Alternative Care for Children: A Case for Foster Care

"In baccho mein mere bacche kab bade ho gaye, pata hi nahi chala (Among all the fostered children, I did not realise when my children grew up)” is how L¹ sums up the experience of bringing up fostered children. L was a foster mother with an adoption and child welfare agency in Mumbai. She retired after a service of 35 years with the organisation and fostered over 150 children. Like other foster mothers working with the agency, she, too, remembers the name of each child she took care of. For most, she also remembers anecdotes. "N, I fostered for 2 years. She loved dressing up," she recalls while showing me a picture from her photo albums. 

Alternative care for children, particularly through foster care and adoption, is the level of care that is envisioned for all abandoned, neglected, abused and orphaned children. The child rights fraternity supports it reverently as a substitute for any form of institutional care. Adoption and foster care for children in need of care and protection (CNCP) also stems from children's right to family environments, enshrined in the United Nations Conventions on the Rights of the Child (UNCRC) (1989). 

The importance of a healthy family environment is deemed unquestionable in child development. Bronfenbrenner (1979) stresses it in his ecological theory. "The micro system is the home, involving interactions with only one or two people in the family. As the child ages, the micro system is more complex, involving more people–such as in a child-care centre or preschool." Perspectives on the family both as an entity and as a producer of developmental outcomes of its members (Kreppner and Lerner 1989) depict it as a social context or "climate" facilitating the individual's entry into other social contexts and as an environmental factor containing both genetically shared and non-shared components for the developing individual.

Institutions, on the other hand, are found to be detrimental to a child's overall growth and development. The perils of long-term institutional care have been described through the “institutional child syndrome,” a result of "structural neglect" that may include minimum physical resources, unfavourable and unstable staffing patterns, and socially and emotionally inadequate caregiver–child interactions (Nigudkar 2017). Alternative care, then, is based on the premise that children must be removed from institutional care and placed with families. These families can either be adoptive or foster families. 

Foster Care and Adoption: Similarities and Differences

A crucial prerequisite to delving into foster care is to define it and differentiate it from adoption. While both come under the purview of the juvenile justice system, there are two important distinctions to be made. One, adoption is permanent, while foster care is temporary. Second, foster families look after the child for a limited period until they go back to their own family, or to another, permanent family through adoption. It does not involve any legal rights of the child. Adoptive families, contrarily, go through the process of adoption and the child becomes a part of the family, legally, including all the “rights, privileges and responsibilities that are attached to a biological child (Juvenile Justice [Care and Protection of Children] Act 2015).” 

Model Guidelines for Foster Care (2016) define three main kinds of foster care. "Kinship care" is family-based care within the child's extended or joint family. "Pre-adoption foster care" means a stage when the custody of a child is given to prospective adoptive parents, pending adoption order from the court. "Group foster care" means family-like care in a fit facility for children in need of care and protection who are without parental care intending to provide personalised care and a sense of belonging and identity.

Foster Families

According to the Juvenile Justice (Care and Protection of Children) Act, 2015, a "foster family" means a family found suitable by the District Child Protection Unit to keep children in foster care. To become eligible for foster parenting, the families have to pass a set of criteria mentioned in the model guidelines. Having done that, they must include a new member in the family, an infant mostly, in the Indian scenario, who has not had the best start in the world. Parenting is not an easy task, and the challenges faced are diverse and many. 

To begin with, an important characteristic of foster families is its temporary nature. The dynamics of a foster family, built on relations that are expected to be temporary, are discussed in the article The Foster Family in a Systems Theory Perspective by Kathleen Eastman (1979). "A sense of loss is perceived to exist since the beginning, because of its temporary nature." "Foster parents are expected to be warm and nurturing and to form a growth-promoting relationship with their foster children, but not too warm and nurturing to create a relationship that is too close that it makes it difficult for the children to return to their birth parents" (Bornstein 2002). 

Just as fostered children face ambiguity about their belongingness in the family, so does the foster family about who is to belong to it. Fostering infants, however, is found to be much easier in terms of this vagueness that older foster children face. While it may be difficult for infants to attach to foster parents, then be removed and required to form attachments to a new set of parents, no encouragement of attachment at all can have far-reaching consequences (Zeanah et al 2011). Fostering for infants is fundamentally different from fostering older children because infants are unable to keep parents "in mind" for long periods in the parents' absence (Kagan 2008). "That is, when parents are absent, young children can no longer hold onto their image—and cannot hold on to the hope that they will return. Whereas older children often hold on to the hope of being reunited with birth parents, infants do not have this capacity. Thus, for infants in foster care, a committed, loving foster parent and stability of placement are critical."

Children who are placed in foster care have usually faced some amount of trauma and neglect, which can render them distant and unresponsive to the love and care that the foster family is extending. A baby fostered by S had rat bites all over him and had spasms of fear which made him shudder violently in his sleep. "They did not speak much. They were always a little sad and silent," recalls R, when talking about children from institutions. Dealing with behavioural problems can often be taxing and discouraging for foster families. Parents often end up dealing and coping with these “problem behaviours” by comparing fostered children to the general population of children (Morgan and Baron 2011). Eastman (1979) fears an entropy and loss of identity among families that are too open. Biological children in the foster families are also vulnerable, as evident when G's son said "You don't care about me," when she started fostering. "The babies cried, my children couldn't study and I was always busy with the child," recalls S. Fostered children's problems can affect the well-being of foster families and the necessity of a stable and well-connected foster family is, hence, stressed (Broady et al 2010). 

Besides the fact that childcare is a 24-hour job, having a child in the house also limits the family from engaging in certain activities. These are children who needed constant supervision and care, increased emotional support, multiple rounds to the hospital, special arrangements and much more patience.

Foster families compromise on their social lives as somebody has to stay back to look after the infant. If the child is ill, somebody has to stay in the hospital. They cannot travel by train or bus with a young child, Money needs to be spent on taxis. If they have to go out of the city, they must make alternate arrangements. Sometimes, they take the fostered children along. Other times, they do not go out at all. The money that is provided is rationed and only enough for covering the minimum subsistence of the child and they often incur out-of-pocket expenses. 

Yet, all of this is a part of foster families treating the child as their own, a positive factor that plays a part in successful fostering, according to Dozier (2006). She defines the “level of commitment” and “this is my baby” attitude to be of utmost importance in fruitful fostering. In her study of the level of commitment, a foster mother was more likely to consider the fostered child as “my baby,” if the child was placed at a younger age, than to a child who was placed at an older age. “We are more connected to a child who has grown up, who started talking and walking in our house," says D. Commitment was shown to be higher among foster mothers who had fostered a lesser number of children. "All the neighbours, old and young, call me 'mother'. My husband and I joke about how many children I have!" K having fostered 12 children, tells me proudly. 

Higher levels of commitment are also associated with a greater likelihood of adoption and long-term placement. It pleases and contents foster families when the child is selected for adoption; more if the adoption is inter-country. They want the children to have great and happy lives, for them to wear the clothes they have packed for them and to remember them sometimes in some way and for the adoptive parents to send them news and pictures of the child. "M always sends me a card for Christmas and tells me that I am her first grandmother," says D. 

In as close a relationship as a parent and child, albeit fostered, it is neither advisable nor possible to not form attachments. All foster mothers interviewed for this study maintain that the most difficult part of fostering, undeniably, is the bittersweet separation. Foster parents can harbour the same level of care, concerns and hopes for fostered children as for their biological children (Anderson et al 1989; Schormans 2004). Reactions to separation and grief, then, must not be discredited. “When a child leaves, it is as if a piece of my heart has gone. The house is silent for days." In albums that L proudly displays, every picture has not less than five children. "My children and foster children—all grew up together. They fought and played and dressed up, called each other sister and brother and it was always like a party." 

A barrier to accepting and expressing this grief is the "unspoken understanding that foster parents should expect the loss, appreciate that departure may be good for the child, deal with it and carry on with their lives" (Herbert et al 2013). The process of shrouding this loss has come to be referred to as “disenfranchised grief,” described as a loss that is socially unacceptable and unsanctioned (Doka 1989). Research also supports the idea that grief can begin long before a loss occurs. “They (the child welfare agency) have written it on the document. But they don't understand what we go through."

In line with the feeling of loss that Eastman describes, Rando (1986) defines anticipatory grief as “encompassing the process of mourning, coping, interaction, planning and psychosocial reorganisation that are stimulated and begun in part, in response to the awareness of an impending loss and the recognition of associated losses in the past, present and future.” Almost all foster mothers have had an incident of falling sick once and getting admitted to the hospital after a child left. "It is almost tragic sometimes. All these children who won't remember us," describes K. 
The challenges faced by foster families are vast, long-standing and profound. Foster families work under the supervision of child welfare agencies. A primary right of parents, to nurture their children without the interference of the state, is missing for foster families. There is a constant negotiation about the role that foster families are required to play in the child's life. The experience of attachment and inevitable separation can be exhausting. What is it, then, that motivates them to continue?

Motivations for Fostering

Altruism is found to be one underlying and major motivating factor. For all foster mothers, the process of fostering has been more fulfilling than challenging. While money is an incentive for some foster mothers to enter the field, monetary compensation is often only enough to meet the needs of the child (Geiger et al 2013). An intrinsic reward in “doing something good and valuable” serves to motivate better than extrinsic rewards in the form of monetary or personal accolades. "It makes us happy when they address us as mother and father," says R. "These children have nobody. When we give them love, we will also receive love in return." By contributing and making a positive change in the lives of needy children, foster parents feel personally useful and the relationships that develop between foster parents and their foster children are rewarding for both (Howell-Mornoy 2014; Broady et al 2010). 

Studies also reflect the positive impact of foster care in developing respect towards various cultures and value systems, creating a positive impact on the entire foster family (Zintle and Pius 2018). Being a foster mother has helped women in becoming financial contributors. More importantly, it has given them an identity, through support and appreciation from families and neighbours. In the course of their work, foster mothers have learned to interact and have become confident enough to deal with the hospital staff, the child's paediatrician and even the police, who often confuse them with baby stealers. G always wanted to do a job but her family was not in favour of it. Looking after fostered children has given her the independence she desired. "This work has become my identity. It has become my prestige. People do not say you are earning so much money. People tell me you are earning blessings." K always wanted to do “social service” and when she looks after children, she believes her dreams are coming true through the blessings of the children. 

Conclusions

The Indian society, primarily following a joint system, has not been unaware of the “kinship foster care.” For centuries, orphaned and neglected children were absorbed into and looked after by extended family members. Only with the disintegration of the joint family system and no relatives to look after these children, were formal laws for child welfare initiated. The first non-institutional scheme for children was introduced in 1972 by the state of Maharashtra, which was revised for the final time in 2005 and renamed the “Bal Sangopan Scheme–Non-Institutional Services.” Indian ratification of the UNCRC in 1992 called for government intervention and support in the field of alternative care. The National Charter for Children (2003), the National Commission for Children (NCPCR) in 2005 and the Integrated Child Protection Scheme (2009)² introduced expectations in relation to state developments with regard to family-based care. Foster care was formally defined, finally, in the Juvenile Justice (Care and Protection of Children) Act in 2015 and the model guidelines for foster care were spelled out in 2016. 

The progress of alternative care in India has been steady but slow. Foster care remains a concept unheard of and is often confused with surrogacy or with guardianship. Compounded with the lack of awareness, is the social standing in terms of caste and religion, which continue to form an important basis of our identity. Alternative care methods of adoption and foster care are considered “unnatural” and viewed from a critical and often negative lens. Terrifying and unsettling cases, such as those of Sherin Mathews (Scroll 2019), are tragic reminders of the fact that a lot of neglect that children face often goes unnoticed and sometimes, even family-based care is not a safe option. However, these cases also lead to distrust and criticism from a public that is largely unaware of its underlying dimensions. Children suffer, but so do foster families, which rarely receive the kind of services and support they need.

Changes in organisational set-ups, policies, and practices have been made, but there is a need for a thoughtful and inherent understanding of the child welfare system. Like adoption, the idea of foster care will take time to develop. Nonetheless, we have courageous, loving families that continue to extend themselves to the children and call them their own in the most tumultuous of times.