With Love, Care and Education

As Vietnam prepares to resume international adoptions to the U.S., Holt reflects on our primary role in the region — helping children grow and thrive in the loving care of their birth families.

Loan* and her husband live in a small brick house in a rural community outside Hanoi, Vietnam. They grew up in this village — a former government commune where the residents continue to harvest rice in the fields surrounding their homes. When we visit in early June, their two young children sit coloring at a short folding table in their front room. Sparse but neat, the room smells lightly of incense and a fan blows overhead. Their wedding photo hangs on the wall — a framed image of a beautiful young couple with warm, genuine smiles.

Looking at them, you would never know the struggles they have faced.

At 16, Loan developed the sickness that created a crisis within her family. Cancer of the cervix, the doctors told her. Although poor farmers, her parents helped cover the cost of her treatment and she moved on with her life — marrying a handsome young carpenter from her village and becoming pregnant within months of their wedding. She miscarried her first child, but soon gave birth to two healthy children — first a son, then a daughter.

After some time, a painful lump began to grow inside her. The cancer had spread. To treat it, she went through surgery, followed by radiation and chemotherapy. At the end of all her treatment, Loan’s hospital bills reached nearly $5,000 — an amount she could not afford to pay without borrowing money from relatives. Loan helped her family farm their small rice plot when not too weak to work. But she and her husband struggled to support their two young children.

Now a 26-year-old woman with streaks of gold in her dark hair, Loan invites us into her home. Holding her daughter in her lap and her son at her side, she tells us about her cancer struggle — her eyes filling with hot tears.

“At first, I did not intend to treat it. I thought, I will just get sicker and sicker and then I will die,” she shares. “But then I looked at these two children and kept trying.”

Two years ago, Holt began serving families and children in this poor farming community in Vietnam. In recent years, the global market economy has come to Vietnam, and across the country, many young people are leaving small villages like this one to work in factories in Hanoi or Ho Chi Minh City. Those who remain behind have few options besides joining their families in the fields they have farmed for generations. Like families anywhere who are living on the edge of poverty, all it takes is one crisis — one injury, one bad harvest — to send them spiraling downward.

Loan’s family came to our attention in November 2013. To help Loan and her husband care for their children, our Holt Vietnam staff identified their strengths — including an available pigsty on the family compound. Confident that they had the makings for success as pig farmers, Holt provided funding for Loan’s family to purchase three pigs. Although one of the pigs died, they were able to sell the other two in April of this year — earning about $150 in profit. With the income, they bought two more pigs and saved some funds to pay their children’s upcoming school fees. Loan and her husband also used some of their profit to purchase clothing wholesale and open a small stall near their home.

Their decision to diversify their income through a combination of raising pigs and selling clothing was a strategic one. “They are trying not to put all their eggs in one basket,” says Hang Dam, who since 2009 has served as Vietnam country director out of the Holt office in Hanoi.

The family’s clothing stall stands by a river on the edge of the village. During the rainy season, large umbrellas shield the hanging rows of sport shorts and colorful patterned pants. Loan cheered up after our interview — and she laughs as she helps us select clothing items to bring home.

“I just wish God gives me enough health to earn money to pay all the debt I have. I want to see my children have an education and grow to become good people,” she says. Now in remission and doing well, Loan has great reason to hope. Her children are in school. Her family business is growing. And her health is slowly returning.

Encouraged to see Loan and her children doing so well, we leave to visit another family. If we had time, we could spend a week or more meeting families in this community who are now succeeding as small business owners, whose children are thriving and whose lives are more hopeful — largely in thanks to Holt and Holt’s supporters. In just two years in Loan’s community, Holt has already helped over 60 families to become stronger, more self-reliant and better equipped to care for their children.

Among nongovernmental organizations working in Vietnam, Holt is just one of many. But our history is long and significant, and our approach is unique.

After the highly publicized “Baby Lifts” at the end of the Vietnam War — when Holt and other agencies airlifted to safety children who were legally free for adoption and matched with families in the U.S. — Holt did not return to Vietnam in a major role until the early 1990s. In the years that followed — and between moratoriums on international adoption to the U.S. — we continued to find adoptive families for children who truly needed them. But mostly, we focused on helping children to grow and thrive in the loving care of their birth families.

“There are lots of organizations in Vietnam, and we are very small scale in comparison. But none of them do what we do,” says Thoa Bui, Holt’s senior executive for programs in S.E. Asia. “None of them focus on keeping children in families.”

Following our family strengthening model, Holt has through the years helped thousands of children in Vietnam remain with their families. Our goal, as everywhere, is to give families the tools and resources they need to independently support their children. We provide resources and funds to help parents in Vietnam build small businesses — generating reliable income to support their children.

Unlike organizations that provide broad-stroke community development projects, Holt looks at families individually and tailors services to their circumstances and needs. “We are more case management-focused,” Thoa explains. “Vietnam needs both. It’s good to have organizations focused on different things.”

For an organization like Holt to be successful in our mission, local social workers must work closely with each family — identifying their strengths and weaknesses, developing an action plan and following up on a regular basis. Some families may not have the resources to raise pigs like Loan’s family, but they can run a small grocery. Another family may need short-term emergency aid after a typhoon washes away their livelihood. A pregnant mother in crisis may come to us for help delivering and caring for her newborn baby. Or we may receive a referral for a two-parent household in which both parents have stable jobs, but they need help caring for their kids so they can work.

As Hang explains, “If a family doesn’t need capital for a business, but needs time to work, we can pay for daycare for a couple months until they have enough money. Case management is very specific to the family and their unique needs.”

Before Hang became the director of Holt Vietnam, she took a break to earn her Master’s degree in social work at Washington University in St. Louis, Missouri. As social work is a relatively new profession in Vietnam, Hang is often called upon to help train orphanage and government staff. During our visit in June, we stopped off at the local social welfare center in Da Nang, which Holt partners with to serve at-risk children and families in the community. While Holt provides some equipment and funding, our role is primarily to train and support the staff — a young, enthusiastic team of caseworkers, many of them the first social work graduates in Vietnam.

Just last year, the social welfare center opened services for single mothers struggling with unexpected pregnancies — a significant need in this region, and a service Holt has provided in Vietnam for many years. Hang assisted their efforts by writing a training curriculum about counseling single mothers, and during our visit, we had the opportunity to observe as she helped the government caseworker counsel a young woman in crisis.

In a quiet, air-conditioned room at the social welfare center, Hang and the caseworker sit around a small table with the young mother. She is 24 years old and four months pregnant. The small bump of her belly presses against her blue and white floral maternity dress as she sits with her feet demurely crossed under the table.

“When she learned she was pregnant, she was already separated from her boyfriend, who is now married to another woman,” Hang says, translating the young woman’s story. “She couldn’t stand to stop the pregnancy so she decided to keep the baby.”

She has not visited her mother since her pregnancy. Her mother does not even know she’s expecting. “She feels she can’t tell her because it will hurt her mother’s feelings,” Hang says. At this point in her story, the young woman’s face turns red and she speaks through breathless sobs. In a soothing voice, Hang encourages her to reach out to her mother. Turning to us, Hang says, “I had to do a little counseling about how moms feel when their kids go through hard times.”

Although the caseworker chimes in every so often, Hang leads the session. She emphasizes the mother’s strengths and tries to build her confidence — reinforcing that, with help, she is capable of caring for herself and her baby.

Unlike many of the young expectant mothers who seek crisis  counseling in Vietnam, this young woman has a particularly unique strength — she is college educated. “She has two years of business training as an accountant,” Hang says.

As in many of the countries where we work, however, a strong stigma against unwed mothers endures in Vietnam. Although she has the education needed to earn a decent salary, she may face discrimination when searching for an accounting job. She currently runs a small business serving breakfast for factory workers, and spends her afternoons working in a food stall. She earns $5-7/day, which is enough to pay her rent and not much else.

“From the bottom of her heart, she wants to keep the baby,” Hang says. “But she worries if she keeps the baby, who will help her during the first month? She worries about whether she can find a good job to cover the costs of raising her baby. And she worries about providing a good future and education.”

Working with the social welfare center, Holt can help support her during the delivery and for a month afterward. We can help pay part of the hospital fees. And, if she ultimately decides to keep her baby, Holt can also provide support for six months of daycare so she can seek work in her field.

Although this should help to alleviate some of her fears, she has one last nagging concern. “She feels pity if it’s a girl,” Hang says. “She is afraid the girl will repeat her life cycle.”

At this, Hang — a mother of two — offers some motherly advice and encouragement: “I told her she will find a way for her daughter to break the cycle, with love, care and education.”

In both Hanoi and Da Nang, we visit single mothers who Holt supports through our family strengthening programs. Both are widows whose husbands died young — one from cancer, the other in a drowning accident. Both have received funds to start small businesses that help them support their children.

From early intervention with birth moms to supporting single mothers with growing kids, Holt strives to help struggling mothers early — before poverty and hardship compel them to abandon or relinquish their children. In this way, Holt is also unique among child welfare organizations in Vietnam. “Holt is the only organization that works the way we do,” Hang says, “counseling and supporting and encouraging birth moms to keep their babies.”

It is a sad fact that not every child can — or should — remain in the care of their birth family, however. For these children, Holt has always sought a permanent, loving family through adoption. Although international adoption to the U.S. has remained suspended since 2008,** Holt has continued to place children domestically within Vietnam — and also to seek alternative, family-like care for children living in orphanages. In the early 1970s, Holt introduced foster care as a more nurturing care model in Vietnam, and continues to be the only organization training and supporting foster families here. In recent years, Holt Vietnam’s thriving programs moved Vietnam’s Ministry of Labour, Invalids and Social Affairs to promote this family-like alternative to institutional care — with Hang and her staff developing the training curriculum.

Soon, Holt may also resume international adoptions from Vietnam** through a small pilot program for children with special needs. Two U.S. placing agencies will be licensed, and Holt is being considered as one of a few final candidates.

For those children who truly need families through adoption, Holt will continue advocating for international adoption from Vietnam. But in the 41 years since we first came to this vibrant but troubled country in Southeast Asia, our role has evolved. First and foremost, we strive to keep children in the loving care of their birth families, whenever possible. And as we saw in homes from Hanoi to Da Nang, this is not just a distant possibility. Our family strengthening model works. In Hanoi, our success rate is 90 percent.

It doesn’t take much, either. Just a few pigs or the cost of daycare. As Thoa says, “A couple hundred dollars goes a long way in Vietnam.”

As we say goodbye to Loan and her husband in Hanoi, they stand before their clothing stall with their hands on their children’s shoulders — a strong and beautiful family. Their lives are not easy, but they feel encouraged by the support of Holt and Holt’s supporters. “The amount of capital assistance provided was neither small nor big compared to the debt our family has,” Loan says, “but I feel warm because there are still people caring about us. I am very touched and am very thankful.”

Robin Munro  | Managing Editor

* Name changed

** On September 16, 2014, Vietnam’s Central Adoption Authority granted Holt International a license to facilitate international adoption for children with special needs, children older than 5 years old and children who are part of singling groups — effectively ending a 6-year moratorium on adoption from Vietnam to the U.S.