有很多戰爭或是天災 在歐洲仍有許多孤兒? 事實上,其中超過百分之九十五的孩子 他們的父母還在世 通常社會上的輿論傾向責備這些家長 遺棄他們的孩子 但是研究報告顯示大部份的家長想要留住孩子 而造成機構收養的主因 來自於貧窮、身心障礙以及種族身份等問題 許多國家並未發展全納教育的學校 因此即使孩子有非常輕微的身心障礙 都會在六到七歲的時候 被送到住宿型的特教學校 機構可能離家好幾百英里遠 如果這戶人家很窮 他們會發現探訪孩子不容易 然後他們彼此間的關係就會逐漸變淡 上百萬名在機構裡居住的孩子背後 通常都會有一段故事 關於他們的家長感到絕望、別無他法 像是住在摩爾多瓦的納塔莉亞 她所有的錢只夠餵飽孩子 所以她必須將長子送到機構裡 或是住在保加利亞的德西 她的丈夫還在世前,她在家帶四個小孩 但是在她的丈夫過世之後 她必須去做全職工作 由於沒有任何支援,別無他法 她不得不送出一名身障的孩子到機構去 另外還有一些數不清的年輕女孩 由於太害怕要告訴父母她們懷孕了 因此把寶寶留在醫院裡 也有一些新手父母 發現他們的第一個孩子身體有殘缺 醫生沒有選擇要提供關於孩子潛力的正向訊息 反而告訴他們: 「忘了這個孩子吧,把她放在機構裡 回家去生個健康的孩子。」
This state of affairs is neither necessary nor is it inevitable. Every child has the right to a family, deserves and needs a family, and children are amazingly resilient. We find that if we get them out of institutions and into loving families early on, they recover their developmental delays, and go on to lead normal, happy lives. It's also much cheaper to provide support to families than it is to provide institutions. One study suggests that a family support service costs 10 percent of an institutional placement, whilst good quality foster care costs usually about 30 percent. If we spend less on these children but on the right services, we can take the savings and reinvest them in high quality residential care for those few children with extremely complex needs.
這種事既不必要,但也無法避免 每一個孩子都有權利擁有、也需要一個家 而且孩子擁有驚人地恢復精神能力 我們發現如果讓孩子早點離開機構、回到家中 他們會恢復發展遲緩的部份 然後會逐漸恢復正常 過著快樂的生活 另外,和機構相比 家庭支援所需的補助費用也低許多 一份研究報告指出 提供給家庭支援的補助費用 只佔機構安置的百分之十 而較優良的寄養服務 通常只需百分之三十的費用 如果我們可以減少支出 並且為這些孩子提供更合乎需求的服務 我們可以將這些省下來的費用改為 幫助其他有複雜需求的孩子 提供他們有更高品質的安置照顧
Across Europe, a movement is growing to shift the focus and transfer the resources from large institutions that provide poor quality care to community-based services that protect children from harm and allow them to develop to their full potential. When I first started to work in Romania nearly 20 years ago, there were 200,000 children living in institutions, and more entering every day. Now, there are less than 10,000, and family support services are provided across the country. In Moldova, despite extreme poverty and the terrible effects of the global financial crisis, the numbers of children in institutions has reduced by more than 50 percent in the last five years, and the resources are being redistributed to family support services and inclusive schools. Many countries have developed national action plans for change. The European Commission and other major donors are finding ways to divert money from institutions towards family support, empowering communities to look after their own children.
有一項運動正在歐洲形成 目標在改變焦點 並將資源從提供低照顧品質的大型機構 轉移到以社區為基礎的服務 能夠保護孩子避免受到傷害 並且讓他們得以發揮潛能 當我二十年前剛開始在羅馬尼亞服務時 當地有二十萬名孩童住在機構 而且逐日增加 現在,人數已低於一萬名 而且家庭支援服務也遍及全國 在摩爾多瓦,不論是極度貧窮 還是全球經濟危機所造成的嚴重影響 近五年裡 住在機構裡的孩子數量已減少百分之五十以上 資源也重新分配給 家庭支援服務與全納教育學校 許多國家為了改變已制定國家行動計畫 歐盟委員會以及其他主要的捐助人 正在找尋能夠將經費從機構轉移至家庭支援的方法 授權給社區 來照顧他們自己的孩子
But there is still much to be done to end the systematic institutionalization of children. Awareness-raising is required at every level of society. People need to know the harm that institutions cause to children, and the better alternatives that exist. If we know people who are planning to support orphanages, we should convince them to support family services instead.
但是要終止孩童在系統中被收養 仍有很多需要做的事 我們需要提升社會各個階層的體認 人們需要知道機構對孩子造成的傷害 以及現存更好的替代方式 如果我們知道有人要支持孤兒院 我們應該說服他們改為支持家庭支援服務
Together, this is the one form of child abuse that we could eradicate in our lifetime.
這是我們此生中 能夠為終止兒虐盡一份心力的方式之一
Thank you. (Applause)
謝謝(鼓掌)
(Applause)
(鼓掌)