In my last post, I talked about our reawakening. The pandemic, despite being a period of crisis, gave us a chance to reflect on our work in Perù’s child welfare sector and recognize our unique position to be more of service to others.
From the coalitions we established with partners to serve street youth, to our efforts in supporting abandoned boys at Casa Girasoles, we’ve seen that child welfare practices and therapies grounded in science and evidence help youth build the resilience and emotional health they need for better life outcomes, such as healthy relationships and stable jobs.
In traversing Latin America’s child welfare sector these past 25 years, we’ve encountered and worked with various state-run programs, faith-based ones, and nonprofit-led projects. Through them, we’ve seen firsthand different methods and models to care for children living in residential care facilities, group homes, or child-welfare services. Some borrowed from science-backed or evidence-supported interventions, while others adopted unique approaches.
Despite the positive impact of these groups, a number of them worked in isolation and efforts were not connected to broader services delivery. There was no child services framework to consolidate these valuable resources and best practices, which other well-intentioned organizations could tap into. The absence of a structured model between facilities means that many youth may leave their care without a clear plan for their future and have a higher risk of bouncing between residential care settings and unstable—even abusive—home environments.
We had to act to fill this gap. Now, fueled by the need to bridge and elevate child services, our team set its sights on our Center of Excellence to bring the science to the people who do the work: the caregivers and institutional care providers who directly work with children in residential facilities.
The Girasoles Sanos Center of Excellence model, Health Bridge’s newest research program, aims to develop a framework on evidence-based practices that will reshape care and support services for youth and adolescents in residential care settings in developing countries. We’re currently working with the Sidney Kimmel Medical College of Thomas Jefferson University in the US and the Universidad Católica Santa Maria in Perú on a five-year study (2021-2026) to develop a model that can be scaled to other child care facilities focused on serving marginalized youth. The Girasoles Homes, which we continue to run for formerly homeless and abandoned boys, will be at the core of this research. The homes will serve as the base of the Center of Excellence program and be incubators for best practice and training facilities that can offer technical assistance to other NGOs, government agencies, and programs.
The study, split into phases, seeks to better understand the complex needs of service providers, administrators, and children. The first phase will be a 12-month effort that will focus on the training of Girasoles staff on evidence-based child welfare interventions. The remaining phases will evaluate the effectiveness and impact of phase one’s training model and strategies on child outcomes. Throughout the project, we will consult study participants on refining activities and materials to best support their unique culture and community dynamics.
We expect our research to yield a Center of Excellence Training Toolkit for caregivers and health professionals. This will provide a consolidated set of evidence-supported best practices and guidelines for organizing the activities, built-environment, staffing and services delivery in child welfare and care facilities in developing and middle-income countries. We also aim to establish an advisory group of diverse international experts, all with backgrounds in child welfare and family support services.
Once the study is complete, we aim to share our findings with the government of Perú, encouraging them to adopt the Center of Excellence as the standard by which all programs are set up and administered. Given their vast reach and resources, they are in the best position to contribute to our endgame of overhauling and reshaping child support services from a welfare-based model into a whole-child empowerment model.
We will also share the model with other youth programs and organizations and, through the advisory group, help them adopt it in culturally humble and informed ways. We recognize there is no one-size-fits-all approach to complex challenges – we are not seeking to use simple solutions for complex problems. Rather, we are seeking to provide a proven structure that can be replicated, standardized, and scaled. A model that will ensure children have access to the future they so clearly deserve.
It has been inspiring to see these developments slowly and steadily rise through the efforts of so many people – all to help make sure children will always be empowered with health, hope, home, and purpose. We’ll be sharing more exciting updates about our Center of Excellence in the coming months.
“The arc of the moral universe is long, but it bends toward justice.”
Dr. Martin Luther King, Jr.
Dr. King's words ring true in the context of this past week. It seems the arc of the moral universe is bending toward justice. The trial and conviction of Derek Chauvin brings justice front and center for a country reeling with bigotry, racism, inequity and inequality. The arc bent, and moral clarity and justice prevailed in the conviction of Derek Chauvin.
Yet, at the same time - two more police killings just this week, bring a deeper and more profound call to justice.
It seems to me the arc of the moral universe bends and flips . . . never truly reaching the justice that will provide all human souls the peace, protection, and equity we deserve.
There is so much pain in the world. So many people are struggling, suffering, to meet their basic life needs - health, hope, home, purpose, connection, security, identity, and community. The gaps in our world make it hard for so many to find a path to a future.
Our work must be focused on bending the circumstances and situations that prevent the full expression of the moral universe. The arc will not bend without us. The opportunities of the moral universe will not be fully attainable without our efforts. We are the instruments of equity and equality. We are the instruments of justice and peace. It is our job, our purpose, to bend the arc.
Let's keep bending the arc - together - so that everyone can have access to the lives we all deserve.
As the world slowly pulls back the curtain of the pandemic and restrictions start to cautiously lift where it’s safe to do so, I’ve been thinking a lot about reawakenings. A couple of weeks back, I spoke at the Southwestern Political Science Association Centennial Virtual speaker series. I was on a panel with researchers from North Carolina State University, Dr. Thomas Birkland, and Wayne State University, Dr. Kristin Taylor, who are leading a longitudinal study examining COVID-19’s impact on the lives of Americans. A common theme came up repeatedly - we are entering a time that will require us to think, act, and evolve differently. There will be no “redo of 2019.”
With all the upheavals last year, we’ve had to ask ourselves the hard questions. Like every NGO, we felt overwhelmed and, at times, hopeless: so many have died, economies have fallen, and children have suffered. Yet, we also saw the world respond in profound ways to support one another. Charitable giving reached an all-time high. Ingenuity and innovation sparked unique partnerships, bringing resources and support where needed. New local initiatives helped with food insecurity, economic challenges, emotional support, and community connection. All the work we saw jolted us to ask: What is our endgame as an organization? What are we uniquely qualified to address? And what are we most passionate about? We wrestled with our own relevance, credibility, and utility, spending hours examining our role in a COVID-19 world and the more extensive work of a global organization.
The introspection and examination brought us to a recognition of our unique position. It started with understanding and accepting that we can't be everything to everyone. Recognizing our limitations was both a robust and humbling experience for our team. Out of this, we’ve gained a reawakened determination, a clarification of our "superpower." Not the bulky, might-make-right power of a Marvel character; instead, a laser-sharp focus on what we’re best suited to do in the world now and how our talents, interests, and connections can work together for the greatest good.
Since the 1990s, we've been working at the intersection of child abandonment, homelessness, social justice, health equity, and systems development in Perú. From our early experience doing outreach on Lima's streets to our efforts in running two model homes for formerly abandoned children, we have gained important insights and walked humbly into critical lessons. One thing we’ve learned from listening to and working with children and young adults is that they need hope - the kind that comes from deep, meaningful, loving relationships. They need the hope that comes from family connections and the support that grows from healthy attachments and molded resilience. Ideally, children would be nurtured in a family of origin and raised in a house filled with love, compassion, and deep connection, yet such a scenario is impossible for millions of them.
Over 30 years of published research points out that children need caregivers with the training and skills to foster meaningful relationships (Quiroga, Hamilton-Giachritsis, 2016). When provided attachment relationships from competent caregivers, children in residential facilities tap into their innate resiliency and demonstrate significantly better life course outcomes (Nelson, Bos, Gunnar, Sonuga-Barke, 2011). Science shows that building resilience leads to healthy relationships, stable jobs and housing, and emotional wellness, and reduces the likelihood of involvement with the criminal justice system.
We know what to do: make bold moves to overhaul child support services from a welfare-based model to an empowerment model. We know it will take decades, and we are in it for the long-haul. Our two decades of work in child welfare have given us key partnerships with academic institutions, subject matter experts, and youth ambassadors. With their support, we are educating institutional caretakers, influencing government policy, and training other organizations in evidence-based practices and tools for caring for marginalized children. The timing could not be better.
The pandemic taught us that we have what it takes to respond to children’s immediate needs, all while planning for the future. We will take our realizations from this crisis, past lessons, and hopes for the future to build a unified model that will offer a roadmap for serving the diverse and complex needs of children, youth, and young adults. A model that will offer a platform to transform child welfare services. I can’t wait to share our new directions/strategy with you.
Early in the pandemic - way back in April 2020 - we realized very quickly, one of the greatest challenges the people we serve would face was isolation and loneliness We felt this would be particularly true for the adolescent siblings of the children living with disabilities in our Ines Project.
In response to this recognition, we started an adolescent mental health support group. We called it "HBI Youth Accompaniment." Completely delivered through WhatsApp chats, the group is facilitated by one of the psychologists on the Health Bridges team. She meets with the adolescents weekly - offering small talks on a wide range of subjects, providing one-one-one video check-ins, and helping provide purpose to the lives of the young adults.
The cohort in the project represents some of the hardest hit populations in Perú. Living in extreme poverty in a family headed by a single mother employed in the informal economy, and balancing the needs of a sibling with a disability - they are incredibly vulnerable to dropping out of school, working on the streets and potentially exposing themselves or their families to COVID.
This simple project - using WhatsApp to connect - has been powerful. It is providing a platform for finding community, breaking from isolation, and re-discovering purpose.
On Tuesday night we had a virtual graduation ceremony for the first group. The young people - in their dimly lit homes in some of the poorest neighborhoods in Lima - expressed their gratitude, discussed their learnings, and offered ideas for the next group. It was really humbling.
This has been, and continues to be, a challenging year. One thing I keep learning is the power of connection. Without a doubt the pandemic has shown us that we can be in the lives of the people we are called to serve, even if we can't be in the same room . . . or on the same continent for that matter.
Keep building bridges . . . and thank you for your continued support.
The HBI Blog is a rotating journal from our staff. Our Blog is a series of messages from the field, insights from our work, and lessons in service.