The Parenting Vaccine : Because I Grew Up In An Orphanage 3

The short walk from Grand Central to the United Nations this Tuesday completes a journey that has taken a lifetime. It started at 13 when I fled a violent children’s home and shivered through the night on a park bench. I like to think running away was a defiant refusal to accept my lot . An effort to re-sanctify my humanity and sense of selfhood. Probably I was just very scared.

I always thought child maltreatment was an anomaly, blighting a small number of us. At leastone in three children grow up in chaos or emotional poverty. We all know the stories of Elton John, Oprah, and Billy Conolly. 30% of Oscar-nominated films in 2020 had a storyline of child trauma. Why would we be surprised?

For children, danger is not just the presence of violence but also the absence of love. A child’s adaptation to danger creates lasting trauma that can drive a lifetime of pain, poverty, and ill health. Childhood adversity is catastrophic for the child and the costliest and deadliest of social problems. for society.

Yet none of it is inevitable

On Tuesday I will present a joint UN policy call [1] to member states aimed at preventing abuse, neglect and abandonment before it happens. The call draws on the recent body of global science on why child maltreatment occurs and what works in preventing it.

In the decades that have passed since that lonely park bench, our global understanding of child maltreatment has transformed in three ways.

We know child abuse and neglect are not marginal.  These adversities do not only affect the 1-3 per cent of children who become child protection cases. Globally, at least a third of us experience significant maltreatment during childhood. Abuse, neglect and dysfunctional parenting are transmitted across generations, often automatically and unintentionally. It doesn’t always occur in chaotic, rage filled homes. It can be mild or moderate, quiet and unseen. In all cases it causes lasting  harm.

Child maltreatment costs a packet. It is the main preventable cause of life-course mental illness , addiction, obesity and vulnerability to exploitation and violence. It also increases the likelihood of non-communicable disease poor learning outcomes and fewer job prospects. It is the most common factor amongst those recruited by organized crime, extremist and terrorist groups. Abuse and neglect are one of our greatest social problems and  estimated to cost between 2 and 5 per cent of global GDP. In one way or another, we are all affected by childhood adversity.

It is not inevitable. The best protective factor is a dedicated, loving parent or caregiver. Babies are biologically programmed to attach with a parent for care and protection. The absence of love and attachment is seen by children as a threat. This activates the stress response system and derails healthy development. Parents who were neglected or abused as children themselves are at higher risk of poor attachment with their own kids. This inter-generational transmission of trauma can be disrupted by providing an opportunity to develop parenting skills and self-awareness  . Evidence-based, low cost parenting programmes have shown improved outcomes in attachment, nurturing care and violence prevention. Nobel prize winning economist James Heckman argues that parenting programmes deliver up to US$13 return on every dollar invested through better life outcomes

Global progress occurs when humanity unites behind a single accelerator that attacks multiple problems . A  laser focus on vaccines against childhood diseases in the 1980s increased global coverage from 20 to 80% of under-fives and halved child mortality. The world became a place where child death was no longer seen as inevitable or unpreventable.  

As an absolute minimum standard, the World health Organization and UNICEF are calling  on governments to ensure 5-7 home visits  in early childhood with ‘booster’ sessions at critical development stages such as adolescence. Like vaccines, parenting programmes are an accelerator rather than a panacea. They are the most effective and proven way we currently know to prevent abuse and neglect. This very minimum package could tip the balance and disrupt transmission of intergenerational trauma. They should be made available globally and universally in the same way that vaccines are intentioned. We call this the parenting vaccine

The minimum standard is for deployment in all contexts including humanitarian and low-income countries. The more a country can do, the more it should do. The parenting vaccine is a galvanising  accelerator that would turbo-boost support for other critical interventions including family friendly policies, caring for the caregivers, universal pre-school and better funded mental health and social work services.

The launch of the parenting vaccine carries the same urgency for me as the work I have done on humanitarian crisis and natural disaster. At thirteen I refused to accept my maltreatment as inevitable. With a small and cherished group of colleagues from the UN and academia we are refusing to accept it as inevitable for any child.

For most of adulthood I suppressed an inner pain, buttoned up under the cover of sporting, academic or professional accomplishment. Therapy delivered an Ebeneezer Scrooge-style epiphany. I was never financially stingy like scrooge for the record. My austerity was with emotions. The world seemed so much more joyful, enchanting and loving after recovery . I have a deep appreciation for the feelings and sensibilities that cascaded from a place that had felt barren and broken. All around me I see people who live with unresolved trauma. They don’t even have the vocabulary to describe it, let alone acknowledge and change it. We could build a world in which everyone could understand, describe and seek to overcome trauma.

Until a few years ago I had no photo from my childhood. My mother had died when I was a young adult without me really knowing her or holding her image in my head. A long-lost family friend recently shared some much-treasured childhood photos and a single video. In the grainy film I can see my mother and the friend chatting. The friend bounces her infant on her knee effortlessly while chatting. I am off to the side, out of my mother’s gaze or affection. In my mother I see the face of someone deeply unsure of herself. We rarely think of our own parents as once having been children. I imagine my mother had been neglected herself as a child and simply lacked the relational tools to protect or love a child. Someone who never recovered. I imagine her as a beneficiary of the parenting vaccine programme . I imagine her bouncing that child on her knee and of them growing in mutual love. This is what we should all want for every child and parent.

Previous generations dramatically reduced hunger, disease and war as the science and resources became available.  In doing so they uplifted humanity.  We are the generation that can end abuse and neglect as an accelerator for health, wellbeing, prosperity and peace . We can imagine a world where Ebeneezer Scrooge doesn’t need an epiphany and I didn’t need a bench.

NB: This Article if the third in a triology. The first can be found here and the second here. I dedicate this article to my amazing colleagues Etienne Krug, Sabine van Tuyll and Alex Bouchart of WHO, Professor Lucie Cluver and Professor Frances Gardiner at Oxford University and Stephen Blight, Oluwatosin Akingbulu, Emma Ferguson, Cornelius Williams and Zeinab Hijazi of UNICEF> All of whom work tirelessly for the cause set out in this blog. The photo is taken from with the last cohort of abandoned babies who were de-instutionalised as part of a programme with the Government of North Macedonia

[1] Created by UNICEF, WHO and the UN Special Representative  on Violence Against Children

3 thoughts on “The Parenting Vaccine : Because I Grew Up In An Orphanage 3

  1. Too many people will procreate regardless of their questionable ability to raise their children in a psychologically functional/healthy manner. Being free nations, society cannot prevent anyone from bearing children; society can, however, educate all young people for the most important job ever, even those who plan to remain childless.

    It’s known that trauma from unhindered toxic abuse usually results in a helpless child’s brain improperly developing. If allowed to continue for a prolonged period, it can act as a starting point into a life in which the brain uncontrollably releases potentially damaging levels of inflammation-promoting stress hormones and chemicals, even in non-stressful daily routines. I consider it to be a form of brain damage.

    The lasting emotional/psychological pain from such trauma is very formidable yet invisibly confined to inside one’s head. It’s like a discomforting anticipation of ‘the other shoe dropping’ and simultaneously being scared of how badly I will deal with the upsetting event, which usually never transpires. It is solitarily suffered, unlike an openly visible physical disability or condition, which tends to elicit sympathy/empathy from others. It can make every day a mental ordeal, unless the turmoil is treated with some form of medicating, either prescribed or illicit.

    I would like to see child-development science curriculum implemented for secondary high school students, and it could also include racial- and neuro-diversity, albeit not overly complicated. It would be mandatory course material, however, and considerably more detailed than what’s already covered by home economics, etcetera, curriculum: e.g. diaper changing, baby feeding and so forth. I don’t think the latter is anywhere near sufficient (at least not how I experienced it) when it comes to the proper development of a child’s mind.

    For one thing, the curriculum could/would make available to students potentially valuable/useful knowledge about their own psyches and why they are the way they are. And besides their own nature, students can also learn about the natures of their peers, which might foster greater tolerance for atypical personalities. If nothing else, the curriculum could offer students an idea/clue as to whether they’re emotionally suited for the immense responsibility and strains of parenthood. I often wonder: how many instances there have been wherein immense long-term suffering by children of dysfunctional rearing might have been prevented had the parent(s) received, as high school students, some crucial child development science education by way of mandatory curriculum?

    By not teaching child-development science to high school students, is it not as though societally we’re implying that anyone can comfortably enough go forth with unconditionally bearing children with whatever minute amount, if any at all, of such vital knowledge they happen to have acquired over time? I feel it is. A psychologically sound as well as a physically healthy future should be all children’s foremost human right — especially considering the very troubled world into which they never asked to enter — and therefore basic child development science and rearing should be learned long before the average person has their first child.

    Sadly, due to the common OIIIMOBY mindset (Only If It’s In My Own Back Yard), the prevailing collective attitude, however implicit or subconscious, basically follows: ‘Why should I care — I’m soundly raising my kid?’ or ‘What’s in it for me, the taxpayer, if I support child development programs for the sake of others’ bad parenting?’ While some may justify it as a normal thus moral human evolutionary function, the self-serving OIIIMOBY can debilitate social progress, even when social progress is most needed; and it seems that distinct form of societal penny wisdom but pound foolishness is a very unfortunate human characteristic that’s likely with us to stay.


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