To the Government of Israel: Listen to The Lancet

I snapped this today

I passed this scene in a park near my home - people with disabilities enjoying themselves outdoors despite Covid-19 and thanks to kind volunteers.

And not locked up in institutions!

Israel's institutions for people with disabilities concede that this pandemic has them in a tight spot. Their resources - financial and human - are seriously depleted. Nonetheless they still insist that institutions are ideal for their residents.

Aleh, for instance, Israel's leading chain of such institutions, is relying on Covid-19 to solicit extra (!) handouts from government and private donors [LINK].

Those of us who oppose institutionalization are baffled.

Obviously the ease with which Covid-19 spreads in large, closed facilities should stress the urgent need to de-institutionalize. We'd expect this pandemic to propel our government to finally promote alternative living options for our most vulnerable population.

So it was with huge sense of vindication that I read recentlly published articles by experts advocating the immediate transfer of citizens with disabilities to families. They view this pandemic as the perfect juncture for that move and note the success of past de institutionalization in North America and Western Europe. Their unequivocal conclusions appear in none other than The Lancet.

a weekly peer-reviewed general medical journal. It is among the world's oldest and best-known general medical journals. The journal was founded in 1823 by Thomas Wakley, an English surgeon who named it after the surgical instrument called a lancet (scalpel), as well as after the architectural term lancet window, a window with a sharp pointed arch, to indicate the "light of wisdom" or "to let in light". The journal publishes original research articles, review articles ("seminars" and "reviews"), editorials, book reviews, correspondence, as well as news features and case reports. [Wikipedia] 

Some excerpts [Source: "Institutionalisation and deinstitutionalisation of children 2: policy and practice recommendations for global, national, and local actors", Lancet Group Commission, June 23, 2020]

Worldwide, millions of children live in institutions, which runs counter to both the UN-recognised right of children to be raised in a family environment, and the findings of our accompanying systematic review of the physical, neurobiological, psychological, and mental health costs of institutionalisation and the benefits of deinstitutionalisation of child welfare systems...We define an institution as a publicly or privately managed and staffed collective living arrangement for children that is not family based, such as an orphanage, children’s institution, or infant home...
A December 2019 UN General Assembly Resolution on the Promotion and Protection of the Rights of Children recognises that a child should grow up in a family environment to have a full and harmonious development of her or his personality and potential; urges member states to take actions to progressively replace institutionalisation with quality alternative care and redirect resources to family and community-based services; and calls for “every effort, where the immediate family is unable to care for a child with disabilities, to provide quality alternative care within the wider family, and, failing that, within the community in a family setting, bearing in mind the best interests of the child.

Same place, same time - my photo

And these bullet point recommendations appearing in the same source, quoted from key recommendations for the December 2019 UN General Assembly Resolution on the Rights of the Child:

• Recognise and prioritise the role of families
• States [emphasis added] are responsible for promoting parental care, preventing unnecessary child separation, and facilitating reintegration where appropriate
• Families have a crucial role in physical, social, and emotional development, health, and intergenerational poverty reduction
• Services delivered to children are most effective when they consider the vital role of family
• Formal alternative care should be temporary
• Care options should prioritise kinship care, foster care, adoption, kafalah, and cross-border reunification...
• States are encouraged to work to change norms, beliefs, and attitudes that drive separation [emphasis added]
• States should recognise that reintegration is a process requiring preparation, support, and follow-up
• Recognise the harm of institutional care for children and prevent institutionalisation
• States should phase out institutions and replace them with family and community-based services
• States should address how volunteering and donations can lead to unnecessary family–child separation
• States should recognise that funding for institutions can exacerbate unnecessary family–child separation and institutionalisation

And these bullet point insights from another The Lancet article published the same day, last month [here]:

• Millions of children worldwide are housed in institutions, although the number appears to have decreased in recent years
• Many countries are increasingly supporting alternative, family-based approaches to care—eg, kinship networks, foster care, adoption, or kafalah
• Residency in an institution is associated with substantial developmental delays and other risks to children
• Longer stays in institutions are associated with larger developmental delays and atypical development in a dose–response manner
• Delays are most prominent in physical growth, brain growth, cognition, and attention; atypical attachments are also seen
• Children show rapid recovery in the years immediately after deinstitutionalisation, particularly in physical and brain growth, although substantial impairment can persist for the most seriously affected children over the longer term

Israeli Knesset members, "states" includes you! 

How many different ways does the message need to be stated before it gets through? Remember, the State of Israel provides its largest chain of institutions, Aleh, with over 80% of its budget.

Lawmakers, listen to The Lancet!