Lead Article

Chinese Children at Risk

China is riding a wave of dramatic economic development. Historically, countries that have experienced significant change discover there is a wide range of social ramifications, both positive and negative. Negative ramifications tend to be seen in the society's weakest members: children, women, the elderly and the disabled. This article is a compilation of insights, observations and trends noted by persons working across China. It is by no means academic, but descriptive, focusing on those social trends that place China's children at risk.

For this article these trends have been separated into two categories labeled Wave One and Wave Two. Wave One includes work with a base broad enough that people coming to China can build on them. They do not require pioneer type work. Wave Two is pioneering work, or work that is not well understood because few are involved in it. The chart shows the characteristics of these two waves.

CategoryWave OneWave Two
Types of Children in this CategoryOrphans
​Disabled children
Children of migrant workers
Single parent homes
Street children
​Children affected by HIV/AIDS
Western Workers and ProgramsIncreasing since 1980s
Workers are relatively numerous
Some established programs
Many new projects

Still no official access
Workers are rare/relatively few
​Few scattered pioneering sites 

Chinese Workers and Programs

Chinese workers being trained
​Some Chinese starting up their own programs

Society AwarenessSeen in TV shows and newspapers
​Seen as an embarrassment that needs to be "helped"
Rarely seen in media
​Seen as an embarassment that needs to remain hidden
Social TrendsFoundation in place for general improvementAnticipate escalation of the underlying issues

Wave One

Orphans. When China reopened in the 1980s, Western workers typically obtained access through educational routes, often teaching English. These teachers built bridges of trust allowing them access to the "cutest" children of their local orphanage. Often they were asked to help provide improved facilities and enriched educational opportunities for these children. The loving nonjudgmental responses of these early workers have allowed for teamwork and outside intervention to affect the lives of these children. For example, where Chinese officials initially held the intentions of adoptive parents as suspect, now thousands of Chinese infant girls are adopted internationally every year. Volunteers are now allowed into orphanages to provide training to childcare workers. Experiments in foster homes, for newborns to children six years old, that try to decrease the institutionalization of infants are being seen as successful by both volunteer agencies and orphanage management. Other programs train Chinese families and place one or two long-term foster children in a local home.

One particularly exciting new trend is that local Chinese are initiating programs to help the children in their local orphanage. These model sites are typically in urban areas, but they have laid a foundation and set a precedent. Orphanage management, leery of allowing outside assistance into their sites, can be pointed back to successful teamwork at a number of high- profile Chinese orphanages.

More Western and Chinese workers are needed to help meet the needs in the vast rural areas of China. Chinese persons who already run programs that reach out to the orphans in their community need training and financial support. Workers in the area of orphans also note that international adoptions are only a temporary answer, exacerbating the present inequality in the number of women versus men particularly noted in China's rural areas. Creative interventions need to be made that will allow China to not only keep its already rare infant girls, but to value, educate and socialize them, and to somehow integrate them back into Chinese society.

Disabled in orphanages. As trust increased in the 1980s, relief workers were introduced to previously hidden children. These children were often in need of surgery to repair their cleft lip or clubbed foot. With time, volunteers were ushered into rooms housing progressively more severely disabled children. With the consistent experience of nonjudgmental assistance, more and more orphanages are opening up to outside assistance in the care of their disabled population. Although these are typically in more urban settings, the precedent has been set. More workers, both foreign and Chinese, are needed to build on this foundation and take assistance out into the many under-funded, understaffed and under-trained orphanages of rural China. Workers presently in the field note that strategies need to begin now to address the large number of severely disabled children that would have normally died who are becoming adults and still require long-term care.

Disabled in the community. The decrease of funding through the central government for children in orphanages is a major force resulting in disabled children remaining in the community. Previously orphanages turned a blind eye to persons who abandoned children. Now, parents are tracked down and required to pay for the care their child receives in an orphanage. Faced with this cost, parents often choose to care for the child at home.

At the same time, government funding of services for the disabled in the community is increasing. Spearheaded by Deng Pufang, the son of Deng Xiaoping, who is spinal cord injured, these changes are also encouraged by the 2008 Olympics. Community-based programs are starting for the blind, deaf and physically disabled in Chinese cities. Trainers and mentors in all areas of therapy, special education and social work are in demand. Not only are foreign and Chinese workers needed to take similar programs out to the rural areas, they are also being called into the new field of parent support groups and parent training. Patience and creativity are needed to model the value of these children to their parents and the value of these families to the surrounding community.

Wave Two

Children of migrant workers. The economic lure of the city increasingly displaces migrant workers and their families from the countryside into urban areas. Residing illegally in the city, they are at the mercy of unscrupulous landlords. Unable to go to the authorities, these families are regularly cheated as well as forced to live in unsafe conditions. Without "gifts" of money or guanxi, they remain locked out of the educational and health care systems. Some parents have started cooperative classrooms using outof-date textbooks and taught by parents who are barely literate themselves. Western workers, seeking to provide education or health benefits to these families, discover they must walk a fine line between meeting the felt needs of the people and meeting the felt needs of the local officials who are called to discourage lawless behavior. The issues are complex. There is little or no foundational groundwork started. Workers are needed who are willing to put in the years necessary to allow for dialogue in this difficult area. Wisdom is needed to seek out culturally relevant answers to balance the growing needs of these children at risk along with the government's very real need to maintain law and order.

Single parent homes. Increasingly, men seeking employment in urban building projects leave their families back in their rural homes. These workers typically return home only once a year and often are not paid enough to send any significant funds home. Western organizations doing healthcare work in rural areas have found that these functionally single parent families are consistently in the lower socioeconomic levels of their village. The mothers in these homes have few work skills. The children of these families have poorer nutritional levels, lower educational abilities, and more behavioral issues than the other children in their village. Prevention, through community development projects, is one important tool in the fight against the increasing number of rural functionally single-parent homes. Scattered throughout China are projects and workers who have been building the relationships needed to work alongside rural Chinese. Together, they seek out creative ways to facilitate the improvement in economic, health and educational standards in their village. The effects of development work on these functionally single parent families have only just begun to be understood. More workers are needed to join these projects. Others are needed to start up similar community development projects in the vast areas of rural China.

Street children. Street children have been a hidden issue in China for a number of years. Current social trends lead us to believe that this will become an even greater issue in the future. Significantly lower numbers of women than men in the villages, coupled with loosening social mores, mean that more rural women who are functionally single parents choose to remarry, and traditionally children of the first marriage are "sent away" by the new husband. Many street children report they chose to leave their rural homes with a dream of helping their family by finding work in the cities. Urban children, who are unable to succeed in the highly competitive educational system, increasingly choose to run away rather then continue to "fail" their parents. The skyrocketing increase in urban divorce and remarriage is resulting in children either being "sent away" or choosing the streets rather than remaining at home in abusive situations.

Only a few Westerners have begun to look into the culturally taboo area of street children. What they report is that those with behavioral or emotional issues do not make it in those workshops that illegally hire children. Those unable to make it in a workshop are prey to whatever adult is willing to use them in return for some form of food and shelter. Prevention, as noted above, is paramount. For the growing number of children already on the streets, workers are needed who are willing to commit to the years required to build healthy relationships. Work with street children in any culture is not for the faint of heart. Time, patience and wisdom are required to help work through the complex needs and baggage they bring with them. Those few people pioneering this area in China not only see the present intervention needs of these children but recognize that long-term vocational training will be needed to help plug these young adults with no guanxi relationships back into society in a meaningful way.

Children affected by HIV/AIDS, prostitution, drugs, abuse, etc. In any society, but particularly in one like China, it takes time and relationship to be allowed to enter these very taboo areas of children at risk. Although there are a few pioneers working in the area of children affected by HIV/AIDS, this author was not able to interview any of them. As for other areas of risk, those seeking to work in these areas have yet to build the kinds of relationships necessary to get even a basic understanding of the needs or issues.

With the assumption that these are also on the rise, prayer for workers as well as openness in their Chinese counterparts is desperately needed.


Economic development brings with it both positive and negative social consequences. To truly understand the intricacies of these consequences, to wisely develop intervention strategies as well as to earn the right to implement these options requires time. It requires time in the West where instant answers are an acceptable norm. It requires even more time in a relational society like China where a deep level of trust is needed just to be ushered into a basic level of confidence.

Following the example of workers in Wave One issues, we can see that the time invested in building relationships has placed a foundation where not only these workers but others, both foreign and local, are able to start making a difference in children's lives. In our instant society where long-term volunteer experiences are three to four weeks, the concept of years is daunting. Yet, every worker interviewed for this article asked for more people willing to invest in learning Chinese, to invest in building relationships, and to invest in facilitating local Chinese workers. All mentioned the need for specialists with children such as therapists and social workers, as well as specialists in development such as agriculturalists and engineers. Those interviewed also regularly noted a desperate need for persons with skills in management and strategic planning.

As social services the world over are rarely able to be totally self-supporting, the need exists for funding to support both Western- and Chinese-initiated programs. With relationships being so important, all mentioned the need for prayer to prepare the hearts of those Chinese persons God has intended to be the champions, who will come alongside Western volunteers and help open doors into Chinese culture and communities. We need to learn from our experiences in Wave One and begin building relationships now before we are overwhelmed by the needs of those children at risk in Wave Two.

Amy Lewis

Amy Lewis has been volunteering with disabled children in northern China for more than five years.View Full Bio