Asking Why: One Important Question for Family Preservation

A central question that those who care for vulnerable children must ask is “Why are children separated from their families?” Answering this fundamental question clarifies what interventions could be implemented or accessed to preserve and strengthen families, potentially preventing unnecessary separation of children from their parents in the first place. Children of the Promise’s (COTP) exploration of this question led them to develop unique programs that address the specific challenges facing families in a Northern Haiti community.

In 1999, two Americans, Jan and Bud Bonnema, went on a short-term mission trip to Haiti, where they learned that families were abandoning children. As they considered why, they discovered one common reason was that the medical needs of children left families disempowered to care for their children. They also learned that local orphanages were not accepting young children and hospitals were caring for them instead. In response, they formed COTP as short-term residential care for young children with medical needs. It was always COTP’s goal to find a loving family for each child who temporarily came into their care. In the early days, their primary focus was on international adoption. However, in response to what they learned on the ground and their increasing knowledge of best practices, COTP expanded their programs to contribute to a broader continuum of care, which recognizes the priority of family preservation and family-based care.

COTP made a decision to increase their family-strengthening efforts to emphasize working with at-risk families. They had found that two key causes of family separation were poor prenatal health and malnutrition during the first two years of a child’s life. To address these causes within the community they created prenatal health and malnutrition programs. Pregnant women in the prenatal program meet weekly throughout their pregnancies and then monthly for the first six months postpartum. The program seeks to provide basic education on prenatal care, infant care, breastfeeding, and nutrition. Beyond the educational aspect, COTP has found a vital piece of this program is the friendships fostered between the expectant mothers. By holistically addressing the needs of the mothers, COTP is decreasing the likelihood of separation after birth.

Likewise, the malnutrition program seeks to educate caregivers, usually family members, about infant and toddler health and nutrition. This is done through biweekly meetings and case management support. If breastfeeding is not possible, COTP provides appropriate supplements for the caregiver to give the child. However, if the child’s medical or malnourishment needs are more than can be managed at home, COTP has nurses and staff trained to provide full-time short-term care. Nearly 200 children have been serviced with temporary rehabilitative residential care and then reintegrated back into their families, either with their parents or in kinship care. COTP continues to work with these families to ensure the family is fully supported and able to keep their children at home.

Esther,* a single mother, became increasingly concerned about the health of one of her daughters. After being connected with COTP, staff determined that her daughter was malnourished. Additionally, Esther was battling her own health problems and needed a short hospital stay. This family was in a crisis that could have easily led to the long-term separation between this loving mother and child. Without the option of providing treatment for her daughter’s malnourishment at home, COTP admitted Esther’s daughter into the short-term malnutrition program while Esther received the medical care she needed. The mother and daughter were quickly reunited after Esther’s recovery and COTP social workers supported Esther to find a long-term housing solution. Thanks to support from COTP, Esther and her family were able to receive individualized case management, medical care through appropriate partners, and empowerment so she could keep her child at home and out of residential care.

Nearly 20 years ago, the Bonnemas took the time to ask, “Why are children separated from families?” and in response shaped a unique program to care for young children at risk of being separated from their family due to medical issues. Since then, COTP has flourished into an organization that is effectively working to stop family separation and supporting children’s care in healthy and loving families, including a new partnership with Bethany Christian Services, for the development of domestic foster care for children who cannot return home.

*Name changed for privacy.