Baby rescue is the ultimate volunteer experience. At Hope of Life International, a Christian mission in rural Guatemala, a rescue team springs into action when news arrives that a baby is dangerously ill in a nearby mountain village. The mission, which hosts hundreds of volunteers from North America every month, sends a caravan of Jeeps, canoes and an ambulance to bring the child to its hospital. On the charity’s website, you can see photos of volunteers, their faces rapt with grim determination, walking down a steep mountain path or fording a river, holding tiny babies wrapped in blankets. A video shows dramatic scenes in which Carlos Vargas, Hope of Life’s founder, rescues a baby alongside volunteers, the music pulsing and urgent. “Every second, every minute matters,” Vargas says. “Maybe if we reach her an hour late, we lose her.”
Hope of Life has scouts who work in these mountain villages, looking for sick infants. Although time is of the essence, when they find an ailing baby, the scouts do not bring them directly to the hospital. Instead, they alert the organisation, which assembles a team, accompanied by volunteers, to collect them. Many volunteers who come to Hope of Life are drawn by the dream of taking part in one of these expeditions: they get to save lives, and have a transformational encounter. One woman wrote in a blogpost about her experience: “This is what we came for. This is what I have been waiting for. This is what they’ve been waiting for.”
Every year, millions of people from wealthy nations travel to poor countries, hoping to do good. University students want to spend a school break or part of a summer giving back, perhaps even to improve their CV. Christians go with their churches for one- or two-week missions. All seek personal growth, connection to those less fortunate, and the satisfaction of making a difference. For many, the destination is an orphanage, where they aim to bring joy to needy children in the brief time they can spare.
The aspiration to help the most vulnerable children is a noble one, but the booming business of “voluntourism” sustains practices and institutions that actually do harm. There is no such thing as a “good” orphanage, according to child development experts. Eighty years of research confirms that children do best in a family. They are far more likely to experience abuse, cruelty or neglect in an institution than in any other setting. Even in a well-run facility, children do not develop normally.
In wealthy countries, the institutionalisation of children has almost completely stopped. Instead, governments offer services that can help families keep children with them; if that is not possible, they seek adoptive parents or foster families. These solutions are imperfect. Some foster families are abusive; children, especially those most in need of a steady home, can get shuffled from one family to another. “But nobody is advocating going back to institutions,” says Philip Goldman, the founder and president of Maestral International, a Minneapolis-based organisation that advises on social welfare and child protection.
Almost every poor country, by contrast, still puts children in institutions, even though the vast majority of those children have families. Wealthy countries, who consider orphanages harmful for their own children, nonetheless provide a stream of charitable giving that makes orphanages viable businesses abroad. And orphanages need “orphans”. Parents may hand over children because they have special needs, or because the family can’t afford to send them to school. “It’s a huge pull factor: if they can get food, health care, education, specialised services, parents make a decision they think is in the best interests of the children,” says Shannon Senefeld, senior vice president for overseas operations at Catholic Relief Services.
Save the Children looked at orphanages in Sri Lanka in 2005 and found that 92% of children had a living parent. A 2006 survey by Unicef in Liberia found that 98% of children living in orphanages were not orphans.
Donors from wealthy countries – most often, religious groups – often establish orphanages in response to a crisis. But after the crisis is over, donations keep arriving, so the institution stays open. In Aceh, Indonesia, after the 2004 tsunami, hundreds of institutions for children were opened. But Maestral found that more than 97% of the children in them were brought by their families so they could get an education. “Very few of the children had been affected by the tsunami at all,” says Goldman.
According to a report by Lumos, a London-based group founded by JK Rowling that seeks to end institutionalisation of children, one orphanage in Haiti, established by a US religious organisation after the earthquake in 2010, kept children malnourished and living in filth, with no stimulation. Yet it collected donations averaging $10,000 (£7,700) a year per child – much of which ended up in the director’s bank account, a former staff member alleged. That institution, which Lumos believes was engaged in trafficking and selling children for adoption to families in wealthy countries, recruited children using a baby-finder, who convinced poor parents their children would be better off in the institution. “We’ve seen it in Kenya, Uganda, Cambodia – eerily similar patterns,” says Alex Christopolous, deputy chief executive of Lumos. “Child-finders go into communities. They are paid $50 to $100 to identify [needy] families.”
In Cambodia, 40 years after the Khmer Rouge genocide, the number of orphanages has been growing, according to the UN. The reason is demand – but not from abandoned children. Instead, it comes from a huge rise in Australian tourists willing to pay to work in them.
Voluntourism is an outgrowth of the ecotourism movement of the 1990s. According to Pippa Biddle, author of a forthcoming book on voluntourism, travellers rebelled against package trips and resorts and wanted a more authentic experience – and they were willing to pay for it. Many charities in developing countries run such programmes and collect fees from volunteers. “It used to be if you wanted to volunteer abroad, you wrote letters to overseas contacts,” says Claire Bennett, co-author of Learning Service: The Essential Guide to Volunteering Abroad. “Now you can buy a volunteer experience with a few clicks.” The newest trend is corporations sending employees to volunteer. It’s a team-building exercise and associates the brand with good works. Hope of Life, the Christian mission in Guatemala, has built an executive conference centre for just this purpose.
Voluntourism may be fuelled by noble feelings, but it is built on perverse economics. Many organisations offer volunteers the chance to dig wells, build schools and do other construction projects in poor villages. It’s easy to understand why it’s done this way: if a charity hired locals for its unskilled work, it would be spending money. If it uses volunteers who pay to be there, it’s raising money.
But the last thing a Guatemalan highland village needs is imported unskilled labour. People are desperate for jobs. Public works serve the community better and last longer when locals do them. Besides, long-term change happens when people can solve their own problems, rather than having things done for them.
“There are few things more cringeworthy than watching 20 British schoolgirls trying to build a well under the scalding Nepalese heat,” one Durham University student wrote about her trip to an orphanage. Villagers, wary of offending their visitors, say nothing. An American volunteer in Tanzania recalled: “We … were so bad at the most basic construction work that each night the men had to take down the structurally unsound bricks we had laid and rebuild the structure so that, when we woke up in the morning, we would be unaware of our failure.”
Defenders of voluntourism maintain that its real value is to change the visitor. But while it’s definitely more transformational for the visitor than the host, it’s not clear how significant the effects are. A study of 162 Americans who travelled to Honduras to build houses after Hurricane Mitch in 1998 found that years later, this work had made no difference to their giving or volunteering. And even if the houses they built didn’t fall over, they were expensive. The houses in Honduras built by international volunteers cost $30,000 apiece, including airfare, while local Christian organisations could build them for $2,000. If well-wishers had contributed money instead of labour, 15 times more houses could have been built. The helpful choice would have been to stay at home.
Money goes far in poor countries. Two thousand dollars can pay for a week-long trip by an unskilled American volunteer – or it could pay the salary of a village teacher for four months. “If the church in the US would simply tithe, with just half that increase in giving, you could feed, clothe and medically treat the entire developing world,” says Daryl Fulp, an American missionary who works with disabled children in Guatemala.
If children go to institutions because their families are poor, the solution would seem to be working to reduce poverty rather than building and funding more institutions. But institutions become the solution because governments don’t have – or are not willing to spend – money for anti-poverty work. Funding for orphanages, by contrast, just drops from the sky. In many poor countries, it dwarfs funding for every other kind of relief or development work.
In Haiti, some 30,000 children live in orphanages. Lumos found that these institutions get at least $100m a year in foreign donations. That is half the total amount of US aid to Haiti last year, five times the budget of Haiti’s social affairs ministry, and 130 times the country’s child protection budget.
Hope of Life, which occupies a 3,000-acre complex in the mountains about a four-hour drive from Guatemala City, is one of the biggest organisations offering an emotionally charged tourist experience. The orphanage, founded in 1989 by Vargas and his American wife, Cheryl, now houses 195 children, at least 60 of them with disabilities. Volunteers pay between $750 and $1,000 to come and work for a week: the higher sum gets you an air-conditioned suite with private bathroom. (Baby rescue is extra: one man who takes employees of his company on trips to Hope of Life told me his group pays $1,500 for a baby rescue trip.) When I visited this year, the lunch I ate was excellent, the swimming pool I saw spectacular. There’s a zoo, with a lion, tiger, crocodile and jaguar.
Lourdes Milian, who manages Hope of Life day-to-day, said that during summer and school vacations, about 400 volunteers come every week, and, on average, 150 during other weeks. Volunteers, then, bring at least $9m a year to Hope of Life.
Hope of Life had a budget of $15.7m in 2016, which funds its many programmes: projects in villages to dig wells and build schools, baby rescue, the feeding centre, the hospital. But when I visited, it seemed clear that not much money was being spent on its most vulnerable, disabled residents, while a lot of investment has gone towards making the volunteer experience as comfortable as possible – and as emotionally rewarding. I asked Katie Arriaza, the daughter of Carlos and Cheryl – she is president and chief executive of Hope of Life International – why they put so much emphasis on bringing volunteers to rescue babies.
“We ask people to donate to the programme, which helps us with medicine,” Arriaza said. “If our team is going out on baby rescue, [volunteers] can be a participant if there’s room in the vehicle. But it’s not like ‘oh you’re going to give us money,’” she said. “It’s not like a tourist event.”
And yet, in a sense, a tourist event is exactly what it seems to be. Hope of Life’s baby rescue saves dying children. But it also appears to be an expensive and inefficient way to do so. On its website, Hope of Life says that the children are sick because “their parents are too poor to help them”. Instead of stepping in when a child is close to death, it would seem that Hope of Life could save more children if it simply gave vulnerable families the equivalent of a few dollars a month to buy food.
Governments all over the world are eager to let foreign-funded institutions take care of vulnerable children – because it means they don’t have to. Otto Rivera, who coordinates a group of a dozen Guatemalan organisations working for children’s rights, said that Guatemala spends a dollar a day per child – and half of that goes to education. “There is 50 cents left for health, food, protection and culture,” he said. “The government has no capacity or will to have an integral vision of the rights of children.”
There is no room in the budget for oversight of institutions. Cases of neglect, cruelty, sexual and physical abuse and sex trafficking are widespread at orphanages. Nowhere in recent times was this more shockingly revealed than at an orphanage near Guatemala City called Hogar Seguro.
On 7 March 2017, dozens of teenage girls escaped from Hogar Seguro Virgen de la Asunción (the name means “Secure Home”), an institution that housed more than 700 children, 173 of whom had disabilities. The place was a medieval hell. It had no reliable count of residents, which meant that children could disappear easily. Guatemala’s human rights ombudsman had found that abuse and trafficking were taking place. Girls said that staff abused them, raped them, took them out at night and prostituted them, but no action was taken.
The girls who escaped were caught, returned and locked in a classroom overnight with just some thin mattresses. In the morning, one girl set a mattress on fire to get the police to open the door. It remained closed. Later, police and paramedics carried out charred bodies. Of the 56 girls, 41 died. The others were seriously wounded.
The deaths at Hogar Seguro closed the last of Guatemala’s giant public children’s institutions. Three top officials, including the former social welfare secretary, are scheduled to be tried, beginning in February 2019. The surviving children were scattered. Some turned 18 and left the system. One child entered a foster home. Foster care is a promising new initiative in Guatemala, but when I visited, there were fewer than 40 foster families in the country – not nearly enough to cover the need. The government reported that it sent 223 children back to their families, although it was unclear whether they would get the support they might need.
The inter-American commission on human rights instructed Guatemala to keep the Hogar Seguro children out of institutions, but 180 children, 120 of them with disabilities, were placed in other facilities, both state-run and some of Guatemala’s more than 125 registered private institutions (there are probably many more that are unregistered). More than 40 children from Hogar Seguro ended up at Hope of Life.
In March, Lisbet Brizuela of Disability Rights International (DRI), an advocacy organisation based in Washington DC, took a small team around Guatemala to visit the places now housing Hogar Seguro’s disabled children, to check on their care. They visited 11 public and private institutions. In one Catholic children’s home, Albergue del Hermano Pedro, Disability Rights found four teenagers lying on mats with their hands tied behind their back, in what was called the rehabilitation room. At Virgen del Socorro, another Catholic home, girls were held in cages. All children with disabilities were tied to chairs or wheelchairs, even those who could walk.
I went along on some of the DRI inspections. We visited two new state-run group homes for boys and young men with mental disabilities. They were obviously much more humane than Hogar Seguro – but they were chaotic, impersonal and lacking stimulation. Children from Hogar Seguro had survived terrible trauma. We saw plenty of psychiatric medicines, but no sign of trauma care.
At Hope of Life, the most severely disabled children live together in a building called Kelly’s House, with four rooms, each with between eight and 11 children. There they sleep and spend most of the day, in the care of two staff members a room. Three of the rooms house kids who came from Hogar Seguro. Some are sitting in wheelchairs, some are rocking or walking back and forth. The rooms have cribs and some beds but are otherwise bare. There are few toys, almost nothing on the walls, nothing for children to look at or do, although Arriaza, the chief executive, told me there was a day in the past two months when the children were able to play with small animals, such as rabbits.
Volunteers have reported concerns. One mission volunteer at Hope for Life wrote on a church blog: “The more time I spent there, the more my heart broke for these special needs kids. They need more trained carers, physical therapists and speech therapists. But as it is now, they are understaffed and the staff they have is not educated enough to handle the children they care for. Kelly’s House has a lot of great equipment that has been donated but it is sitting unused because they don’t have professionals to teach them to use it.”
Arriaza said that a therapist would be coming soon from the US and would stay for a month, teaching the staff new techniques for helping the children. I asked how much stimulation the children received. “We have cognitive therapists who play with colours and different things,” she said.
One Guatemalan government official – a woman highly respected for her seriousness and dedication – had told the DRI inspectors before their visit to Guatemala that the government was launching an innovative way to care for some of the children, along with some adults, with mental disabilities. In Quetzaltenango, a four-hour drive from Guatemala City, we visited this new government care initiative, called Nidia Martínez, and were disappointed to find it was another institution. The land it was built on had become available, we were told, and it was decided that building a new care home was easier and faster than setting up any kind of family-based structure. Housing a child in an institution costs six to 10 times as much as family-based care, but setting up the necessary support for families requires dedication, know-how and planning.
The Nidia Martínez buildings were new, clean and spacious, with 80 beds. The rows of bunk beds in the girls’ room had pink Disney princess blankets. The residents were dancing to music (perhaps for our benefit). Most of the staff had come from Hogar Seguro. It was impossible to tell how implicated they had been in what went on there, since there has never been any investigation.
The medical expert on the DRI inspection team was Matt Mason, clinical director of the Georgetown University Center for Child and Human Development. I asked him how many of the children we saw could live – if they had help – with their own or other families.
“All of them,” Mason said.
When I was 16, I worked for a summer at St Francis Home for Orphan Boys in Detroit, as part of a Jewish youth group, 10 teenagers from all around Michigan. St Francis was a forbidding, five-storey brick building. I helped care for a group of boys aged eight and nine. My job was to offer them individual attention. I spent much of the day taking long walks around the grounds with one boy at a time.
As at other institutions, my boys were not orphans. On the weekend, many got visits, and some went home. Some had behavioural problems that their parents couldn’t handle. In other families, their parents had the problems and lost custody as a result. In both cases, the boys needed help. As far as I remember, they got no treatment whatsoever for their problems. Some of the boys came from families that were simply poor. One boy was at St Francis with his younger brother because their father, who worked at the Ford plant, was alone and could not afford childcare.
At the end of the summer, as teenagers do, I cried about whether I had made a lasting difference in their lives – and as teenagers do, I wrote poetry about it. One boy, Rodrick, had given me a ring of his own making when I left. This was part of one of my poems:
I still have the ring, a circle of wire I sometimes wear.
But what do you still have of me to tell you that I once was there?
I now understand that I did leave Rodrick with something: a sense of abandonment. Every single boy in that institution already had abandonment issues. If it was hard for me to leave these boys behind, how much harder was it for them to see me go? And the next adult who came for a few weeks? And the next one? They might have learned that there are people who love them and will take them on walks. But they also learned that these people always leave.
St Francis closed in 1992. The United States doesn’t use orphanages any more. Nor does Britain. No matter how well-run the orphanage, it cannot provide what children most need: a parent. When volunteers turn up at an orphanage and children run to hug them, it’s understandable that they feel they are providing much-needed love and attention. But children shouldn’t turn to random strangers for affection. When they do, it means they can’t develop healthy attachments. And a parade of short-term adults to hug them makes it worse.
What puts children in crisis isn’t something hugs can solve. Andrea Freidus, an assistant professor of anthropology at the University of North Carolina, wrote that voluntourism gets in the way of recognising the structural issues that create humanitarian crises. “My research suggests that students who engage in these programmes actually contribute towards the mystification of larger systems that produce inequality, poverty, particular patterns of disease distribution and various forms of violence.”
In a 2012 essay on what he dubbed “the White Saviour Industrial Complex,” the novelist Teju Cole pleaded for humility. It is “not about justice,” Cole wrote. “It is about having a big emotional experience that validates privilege.” Voluntourism, he argued, perpetuates the myth that change happens as a result of expressions of caring from rich white people.
Romania, infamous for keeping many thousands of children in institutions during the Ceauşescu years, has now greatly reduced its institutionalisation of children. So have Bulgaria and China. A consortium of Lumos, Maestral and Catholic Relief Services is starting to work in Haiti, Guatemala, Lebanon, India, Kenya, Moldova and Indonesia to help these countries move from institutional care to family care.
Sudan, where civil war has left many children without protection, has created a system of emergency foster care and adoption. Rwanda aims to have zero children in institutions by 2020. It has turned orphanages into day-care centres and retrained staff as day-care workers. It supports and monitors families who take in children. “Rwanda is a poster child for de-institutionalisation,” says Philip Goldman at Maestral. “They have placed four out of five children in safe, nurturing, monitored homes.”
Almost all of the children who remain in institutions in Rwanda are disabled. Families abandon these children because they might require unaffordable equipment or medicine. They might need care that a working parent cannot provide. In some places, disability is seen as a curse. Once institutionalised, a disabled child almost never leaves.
“In the US, we know disabled children can go to school, play, live in families,” says Laurie Ahern, the president of Disability Rights. “Why are we supporting this [practice] around the world?”
The support and monitoring required in family care is more challenging to set up than placing a child in an orphanage, and far harder for children with disabilities. “I don’t think that’s impossible,” says Shannon Senefeld, from Catholic Relief Services. “But it requires case management for each individual child.” And it requires families willing to care for children with complex needs. “The government cannot create those families by fiat,” says Jedd Medefind, the president of the Christian Alliance for Orphans, a group that seeks to direct short-term church missions towards family care instead of orphanages.
Such families do exist. Daryl and Wanda Fulp, Christian missionaries, came to Guatemala from Ohio in 2007 to adopt their son John – their third adopted child with special needs (they also have five biological children and two adopted children they had fostered). During the trip they visited an institution for disabled children and left weeping at the conditions they saw. They sold their possessions in Ohio, moved to a large house outside the city of Antigua and began taking in children with severe disabilities, including those near death.
The Fulps’ Hope for Home feels like a chaotic, giant family doing what it can for 25 children with disabilities. Caring for any of them could be a full-time job. Local authorities call frequently asking them to take new children, and they have no reliable source of funds. The place runs on the family’s faith – the Fulps’ adult children and their spouses make up a lot of the staff – and on Daryl’s charisma and energy. But even he sometimes seems overwhelmed by the need, and the deaths of so many children.
The Fulps’ pioneering work aims to help families keep their disabled children at home. Because so many children are disabled due to cerebral palsy, which can result from injury during birth, in August Hope for Home opened a birthing centre, run by a midwife who is training other midwives. Hope for Home also has three teams of people, who visit some 150 families with disabled children. Donors – mainly Christians in the US who follow Fulp on his blog – sponsor the families, providing between $10 and $200 a month to cover what the family needs.
Families get free monthly visits from a nurse and from a physical therapist who trains them to do therapy with their child. They get free medical appointments with private doctors, transport to appointments and whatever else they need to keep their children: special formula, medicines, wheelchairs, leg braces. Crucially, Hope for Home also provides food for the whole family if needed – thus turning a disabled child from a serious economic liability into a modest asset. Disability Rights observed that keeping children in institutions costs the state more than 15 times what Hope for Home pays to keep children with their families.
In March, Lisbet Brizuela of Disability Rights and I went to see the family of 14-year-old Walter, who has spina bifida, hydrocephaly and hearing loss. His mother said that until Walter was six, the family carried him everywhere. But then they met Fulp, who brought Walter a wheelchair. When Walter outgrew the first chair, Fulp brought him a new one. Fulp has brought braces for Walter’s feet and treatments for pressure sores. He is also paying school fees.
That day we also saw Sayli, who was 14 months old. Fulp had met her 10 days before, and recognised the signs of cerebral palsy. It is hard to imagine a family less equipped to deal with a child with her complicated needs. Sayli lives with her mother, Yulisi López, 20, her grandmother, 42, and six of López’s young siblings. They all live in one room and sleep on one mattress. Only two of the school-age children go to school. Sayli was thin and sickly, and suffered from frequent respiratory infections. A week before our visit, Fulp had brought special formula for Sayli. He also brought a laundry basket containing 18kg of food: dried beans, rice, corn flour for tortillas, oatmeal, powdered milk, sugar.
Fulp told the family that Sayli had an appointment with a neurologist, and he had arranged transport for her and her mother. “My friends will come here and get you, and then bring you back home,” he told López. He said he understood they were devastated by the news about Sayli’s condition, but promised to find a sponsor to supply the $80 a month the family needed to stay together and survive. He prayed with them. “The good news is we’re going to walk with you,” he told the family. “You are not alone.”
Organisations around the world have been working for years to end orphanage tourism. Their work is starting to bear fruit. Australia is now discouraging the practice, and the Australian parliament is considering a law to label orphanage tourism as child trafficking and ban it entirely. In July, the UK international development secretary, Penny Mordaunt, announced that the government’s foreign aid programme would now support family- and community-based care for all children. In May 2016, the London School of Economics set up a consortium of universities pledging not to advertise orphanage placements to their students.
Many major tourism companies – for example, Global Crossroad – still prominently feature orphanage work. Nancy McGehee, a professor of hospitality and tourism management at Virginia Tech University, says that companies send representatives to speak on campuses. But some companies are closing their voluntourism programmes. The International Volunteer HQ announced that it would stop sending volunteers to orphanages by March 2019. Projects Abroad stopped in January 2018. “I don’t think we’ve lost any business from it,” says Jessi Warner, chief operating officer of Projects Abroad. “Quite often someone will phone and say: ‘I want to work in orphanages.’ When our team explains why we don’t do that, everyone is open to it. They often join our community care programmes. It’s just about awareness.”
Some religious groups are also trying to channel efforts into family and community care. The Catholic church has set up more orphanages than any organisation in history, but is now changing its policies. “We recognise we were part of the problem and we had to really work to change,” says Senefeld. The Christian Alliance for Orphans recently published a guide for short-term volunteers working with children. It advised groups running trips for volunteers to commit to the best interest of each child first, over the visitors’ emotional needs. Jedd Medefind, the president, said that volunteers could switch from directly caring for children to supporting local caregivers. It’s a question of managing expectations, he said.
“This is a huge, committed, passionate, motivated population willing to do just about anything to care for these kids,” says Nicole Wilke, research fellow at the Christian Alliance. “These people are not the enemy. They are the solution here. If we don’t want them going into orphanages, what do we have for them?”
For some people, the answer might be nothing. “We are competing with that incredible emotional reward of walking into an institution and having 10 kids jump into your arms,” says Goldman, of Maestral International. “It’s something very difficult to replicate.”
McGehee at Virginia Tech would like to see voluntourism recast as “transformational tourism”, with visitors rewarded by gaining a better understanding of people’s lives, and the way the economics of charity work. By all means, visit people who need help, she says. “But do it beside me and hear who I am. Get to know me and not all those stereotypes about me. And then go home and see if there’s something you’re doing that somehow perpetuates my situation.”