Collaborative on Global Children's Issues

An estimated 5.5 million children worldwide are in residential care facilities funded and managed by the Roman Catholic Church (RCC) and Church-affiliated organizations. These facilities are often referred to as “orphanages,” but studies show that the vast majority of the children in them have a living parent or other relative able to care for them, leading many child welfare and protection experts to abandon this term. Research also shows that residential care of children is harmful for children’s physical, cognitive, social, and emotional development; residential placement can put children at significant risk of physical and/or sexual violence. 

This blog provides a brief overview of the origins and history of the Church’s involvement in residential care, which was initially based on charitable intentions rooted in the Gospels, but which is now known to be at odds with the promotion of children’s rights, safety, and well-being. This is leading some prominent Catholic organizations to shift their efforts from residential care to promoting safe and nurturing family-based kinship care, foster care, adoption, or other family-based placement options.

References to the obligation to protect “widows and orphans” can be found as far back as (and even predate) the Code of Hammurabi, one of the earliest legal texts dated to 1755-1750 BCE. Indeed, rulers of ancient Mesopotamia often made a point of exemplifying their virtue by highlighting the measures they took to care for widows and orphans, such as setting aside food stores or establishing harsh punishments for those that did them harm. Women and children in the ancient Near East were especially vulnerable after the loss of a husband or father, as this had profound implications for their livelihoods, access to land, inheritance, and protection. It is thus not surprising that we see numerous references to the protection of “orphans and widows” throughout the Christian scriptures, especially in Deuteronomy, and later reflected in the New Testament “Religion that is pure and undefiled before God and the Father is this: to care for orphans and widows in their affliction and to keep oneself unstained by the world” (James 1:27). Care for children who have lost just their mother is not similarly addressed in scripture, perhaps because the surviving father was much less economically and socially vulnerable.

Prior to and during the early Christian period (and in fact to this day), children who lost parental care were almost universally taken in by relatives, whether through a surviving parent or through the extended family. If no relatives were available, forms of adult guardianship were practiced through antiquity. Early Christian Church leaders did embrace the obligation to care for the most vulnerable—the third century Didascalia Apostolorum outlined numerous provisions of the responsibilities of the bishops towards widows and orphans, who were interestingly also considered Church officials. The Didascalia Apostolorum further outlined provisions for the adoption of children who had lost their parents.

The first known historical examples of residential care of children are the Orphanotropheion of Zoticus and the Orphanotropheion of Saint Paul, established in Byzantium during the fourth and fifth centuries for children who could not secure care, which functioned through the fourteenth century. In 787 CE, the Milan Foundling Hospital was established to take in babies born out of wedlock, the first such institution in Italy. In 1198, Pope Innocent III established the concept of the “foundling wheel” after witnessing the bodies of dead infants floating in the Tiber River. This was a cylinder placed in the wall of a Church building, whereby a mother would place the infant from outside, turn the wheel so the infant faced inside, and ring a bell to alert those inside, usually nuns. The hospital Santo Spirito de Sassia in Rome (the oldest operating hospital in Europe) began to take in infants at this time using the foundling wheel for admissions. Modern version of this practice still exists in many countries, sometimes called the “baby hatch” or “baby box.

This residential model spread rapidly throughout Italy through the fifteenth century, in France through the seventeenth century, and in Germany and Austria during the eighteenth century, in part driven by high levels of adult mortality from disease and conflict. By the nineteenth century, missionaries were responsible for the further spread of the model across the globe, with particularly severe consequences for Indigenous children. The RCC opened 87 Native boarding schools in the United States and another 66 in Canada, leaving a terrible legacy of devastated lives and communities for which Pope Francis apologized in July 2022. According to analysis by the Global Sisters Report, burial sites have been found at 53 of them, and some 500 children died in just 19 of the schools. Other countries like Australia are grappling with similar harsh legacies.

While kinship care was widely available prior to the spread of residential care models globally, some children did face significant family placement challenges such as severe stigma due to disability or being born out of wedlock. Infant euthanasia has historically been practiced in parts of the world–indeed, Uganda was recently singled out by the European Parliament, which condemned the modern-day practice of “mercy killings” for children with disabilities. That said, organizations like Human Rights Watch and Disability Rights International have called on the global community to address these stigmas and to promote the full inclusion of children in family and society, while simultaneously working to end residential placement and separation of children at risk.

By the eighteenth century it was already becoming evident that the goal of saving children’s lives through residential placement was far from being realized. In the eighteenth century, “foundling homes” across Europe had an infant mortality rate ranging from 55% to 95%. In the nineteenth century, evidence continued to amass on the harm of residential care on children, as most of the children in them perished or didn’t thrive even if feeding practices in them were improved. The Foundling Asylum of the Sisters of Charity was established in New York in 1869 to address high levels of infanticide but itself had a mortality rate of well over 50% for children in its care. Concerns were also being raised by the terrible conditions children were facing in almshouses and foundlings’ homes, epitomized by the works of Charles Dickens and other authors. The Irish Church recently apologized after a judicial investigation revealed significant levels of abuse and high mortality rates among children who were in homes run by a number of orders decades ago.

With the increasing recognition that children are more likely to thrive in a family environment, Methodist minister Charles Loring Brace established the Children’s Aid Society in 1854 and launched the controversial Orphan Train Movement to place children in families in the American West rather than residential care. The RCC opposed the Orphan Train Movement because disproportionate numbers of children in almshouses and foundling homes were Roman Catholic (as well as Jewish). Fearing that the children would be placed in Protestant homes and converted, the Sisters of Charity set up their own Mercy Train program to place many children from its large New York Foundling Hospital with families. Unlike the orphan trains, where children were simply paraded before onlookers interested in taking a child home, the Mercy Trains carried children that were pre-matched with families by the parish priest. While some of these placements were harmful given the lack of a proper assessment and placement process, the Sisters of Charity would increasingly adopt more sophisticated measures over time to improve placement success.

In 1909, U.S. President Theodore Roosevelt assembled some 200 experts at the Conference for the Care of Dependent Children, which focused on how the country could end reliance on residential care for children and promote family-based care alternatives. The St. Vincent de Paul Society helped to organize and lead the conference, which ended up producing 13 recommendations that served as the basis for the modern family-based child welfare system in the United States. As an initial step, large residential care settings were to be transformed into the “cottage system” with no more than 30 children per cottage, and with foster care and adoption to be promoted as the preferred measures for children. Many European countries were making similar transitions to formalize foster care and adoption and to reduce reliance on institutions, such as the United Kingdom’s passage of the Adoption of Children Act in 1926. Catholic organizations on both continents (such as Catholic Charities and Caritas) progressively shifted from the foundling homes model to support for social services that keep children in family care. While many serious problems are embedded in foster care systems, it is widely recognized by those organizations that residential care is not the solution to those problems. 

It is heartening to see the many examples of RCC-supported residential facilities that have transitioned to family-based care and community support mechanisms. For example, U.S. President Abraham Lincoln signed an Act of Congress in 1863 to establish St. Ann’s Infant Asylum in Washington, DC, run by the Daughters of Charity. In the intervening years, St. Ann’s progressively adapted its model, starting with programs to support single mothers (many widowed by the Civil War) and creating public-private partnerships that eventually became the basis for the United Way of the National Capital Area. Over time, the sisters transitioned away from the residential care model to a holistic spectrum of support for mothers and children that includes child care, parenting programs, medical care, counseling, transitional housing, and other programs. The program has been renamed to St. Ann’s Center for Children, Youth and Families, with CEO Sister Mary Bader, D.C., noting that the goal is to “help women heal and then strengthen families to move on to be independent and equipped.”

Still, even as the RCC has played an important role in the shift to family-based child welfare in the United States and Europe, it has continued to promote and support the residential model in low-income countries.  Recognizing this, the International Union of Superiors General launched the Catholic Care for Children Initiative with the mission of assisting “religious institutes with a charism of care to read the signs of the times.” They hope to provide the best care possible for children and vulnerable persons by reducing recourse to institutional care and encouraging family and community-based care for children. They are actively networking and supporting Roman Catholic women’s religious orders around the world to place children out of residential care and into families, as well as to refocus their resources on strengthening families and preventing separation. Similarly, Catholic Relief Services is a founding partner of the Changing the Way We Care initiative, which supports national, regional, and global efforts to ensure every child secures their right to a safe and nurturing family. 

These two initiatives are working to ensure every child receives the best possible evidence-based care in the families and communities in which they live. They seek to strengthen families and to prevent child separation, to place separated children in families, and to assist with the transition of residential homes to other community assets like day care centers (which can be run at a fraction of the cost). How can the RCC help realize a commitment it embraced in the Gospels over two millennia ago to protect children losing parental care? In 2022, Pope Francis said that every child without a family is “a cry that rises up to God and shames the system that we adults have built.” Catholics Care for Children International and Changing the Way We Care are working to change that system. What a remarkable commitment to James 1:27 it would be to bring both of those initiatives to scale and to find a suitable home for the millions of children in RCC-supported residential care settings.

Philip Goldman is the President of Maestral International, a team of global experts supporting the strengthening of child protection systems that meet the needs of children in adversity. Maestral has worked in some 100 countries since 2008 in close collaboration with UNICEF, USAID, the World Bank, NGOs, and faith-based organizations.