Countries in eastern Europe are facing a social crisis after 10 years of the transition to capitalism. But UK social services and international charities are working with governments to help build social services. Frances Rickford reports.
"Countries in transition" is the fashionable definition of the 27 countries in central and eastern Europe, which were formerly part of the Soviet Union or Warsaw Pact. There are big differences between them but, after 10 years of political and economic upheaval, all are now facing a major social crisis.
If the people of eastern Europe expected capitalism to deliver prosperity they will have been bitterly disappointed so far. Although economically there are signs that some countries in the region have turned the corner, many of the problems besetting them at the end of the 1980s have become far worse. To take Russia - admittedly one of the worst - as an example:
- By 2000 gross domestic product was at 61 per cent of its 1989 level.
- The annual mortality rate among young men shot up by more than 70 per cent over the decade to nearly one in 200, and male life expectancy at birth had fallen by 5.5 years to just under 60.
- The institutionalisation of children has worsened. The proportion of babies and young children in institutions over the same period increased by 85 per cent to more than 380 under-three-year-olds per 100,000 in the population.1
There have been some positive developments, such as a slight fall in infant and maternal mortality rates, but teenage deaths from all causes have risen sharply and school enrolments have fallen. It is in this social situation that social workers from the UK are being asked in growing numbers to share their skills and expertise to help build a framework for social care in the region. Big funders, such as the World Bank, are investing in social care and want UK know-how to get it off the ground. The UKgovernment's own Department for International Development is also ploughing money into social welfare.
Brian Munday is senior lecturer at the European institute of social services at the University of Kent and has written a book about social care in eastern and central Europe.
He says that UK social workers and managers are seen as skilled not only in planning and delivering front-line services, but also, crucially, in understanding the role of the voluntary sector or non-governmental organisations (NGOs). Funding bodies are keen to support fledgling NGOs in the region where they were almost non-existent until a few years ago.
But worries about crime and fraud have provoked caution among most funders who often insist the money is held by a western organisation partner rather than paid to a local body directly.
Munday identifies de-institutionalisation as one of the main objectives of the funded programmes. Children have been the main focus, while the plight of older people is receiving little attention. But there are attempts to promote community-based alternatives to large institutions for people with mental health problems. One British-based NGO, the Hamlet Trust, works exclusively in central and eastern Europe helping users and staff build grassroots organisations and projects to improve the quality of life of people with mental illness.
Munday says: "There is little between the family and institutional care, for any group. With rising unemployment and poverty families often simply can't afford to look after their children and elderly relatives, so economics plays a huge part."
Munday is concerned about too great a reliance on NGOs, and too great an expectation of what they can achieve. He says: "The building of civil society through NGOs is very important, but we know from our own history that the state is extremely important in the provision of social care. If you rely too much on NGOs, provision is very patchy and tends also to be underfunded."
The World Bank has recognised this in its programme for Albania where it is trying to build a state-run social care system from scratch. Munday's European institute was asked by the World Bank to find a senior manager to be based in the country full time for two years to work alongside the minister and senior officials setting up new services.
They were unable to oblige, but staff from the institute, together with practitioners from Kent and Suffolk social services departments, are currently training mental health workers in Estonia and helping develop an accreditation system for Romanian NGOs working in child protection.
Munday says: "UK social services have a good reputation in other European Union countries as well as in eastern Europe and British expertise is very much in demand."
1 Unicef Innocenti Research Centre, A Decade of Transition: Regional Monitoring Report 8, Unicef is available from www.unicef-icdc.org/publications/pdf/monee8/eng/index.html
'Steep learning curve'
Hugh Salmon works for Everychild, formerly the European Children's Trust, as technical adviser in Moldova and Georgia.
"The idea of doing social work overseas originated from my time in a Jordanian children's home as a volunteer before university. Enjoying working with children in a residential setting prompted me to look into social work careers once I was at university.
"It was the stimulation of working with other cultures that made me want to transfer to an overseas setting, having first qualified and gained experience as a social worker in the UK."
Salmon worked for the Caldecott Community; at a post-adoption centre in London; with unaccompanied asylum seekers in a London borough; and at NCH, recruiting, training and assessing adoptive parents for children with special needs and years in care already behind them. But his interest in working overseas persisted.
"I had already learned that the region where my skills would be most likely to be of some use was eastern Europe and the former Soviet Union, owing to the pressing needs of children in institutions, combined with the existence of at least a skeleton of a welfare state but without the precedent of state intervention to protect children and support families.
"Just as I was considering whether to go abroad with VSO my manager at NCH handed me a letter from the European Children's Trust, which was looking for people prepared to work as technical advisers in eastern Europe under what was then called its social exchange programme.
"ECT was an organisation into which many social work colleagues from the UK had already put a lot of work over the 10 years since it started out as the Romanian Orphanages Trust. Its programmes had evolved from trying to rescue failing residential institutions to helping state structures develop networks of community-based services.
"I experienced a steep learning curve during my first year in Moldova, and have stayed with the trust because it has given me the chance to contribute to rapidly developing, innovative programmes in two countries where most of our success is owed to the enthusiasm and determination of local staff and partners."
The two main programmes have been family support and fostering. The family support programme in Moldova, which has the higher rate of children in institutions, aims to prevent children being abandoned in the first place and to rehabilitate those in institutions into their families through intensive, time limited support. In Georgia the foster care programme is based in three areas, including the capital Tblisi and the rural region of Telavi. "Although we've used TV and radio advertisements most foster carers hear about it by word of mouth. In one village in Telavi there are four or five foster carers while in Tblisi recruitment has been very difficult."
Both Moldova and Georgia have asked Salmon to continue for another year - satisfying for him not only because many projects are reaching an exciting stage, but also because both countries need to become much less reliant on overseas consultants and managers. EveryChild has a native country director in both Georgia and Moldova, and local staff have become skilled in training new social workers - in Georgia members of the existing three teams in the east of the country will provide the initial training to two new teams in the west.
"But we still need new technical expertise from other countries. We have just recruited two physiotherapists, one Dutch, one British, to help develop community alternatives for disabled children who are currently destined to a life in institutions."
'Not there to colonise'
When Richard Servian came into social work in the mid-1970s, he was working with disabled children, most of whom were living in large hospitals and other institutions and were widely considered impossible to look after in the community. Now service manager for disabled children at Dudley social services in the west Midlands, for the past year he has been helping to develop foster care and other community-based services for children in Moscow. Servian made his second trip to Moscow for a week in February together with three management colleagues from the social services department, a member of the Social Services Inspectorate and a foster carer. But on his previous trip he was the only social worker with a party of three foster carers.
Dudley is working in partnership with an international charity, Christian Solidarity, and Moscow's own regional government in a project called Our Family. The project is the brainchild of one Russian woman, Maria Ternovskaya, who was determined to develop a fostering service in the city. The partnership is a two-way street, and Moscovite social workers and carers have visited Dudley and are set to do so again in June. Servian says:"We're not going there to colonise, but to share experiences and skills. It's about developing fostering in Moscow and Dudley."
The partnership is funded by the UK government's Department for International Development, and part of the deal is that Dudley Council releases staff to make the trips in their work time. International aid agencies are currently pouring money into social welfare projects in central and eastern Europe, and UK social services are perceived as having the expertise that can help build what is needed. But can hard-pressed departments justify releasing staff to work overseas? Servian argues that there are clear benefits for Dudley as well as Moscow in the arrangement.
"Social workers have got a really bad deal in terms of their public image. It really boosts your confidence that you have got something to offer.
"When I first started working, disabled children were in big institutions so it reminds you that it really hasn't been a waste of time in the UK."
The enthusiasm and energy of the local government officials have also impressed him, and new legislation has allowed the framework to be created to prevent children coming into care, and to help them return to their own families. Servian says: "Until recently local authorities couldn't do preventive work. Now they can but they don't really have the resources. I visited the child protection office in the local town hall. They seemed to have three people trying to do the job of perhaps 100 in Dudley.
"Things there are not much different from how it was in this country 30 years ago. But there are more people there wanting things to change than in the UK. It helps you understand why you exist as a social work professional - it's a different perspective from performance indicators. And it helps you understand different cultures, and different ways of developing services. We will have more rounded and confident staff, managers and foster carers as a result of this project."