VietNamNet Bridge – Rather than living at orphanages, about 400 children benefit from a programme that provides temporary foster care.

Classroom: Kids listen attentively to their teacher at the Phuc Tue Centre, a day care centre for children with intellectual disabilities.

Joy lit up four-year-old Nguyen Dieu Huong's face as she squealed in delight at the pen and blank paper that was given to her.

The scrawl she was making with pen on paper meant nothing to unconcerned and uncaring eyes, but it meant the world to her.

At times, she would raise her bright eyes to seek words of encouragement from me as she laid on the floor and drew images from her own imagination. The level at which she expressed herself in speech and art made me question my own perceptions of the limitations of the mentally handicapped.

"Huong was very timid and easily frightened at things when she first came to my family," recalled Huong's caregiver, Nguyen Thi Sen. "Hardly a day passed by when she did not cry upon seeing strangers. She had to take tranquilisers because we feared she might have an epileptic fit."

"Thank God Huong is different now. Not only has she become accustomed to everyone, but she has also proven to be an emotionally stable girl," Sen said.

Needed care: Children from extremely difficult circumstances are cared for at a Social Sponsor Centre in Ninh Thuan Province.

Huong seemed conscious of us talking about her and of the encouraging words I spoke to her while she was scrawling, so she put down her pen, walked to me and sat on my lap. She sat like a bird and looked at me with longing. Then all of a sudden, she called me "Mom".

"She is a bright girl, though we wish she could go to school and blend with her peers in class," Sen remarked, as she spread her arms to give Huong a hug.

The Ha Noi Labour, Invalids and Social Affairs Department understands the benefits of family-based care for children separated from their natural families. So it has collaborated with Holt International Children's Services (Holt International) in implementing a programme that provides temporary foster care services to about 400 orphans in circumstances similar to that of Huong.

Instead of keeping Huong at her orphanage, Holt International has hired Sen to take care of her in Sen's own home before bringing her to her foster parents.

Under the programme, Holt International is providing a VND958,000 (US$45) food budget and 1.5 kilos of powdered milk to Huong each month. It is also paying Sen VND780,000 ($37) per month to care for Huong and is shouldering the tuition fees for the child's kindergarten education.

Medical expenses are not included in the monthly budget for Huong but are covered based on the actual cost of doctor's prescriptions.

Nguyen Thi Loan, a Holt International staffer, admitted it had taken a year for Huong to attend kindergarten. "Most public kindergartens do not want to recruit orphaned children because they do not have permanent residence in Ha Noi. Adding to this are the tuition fees, which are much higher in private schools," Loan explained. Yet through the donors' efforts, Huong was able to enter a private kindergarten.

Ideal models

In keeping with global practices, Viet Nam has shifted from institutional to family-based care for people in need, including children who are abandoned, orphaned, afflicted with HIV/AIDS or with poor single parents, as well as poor and homeless elderly persons and people with disabilities.

The transition began in 2007, when the Government aimed to provide social assistance and financial support to people living in extremely difficult circumstances under family and community-based care.

Beneficiaries: The two girls (left) benefit from scholarships and allowances from the Binh Dinh Red Cross that encourage individuals and organisations to provide foster care for orphans and abandoned children.

Individuals and organisations like Holt International are encouraged to take part in providing services such as foster care, kinship care, small group homes and respite day care.

But this type of family and community-based care was intensified last year after the Government issued Decree 136, calling for social assistance and financial support to people in need and their foster families.

According to the decree, people living in extremely difficult circumstances shall be given a minimum allowance of VND270,000 ($12) per month, which will be multiplied by coefficients ranging from 1.0 to 3.0 depending on their family situation. The beneficiaries shall also be given free health insurance, educational support and vocational training.

Likewise, families and community-based care organisations that volunteer to provide foster care for people in need are to receive the minimum allowance multiplied by coefficients between 1.0 and 2.5 as their monthly payment. They will also be trained in foster care, given access to credit at low interest rates and be prioritised in hiring for employment.

People in need

Government figures show that about 20 per cent of the population in Viet Nam need social welfare services. There is a great need to provide alternative care for them under informal arrangements for family and community-based care rather than institutional care, said To Duc, deputy director of the Social Protection Department.

Figures from UNICEF reveal that approximately 2.1 million children live in extremely difficult circumstances in Viet Nam, including 176,000 orphaned and abandoned ones.

The country has 6.5 million people with disabilities arising from war, disease, poverty, and low-quality health care.

An increase in the number of elderly people has also become a social issue, affecting sectors such as the economy and health care. According to the Viet Nam Association of the Elderly, the country had about 8.5 million people over the age of 60 in 2009, or 9.9 per cent of the population.

According to the Ministry of Labour, Invalids and Social Affairs, Viet Nam had more than 2.1 million poor and more than 1.4 million nearly-poor households in 2012, accounting for 9.6 per cent and 6.6 per cent of the population, respectively.

Mealtime: Orphans and abandoned children eat together before being sent to their foster families.

Though the figures cited do not include people with HIV/AIDs, Agent Orange victims and single mothers, among others, they represent a huge demand for welfare among the beneficiaries needing social support.

The majority of people in need are living in informal arrangements within the community. Duc said only 41,000 of more than 18 million people were being cared for in State and non-State social sponsor centres which also serve as shelter for homeless elderly people, abandoned and orphaned children and people afflicted with HIV/AIDs and other disabilities.

"Vulnerable people are left in the care of these centres only when they have no chance to be taken care of in family and community-based care models such as foster care, small group homes and respite day care," the deputy director said. "This type of care is especially good for abandoned children and orphans."

International studies have proven that warm, loving and home-like settings are the natural environment for children to receive the safety and comfort they need in childhood. When properly implemented, family care in a child's own community is the best option, the research showed.

"Nurturing from natural parents typically provide the best conditions for a child's healthy development," Duc said.

"Where this is not possible, an alternative arrangement such as foster care and kinship care is needed to give children a sense of belonging and the life skills training that are integral to their development."

Research has shown that years of institutional care have made a good number of children feel alienated and cut off from society, Duc added.

"They find it hard to live in harmony with their peers in the community after being discharged by social sponsor centres at the age of 22. In most cases, many have no choice but to return to these centres," the deputy director noted.

Low allowances

Due to the large number of people in need and the speed at which this number is growing, maintaining these people, particularly children, in family and community-based care is the most efficient and effective way to help them.

The case of Huong provides a good example of how foster care can change a life in a positive way, no matter how long it took her to make it to kindergarten.

Experts, however, believe this type of care will be most appropriate when the needs of the child, the society's traditional care practices and the available resources are taken into consideration.

Duc said each foster child needed a caseworker who must ensure that the child would receive good care in his or her foster home.

Dam Thi Thuy Hang, Holt International country director, remarked that all forms of care should be developed within the context of a plan that would address the best interests of the child and work towards family reunion.

Besides this, Holt International also attaches importance to helping foster families improve their means of subsistence through monthly payment for caregiving responsibilities.

The Government has made similar efforts to support people in need, including abandoned and orphaned children and their foster families, through social assistance and cash transfers.

The reach of such policies remains limited, however. Nguyen Dinh Lieu, chairman of the Viet Nam Association for the Support of Disabled People and Orphans, said current allowances paid to people in need and their foster families remain low compared with the national poverty line of VND400,000 ($19) per capita per month in rural areas and VND550,000 ($26) per capita per month in urban areas.

"The current allowances are far too low to meet their living costs, even when they are readjusted at the same level of the national poverty," Lieu observed.

The chairman noted that people cared for at social sponsor centres were paid at least VND700,000 ($33) per month for food and another VND100,000 ($4.7) per month for other expenses like books and school uniforms.

"This kind of payment should be applied to people living in family and community-based care. Otherwise, the Government will fail to support more people and provide the stability that they need with extended family members and the community where they have grown up," he added.

Funding constraints and a lack of guidance have resulted in interest in foster care for people in need among only a few individuals and families, Duc said.

He agreed that current allowances were lacking but explained that these were being taken from the budgets of cities and provinces, whose coffers remain quite meagre as a result of economic challenges.

"I believe that many individuals and families have the hearts and the ability to take care of children in need. But they need incentives to convert their hearts into skills," Duc added.

No doubt, in Viet Nam, foster care, small group homes and respite day care remain scattered and in most cases, informal or unregulated by the State.

In an attempt to tackle the issue, the Social Protection Department is drafting support policies and preferential treatment to encourage individuals and organisations to get involved in community-based care models.

Duc said the project would be submitted to the Government in the fourth quarter of this year for approval.

"Although there is enough legal basis for the project, it is hard to say for sure whether it will be implemented because resources are decided by State budget," he added.

VNS/VNN