Across Vietnam, Holt sponsors and donors provide support and care to children growing up in residential care centers. Each child — who they are, why they are here, and the type of care they require — is different. We invite you to meet the children living at one facility in Vietnam, to learn about their lives, and their hope for the future.
Hai cranes his neck to look through the doorway of his room. His eyes light up and his smile widens when he sees that there are visitors here to see him.
Every day, Hai spends most of his time in his crib. The crib is made of metal, with wooden slats on the bottom covered by a thin woven mat. Caregivers come in to help him eat, get dressed and go to the bathroom. Twice per day, he’s placed in a special chair and wheeled out to the courtyard to sit in the sun.
Hai has severe cerebral palsy, and very limited mobility. He can lay on his back, and turn his head from side to side, but his legs and arms are twisted tightly, and very thin for a 16-year-old boy.
“It breaks my heart,” says Hang Dam, Holt’s U.S.-based director of programs for Vietnam. “When he was in his former room, he used to have a television so he could at least watch cartoons and interact with younger children.”
Now that he’s older, Hai shares a room with a 22-year-old girl with a severe mental disability. This girl has only been here a few months, and before that she spent her whole life locked in her family’s home — because they had no resources to teach her how to function in public. This is heartbreakingly common for children with disabilities who are born into poverty. Now that she’s at the center, she has to be on medication to help her stay calm. She isn’t able to speak, and cannot interact with Hai at all.
Hang pulls stickers out of her bag and puts them on the bars of Hai’s crib. His smile widens, and he can’t take his eyes off them. He asks her to give him the rest of the sheet of stickers. He doesn’t want to use all of them up right away.
Child Welfare Centers in Vietnam
The orphanage where we meet Hai is located in a province several hours south of Ho Chi Min City in Vietnam. In Vietnam, orphanages are called “child welfare centers,” and they are directed and employed by the local government.
This child welfare center is a large, white two-story building centered around an open-air courtyard. The rooms, coming off of the courtyard, have white painted walls and white tiled floors.
From the outside, you wouldn’t immediately know kids live here. Not until you see the small plastic play structure in one corner of the courtyard, or the sports court lines painted on the ground outside.
The facility is clean, orderly and well-run. The caregivers and orphanage directors have strong relationships and bonds with the children, and they work hard every day to make sure the children’s needs are met. With the support of Holt sponsors and donors, Holt’s team in Vietnam helps provide medical care, more nourishing food for the children, nutrition and feeding training for the caregivers, and helps advocate for the children to ultimately join families through reunification or adoption.
But not every child will leave to join a family. And even though Holt has helped improve the quality for care at this orphanage, even a “good” orphanage is no place that a child should grow up.
No Place to Grow Up
The reasons children come to live in child welfare centers in Vietnam are because their families can’t care for them — either because they are truly orphaned, or their parents or extended family are incapable of caring for them due to mental illness, disability or imprisonment. Some infants, and even older children, are left at the gates of the center — and found and brought in by the staff.
This is a safe place for a child to live. But it’s meant to be temporary.
“The government strategy is now to deinstitutionalize,” says Huong Nguyen, Holt’s Vietnam country director. Deinstitutionalization, or transitioning children out of orphanage care, is Holt’s goal in every country where we work. We believe children are meant to grow up in a family, not an institution.
Huong explains that the government has strict criteria for who can and can’t be enrolled into orphanage care. “First [the government] sees if the child has any kind of relatives who can take care of them,” she says. “And even if a child does come to live at the center, they have a plan for reaching out to the family to discuss when they are able to reunite the child and the family.”
Around the world, Holt advocates for every child to thrive in the love and care of a permanent, loving family. Whenever possible, a child should be reunited with their birth family. But if this isn’t possible, we next pursue domestic and then international adoption. But each of these paths can be complex, and the reality remains that thousands of children around the world live in long-term orphanage care settings.
Holt-Supported Orphan Care
Holt sponsors and donors have supported this particular child welfare center in Vietnam for over ten years. The youngest children in the center, and those with special needs, have Holt sponsors who help provide for their nutrition and educational needs. And over the years, Holt has provided supplemental funding to hire additional caregivers, as well as nutrition and feeding trainings for the staff through our Child Nutrition Program.
One of the caregivers, Le Leiu, has worked here for nine years. Her background was in nursing, which she said has been a perfect fit for taking care of the children, especially those with medical needs. She walks around, holding 22-month-old Vy on her hip, balancing the child around her own pregnant belly. Le Leiu says Vy has bonded especially closely with her. Vy isn’t walking yet, and is small for her age — it’s possible that she has dwarfism, and the caregivers and medical staff are continuing to assess her as she grows. She snuggles into her Le Leiu’s arms, giving a shy and small grin.
“This job is very hard work,” she says, “but seeing the children grow and develop every day gives me motivation.”
In 2019, Le Leiu took part in a training from Holt’s Child Nutrition Program. During the training, she and the other caregivers learned how easily children with disabilities can choke and get injured during meals, how to position them properly, and about the specialized formula or food they need to grow and develop. She says this training made a big difference for the children.
“Phillip,” for example, has cerebral palsy, and has benefitted greatly from the nutrition training.
His caregivers received the training when he was just a baby, so his whole life he’s been fed upright with the proper chair, utensils and technique. He hasn’t experienced as much aspirating, and the lung infections that can follow, like some of the other children have had to suffer.
Philip’s eyes are bright, and he smiles freely as he moves around in his crib, playing with a toy. Properly trained caregivers, and having enough of them employed at the center, have made all the difference for him. But this is a constant struggle for orphanages, which are chronically understaffed. Despite Holt’s efforts to bring in more caregivers, this problem persists due to Vietnam’s complex bureaucracy and strict policies.
Right now, for example, there are six caregivers who take care of the youngest children and those with special needs. But Le Leiu will soon go on maternity leave, and another caregiver recently got injured and is unable to come to work. So for the foreseeable future, there are just four caregivers – split up over three shifts – caring for 14 children with disabilities. The orphanage is doing its best to fill the gap by assigning one or two additional administrative staff to support the caregivers during meals and bath time, and by allowing older children to play and interact with the toddlers after school hours.
Many of the children here — like Philip, Hai and Vy — have disabilities or special needs. But many others who live here are perfectly healthy, both physically and mentally. Some children live here for a short while, just several months or years until the can be reunified with their birth families. But many others, like Hai, will likely live here for their entire childhood, until they either age out and go out into the world on their own, or are transferred to a center for adults with disabilities sometime in their mid-20s.
Aging Out, or Adoption
What happens when a child moves to an adult facility?
“They stay there forever,” Huong says.
But thankfully, many of these children have another option — international adoption. That is, if a family comes forward before they age out of eligibility at 16.
While Hai is too old to be adopted internationally, there is still hope for 6-year-old Phillip, who has been on Holt’s waiting child photolisting for years.
“They see international adoption as very good for children.” Huong says of how intercountry adoption is perceived in Vietnam. “Because [the child] will have a better life, and they will be cared for better, and they will have more opportunities to develop themselves.”
This is because at even the best orphanages, they rarely have the specialized resources needed to help a child with disabilities and medical needs.
“What I’ve seen, and what makes me so sad,” Huong says, “is that for children with cerebral palsy, or autism or other disabilities, if they have enough therapy, their functions can be improved.”
But while they continue to live in the orphanage, their development is slow. While the resources provided by Holt donors address the most basic needs of the children — nutrition, education, medical care, even some therapy — their psychosocial and emotional needs can never fully be met in an institutional setting.
That’s why international adoption offers so much hope — in the care of a loving family, children can receive the medical care and therapies that are simply inaccessible in an orphanage.
Domestic Adoption in Vietnam
At Holt, our priority is to reunite children with their birth families. If that’s not possible, domestic adoption is explored for a child, and this option is always pursued first before international adoption.
However, domestic adoptions, Huong explains, really only happen for the youngest and healthiest children.
For the children who are eligible for domestic or international adoption, they live each day, month and year in hopeful waiting for a family to adopt them.
The Complexity of Reunification
For some children, it’s a different kind of waiting. These children are waiting for their birth family to become stable enough to bring them back home.
“I felt scared when I first came here to live,” says Thuy. Today she’s 16, but she started living here at just 6 years old. She’s a beautiful young woman, petite with an athletic build. Glasses frame her deep, bright eyes, which fill with tears as she shares her story.
“He can take care of me,” she says about her father, who lives just a couple miles away from the center. But the heartbreaking, unspoken implication is that he’s not truly capable of caring for her…
Thuy says her father used to come and visit her, as well as her older biological sister who lived in the center. But he visited less and less frequently as she grew up. Now, she mostly sees him on holidays.
“I wanted to live with my father, but he often drinks,” she says. “He goes out and gets drunk all the time, and comes back violent… So I feel safer here.” She cries softly as she shares this, and the orphanage staff who sit with her fail to hold back their tears as well.
Thuy says that in the future she wants to graduate and get a good job, so that she can help support her father and biological sister.
Despite her father’s abuse and unhealthy lifestyle, it’s evident that she still cares for him deeply. It’s a complexity that shows a child’s deepest desire – to be loved and wanted by family. And while the children live here at the center, the caregivers try to operate as close to a family as they can.
Orphanage Family
The children who live here refer to each other as brothers and sisters, and to their caregivers as mothers. Because for the time being, they are each other’s family.
Caregivers will take the older children out for coffee, to talk with them and offer support. And even when children age out of the center, they often come back to help take care of the younger children — or to receive support from the staff as they learn how to find an apartment, apply for a job, budget their money and learn how to cook.
“I’m both happy and sad when I’m living here.”
Thuy walks upstairs, down an open-air hallway to a room that she shares with six other girls. Above the entrance to their room is a brightly colored, handmade sign that reads “Tiem Salon” with drawings of hearts and stars around it.
The room consists of three bunk beds, and in one corner are several clothes racks that hold the girls’ school uniforms and outfits.
Thuy shows us her bunk, but then points to a different bed across the room.
“I sleep here, though, with my sister,” she says.
“They love each other,” her caregiver says smiling. These girls aren’t biological sisters, but have bonded closely as sisters while they’ve lived here.
“I’m both happy and sad when I’m living here,” Thuy says.
This sentiment could describe every child who lives here. Each of them has experienced the heartbreak of illness, poverty, family loss and more. But they live every day with hope.
Here at the center, they are safe, they have enough food, go to school and have their basic needs met. Their caregivers do all they can for them, and are constantly striving to make their lives better.
They hope for a family — whether that means going home to their birth family or joining a family through adoption. And they embrace their “family” in the orphanage as they wait.
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