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Children at the Jimma community orphanage between the ages of 5 and 14 years were given a battery of tests to assess their intellectual, social, and nutritional well-being relative to a group of family-reared controls. On two tests of intellectual ability, the Ravens Progressive Matrices and the Conservation test, the orphanage children performed as well as the family children. Children who entered the orphanage at an early age scored higher than those who entered later. On social-emotional measures of self-esteem, the orphanage children scored higher than or similar to the controls. However, in terms of their relationships with adults, the orphanage children reported fewer interactions and weaker attachments to adults. This was largely determined by the higher child: adult ratio in the orphanage than in family homes. Also, the orphanage children were more likely to be stunted but not more likely to be wasted than the family children. The former was attributed to the malnutrition experienced by children before they entered the orphanage, which in many cases was during the 1984 famine. Stunting was associated with lower Ravens scores. The generally favourable status of the orphanage children can largely be attributed to the noninstitutional orphanage rather than to their preorphanage family life. This raises disturbing questions about family life under conditions of economic stress.
The study was carried out in all orphanages listed in sanitary-epidemiological stations. The main purpose of the study was to assess children nutrition and sanitary-hygienic conditions of meal's preparation in orphanages. Inspectors of Children's and Youth's Hygiene Departments of the sanitary-epidemiological stations assessed, by means of a uniformed questionnaire, the sanitary-hygienic conditions of kitchens and dinning-rooms and quality of diet served in orphanages. From total 327 children's homes (with 16471 inmates aged from 3 days up to 25 years) included in the study, 93% were run by State, 6% by the Church and 1% by Foundations. Results of the study showed that in majority of orphanages the sanitary conditions of meal preparation and consumption were satisfactory. Kitchens with proper equipment were recorded in 301 orphanages (92%), with good ventilation in 316 orphanages (97%) and with sufficient lighting in 304 orphanages (93%). Dietary assessment of children showed that in some orphanages inmates have eaten too few meals a day. In contrary it must be emphasized that in 241 orphanages (73%) the meals were served five times a day. It leads to assumption that in remaining 27% such a way of meals giving should be possible to achieve.
BACKGROUND AND OBJECTIVES: In developing countries, caring for the large number of babies in orphanages is very hard work. Whereas the physical needs of most of the children are met, play often gets neglected. Studies have repeatedly shown that babies in such institutionalized settings suffer from severe psychomotor retardation. The aim of this project was to develop an intervention programme of structured play. We hypothesized that such an intervention would result in acceleration of psychosocial development in otherwise healthy institutionalized children. DESIGN: Prospective longitudinal. SETTING: Mother Teresa's Orphanage, run by Missionaries of Charity. SUBJECT AND METHODS: All 30 children in the orphanage aged 6 months-2.5 years, were assessed for their Motor, Mental and Social Quotients, using the Indian adaptation of Bailey's Scale of Infant Development(DASII) and the Vineland's Social Maturity Scale. A structured 'Regime of Play' was then built into the routine of the orphanage. A repeat developmental assessment was performed at the end of 3 months to assess the impact. RESULTS: Out of the original cohort of 30, 19 children were available for post-intervention assessments. The remainder were adopted before their assessments. Their mean Motor Quotient rose from 63.7 to 81.7, mean Mental Quotient rose from 65.8 to 89.6 and the mean Social Quotient rose from 61.9 to 91.3, a gain of 18, 23 and 30 points respectively (p < 0.0001). There was also an overall change in the environment of the orphanage. Children became more active, playful, responsive and independent. Contrary to what caretakers assumed, their workload actually decreased. The responsiveness in the children awakened as a result of play, acted as a positive feedback for caretakers to continue the play sessions. CONCLUSIONS: This study shows that short daily sessions of play can significantly improve the development of children in such institutions. It is vital to remember that children grow 'Not by Bread Alone'.
Six and a half years after adoption. 6- to 12-year-old children reared in Romanian orphanages for more than 8 months in their first years of life (RO. n = 18) had higher cortisol levels over the daytime hours than did early adopted (EA, < or = 4 months of age, n = 15) and Canadian born (CB, n = 27) children. The effect was marked, with 22% of the RO children exhibiting cortisol levels averaged over the day that exceeded the mean plus 2 SD of the EA and CB levels. Furthermore, the longer beyond 8 months that the RO children remained institutionalized the higher their cortisol levels. Cortisol levels for EA children did not differ in any respect from those of CB comparison children. This latter finding reduces but does not eliminate concerns that the results could be due to prenatal effects or birth family characteristics associated with orphanage placement. Neither age at cortisol sampling nor low IQ measured earlier appeared to explain the findings. Because the conditions in Romanian orphanages at the time these children were adopted were characterized by multiple risk factors, including gross privation of basic needs and exposure to infectious agents, the factor(s) that produced the increase in cortisol production cannot be determined. Nor could we determine whether these results reflected effects on the limbic-hypothalamic-pituitary-adrenal axis directly or were mediated by differences in parent-child interactions or family stress occasion by behavioral problems associated with prolonged orphanage care in this sample.
Children of eight orphanages at the different districts in Taipei were examined with scotch adhesive tape method and flotation of saturated NaCl solution from Sept. 1973 to Jan. 1974. The results are summarized as following: General incidence of Enterobius verminularis was 74.40% in 461 cases examined, male 76.45% (224/293), female 70.83% (119/168). There was no significant statistical difference between the male and female. Incidence of Enterobius among the orphanages was 83.33% (25/30) in Po-Ai, Fu-Ann 82.61% (38/46), Ta-Tung 82.43% (61/74), Hau-Sen 77.25% (34/44), Chung-I 75.00% (51/68), Jen-Ai 72.97% (23/37), Ti-Hwei 72.50% (29/40) and Sen-Tao 63.93% (78/122). There were no significant statistical differences among the orphanages except the differences between Sen-Tao and Ta-Tung; Sen-Tao and Fu-Ann, Sen-Tao and Po-Ai. Incidence of Enterobius according to age-groups: The highest rate was 79.34% (242/305) in primary school group followed by 70.00% (21/30) in kindergarten group, 64.40% (73/114) in Junior high school and the lowest was 63.64% (7/11) in nursery group. There was a significant statistical difference between primary school group and junior school group. (Table 3) The larger the space for the children's free activity was the lower the incidence of Enterobius, and the smaller space resulted in the higher incidence. The distribution of Enterobius ova in the different body parts of the 461 orphans was 80.91% (373/461); The highest 74.40% (343/461) at perianal area and the lowest 11.93% (55/461) at ears. The incidence of Enterobius on the various objects in the orphanages was found as the following: 85.71% (6/7) on bed pans, 83.67% (333/398) on linens, 78.46% (51/65) on w. c. appartus, 77.39% (89/115) on specimens of dust, 13.33% (1/15) on stairrails 8.04% (32/39) on bedposts, 7.33% (11/150) on closets, 4.24% (5/118) on desks and 3.64% (2/55) on toys.
In 1960, a survey showed Japanese orphanage children to be shorter in stature than Japanese children in general. In 1964, food budgets for orphanages were increased and, on Hokkaido, 180 gm. milk per day was made available for each child. In 1968, a further improvement in the diet was made by providing for an egg a day for each child, plus more liberal money allowances. Data from surveys in 1965 and 1970 on food served to these children reflected the improvements, as compared with 1960, Figures on the stature of the orphanage children were also compared. By 1970, the only orphanage children falling below the national mean were the teen-age boys and, to a lesser extent, the adolescent girls. Weight differences in all three surveys were less striking.
In order to investigate orphans' situation and development in Iraqi Kurdistan, samples from the two available orphan care systems, the traditional foster care and the modern orphanages, are examined at an index test and at 1-year follow-up regarding competency scores and behavioral problems at both test occasions, and post-traumatic stress reactions at a 1-year follow-up. Achenbach Child Behavior Check List (CBCL) and two instruments regarding post-traumatic stress disorder (PTSD) were used. While competency scores showed an improvement in both samples at the follow-up test, the problem scores increased in the orphanage sample and decreased among the foster care subjects. Moreover, the orphanage sample reported higher frequency of post-traumatic stress disorder (PTSD) than the foster care children. The results are discussed with regard to the value of the Kurdish society's own traditions in taking care of orphans.
Children living in institutions as orphanages are more exposed to intestinal parasitism, since crowding and behavioral pattern contribute greatly to the spread of parasitic infection. The present study was conducted on 100 children living in Ain-Shams and El-Mowassa orphanages, Cairo. Twenty children living under appropriate health conditions were studied as controls. Ages of both groups ranged from 6-12 years. The results of this study revealed that 69/100 (69%) orphanage children were positive for parasitic infection, while 8/20 (40%) control subjects were positive for parasitic infection; the difference was statistically significant. Enterobius vermicularis was the commonest parasite among both groups. Other parasitic infections detected were; Giardia lamblia, Entamoeba histolytica, Hymenolepis nana and Entamoeba coli with a prevalence of 10%, 9%, 2% and 9% respectively in the study group compared to 15%, 10%, 0% and 5% in the control group; the differences were statistically not significant. Cryptosporidium oocysts were not detected in both groups.
A large body of medical knowledge exists that can inform the public policy debate as to whether the current needs and future life prospects of poor children could better be served in orphanages than by continuing safety net programs, such as Aid to Families with Dependent Children, Medicaid, and Supplemental Social Security Income, which maintain children in families. This special article explores a century of pediatric and child psychiatry research covering five areas of potential biologic and social risk to infants and young children in orphanage care: (1) infectious morbidity, (2) nutrition and growth, (3) cognitive development, (4) socioaffective development, and (5) physical and sexual abuse. These data demonstrate that infants and young children are uniquely vulnerable to the medical and psychosocial hazards of institutional care, negative effects that cannot be reduced to a tolerable level even with massive expenditure. Scientific experience consistently shows that, in the short term, orphanage placement puts young children at increased risk of serious infectious illness and delayed language development. In the long term, institutionalization in early childhood increases the likelihood that impoverished children will grow into psychiatrically impaired and economically unproductive adults.
OBJECTIVE: This study compared the mental health and cognitive development of 9- to 12-year-old Eritrean war orphans living in two orphanages that differed qualitatively in patterns of staff interaction and styles of child care management. METHOD: The directors and several child care workers at each institution were asked to complete staff organization and child management questionnaires. The psychological state of 40 orphans at each institution was evaluated by comparing their behavioral symptoms and performance on cognitive measures. RESULTS: Orphans who lived in a setting where the entire staff participated in decisions affecting the children, and where the children were encouraged to become self-reliant through personal interactions with staff members, showed significantly fewer behavioral symptoms of emotional distress than orphans who lived in a setting where the director made decisions, daily routines were determined by explicit rules and schedules, and interactions between staff members and the children were impersonal. CONCLUSIONS: When orphanages are the only means of survival for war orphans, a group setting where the staff shares in the responsibilities of child management, is sensitive to the individuality of the children, and establishes stable personal ties with the children serves the emotional needs and psychological development of the orphans more effectively than a group setting that attempts to create a secure environment through an authoritative style of management with explicit rules and well-defined schedules.
A prospective observational study was conducted in a male orphanage to find out the prevalence of enterobiasis and its incidence after blanket chemotherapy using mebendazole. We found that the prevalence of enterobiasis was 28.9%. The incidence density of enterobiasis after blanket chemotherapy was 379.82 per 1,000 person-years which was quite high. We suggest that blanket chemotherapy should be repeated at every 6 months interval to control enterobiasis in orphanages.
In Thailand, the morbidity rate of measles has declined since measles vaccination was included in the National Immunization Programme. A measles outbreak affected 41 infants in an orphanage in Bangkok during September-October 2000 prompted an investigation to study the epidemiological distribution, assess vaccine coverage and vaccine effectiveness. The attack rate was 66 per cent, among infants aged 6-12 months in two separate rooms. Sixty-three per cent of the 41 cases were less than 9 months old. Measles vaccine coverage among infants over 9 months was 45 per cent due to delay in immunization caused by mild illnesses of the infants and the vaccine effectiveness was 91 per cent (95%CI 42%-99%). Inefficiency of the surveillance system to early detect and respond to the outbreak was observed. A catch-up immunization program, close supervision for surveillance and immunization systems and an increase of measles vaccine coverage to more than 95 per cent in this and other orphanages in Thailand were recommended.
The reported study was carried out in all orphanages controlled by the health conditions in these homes and inquiry form was evolved which made possible recording of deviations from the required state of hygiene and from the sanitary-technical requirements. In the realization of the study workers of the children and youths hygiene of the sanitary-epidemiological stations were participating. These workers supervised normally these homes in their areas. Out of 327 homes 93% were run by the state, 6% by the church and 1% by foundations; 30% of the homes were in rural areas, 45% in small towns, and 25% in province capitals. In 1995 these homes housed 16,471 inmates, 8,839 boys and 7,632 girls. On the basis of the obtained information it could be said that the health conditions varied greatly between these homes, and depended in a high degree on the care shown for the good of the inmates, and on the commitment of the staff. The poor sanitary-epidemiological conditions in certain homes were due to poor technical state of the buildings exploited during many years. Faulty were noted also due to negligence of the users of these homes. It is necessary to undertake current and remote future actions for improving these conditions of orphanages from the viewpoint of hygiene.
The practice of adoption, though long accepted as a social phenomenon, is only recently gaining popularity in India. Due to the paucity of adequate follow-ups, evaluation of these adopted children is incomplete. For the purpose of studying the well-being of these children after adoption, they were followed-up at the various places, i.e., orphanages, institutions, juvenile courts and adoption agencies, responsible for their care. One hundred sixty children, 63 boys and 97 girls, adopted from an orphanage in the vicinity of our hospital over a period of 13 years are included in this study. There were 104 local and 56 foreign adoptions. Due to sociocultural background in Indian adoptions, males were preferred; whereas the international adoptions mostly depended on human considerations without any specific preference for the sex of the child. On follow-up, all children except three were reported to be physically healthy and well-adjusted emotionally in the new family, and well accepted by the society. Although adoption is not the only solution for an abandoned child, it may open some avenues for the betterment of socially deserted and deprived children.
Of 57 seals hospitalized in the Norddeich Orphanage, 37 (65%) had died until 22nd of August, 1988, when the first collection of blood samples from the survivors commenced. All the sera including those obtained at a later date from the remaining animals had invariably higher neutralizing antibody titres against a phocine distemper virus (PDV) isolate than against canine distemper virus (CDV). The difference of mean titres was calculated to be more than 1.5 x log10 serum dilution. Peak titres demonstrated by a direct neutralization peroxidase-linked antibody (NPLA) assay reached 1/90,000. Attempts to isolate PDV in seal kidney cell cultures from heparinized blood samples collected from convalescent animals were not successful. From the increase in antibody titre following the last fatal case it was concluded that the devastating epidemic sweeping through the Norddeich Orphanage was primarily due to phocine distemper.
Two hundred and fifteen children in an orphanage in Romania were examined for serum markers of present or past hepatitis B and C virus and HIV infection. In total, 183 children (85.1%) had at least one marker (HBsAg, anti-HBs or anti-HBc) of hepatitis B virus infection. An HBsAg carrier state was diagnosed in 38 (20.8%) of the infected children. Among the carriers 24.3% were HBeAg carriers, 51.4% had anti-HBe and 24.3% had neither HBe antigen nor antibody. Nine children (4.2%) had antibodies to hepatitis C virus. All sera were negative in tests for HIV antibodies. False-positive reactions represented a considerable problem with these sera. Six percent of the sera gave false-positive reactions in indirect ELISA tests for hepatitis C and HIV. Sera giving false-positive reactions had rather high serum IgG levels. The results of this study indicate that these children have been heavily exposed to hepatitis B virus and to a certain degree to hepatitis C virus, while there were no cases of HIV infection in this orphanage.