Amid continuing international outcry over conditions in China's orphanages, sparked by a Human Rights Watch report which alleged that unwanted children are left to die as a matter of policy, UNICEF has announced a training package for orphanage staff, and other agencies may be set to follow suit.
But it is not yet clear how much help will be accepted by Chinese authorities still smarting from a report that one independent welfare organisation has criticised as sensationalist and overstated.
The Human Rights Watch (Asia) report, Death by Default: A Policy of Fatal Neglect in China's State Orphanages, published in January, claimed that children in Child Welfare Institutes are routinely left to die from medical neglect and starvation, with the tacit approval of senior political leaders. Two days after the report's publication an extended version of the British television documentary The Dying Rooms, first shown last June in Britain and Sweden, was re-screened in the UK.
Posing as international charity workers the programme's makers had toured Chinese orphanages and secretly filmed scenes of extreme neglect. The macabre odyssey culminated in footage of a girl baby left alone in a room set aside, it was said, for dying.
The expanded version of the film included footage of the Shanghai Children's Welfare Institute, which featured prominently in the Human Rights Watch report.
Whilst Beijing reacted furiously to the report, taking the unusual step of inviting foreign reporters to inspect the Shanghai orphanage, petitions began to circulate in Sweden and the UK protesting at Chinese government neglect.
But welfare organisations with experience of working in Chinese orphanages did not endorse the Human Rights Watch findings.
The independent, Nanjing-based Amity Foundation issued a strong rebuttal, criticising the report for making "sweeping judgements" and "employing highly charged rhetoric but failing to substantiate many claims." The Foundation has organised support and rehabilitation programs in the Nanking Child Welfare Institute, and voluntary care schemes in orphanages in Yangzhou, Wuxi, Changzhou and Shanghai.
Its statement went on to argue that the Human Rights Watch document "distorts the reality that one of the basic problems with China's welfare work is insufficient funding from the government." It also called for more accountable and participatory management of the orphanages, now run by local civil affairs Bureaus.
Save the Children Fund (UK), which has a project in an Anhui orphanage to promote local adoption and a deinstitutionalised approach to childcare, declined to comment on the allegations of that children are deliberately left to die, but a spokesperson noted that "the very poor conditions and high mortality rates in Chinese orphanages have long been well known and documented, and we feel the debate should now move on to talk about realistic solutions. In our experience, the problems have more to do with resourcing and ignorance of children's physical and emotional needs than with deliberate neglect."
All agencies agree, however, that care of orphans is accorded a very low political and resourcing priority in China compared to that given to, for example, basic education.
Cash strapped orphanages now have to pay medical and school fees for their charges. Staff are poorly paid, poorly motivated and basically untrained. It is training that UNICEF means to address in two projects recently negotiated with the Ministry of Civil Affairs, which is responsible for the orphanages.
The first aims to identify those orphanages most at risk, "set up training for staff, improve rehabilitation service and establish appropriate management procedures." It is intended to select one institute in each province to serve as a model and training resource centre.
A second project will "concentrate on in-service training through China's existing national training and rehabilitation centres, which will develop training curricula and management procedures and train trainers to supervise staff throughout their own provinces."
However, the projected budget of $S850,000 for 1986/87 is insufficient to support a comprehensive program in China's orphanages, of which there are more than 700.
The budget is understood to have been found from funds already allocated to China, since the government is unwilling to accept any new money raised on the back of recent adverse publicity.
The company which made The Dying Rooms, Lauderdale Productions, set up a Dying Rooms Trust to raise funds for Chinese children, but the government is reportedly outraged at the prospect of being offered money from such a source.
Yet there are also contrary signs that local authorities are keen to accept help from outside. In one province, visitors from a nascent Swedish ngo were, two weeks after the Human Rights Watch furore, given frank, conducted tours of three orphanages, including one where they encountered very dismal conditions.
This is in striking contrast to last year when, after the first screening of The Dying Rooms, several Hong Kong based welfare and rehabilitation agencies found that relations with local authorities became very strained. In some cases project staff were denied access to orphanages with which they had long standing relations. However, the agreement with UNICEF is seen by some agencies as a sign that Civil Affairs officials at the highest levels are now ready to address the orphanage issue with the help of international organisations.
There is also speculation that the UN population agency UNFPA, now in the process of negotiating a new project cycle in China, will include support for orphanage rehabilitation and training in its program.
Meanwhile, international publicity is certain to stimulate demand for Chinese babies for overseas adoption.
Several private agencies and at least one registered charity -- the Geneva based International Social Service -- already arrange adoptions for overseas clients who pay an "adoption fee" of around $US3,000.
Save the Children Fund has expressed concern that intercountry adoption will detract from the effort to establish humane and sustainable local provision for the majority of children left behind.