Across Europe and Central Asia,

大約有一百萬名孩童

approximately one million children live in large

住在大型收容機構，通常稱為孤兒院

residential institutions, usually known as orphanages.

大部份的人想像中的孤兒院

Most people imagine orphanages as a benign environment

是可以照顧孩童的優良環境

that care for children.

其他人雖然了解孤兒院的居住環境

Others know more about the living conditions there,

仍然認為孤兒院的存在是必要之惡

but still think they're a necessary evil.

否則，我們還能將那些失去父母親的小孩

After all, where else would we put all of those children

安置在哪裡呢？

who don't have any parents?

經過六十年的研究

But 60 years of research has demonstrated

發現讓小孩與原生家庭分開

that separating children from their families

並把他們安置在大型收容機構

and placing them in large institutions

會嚴重影響他們的健康與發展

seriously harms their health and development,

對嬰兒來說更為嚴重

and this is particularly true for young babies.

就我們所知

As we know, babies are born

嬰兒出生時肌肉和大腦

without their full muscle development,

都尚未發展完全

and that includes the brain.

在三歲以前，大腦會發育至完整的大小

During the first three years of life, the brain grows

在六個月大前，則會完成大部份的成長

to its full size, with most of that growth taking place

大腦就能夠對體驗和刺激

in the first six months. The brain develops

做出反應

in response to experience and to stimulation.

每一次新生兒學習新的事物

Every time a young baby learns something new --

－－比如雙眼對焦

to focus its eyes,

模仿一個動作或是臉部表情

to mimic a movement or a facial expression,

撿起東西、學習單字、或是坐下－－

to pick something up, to form a word or to sit up --

大腦中會產生新的聯結

new synaptic connections are being built in the brain.

新手家長對這樣快速地學習感到驚訝

New parents are astonished by the rapidity of this learning.

他們會對孩子的聰穎感到吃驚與開心

They are quite rightly amazed and delighted by their children's cleverness.

他們會向孩子表達出喜悅

They communicate their delight to their children,

孩子露出笑容

who respond with smiles,

並且期待學會與完成更多事情

and a desire to achieve more and to learn more.

在父母與孩子之間強大的連結過程

This forming of the powerful attachment between child and parent

幫助了肢體、社交、語言、認知

provides the building blocks for physical, social,

以及心理性肌肉運動的發展

language, cognitive and psychomotor development.

這是未來與朋友、夥伴以及與他們自己的小孩

It is the model for all future relationships with friends,

的人際互動範本

with partners and with their own children.

這件事很自然地在大部份的家庭中發生

It happens so naturally in most families

以致於我們從未察覺

that we don't even notice it. Most of us are unaware

其對人類發展以及延伸出來

of its importance to human development and, by extension,

對健康社會發展的重要性

to the development of a healthy society.

直到事情開始發生狀況

And it's only when it goes wrong that we start to realize

我們才開始懂得家庭對孩童的重要性

the importance of families to children.

在1993年八月時

In August, 1993, I had my first opportunity to witness

我有了第一次的機會見證

on a massive scale the impact on children

機構化與缺少養育對孩童的重大影響

of institutionalization and the absence of parenting.

我們之中有些人還記得

Those of us who remember the newspaper reports

1989年羅馬尼亞革命後的新聞報導

that came out of Romania after the 1989 revolution

都會回想起在某些收容機構裡的恐怖狀況

will recall the horrors of the conditions in some of those institutions.

我被邀請去幫助大型機構的主管

I was asked to help the director of a large institution to

協助他們預防孩童與家庭分離

help prevent the separation of children from their families.

壽西斯古的示範孤兒院目前照顧550名嬰孩

Housing 550 babies, this was Ceausescu's show orphanage,

他們告訴我這樣的情況已經改善很多了

and so I'd been told the conditions were much better.

我有許多和幼童工作的經驗

Having worked with lots of young children, I expected

因此在我的預期中 機構應該會有很多的噪音

the institution to be a riot of noise,

但這裡卻靜得像修道院

but it was as silent as a convent.

很難相信這裡面居然有小孩

It was hard to believe there were any children there at all,

主管帶我走過一間又一間的宿舍

yet the director showed me into room after room,

每一間裡面有好幾排的小床

each containing row upon row of cots,

每一張床上都躺著一個凝視著空氣的孩子

in each of which lay a child staring into space.

在一間有40名新生兒的房間裡 沒有一個孩子在哭

In a room of 40 newborns, not one of them was crying.

我可以看到有已經髒了的尿布

Yet I could see soiled nappies, and I could see

還有一些難過的孩童

that some of the children were distressed,

然而唯一聽得見的噪音 只是不間斷的低沉呻吟聲

but the only noise was a low, continuous moan.

護理長驕傲地告訴我：

The head nurse told me proudly,

「你看，我們的小孩都很有教養。」

"You see, our children are very well-behaved."

在之後的幾天裡 我開始了解

Over the next few days, I began to realize

這樣的寧靜並不奇怪

that this quietness was not exceptional.

新進的孩子也許會在前幾個小時哭

The newly admitted babies would cry for the first few hours,

但是他們的需求並未被滿足

but their demands were not met, and so eventually

最後他們就學會了不吵人

they learned not to bother. Within a few days,

幾天內，他們就會變得無精打采、成天昏睡

they were listless, lethargic, and staring into space

然後變得和其他人一樣都凝視著空氣

like all the others.

歷年來，許多民眾和新聞報導

Over the years, many people and news reports

指責機構裡的工作人員

have blamed the personnel in the institutions

因為他們傷害了孩子

for the harm caused to the children, but often, one member

但是通常一名職員得照顧10個、20個 甚至是40名孩童

of staff is caring for 10, 20, and even 40 children.

因此他們別無他法，只能將工作標準化

Hence they have no option but to implement a regimented program.

七點要叫孩子起床、七點半要餵食

The children must be woken at 7 and fed at 7:30.

八點一到，他們的尿布就得換了

At 8, their nappies must be changed, so a staff member

所以一名員工只有半小時 來餵飽十個或二十個孩子

may have only 30 minutes to feed 10 or 20 children.

如果一個孩子在八點半時弄髒了尿布

If a child soils its nappy at 8:30, he will have to wait

他得等上好幾個小時才能換上乾淨的尿布

several hours before it can be changed again.

孩子與其他人的日常接觸

The child's daily contact with another human being

被減少到只有在餵食和換尿布時的匆促幾分鐘

is reduced to a few hurried minutes of feeding and changing,

否則他們唯一的刺激

and otherwise their only stimulation is the ceiling,

就只有天花板、牆壁或是小床的橫板

the walls or the bars of their cots.

自從我第一次抵達壽西斯古的機構後

Since my first visit to Ceausescu's institution,

我已去了上百個類似的地方

I've seen hundreds of such places across 18 countries,

從捷克到蘇丹等十八個國家

from the Czech Republic to Sudan.

在這些不同的地方、文化、機構

Across all of these diverse lands and cultures,

以及孩子在這之間的旅程

the institutions, and the child's journey through them,

遺憾地都很雷同

is depressingly similar.

缺乏刺激通常會造成自我刺激行為

Lack of stimulation often leads to self-stimulating behaviors

像是拍手、前後搖晃或是侵略行為

like hand-flapping, rocking back and forth,

在某些機構中，精神疾病的藥物

or aggression, and in some institutions, psychiatric drugs

被用來控制這些孩子的行為

are used to control the behavior of these children,

在其它情況時 為了避免孩子傷害自己或是其他人

whilst in others, children are tied up to prevent them

孩子會被綁起來

from harming themselves or others.

這些孩子很快地會被貼上身心障礙者的標籤

These children are quickly labeled as having disabilities

然後被轉介到另一家 服務身心障礙孩童的機構

and transferred to another institution for children with disabilities.

大部份這樣的孩子都不會再次離開所屬的機構

Most of these children will never leave the institution again.

然而，對於沒有身心障礙的孩子

For those without disabilities, at age three,

滿三歲時，他們會被轉到另一間機構

they're transferred to another institution, and at age seven,

七歲時，再轉到另一間 他們會被依照年齡和性別來隔離

to yet another. Segregated according to age and gender,

他們被迫和兄弟姊妹分離

they are arbitrarily separated from their siblings,

而且通常連道別的機會都沒有

often without even a chance to say goodbye.

他們很少吃得飽 通常都處在飢餓的狀態

There's rarely enough to eat. They are often hungry.

年長的孩子會覇凌年幼的孩子

The older children bully the little ones. They learn to

他們學著生存、保護自己 否則他們的性命就會不保

survive. They learn to defend themselves, or they go under.

當他們離開機構

When they leave the institution, they find it really difficult

會發現難以適應、融入社會

to cope and to integrate into society.

在摩爾多瓦 機構裡長大的年輕的女性

In Moldova, young women raised in institutions

被販賣的機率是同儕的十倍

are 10 times more likely to be trafficked than their peers,

一份俄國的報告指出，青少年離開機構兩年後

and a Russian study found that two years after leaving institutions,

其中有百分之二十的人有犯罪紀錄

young adults, 20 percent of them had a criminal record,

百分之十四的人從事性交易

14 percent were involved in prostitution,

百分之十的人自殺了

and 10 percent had taken their own lives.

但是為什麼這幾年沒有很多戰爭或是天災

But why are there so many orphans in Europe

在歐洲仍有許多孤兒？

when there hasn't been a great deal of war or disaster in recent years?

事實上，其中超過百分之九十五的孩子 他們的父母還在世

In fact, more than 95 percent of these children have living parents,

通常社會上的輿論傾向責備這些家長

and societies tend to blame these parents

遺棄他們的孩子

for abandoning these children, but research shows that

但是研究報告顯示大部份的家長想要留住孩子

most parents want their children, and that the primary drivers

而造成機構收養的主因

behind institutionalization

來自於貧窮、身心障礙以及種族身份等問題

are poverty, disability and ethnicity.

許多國家並未發展全納教育的學校

Many countries have not developed inclusive schools,

因此即使孩子有非常輕微的身心障礙

and so even children with a very mild disability

都會在六到七歲的時候

are sent away to a residential special school,

被送到住宿型的特教學校

at age six or seven.

機構可能離家好幾百英里遠

The institution may be hundreds of miles away from the family home.

如果這戶人家很窮 他們會發現探訪孩子不容易

If the family's poor, they find it difficult to visit,

然後他們彼此間的關係就會逐漸變淡

and gradually the relationship breaks down.

上百萬名在機構裡居住的孩子背後

Behind each of the million children in institutions,

通常都會有一段故事

there is usually a story of parents who are desperate

關於他們的家長感到絕望、別無他法 像是住在摩爾多瓦的納塔莉亞

and feel they've run out of options, like Natalia in Moldova,

她所有的錢只夠餵飽孩子

who only had enough money to feed her baby,

所以她必須將長子送到機構裡

and so had to send her older son to the institution;

或是住在保加利亞的德西

or Desi, in Bulgaria, who looked after her four children

她的丈夫還在世前，她在家帶四個小孩

at home until her husband died,

但是在她的丈夫過世之後 她必須去做全職工作

but then she had to go out to work full time,

由於沒有任何支援，別無他法

and with no support, felt she had no option

她不得不送出一名身障的孩子到機構去

but to place a child with disabilities in an institution;

另外還有一些數不清的年輕女孩

or the countless young girls too terrified to tell their parents

由於太害怕要告訴父母她們懷孕了 因此把寶寶留在醫院裡

they're pregnant, who leave their babies in a hospital;

也有一些新手父母

or the new parents, the young couple who have

發現他們的第一個孩子身體有殘缺

just found out that their firstborn child has a disability,

醫生沒有選擇要提供關於孩子潛力的正向訊息

and instead of being provided with positive messages

反而告訴他們：

about their child's potential, are told by the doctors,

「忘了這個孩子吧，把她放在機構裡

"Forget her, leave her in the institution,

回家去生個健康的孩子。」

go home and make a healthy one."

這種事既不必要，但也無法避免

This state of affairs is neither necessary nor is it inevitable.

每一個孩子都有權利擁有、也需要一個家

Every child has the right to a family, deserves

而且孩子擁有驚人地恢復精神能力

and needs a family, and children are amazingly resilient.

我們發現如果讓孩子早點離開機構、回到家中

We find that if we get them out of institutions and into loving

他們會恢復發展遲緩的部份

families early on, they recover their developmental delays,

然後會逐漸恢復正常 過著快樂的生活

and go on to lead normal, happy lives.

另外，和機構相比

It's also much cheaper to provide support to families

家庭支援所需的補助費用也低許多

than it is to provide institutions.

一份研究報告指出

One study suggests that a family support service

提供給家庭支援的補助費用 只佔機構安置的百分之十

costs 10 percent of an institutional placement,

而較優良的寄養服務

whilst good quality foster care

通常只需百分之三十的費用

costs usually about 30 percent.

如果我們可以減少支出 並且為這些孩子提供更合乎需求的服務

If we spend less on these children but on the right services,

我們可以將這些省下來的費用改為

we can take the savings and reinvest them in high quality

幫助其他有複雜需求的孩子 提供他們有更高品質的安置照顧

residential care for those few children with extremely complex needs.

有一項運動正在歐洲形成 目標在改變焦點

Across Europe, a movement is growing to shift the focus

並將資源從提供低照顧品質的大型機構

and transfer the resources from large institutions

轉移到以社區為基礎的服務

that provide poor quality care to community-based services

能夠保護孩子避免受到傷害 並且讓他們得以發揮潛能

that protect children from harm and allow them to develop

當我二十年前剛開始在羅馬尼亞服務時

to their full potential. When I first started to work in Romania

當地有二十萬名孩童住在機構

nearly 20 years ago, there were 200,000 children living

而且逐日增加

in institutions, and more entering every day.

現在，人數已低於一萬名

Now, there are less than 10,000, and

而且家庭支援服務也遍及全國

family support services are provided across the country.

在摩爾多瓦，不論是極度貧窮

In Moldova, despite extreme poverty and the terrible effects

還是全球經濟危機所造成的嚴重影響

of the global financial crisis, the numbers of children

近五年裡 住在機構裡的孩子數量已減少百分之五十以上

in institutions has reduced by more than 50 percent

資源也重新分配給

in the last five years, and the resources are being

家庭支援服務與全納教育學校

redistributed to family support services and inclusive schools.

許多國家為了改變已制定國家行動計畫

Many countries have developed national action plans for change.

歐盟委員會以及其他主要的捐助人

The European Commission and other major donors

正在找尋能夠將經費從機構轉移至家庭支援的方法

are finding ways to divert money from institutions

授權給社區

towards family support, empowering communities

來照顧他們自己的孩子

to look after their own children.

但是要終止孩童在系統中被收養

But there is still much to be done to end the systematic

仍有很多需要做的事

institutionalization of children.

我們需要提升社會各個階層的體認

Awareness-raising is required at every level of society.

人們需要知道機構對孩子造成的傷害

People need to know the harm that institutions cause to children,

以及現存更好的替代方式

and the better alternatives that exist.

如果我們知道有人要支持孤兒院

If we know people who are planning to support orphanages,

我們應該說服他們改為支持家庭支援服務

we should convince them to support family services instead.

這是我們此生中

Together, this is the one form of child abuse

能夠為終止兒虐盡一份心力的方式之一

that we could eradicate in our lifetime.

謝謝（鼓掌）

Thank you. (Applause)

（鼓掌）

(Applause)