Whole Child International will work within orphanages and childcare settings in Nicaragua and El Salvador to improve the quality of care for 18,000 children, while also advocating for national childcare policy. These programs target the specific causes of psychological damage to institutionalized children during early childhood. Whole Child's in-country staff provides childcare organizations with culturally-sensitive training to incorporate a sustainable and scalable 'training-the-trainer' model with a threefold approach: caregiver education and training, organizational change, and structural modification.
Whole Child works to increase the efficacy of existing childcare structures, adjusting organizational behavior rather than forcing infrastructural overhaul. Programs center on 'interventions' with individual institutions, beginning with training sessions for institutional leadership. Based on a memorandum of understanding produced in these sessions, Whole Child guides the institution through alterations such as staffing schedule modifications, primary caregiving assignments, and formation of smaller, family-like groups to facilitate quality caregiving.
Over a seven-month period, childcare providers attend training in principles and practices developed by Whole Child's partners at the University of Pittsburgh; the University of California, Davis; Loyola Marymount University; and the Pikler Institute to empower caregivers to provide responsive, child-centered care. Whole Child trainers additionally provide hands-on technical support in the orphanage, observing and coaching caregivers while facilitating the transfer of knowledge gained in training sessions directly to caregivers' work with children.
In addition, Whole Child implements minor facility modifications and provides caregiving equipment and play materials to support the training and administrative change components.
Beyond direct work with facilities, Whole Child partners with governments, including the First Lady of El Salvador, to enact national childcare policy. Whole Child is also developing formal Early Childhood Education (ECE) programs with University of Central America and Loyola Marymount University. Through a partnership with the University of Pittsburgh, Whole Child services are independently evaluated for programmatic efficacy.
Soaring numbers and few resources for orphans in developing countries have resulted in an abundance of children starved of the basic human right to fulfill their developmental potential. UNICEF estimates that in 2007 there were 110,000 orphans in Nicaragua and 130,000 in El Salvador. Current institutional systems rob children of normal childhoods and the ability to form healthy relationships. As a result of substandard care, the majority of institutionalized children, who might otherwise thrive, score in the mentally-disabled range. These emotionally and physically desolate environments produce unproductive adults that burden society with inordinate rates of crime, incarceration, prostitution, and re-abandonment of offspring.
The lack of institutional knowledge and caregiver education on how to nurture individual children while managing a group has led to the establishment of development-suppressing practices. To ensure disciplinary order, most institutions are run as assembly lines. Daily tasks are done en masse on a rigid timetable. For example, while language is vital for brain maturation, children are spoken to only minutes a day, usually as reprimand. Play, essential to cognitive development, is drastically limited: in many orphanages, institutionalized children spend 23.5 hours a day in a crib. Toys are locked in closets or hang within sight but out of reach. Hungry for attention, many children manifest aggressive behavior that worsens with age.
According to a University of Pittsburgh study, the quality of care provided to Nicaraguan orphans was characterized 'as low as possible?dismal by any standard.' Caregiver shifts are irregular and often span longer than 24 hours with no breaks. The instability, high turnover (up to 30% annually), and inconsistent scheduling of caregivers negates any possibility of primary bonding for children. By age five, a single child could have been under the care of as many as 50-70 or more caregivers.
Whole Child has successfully proven the positive results for children through our programs to improve quality care, but the organization continues to strive to understand more completely what aspect of its intervention creates the most impact. With this information, the organization could consequently provide policy recommendations as to where limited resources in developing countries are best directed when addressing early childhood. This research component is a costly but fundamental contribution to the larger policy discussion surrounding vulnerable children and their care.