The former Yugoslav Republic of Macedonia

Real lives

"Children are the same, even when they are different"

© UNICEF NYHQ/2002/Accone

The community of Manastirec is home to a dozen foster children, nine of whom are children with disabilities.

The sounds of children playing with toys and board games spill out of the day-care centre, perched on a steep hill in this rural village in the poorest part of the former Yugoslav Republic (TFYR) of Macedonia.

Outside, a pair of five-year-olds scamper across the gravel to a swing set and beg their foster mother to help them on and push them. Little more than a year ago, "Goran" and "Vesna"* were carried into the village by their foster parents: both were unable to walk and Vesna was malnourished and did not communicate.

"Vesna was such a small girl when she came," recalls their foster mother. "She needed so much hugging and emotional things. And Goran, I feel a pain in my heart for him as he struggles for independence, but he is successful at so many tasks [despite] his limited abilities."

Goran was born without arms and was abandoned in an orphanage at birth. The same fate befell his foster sister Vesna, after she was classified as having a learning disability. (This classified by the State as children having mental handicap or retardation. They may also have an additional physical handicap.) In a country where disabilities of any kind are highly stigmatized, the opportunity for the two to grow up in a normal family environment did not exist.

A family is the best place for a child

Both would typically have joined the 350 TFYR Macedonian children institutionalized for life because of their disabilities. They would have been isolated from family, communities and most normal social interaction. Worse still, in under-funded and under-staffed institutions, many children live out their lives, in diapers, bottle fed and physically confined to their beds.

But Goran and Vesna are among the first of a growing number of children being given the opportunity to develop to their full potential in a family environment. "Many of these children do not require 24-hour care and are able to carry out basic activities on their own, such as dressing, personal hygiene and eating," says Dr. Risto Petrov, head of the UNICEF-sponsored project to help such children re-enter family life. Dr. Petrov supervises this work at the country's largest institution, Demir Kapya Institute, in the town of Demir Kapya.

"We try to extract the best from children according to the limits that they can reach," he says. "There is no child without whom we cannot get some positive result." In the 13 months of the project's existence, 11 children have been fostered and another 10-15 children are ready to be placed with foster families.

This project is part of a radical initiative launched jointly by the Ministry for Labour and Social Policy of TFYR Macedonia and UNICEF. The objective is to eliminate the need for children's institutions by providing alternative care options. In the interim, students from Skopje's Ss. Cyril and Methodius University are working with staff to improve the level of care in institutions.

Five epicentres of hope

© UNICEF NYHQ/2002/Accone

Goran’s mother helps him put on his shoes before having some fun on the swings outside the day-care centre.

The Ministry identified buildings that could be used for day-care centres and reallocated personnel to staff them. UNICEF rehabilitated and equipped the centres, and also trained the day-care workers. The workers learned to create individual action plans for each child and to develop a network of local resources - such as hospitals that could provide physical therapy and schools that could offer the children opportunities to socialize with other children.

Manastirec is one of the five centres opened during May and June 2002. Others were launched in Tetovo, Prilep, Veles and Delcevo - locations with some of the highest numbers of institutionalized children with learning disabilities.

"There are now between 20 and 25 children in each centre," says Kerry Neal, Child protection officer with UNICEF's office in TFYR Macedonia. "This accounts for some 50 per cent of such children within the towns… A gap remains in Skopje, but we are seeking both buildings and funding to establish four more centres in the next year, at least two of which will be in Skopje."

Perhaps the best evaluation comes from the programme's beneficiaries. Asked what she thinks about living with her foster family, Vesna uses two of her recently-acquired words: " nice" and "happy." Then she goes back to kicking a ball around the day-care playroom.

* Names have been changed to protect the identities of the children