So Every Child Can Grow and Thrive

In one southern province of Vietnam, an alarming number of children are born with special needs — especially cerebral palsy. To help address the growing need for services, Holt is working alongside one local orphanage to provide daycare and vocational training for children with medical and developmental needs who are living with their families.

With the vocational skills she’s learning in orphanage care, Lan may one day be able to live an independent life.

Lan* rests her foot on the peddle and pauses a moment before pulling the next piece of thread through the loom. This task requires concentration and dexterity. But she has repeated these same steps enough times now to feel confident in her skills. It’s unusual that the orphanage has a few visitors on this overcast Saturday morning, and they observe her now as she carefully demonstrates how to make the colorful woven bags that they admired earlier in the glass case at the front office.

Lan learned to loom as part of a vocational training program for older children with special needs at the Binh Duong orphanage in southern Vietnam. This orphanage is also her home, and will be until she turns 18. Lan and her classmates keep all the profits from the bags they weave, which they sell to customers in the community. Weaving is a fun activity that provides Lan with a little spending money — especially during Christmas and other holidays, when local companies order in bulk. But more than that, the vocational skills Lan is learning can help her to support herself and possibly go on to live a fully independent life when she leaves the orphanage.

The vocational training program teaches the children how to weave these colorful bags, which local companies order in bulk during holidays.

The Binh Duong Child Welfare Center has provided vocational training for many years — often with support from Holt. In the late 1990s, Holt worked with Microsoft to donate computers and provide skills training to youth living in the orphanage. As a result, over 500 children went on to get jobs that required computer skills. The textile training program began about ten years ago. Programs and services like these are vital to helping young people succeed when they leave institutional care, and they are helping to address a growing need in the community. In recent years, this region has seen an alarming increase in the number of children with special needs, especially cerebral palsy. As a result, the orphanage has also seen a large influx. By 2013, a quarter of all children in care had some kind of special need.

Although the cause of this increase is unknown, the orphanage director points to one explanation during our visit.

This little girl came into care severely malnourished. With more outreach to pregnant mothers in crisis, the director believes that fewer children will be born premature, malnourished or with special needs.

Growing industry in the region attracts a large number of migrant workers, says the director — a small but energetic woman who has held her position for more than 20 years. Many of the migrants are young and have minimal education. When young, often unmarried couples become pregnant, they lack the support of their families back home. They have little to no prenatal care, and as a result, many babies are born premature, malnourished or with special needs. With insufficient resources, some mothers abandon their infants at birth — leaving them malnourished and struggling to survive. Many of these babies are referred to the orphanage by the local government for care and rehabilitation. Still, their first few months are critical as they struggle to overcome health issues, and many will develop physical and cognitive delays.

This is one area in which Holt could strengthen our services in the south. “We need to do more outreach services with single mothers,” explains Hang Dam, Holt’s country director in Vietnam since 2009. While Holt Vietnam has in the past provided support services for unwed mothers, the staff has decided to rethink how they approach the program. “We need to provide more technical support and counseling,” Hang says, “not just basic support.” The orphanage director emphasizes the need to provide early intervention for pregnant mothers in crisis. “If they receive good prenatal care,” Hang says, translating for the director, “their babies would be born healthy and less likely to be abandoned.” To develop single mother services in the south, Holt Vietnam would need to train the local orphanage staff in social work skills — building upon the skills Holt has already helped to foster over our near 20-year relationship with the Binh Duong orphanage.

Working together since 1995, the Binh Duong orphanage is one of Holt’s longest-standing partners in Vietnam — and, in fact, Holt Vietnam’s southern office is located within the orphanage buildings. Through these years, the director shares, Holt has provided support to the orphanage in ways both tangible — equipment, supplies, nutritional support — and intangible, such as training in case management and essential social work skills. As more and more children with special needs have come into care in Binh Duong, Holt Vietnam has also helped the orphanage to develop programs and services tailored to their unique needs, such as physical therapy and rehabilitation.

Two years ago, Holt Vietnam began working with the orphanage director to expand these support services to disabled children living with their families. “Families of children with special needs have no access to services,” Hang explains. “So we created a daycare program and opened the services to those children in the community.”

Developing a daycare program for children with special needs at the orphanage offered numerous benefits — including physical, motor and developmental therapies the children would not otherwise receive if they were home all day with their families. Children receive a nutritious lunch, and can participate in the vocational training program while in care during the day. The service also fits within Holt’s family strengthening model as it helps struggling parents to support their children — keeping families strong, stable and self-reliant. Even in two-parent households, families of children with special needs often struggle to earn enough income as one parent must stay home to provide round-the-clock care. Daycare also provides respite for the family, and allows both parents to work.

Because parents can earn more income when their children attend daycare, the program also ultimately pays for itself. “Holt pays for the first year on a sliding scale,” Hang explains. “After the parents are able to work, they can take care of the cost themselves.” For example, Holt provides 75 to 100 percent of the funding at first. Once the child’s mother gets a job, Holt will gradually pay a smaller percentage of the fees. At the end of the first year, the family is expected to pay the full cost of their child’s daycare fees.

When we visit the orphanage on a Saturday in June, all but one child in daycare are home with their families. A 3-year-old girl of a single mom who works weekends, she sits in a room with ten other children — all kids with special needs who live at the orphanage. The director introduces us to several of them, including Lan — the teenage girl who later shows us her weaving skills. The director playfully teases and nudges Lan, who laughs and rests her elbows on another child’s crib. In the next room, several children run giggling to the door to greet us —lifting their arms to be held and jumping into our laps when we sit. These children also have special needs. They run boisterously around the room, creating a joyful — and hopeful — atmosphere.

Many of the children have good reason to hope. Through the years, this orphanage has had significant success reuniting children with their birth families or finding domestic adoptive families for many of them — including some with special needs. With support from Holt in the last two decades, international adoption has also become an option for children with special needs who can’t reunite with their birth families or join an adoptive family in Vietnam.

Before 2010, Holt was the only agency to place children with special needs from Binh Duong and one of very few agencies placing these Vietnamese kids in adoptive families overseas. When the U.S. declared an indefinite moratorium on adoption from Vietnam in 2008, placements halted to the U.S. However, other countries still placed both healthy children and children with medical or developmental needs from Vietnam. Just in 2013, seven children from the Binh Duong orphanage joined adoptive families overseas. And soon, the U.S. and Vietnam will begin partnering again to place children with special needs — a small pilot project involving two placing agencies from the U.S. Holt is being considered as one of a few final candidates.

This little one also struggles with malnutrition. Fortunately, he is able to stay in the care of a loving foster family. By training more foster families to care for children with minor special needs, the orphanage could expand services to more children in the community.

“After almost 6 years under suspension, international adoption between the U.S. and Vietnam will open shortly, focusing on adoption for children with special medical/health needs or children older than 5 years old,” Hang explains. “The Vietnamese government is in the final process of licensing for a limited number of adoption service providers (ASP). Holt is one among the U.S. ASPs being considered for a license.”

In the meantime, Holt and the orphanage director in Binh Duong strive to provide a loving, joyful atmosphere for the children with special needs. The orphanage is not a home, and both Holt and the director would prefer for the children to stay in foster families. In Hanoi, Holt has been able to find and train families open to caring for children with special needs. “In the south, however, most families are not open to it because they believe that the kids will need intensive care,” Hang explains. In the past, some families have cared for children with more minor needs, such as a cleft palate. Both Hang and the director are hopeful that by investing more in expanding and training families, they can place children with more minor needs in foster care.

With this one move, Hang explains, it could create a domino effect for children with special needs. Translating for the director, Hang says that not only will foster care provide a more home-like environment for some children, it will allow the orphanage to open up daycare services to more children with special needs in the community — and to provide more attentive care for the children with more severe needs. “She is thinking holistically,” Hang says of the director — who she describes as “a tiny buy great director” who she feels blessed to have worked with for so many years.

Both the orphanage director and the Holt Vietnam staff are excited about the possibilities. In just two years in operation, the impact of the daycare program has exceeded expectations. In 2013, 93 children attended the daycare program in Binh Duong. Holt provided funds for tuition and nutritional support and local Holt Vietnam social workers managed each family’s case — monitoring attendance and following up to ensure their success. Within six months, 95 percent of the children enrolled were attending daycare regularly. For 95 percent of the children, their physical and mental developmental was on target for their age. And a full 100 percent of birth parents were able to work to supplement their family’s income and meet the basic needs of their children.

“Our daycare program has opened opportunities for poor households that have children with special needs to receive quality child care services,” Hang says, “as well as help families deal with their emotional and economic difficulties — thus soon becoming self-sufficient.” And that is, ultimately, Holt’s goal everywhere we work — helping families become strong, self-reliant and able to provide a stable, loving home for their children.

Robin Munro | Managing Editor

Vocational training for children with special needs in Vietnam from Holt International on Vimeo.

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