Imagine growing up as a child where the narrow corridors of paediatric wards become your playground. These are children who have been medically cleared but have not been discharged from the ward because they have nowhere to go. The doctors and nurses have not failed them. Instead, they are trapped in a system that is so fundamentally flawed that they are forced to live in hospitals.
These are children about whom we do not talk. Children living in hospital wards is not a new thing but yet the system seems unconcerned that wards are not designed to raise children and that children have rights.
T&T ratified the United Nations Convention on the Rights of the Child more than three decades ago, committing the state to protect the best interests of every child. The convention is clear, when children are deprived of family care, the responsibility does not fall on hospitals to raise them. It falls on the state to ensure that every child has access to care protection and a place to belong.
The convention clearly states:
1. A child temporarily or permanently deprived of his or her family environment, or in whose own best interests cannot be allowed to remain in that environment, shall be entitled to special protection and assistance provided by the State.
2. States Parties shall, in accordance with their national laws, ensure alternative care for such a child.
3. Such care could include, inter alia, foster placement, kafalah of Islamic law, adoption or, if necessary, placement in suitable institutions for the care of children. When considering solutions, due regard shall be paid to the desirability of continuity in a child’s upbringing and to the child’s ethnic, religious, cultural and linguistic background.
Hospitals are not recognised as alternative care arrangements under the convention and should not be regarded as ideal places for children to grow up, not on a long-term basis. Having children living in the wards is a direct breach of the convention. Every child should have access to play and learning. But here we have some children who are confined to the wards, with no access to space for play and exercise, and opportunities for formal education are nonexistent. The reality is a hospital ward, no matter how caring the staff, cannot provide a suitable environment for early childhood care and development. As long as they remain in the wards, these children will be denied the fullness of childhood.
A study done in 2019 by Dr Roy Maynard and team, noted that children with complex conditions wait an average of 52 days in the hospital after they are discharged. The study noted that, “Children who reside in the hospital, even after being medically cleared, miss out on all the aspects of regular life. These can include school, time with family and peers, and time outdoors, with all the associated developmental and psychological impacts.”
Now, what do you think is the effect on children who had to stay in the hospital for years? Especially those who do not have families and support systems.
It is obvious that having children living on the wards is an extra burden on healthcare workers. Nurses and doctors routinely step up, beyond their professional roles, to become caregivers. They cannot advocate for the children and call for the State to do better because they are restricted by hospital policies and contract obligations. Their humanity fills the gap left by the failure of policies and a broken system. In many cases, it is just as emotionally difficult for them as it is for the children when they form emotional ties and get attached, but are then transferred to other wards. The thing is that their kindness cannot substitute for proper care and they should not have to bear the weight of the State’s failure.
Having children living in hospitals is not a question of kindness or compassion. It is a question of obligation. A country which has ratified the UN Convention on the Rights of the Child has accepted responsibility for its most vulnerable children. The State cannot continue to ignore its failure. Allowing children to grow up in hospital wards should never be normalised. It is not an unfortunate reality; it has happened because the Ministry of Health/State has allowed it to. It shows our collective failure as a nation to translate rights into action.
It is unfortunate that we can spend millions on many irrelevant things but when it comes to our children, we cannot invest in them properly. We need to remember that childhood once lost cannot be recovered. These children do not belong to institutions. They need homes and communities that will nurture them and give them a sense of belonging. Anything less is a betrayal of our obligations and a clear demonstration of our lack of humanity.
