JOURNAL ISSUE 2
1999/2000

table of contents | abstracts

 

Foster Care for Unaccompanied Children in Exile

Danijela Bucevic
Dusko Ljiljak

ABSTRACT

The war in Bosnia-Herzegovina resulted in many unaccompanied children as refugees in Zagreb. The Unaccompanied Children in Exile project has organized two foster family care programs to respond to the needs of some of these children. One places the children in foster homes, including kinship homes. Center parents can be located and the children safely registrated for reconstruction with these families. The second serves children who have been evacuated to Zagrab for whom treatment of serious illnesses or injuries. Often treatment is needed on an outpatient basis after hospitalization. Foster families are recruited to care for these children during the time of their medical treatment.

 

RATIONALE FOR REFUGEE FOSTER CARE PROGRAM

The Unaccompanied Children in Exile (UCE) program of the Center for Social Policy Initiative (CSPI) provides interim care in a foster family to serve the best interests of unaccompanied refugee minors from Bosnia and Herzogovina. The program was started in 1994 to serve fifteen children. The United Nation High Commission Refugees (UNHCR) was the sponsor and set a condition of involving only fifteen beneficiaries. By the end of 1996, the program expanded to 25 unaccompanied minors. Due to the intensive fluctuation of the refugee population, and the strong repatriation process in 1996, the program has benefitted more individual children than originally planned. In 1996, 54 children were included. After the summer holidays of 1996, 25 unaccompanied minors were in the program including five minors suffering from malignant diseases that needed medical treatment in a family atmosphere (cancer cases, leukemia, nephritis, etc.). In 1997, the program expanded and served 90 unaccompanied minors.

The program was needed for two reasons:

1) Refugee children in Croatia are not entitled to public foster care services. Displaced children, however, are entitled to the same program of care and protection as the other Croatian children’s displaced children are internally displaced children from occupied Croatian territories. Therefore, there is a gap in services and a need for a foster care program for unaccompanied refugee minors.

2) Unaccompanied refugee children were often in the care of some adult caretaker such as relatives, friends, or neighbors. Thus, a second separation was an obstacle for any new care arrangement. Foster care, including kinship foster care, was an interim care solution supported by families and the best interest of the child.

 

CRITERIA FOR INCLUDING CHILDREN IN THE FOSTER CARE PROGRAM

In 1994, 4,000 unaccompanied refugee children were registered in Croatia. They had been separated from their parents due to war circumstances; the majority needed psychosocial, medical, and financial assistance. Admission criteria were developed to enable selection of the most vulnerable group of children among a large group of children in need:


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* Unaccompanied refugee children. Children included in the foster care program were registered with the CSPI Unaccompanied Children in Exile project and were separated from their parents because of war circumstances.

* Age. Younger children were in greater need and had more difficulty with the separation from their parents.

* Post traumatic stress. Not all of the children experienced refugee status and separation in the same way. The circumstances of the separation had a great impact on the child’s well being. Some children were present when their parents were wounded or killed which deepened their trauma.

* Psycho-physical condition. Children were selected whose development and ability to cope had been affected greatly by their trauma.

* Adaptation problems. Children with behavioral and adaptation difficulties were at higher risk and were included in the program. With the assistance of professionals their behavioral and adaptation difficulties could be alleviated and social adaptation as well as success in school assisted.

* Serious health problems. Some of the children were suffering malignant diseases. They were included in the foster care program. Because of the special needs of these children, CSPI developed a sub-project of specialized foster care for children suffering malignant diseases

 

CRITERIA FOR THE SELECTION OF FOSTER FAMILIES

Professional dilemmas, concerning criteria for the selection of foster families, appeared at the beginning of the work.

 

KINSHIP CARE

A primary dilemma was whether to support placement in a kinship family willing to take care of the child or to move the child to a better situated but unknown family. This was resolved in support of placement in a family of relatives (the kinship foster care). The best interest of the child was advanced by preventing second separation, that would cause additional trauma to the already traumatized children. The kinship foster family could more easily support the relations of the child to the birth family or, if the child had lost parents, could help in cherishing the memory of them.

Financial situation of the foster family. Financial assistance received through the foster care program covers the basic needs of the child. Potential foster families with bad financial situations because of unemployment or refugee status were not included in the program. Families of relatives were included in the foster care program when they could provide for themselves, the acceptance of a foster child did not endanger their living standard, and the child would have chances for normal growth and development.

Personal characteristics of foster parents. Age, health, emotional stability, and level of trauma due to the war circumstance were elements that influenced the selection of foster parents. When children did not have relatives, or these relative families did not meet selection criteria, new foster placement was found. The group of seriously sick children was placed in families that were not related to the children. The standard for the placement of seriously sick children was different from the standard of selection for children without serious health problems and included medical education of foster parents, motivation for taking seriously sick children, vicinity of the hospital, and number of rooms. When choosing a family, CSPI staff look for a positive emotional atmosphere, functioning of all family members, and the ability of the family to be a positive influence on the child. Staff look for families that can provide consistency for the child and help the child accept responsibility for school work and other matters.

 

 

PROGRAM IMPLEMENTATION

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An assessment of the care needed for each child is based on data collected by the CSPI Unaccompanied Children in Exile project. An initial selection is made of children who have been accommodated in families, collective shelters, and with relatives, friends of family, or other persons. The assessment determines whether it is possible to continue this placement and whether this placement is adequate or inadequate.

Decisions about matching children and families are based on the collected assessments, reports on foster families, and the evaluation of the child’s situation. This process includes an interview with the child. Children with special needs require medical, pedagogic, or psychosocial treatment. Specialists in these specific fields are provided including special teachers for mentally disabled, for children with behavioral problems and special needs. Special assessments are not required for a child without special needs, a child who does not display significant deviations, and whose behavior is considered normal within an identified family and social surrounding.

The conclusion of the matching process includes an assessment of the potential foster family in terms of its adequacy for the particular child as well as a report on the psychological, physical, and social status of the child.

Foster families are provided with regular monitoring by professionals. This is frequent at the beginning; later on, the maintaining occures once or twice a month depending on the situation and needs of the child. After the initial arrival and inclusion of the child into a foster family, CSPI staff members work with the family. During the first visits they assist with bringing together the child and the family and support the atmosphere of trust between staff and the foster family in order to enable regular monitoring, supervision and intervention, if needed.

Program staff identify the needs of each child based on the assessment information. An individual short term plan and a long term plan of activities are created for each child. Short term plans are mainly at the beginning and consist of getting adequate clothes for the child, activities concerning the change of school, the responsibilities of foster parents and program staff concerning a good start at a school, and conditions for adaptation to a new surrounding. These activities concern the foster parents, all the members of the foster family, and often neighbors.

The long term plans for each child focus on meeting the best interests of the individual child. A long term plan could include include reunification with the birth parents including repatriation or going to a third country. If the parents are dead, reunification may be with close or extended family in the country of origin or in a third country. In some cases, placement can be long term foster care if this meets the best interests of the child under the circumstances.

The K family illustrates the work of the UCE Foster Care Program. The K family lived as refugees in the suburbs of Zagreb. The grandparents and five children escaped from a village near Sanski Most, Bosnia-Herzegovina. The mother of the children left the family when the youngest child was born and their father was killed during the war. Two of the youngest children, a boy (age eight) and a girl (age ten) were included in the CSPI Foster Care Program. The family received psychosocial support to help with local integration, educational process, and alleviating inter-generational problems of the family through regular monitoring and counseling from CSPI staff. As CSPI staff helped the grandparents to regain their self-confidence, the whole atmosphere in the family improved. The children were enrolled in a local school and were encouraged to take part in the life of the local community. CSPI staff helped the grandparents and older grandchildren to overcome inter-generational problems that occurred because of the children’s urge for better adaptation to a new social surrounding and the fear and different views of the grandparents. The grandparents and the children received support concerning their decision to return to their place of origin. The family returned to their village while the children continued their education. After their return to Bosnia-Herzegovina, CSPI receives regular information from the children and the grandparents concerning the family’s well-being.

 

 

SPECIALIZED FOSTER CARE FOR UNACCOMPANIED CHILDREN WITH MALIGNANT DISEASES

During the war in Bosnia-Herzegovina, a number of unaccompanied refugee children with malignant diseases were evacuated to Zagreb for medical treatment. After the hospital treatment, they often

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needed further care and home treatment, but not far from the hospitals, since they needed regular check-ups and laboratory controls.

These children were the most vulnerable group of unaccompanied refugee children. Finding adequate foster homes was difficult, since the foster family had to fulfill a criteria of adequate medical education.

The needs of these children were great and included special nutrition, regular physiotherapy, and regular check-ups at the hospital (usually once a week, but sometimes daily). The foster family had to live near the hospital. If the child was staying in the hospital for additional treatment or laboratory controls, the foster parents were obliged to visit the child regularly.

Before placing the child in a foster family, a period of time was needed for the child to get to know them and to adapt to the new situation. Therefore, the CSPI staff organized regular visits of the foster family to the child still in the hospital. At the beginning, the staff were present during the visits, but later the foster family would visit the child alone. The foster parents were also introduced to the child’s physician, to get information about the further treatment that would be carried on at home. CSPI staff maintained frequent contacts and provided support to both the foster family and the child. They also had regular contacts with the hospital and physicians and with the child’s birth family in Bosnia-Herzegovina. The placement of the child in the Specialized Foster Care would be terminated when the child was rehabilitated. Whenever possible, the child was repatriated; reunified with his or her family.

This program is illustrated by work with T.K., a six year old girl. T.K. was transferred to Zagreb and to the oncological department of the Children’s Hospital because of the war circumstances in Bosnia/Herzegovina and a diagnosis of sarcoma. After medical treatment was received in the hospital, she needed further treatment but did not require hospitalization. She was referred to CSPI by the initiative of her physician and the International Rescue Committee. The foster home CSPI found was Ms. H., a retired nurse, married, without children, and living in an apartment near the hospital. Ms. H. visited T.K. regularly at the hospital. A very strong emotional link was developed between the child and the foster mother. After spending more than six months in a hospital the child was very happy in the foster home. The foster mother supported the child’s treatment with warmth and professional knowledge. She made regular visits to the hospital for physiotherapy special nutrition, and other organizing communication with other children to celebrate the child’s birthday with other children, and so forth. The girl went regularly to the hospital for chemotherapy, but returned happily to her foster home. During the treatment her diagnosis deteriorated and her leg had to be amputated. Extra effort was needed in helping the child to accept the need for the amputated leg. CSPI managed to get an orthopedic leg for the child. She soon managed to walk again.

CSPI staff monitored the foster placement, provided support to the foster mother, and were in regular contact with the girl’s physicians and her birth parents in Bosnia-Herzegovina. CSPI managed to help the parents get a permission to visit the child in Zagreb, even when the war activities in Bosnia/Herzegovina were at their peak.

This story does not have a happy ending. The malignant disease was stronger than all the CSPI efforts and prayers. At the end, T.K. was taken back to Bosnia/Herzegovina by her parents, where she soon died.

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