JOURNAL
ISSUE 2
1999/2000
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
105.
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
106.
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.
107.
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