In 2019, during World Adoption Month, social media was flooded with a beautiful image of a tiny little girl, dressed in a pink party dress, with her face and hands pressed up against the window, a picture of longing, hope and apprehension as she waited for her new adoptive parents to arrive. The photo, which was shared by the Door of Hope Children’s Mission, without any identifying content to protect the child’s identity, was particularly poignant because it captured the nuance of adoption.

Adoptive children have all experienced rejection and the loss of their first families. But in South Africa, although there are some adoptable orphans, and others have been consented for adoption by their birth mother, many (probably most) of the children available for adoption have survived abandonment (often coupled with late-term abortions). And, because the system is so broken and difficult to navigate, many have spent too long in care prior to placement.

Most adoptable children (particularly those that were abandoned), have no known family and no way of returning to them or ever finding them. Most will never be able to complete a medical history or know where they got their sense of humour, or sporting ability. Many (especially those abandoned unsafely), will carry around a profound sense of being unsafe, and no matter how high functioning they are, most have experienced a trauma that’s so profound, it has permeated the very cells of their body.

Anti-adoption advocates correctly point out that adoption does not “fix” trauma. But, it’s equally false to believe that removing the option of adoption will take away these children’s pain. Regardless of where they are raised, they will take it with them. Institutions may even compound the hurt, and they seldom have the counselling services needed for processing it. For children like this little girl, adoption provides their only hope of growing up in a family, and of finding a safe space to work through the early loss.

Yet the government continues to make policies that will result in more children growing up in institutional care. It’s therefore essential for them to hear the voices of children who have lived in children’s homes, stories that are seldom heard.

It’s something Sarah Kgoitsimang knows intimately. Sarah spent her childhood in a children’s home; well, at least the part that she can remember. She has never heard her full story, despite pleading for more details from the home’s social worker, who was resolute that Sarah wasn’t permitted to know. The version she was told most often as a child was that she spent the first two years of her life in the hospital where she was abandoned after her mother died during childbirth.

No one has explained why authorities failed to find her extended family, or why she was in the hospital for so long. Growing up, she heard rumours that her name (her one connection to her birth mother), had been given to her by the hospital, not her mother. Management at the home refuted the story. But if true, it may explain why her family was never located. Even as an adult, she’s still unable to trace her birth story.

What she does know is that she was one of about seven founding children in the institution where she spent 18 years of her life, the only founding child who remained in the home. The others were all adopted, or died. At the time, it wasn’t something that concerned her, there were always new children in the home and plenty of “siblings” to play with. But when she was about 12, she was looking at old photos, and it suddenly struck her that she was the only child who hadn’t been placed in a family.

When she questioned the staff, they told her that, “adoptive parents are looking for something specific in a child”. The unspoken implication was that she somehow wasn’t what they wanted. Even as a child she remembers thinking, “what could possibly be wrong with me, surely I could also have been what they needed?”

The pain of not being adopted was somewhat mitigated in her early years by her first house mother. Sarah describes her as devoted, gentle and insightful, able to see each child and find time to listen to them, and help them with their struggles and through the daily challenges of life. She was especially committed to the children’s education, spending hours on each one’s homework. While she was present, Sarah felt loved and cherished.

Then, one late winter morning when Sarah was in grade 2, she came home from school to find that her house mother was gone. She didn’t say goodbye. The children later discovered that ill-health had forced her to resign, and that she had left so suddenly because she couldn’t face the painful separation. But for Sarah, it was like a physical blow. The children, who received no counselling through the transition, struggled to trust and bond with their new house mother. She, in turn, was cruel and emotionally distant, punishing them and withholding food. None of her successors was able to provide Sarah with the mothering she so desperately wanted. Instead, the children who shared the home with her became her “sisters” and her only family.

Sarah is quick to acknowledge that the home was amazing at meeting the children’s physical needs. Generous sponsors meant that the children had a comfortable home, plenty of food to eat and went to the best private school in the area. Every Christmas was a riot of colour, treats and presents under the tree. But despite these benefits, Sarah felt that the home, which grew very quickly, was less equipped to meet the children’s emotional needs and help them through the complex emotions of loss and rejection that characterised their lives in care. Perhaps as a result, she was one of the few among her siblings who earned a matric certificate and went on to study further.

Yet she never questioned that it was her home. So, nothing prepared her for the moment when, at 20, she, and the other children over 18 received a letter saying that they were too old to stay in the house. They were given three months to leave. Again, there was no counselling, and they were warned that if they did not leave, there may be consequences. Everything changed in that instant. Although Sarah already had a job, she had still felt sheltered. Holding her “eviction” letter in her hands, she suddenly became an adult.

Thandiwe Garrett only spent one Christmas in institutional care. But 24 years later, she is still scarred by her experience. Like Sarah, she was abandoned in a hospital. However, she was removed a few weeks later and put in an impoverished Place of Safety. Despite being so young, she has vivid memories of the place: “There were a lot of babies and children, so many children that I wasn’t able to get unconditional love. I was just one of the many little children, the one in the little red cot. My mommy [her adoptive mom] brought toys for the children, but when she returned, many of the items had vanished. Children were placed outside on cement in the sun. Dogs roamed around, and until I was about five years old, I was terrified of dogs, and men with facial hair. I would become hysterical if they came near me.”

Thandi’s life changed when Ann, a teacher, who had never planned to adopt, fell in love with her when she visited the home. But despite Thandi being abandoned and therefore adoptable, Ann had to fight hard for her. The home was receiving a foster grant for her and did not want her placed for adoption. They told Ann that she could have any child, except Thandi. Eventually, however, through the efforts of a social worker and Ann’s persistence, Thandi left the Place of Safety when she was eight months old. She was formally adopted two months later.

Describing the day she went home, Thandi discloses: “When my mommy came to pick me up, I was covered in lice and stank of urine. She had to wrap me in a jacket so that she could bear to hold me because the smell was that bad. I still can’t sleep without sound at night because for those eight months, I had babies constantly crying or screaming. I wasn’t used to silence. When I came home I was emotionally damaged. I didn’t cry, I just lay in my crib because crying would get me nowhere.”

Significantly, unlike Sarah, Ann was able to help Thandi through the loss of her first family, giving her ownership of her story from a young age.

Thandi, who is a fierce advocate of adoption, says about her mother: “I am so grateful to her every single day because without her I don’t know where I would be. I love my mom so much. When she brought me home, she told me that she will love me always and I believe that I carry her always in my heart. She has given me every single opportunity I could ever have dreamed of, a home to call my own, amazing friends and family. It makes me so upset to think that some little bundle of joy might not have that because adoption may not be the easiest option.”

Incredibly, Sarah’s eviction from the children’s home has also resulted in her joining a family who have taken her in, supporting her as she studies further, and caring for her physical and emotional needs. Sarah says the family has given her an opportunity to be a child again, and to pause and get counselling to work through some of the complex emotional issues from her childhood. They have even opened their home to her “siblings”, many of whom have had significant struggles since they left the home. This new phase of her life has also been the catalyst for her starting a support group where other children or adults who grew up without first families or in institutional care can tell their stories.

Regardless of the positive developments in their lives, Sarah and Thandi’s stories should give us pause. Sarah’s experiences provide insight into some of the greatest concerns expressed by even the best children’s homes with the most nurturing staff. They are that “professional mothering” and a legal age when children have to “age out of care” mean they can never provide a child with a permanent family. In addition, because underage children’s files are closed, they are not able to own their stories during childhood (an option for adopted children whose parents have access to their files). Nor, if Sarah’s story is anything to go by, can such institutions provide adequate psychological support for all the children in their care.

Thandi’s story is equally concerning. With its limited funding, rudimentary infrastructure and too many children for the caregivers available, her Place of Safety is probably the norm in many parts of South Africa. What’s crucial is that although Thandi only spent eight months in care, she is still affected by the experience as an adult. As adoption gets harder, and even children who are placed in families at relatively young ages are spending longer in care (for many, their full first 1,000 days or more), we need to assess how significant the impact of their time spent in institutions will be, especially when compounded with the primary trauma of abandonment or the loss of their first families.

It brings us full circle to the little girl from Door of Hope pictured on her adoption day. Perhaps one day she, like Thandi and Sarah, will share her story. But for now, all we know about her is that she was already quite old to be adopted, had spent at least one Christmas in care and that this one will be her first with her new adoptive family. We also know that she left behind many other children for whom adoption is becoming increasingly unlikely.

Organisations like Door of Hope provide us with important insight about the children in SA’s child protection system. It has had 1,688 children through its doors in the last 20 years. Almost all have been abandoned, many unsafely, in rubbish dumps, pit latrines, open fields, drains and even shallow graves. Many of these children were also victims of third-trimester abortions.

The reasons for abandonment are myriad: women abandoned by the father of their child or family, those who cannot place their children in child protection because they are under 18 or foreigners, mothers who are unable to bond with babies conceived through rape or incest or, shockingly, mothers who are “too poor to parent” and have to choose between abandonment and watching older children starve.

The majority of children abandoned unsafely die prior to being placed in care, but even the survivors sometimes succumb to injuries and trauma. Despite heroic efforts to save every life, the organisation’s on-site memorial garden commemorates the lives of 38 babies who died in their care.

However, while safe abandonment remains illegal in South Africa, Door of Hope welcomed its 225th baby through its baby box this month. It is proof that baby savers and safe abandonment save lives. But that’s only the beginning. One of the burning questions that organisations like Door of Hope must ask is: What will happen to the children whose lives they save?

Tsepho* was already a pre-schooler when he was put in the Door of Hope baby box. As an older child, he may never be adopted locally, and this Christmas will be his second in care. On the video footage of his abandonment, his mother can be heard talking to her terrified child as he waited the short moments until his rescuers arrived. She risked discovery to stay with him, only saying goodbye when he was found.

Staff were concerned that this bright and sweet-natured boy settled too quickly, that he became overly friendly too soon. But then one of the other children in the nursery was adopted. He instantly regressed, devastated by the sight of the album that each child receives before they meet their new mommy and daddy. He began asking, “when is my mommy and daddy coming?” It happens every time a child is adopted.

Kgotso* was nine months old when he was found abandoned on a suitcase, so malnourished and dehydrated that the top of his head was completely sunken in. A battery of tests showed that he was a paraplegic with hydrocephalus and spina bifida. The tests also showed that he had received medical care. It seemed that someone loved him enough to try to help him, but then gave up in the face of his extensive medical problems. After only three months in care, he is a different child who smiles all the time.

The home knows that he probably also won’t be adopted locally. Now, challenges to inter-country adoptions especially in the US (known for the adoption of special needs children), could mean that he will end up spending his life in care.

As abandoned children, both Tsepho and Kgotso should be adoptable. But the organisation is quick to concede that even when children are young, with no special needs, there are many hindrances to adoption. They include too few adoptive parents and unco-operative government departments. During 2019, the adoption agency that handles Door of Hope’s adoptions, in conjunction with Lawyers for Human Rights, took the Department of Home Affairs to court to force it to expedite the process of issuing birth certificates for 33 abandoned children (it was only handling two cases per month). The Department of Social Development (DSD) is also notoriously slow to convene the panel sessions necessary to approve adoptions.

Low adoption rates and huge turnaround times have resulted in pressure on institutions across the country. Head of Operations at Door of Hope, Nadene Grabham, says that the organisation gets constant calls from the DSD, even from outside of Gauteng, asking if they can place babies and even older children in their care. When she asks why they would be placing children outside their provinces, their answer is always the same: “everywhere is full”.

Not only are baby homes overfull, but low adoption rates and slow adoption processes are resulting in children getting older and older in care. Even though many Door of Hope children are still being adopted, there is a limit to the number of children they can accommodate in their baby homes, and they have a strict cut-off age. It’s why the organisation has been compelled to start a Children’s Village to house those children who have aged out of its baby homes without adoptive families. It’s a pattern being repeated across the country, as children, many of whom are tormented by the thought that they haven’t been adopted because there is something wrong with them, get too old to legally stay in baby homes. This can only worsen if the government’s plan to make adoption predominantly for orphans being adopted by relatives is approved.

This Christmas, many organisations will receive thousands of gifts from caring strangers across the country. But faced with the increasing need, what they require is ongoing assistance, to pay for nappies and formula, provide food and groceries, and pay municipal accounts and salaries for caregivers.

And our intervention in the lives of children made vulnerable through poverty, gender-based violence and lack of family support cannot end with donations either. If the government cares about these children, and how its policies will affect and change their lives, it needs to allow them to own their stories and to plan for permanency and family care long after their childhood has officially ended. The future of children like Sarah, Thandi, Tshepo and Kgotso is at stake. After years of policymakers ignoring scientific evidence that institutional care (especially in their first 1,000 days) is not the first prize for children, we ignore their stories too, at our peril. DM

* Not their real names.