Tag Archives: orphanages

Managing Transitions Part V: From Foster Caregiver to Parent

volunteers help

Transition from Foster Caregivers to Parent:
Luis is a 5-year old boy whose mother was a sex worker and gave him to her sister to care for when he was 1-year old. The sister was already taking care of Luis’ older sister, and she had two children of her own. When the sister moved in with a new boy friend, she could only take care of the sister and gave the then 2-year old Luis to a children’s home.

Luis’ mother was a young woman who had spent most of her childhood in a large orphanage, where she was alternatively neglected and abused. When she was 18 she left the orphanage and tried to find work but started using drugs with a boyfriend and became addicted. Unable to support her habit any other way, she became a sex worker. She first became pregnant with Luis’ sister and then with Luis, by different men. It is unknown whether she was using drugs during her pregnancies or whether the infants had problems at birth. The aunt did not notice any health problems in the babies, but did say that Luis was an irritable baby when he came to live with her at 1-year old. According to the aunt, Luis’ mother had wanted to care for him herself, especially after having to give up her first child, but her drug habit and her other activities resulted in her leaving him with neighbors and even strangers from time to time in a manner she herself acknowledged was neglectful.

When he entered the children’s home at 2-years old, he appeared to be a bright, engaging little boy who was, however, extremely anxious about losing control, for example, terrified of having an accident during potty training. This was despite the tolerant attitude the caregivers at the home had towards the toilet accidents of the toddlers. He seemed to thrive at the children’s home and became especially close to two other boys of the same age. He developed warm relationships with two female caregivers who worked with the “little boys” for the three years he was at the home. He loved the attention of the volunteers, especially the young men; some of them returned often to the home and developed real relationships with the children. Luis’ mother visited him in the home sporadically. He seemed pleased and interested in her visits, especially when she brought him presents, but as he got older he got upset when she brought the sister with her to visit and then mother and sister left together, even though the sister was actually living with the aunt.

When the LEPINA (https://www.unicef.org/about/annualreport/files/El_Salvador_COAR_2010.pdf , https://scrippsiij.blogspot.com/2012/12/lepina-law-harms-rather-than-helps.html) law was enacted in the country, it was ordered that he return to his mother. This was in spite of his mother not having a real home to take him to. The mother, anxious to have her son returned to her, told the court that she lived with her sister, and the court, anxious to comply with the law, accepted her statement. The children’s home was distressed at the decision, but they were unable to prevent Luis’ move back with his mother. They were worried not only that Luis would be leaving the home and his caregivers of three years, and not only that they deemed the mother incapable of caring for him at this time, but also they were afraid that the plans they had made for him to go to a good school would be jettisoned and that he would not begin school on time. They decided to work to build their relationship with his mother stronger and to try to support him in the neighborhood, but they were not optimistic.

How do you imagine that the Home could support this caregiver-child pair?


Fraser J, Casanueva C (2013) The Miami Child Well-Being Court Model: A Handbook for Clinicians, The Miami Child Well-Being Court Initiative.

Fraser J, Casanueva C (2013) The Miami Child Well-Being Court Model and Implementation Guidance, The Miami Child Well-Being Court Initiative.

Osofsky J (2009). Perspectives on helping traumatized infants, young children, and their families, Infant Mental Health Journal, vol. 30(6):673-677.

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India – Deenabandhu Trust: First Posting


Ginger and I landed in Bangalore early Saturday morning. The first sight I had of India was twinkling lights in the dark from the plane. The airport is modern and clean. We made our way through passport control and customs with an extra security check after landing, similar to El Salvador. On the other side of customs we found the representative of the travel office, who located our driver. We got into his new taxi, and we were off for Chamarajanagar. 

The driver said it would take us maximum of 4 hours to get there, but we started at 10 of 7:00 am and weren’t there by noon. Two reasons we were delayed were speed bumps – apparently every few yards, and also that we stopped for a “coffee break”. The Indian restaurant we stopped at served us a crispy brown pancake with a vegetable paste inside and two sauces. It was a cozy family type restaurant on a veranda with bamboo trees creeping into the seating area. 

It took us a long time to even get out of the city of Bangalore, which seemed to go on and on forever. There were shops and people, but the cityscape was most remarkable for the large buildings that seemed half constructed, and gave a sad, forlorn quality to the scene. The poverty, manifested in small shacks and storefronts with dingy signs and flimsy construction, reminded me of El Salvador. In fact, except for the local writing on some of the signs (most were only in English) and the occasional Hindu god, it could be mistaken for El Salvador with one exception – the newer buildings though prematurely shabby were on a much larger scale.

In one charming observation from the car, I saw two school girls, dressed in neat white uniforms with navy scarves, facing each other and playing the clapping game that I have seen in the U.S. and at Love and Hope.

We drove through countryside with fields of rice and sugar cane, and then a city calling itself on a green sign”The City of Sugar”, after that, other cities, and then the big city of Mysore. After Mysore, the countryside became more beautiful. A lovely mountain range in the distance framed a green landscape, which up closer was made up of red dirt dotted with trees. We finally arrived in the small city of Chamarajanagar, which resembled the outskirts of San Salvador, or even a huge Nejapa, with its small, dilapidated shops and dusty dirt roads. One important distinction from a Salvadoran city was the bright colors of the women’s clothing. Even in the impoverished areas women wore magenta and chartreuse saris, lighting up the dusty dirt streets in a dramatic way. The driver got directions from some men on the corner and turned down a dirt road. Much later, we arrived at a pleasant cluster of recently constructed houses that were the Deenabandhu Trust buildings.

Prajna came out to meet us. She is a beautiful young woman who left a high paying job working at Cisco Industries to devote herself to orphanage work and began to work here full time. Now she is the primary administrator, along with the man she calls “Uncle”, G.S. Jayadev, the founder, who is in Bangalore at the moment with his ailing father. Professor Jayadev teaches zoology at a local university but has written many books on multiple subjects, and founded the first orphanage here twenty years ago. Prajna told us that the children at the home come from a variety of sources, though most of them are not actual orphans but rather are children of parents who cannot care for them for various reasons. Those reasons include extreme poverty, mental illness, incarceration, and single mothers working in the sex trade. 

Our first introduction to the children was at lunch. The children in the “boys’” part of the home (occupied by boys, their caregivers, Prajna, and a small number of girls who live either with Prajna or with another woman caregiver who lives in a house in this section of the compound) were seated in a large empty room on mats, ready to eat. They were being served from large metal pots by some of the youngest boys whose current job was that of server. This job, I later learned, has special meaning here in that it is considered a gesture of giving, and in that sense, self enhancing. After being served, the children chanted a prayer. Just as I remembered from Love and Hope, the chanting of the prayer was animated and highly rhythmic. It seemed to organize the children both in their independent self-regulation and in their position as part of a well-regulated group. I mentioned this to Prajna, and she noted that before their lessons she leads them through a brief breathing exercise to help them prepare for studying. The meal was a delicious vegetarian meal of some kind of curry, chapatti, curd (yoghurt), and bananas grown by the children. The bananas were unblemished, ripe, and unusually sweet. After their meal, the children all take their big metal dishes and cups to the washing up room and wash them with water, then stack them in place in a large open rack with wooden slats. 

Prajna told us that the two youngest children are 4-years old, a girl and a boy. The Trust dedicates itself to the care of these children until they – especially the girls, Prajna told us – were economically self-sufficient. Some of the children have gone on to high level study and training, but Prajna assured us that the Trust was satisfied if the children grew up to be independent, happy young adults in less high status employment. Prajna took us on a tour of the buildings that house both the 77 children who live at the orphanage, called the “ashram”. The boys live in several free-standing houses, with one house parent in each house. The 16 younger boys lived in one of the houses with one house mother. In the two other houses, 8 older boys lived with one housemother.  The girls live in a new building that is a pride of the Trust. It is painted green and also obtains a significant amount of its electrical energy and heat from solar panels in the roof. An attractive, airy building, it includes multiple sleeping spaces and living spaces separated by internal staircases and corridors. Many of these passages are open to the air, so they are not only lit by sunlight, but they are cooled by breezes. Even in the winter, the temperature is warm by Boston standards, and the encircling mountain range drains the moisture in the air, so that it rarely if ever rains. 

photograph by Ginger Gregory

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Second Morning’s Workshop



Image of Supporting the Caregivers: Leonardo’s “Virgin and Child with Ste. Anne”

In this morning’s workshop we again started with the image of Leonardo’s Virgin and Child with Ste. Anne to remind the participants of the symbolic representation of supporting the caregiver. Then we moved to Sarah’s videos of last evening in the Home. We wanted to follow up our yesterday’s workshop discussion in which we talked about how the caregiving relationship can grow the children’s brains. 

1. A, with V, the cook: The Papusa Maker

In this video, A, a little girl now 7-years old, is watching intently as the cook, V, makes papusas.  The video demonstrates the role models of caregivers in constructive adult activities provide the children. The children observe the caregivers in their roles and imagine themselves engaging in the same activity.

The video shows A imagining becoming a papusa maker. In her expressive face, you can see her longing to be doing what the cook is doing.  Even though there are computer games going on in the same room, A stands enthralled by the papusa maker for about 20 minutes. She is observing the whole sequence of activities involved in making the papusas. As she observes, she is building the capacity for sequencing the steps in an activity, a critically important capacity for development.  She is learning by watching, by imagining, by anticipating, and finally by practicing. V is very patient in letting A be there and get in the way a bit and letting her feel as if she is part of what is happening. This is a great gift. A is beginning to anticipate a little bit, pointing to a papusa that she thinks is nearly ready. Kevin, an older boy, shares her interest, and V allows him to turn a couple of papusas over, because he is older, which is completely right. A can look forward to being older, when she will be able to make papusas too. Continue reading

First Morning Workshop



Best Laid Plans

This time it was Sarah and I alone who made the trip. I had organized the workshop according to my last bog posting on January 1.  Sarah had some excellent suggestions that we incorporated over an early breakfast in the hotel.  I had looked over the evaluations of the participants from the last workshop yesterday afternoon, and had noticed that many people expressed appreciation for videos, which I had not included in the plan for this workshop. I was not sure which videos I had on this computer. At breakfast I suggested to Sarah that we start the day with an emphasis on what good the orphanage has done for their children and a reminder of the importance of the caregiving relationship, especially in the early years. Sarah agreed.  She looked through her computer and found some excellent videos that she had taken of theses caregivers, demonstrating the attentiveness and affection that characterizes a good caregiving relationship; we made a new plan. I had located an image of Leonardo’s Virgin and Child with Ste. Anne, thinking that we could use it as an introduction to get across our point about the importance of supporting the caregiver – the mother (Mary) is holding the baby (Jesus) while she herself is in the lap of her own mother (Ste. Anne). Then I found a wonderful video made by my friend, Ed Tronick, demonstrating through the still face experiment the importance to the infant of the emotional connection with the caregiver. We decided that we would first show the Leonardo image and then show several positive videos of the caregivers who we knew would be present at the workshop. However, our experience this morning confirmed our suspicions that no matter how well we plan, we always revise our workshop during the course of the event. Here is what happened.

Continue reading

Planning a Workshop for Caregivers in El Salvador


Happy New Year, everyone.  This is a picture of me wearing the gift from my Shanghai hosts in front of my family Christmas tree.  Now, I will leave the theme of Shanghai and return to El Salvador, where I am planning a new workshop next week.


The new Salvadoran law requiring all children in institutional care to be reunited with their biological families presents a crisis to orphanages in El Salvador.  Many or most children in care are being returned to families who may not be prepared to receive them and care for them.  Often, neither children nor families have chosen this transition and may feel afraid, sad, and angry.  Community services to support the reunification in most cases do not exist.  Orphanage administrators and workers were also unprepared to deal with these changes – to support the children, to support the families, and to support themselves and one another.  Yet, it is also an opportunity to make positive changes in childcare. Many studies show that family care is superior to institutional care for the developing child (this is not uniformly the case, however). (McCall, J. N. (1999). Research on the psychological effects of orphanage care: A critical review. In R. B. McKenzie (Ed.), Rethinking orphanages for the 21st century. Newbury Park, CA: Sage Publications, Inc.) Supporting care within the family may have more far-reaching benefits.  Supporting care within the family and community preserves local institutional (such as church and others) and cultural assets. 

The workshop (1) maintains a primary focus on the caregiving relationship – whether the relationship of the child and the orphanage caregiver, or the relationship of the child with the biological family caregiver, (2) the use of the “behavior of the child” (Touchpoints Model”, or the words of the child to communicate with the caregiver, and (3) an emphasis on opportunities for mastery.  As in the Touchpoints Model, the workshop stresses a positive attitude and empathy towards caregivers, and a collaborative approach rather than advice from “experts”. 

Here is an example of a case of a child being reunited with his mother: E is 6-years old. His mother has never taken care of him. She has had a hard life.  She reports having been sexually and physically abused as a child, and she escaped from a children’s home when she was 16. She has always been dependent on men, seeming to lack the motivation to succeed on her own. She can be rude and act entitled to the help she wants from the Home. She claims strong moral values, but she struggles to live according to these values. For example, she is easily offended if she perceives E to be mistreated by someone, yet she will often mistreat other children. E is a competent child and generally has good relationships, but he is strong willed and able to play one adult against another when he is upset. The Home worries that he will try to control his mother and cause her to become discouraged or to give up.

The participants will be invited to discuss the case.  Questions to begin the discussion might include: (1) What positive characteristics of the mother can the caregivers identify? (2) How can the caregivers find ways to empathize with this mother? (3) What are the mother’s goals and ambitions for E? (4) How can the caregivers communicate what they know about E to the mother and still emphasize her knowledge of her own child? (5) How can the caregivers support the mother in recognizing the problems they anticipate after the reunification? (6) What ongoing support do the caregivers think would be best for this family?



The purpose of this blog is to gather information about how to support caregivers of children in care in developing countries.  The quality of the caregiving relationship in infants and young children, central to the healthy development of the growing child, can be enhanced by attention to the caregivers in the form of education and other support. This blog will become an archive for information on these issues.


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