Resettlements in the first wave of deinstitutionalisation in Macedonia

The first group of eight children were first resettled in 2001 to another institution – Topansko pole in Skopje, where they stayed for three months. In this period, centres for social work worked on identification of the potential foster families. At the end of 2001, the first group was accommodated in the foster families. In the following years of the project, the cooperation with the centres for social work advanced and the children were resettled directly to foster families.   

Simultaneously there was the initiative of UNICEF to support the Ministry of Labour and Social Policy to open five day centres for children with intellectual disabilities (Veles, Delčevo, Manastirec, Prilep and Tetovo). These centres helped to support the resettled children; they were also seen as a preventive measure for children who have not been in an institution to stay near their homes.

Fifty children were involved in the project, who were mainly categorised by the level of intellectual disability to be severely disabled (42), seven were categorised with profound and only one with moderate disability. There were fewer boys (22) in the cohort to be resettled than girls (28). All but two were under fourteen years old and three were four years old or less; nine were five to six years old, fourteen (14) seven to eight, six nine to ten, nine (9) eleven to twelve and seven (7) from thirteen to fourteen. They were evenly distributed across the age span from toddlers to preadolescents. The residents in the exiting cohort come from all the regions, however their distribution was quite uneven across the country. From Eastern and Southeast region there were more than expected, while from Polog region a very small number.

Table 1: Residence of the children before institutionalisation and municipality to where they were resettled

Region	f	Municipality	N	N actually resettled
East	10	Berovo	2
		Delčevo	2
		Kočani	2
		Probištip	1
		Štip	3
Southeast	7	Valandovo	1	1
		Gevgelija	2
		Radoviš	2
		Strumica	2
Vardar	4	Veles	2
		Kavadarci	2
Southwest	5	Debar	1
		Kičevo	4	1
		Makedonski Brod		5
Northeast	4	Kumanovo	4
Pelagonia	6	Bitola	2	1
		Kruševo	1
		Prilep	2	15
		Resen	1	1
Skopje	13	Skopje	13	4
Polog	1	Tetovo	1

Source: Petrov, 2016

The residents chosen for resettlement were approximately matching the population of the Macedonian regions with exception to Polog region where only one person was selected and of an excess for the East and Southeast regions. However, this mirrors the representation of the residents that originate from those regions. The majority of residents, however, did not resettle to their place of origin but mostly to where foster parenting was available.

Thirty (30) out of fifty (50) children that were involved in the project were resettled. The majority of the children (25) that left the institution were accommodated in foster care families, because most of them did not have real parents. Four were resettled to their families of origin and one to Banja Bansko institution.

Half of resettled children went to foster families in Prilep, another six in Makedonski Brod and Manastirec – traditional places of fostering. The dynamics of resettlement was more intense in the first years and subsided in the final year of the project.

This was an important project, which, not so much in numbers, has surpassed the previous attempts at deinstitutionalisation. It was well prepared, meticulously implemented and what is most important well published and publicised. The team gathered around the project was an important source of future professionalism and for the development of special education. In planning, if not in implementation, it was not skimming the residents.

Looking back, we could have misgivings about the fact it was concentrated only on children, that it was too preoccupied with ‘defectology methods’ (measuring the abilities, training everyday life skills in an artificial environment and probably thus neglecting the support and enabling of the ex-residents and (foster) parents in their new environments). Therefore, it supplanted medical model with a ‘defectological’ approach instead moving directly and consistently in the direction of a true social model. The main issue of the project was that it halted and did not continue with resettlement process. The message then was that it is only children who should leave the institution, and that resettlement process, the deinstitutionalisation, is just a fancy of high standing professionals.

The leader of the project has made a small follow up study of the first 'wave' of deinstitutionalisation (Petrov, 2016). The life of former residents has profoundly improved; some were visiting day centres, most gained friends and had a much more ordinary life.  The project leader found that after resettling for some residents this was not the end of the story. Two have moved from foster families to the families of their origin, which is important to note, whilst originally some families did not feel able to accept a family member back home, they have later on changed their minds. One has moved from a foster family to a group home. This can be seen on one hand as a transinstitutionalisation, being sent to a group home because the family could not cope with their new resident, but it can be seen as a process of emancipation, growing up from living with a family as a child. Foster families are not perfect solutions. For a child who does not have a family to live with it seems the optimal surrogate, for an adult it may be unnecessary prolongation of the childhood.[1]

Five of the ex-residents have re-entered an institution. Three have moved from foster families to institutions – one to Topansko pole and two to Demir Kapija. Two have left their real families to live – one in Topansko pole and one in Demir Kapija. Of the two people that left their own families to stay in institutions, first one went to Topansko Pole because of the ‘bad living condition’ in the family. The other one was abandoned by his mother again and was admitted first to Banja Bansko and then to Demir Kapija. The reason for abandonment was that mother thought that she will receive more money to care for the child, which did not happen. One that went from foster family to Topansko pole did so because the foster family moved abroad. The second one that went from foster family to Demir Kapija was because of his ‘hyperactivity’ (or more probably because there was not enough support to manage it).

After 15 years, from the communication with the employees from the centres for social work and the foster families, the project team found about two important issues that need particular attention:

-          Some of the foster parents are also having difficulties in caring for the children that have become adults.

-          The foster parents are getting old and they are considering to give the children to another foster families or in other form of care services.

There is a need for a comprehensive analysis of the foster families and the resettled children, their achievements and potentials, in order to recommend the most appropriate future form of care.

Claimer: This blog is intended as a part of Situation Analysis and Assessment/ Evaluation Report of Implementation of National Strategy on Deinstitutionalisation 2008–2018, which will be soon presented to the public within the EU framework project Technical assistance support for the deinstitutionalization process in social sector. For this blog, Vlado Krstovski is considered to be co-author.

Reference:

Petrov, R., (2016), 15 godini od procesot za deinstitucionalizacija na deca od specialniot zavod Demir Kapija (15 Years of the Deinstitutionalisation Process of Children from the Demir Kapija Special Institution), Skopje: report for the MoLSP.

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[1] In Macedonian language ‘zgrižuvačko semejstvo’ would literally be translated into ‘caring family’, which is an adequate term for children being cared in a family as well for the adult. However, the way of care and especially the formal and informal status of the resident has to be different.