‘Uplifting babies’ — how to design for an unwanted service within a system that is “crook”
“They are already victims of circumstance, growing up in homes with family violence. By association she is not fit to be a mother. But what is the alternative the state proposes to these young people? We have to take a stand. The system is crook.” Midwife Jean in the recently published documentary “The Uplift” (Newsroom/Melanie Reid, 2019) talks firmly while she leans against a New Zealand hospital bed where a young Māori mother quietly rocks and cuddles her newborn baby.
In “The Uplift” we witness the controversial process — or attempts thereof — to ‘uplift’ a baby without-notice from its mother’s care to state (foster) care. Over the course of two days we see how whānau (extended family), midwives, kaumātua (respected elders), iwi (local, political Māori leaders) all rally around the mother, cell phones in hand to record every step, while institutions — ranging from social workers, police, hospital staff and Oranga Tamariki (Ministry for Children) workers — exercise a range of strategies to take the baby away in a government provided car seat. And with every forceful attempt to take ‘baby’, the systemic power inequality in a post-colonial health care system is laid bare.
Seldom have I rewatched a documentary right away after seeing it for the first time. And not in recent memory have I felt so strongly compelled to write about it. Perhaps it’s because I lived in New Zealand for some time, and made Māori friends, or maybe because I recently became a mother myself. Maybe it was because of my work for a government body that designs and delivers services to citizens, including First Nations/Indigenous peoples. Really I’m not sure the reason why, but this story struck a chord with me. I feel that nearly everyone who works in a public service role in a country with Indigenous/First Nations populations, could potentially glean useful insights from by unravelling this story a bit further. Hence, the topic of this blog:
How to design for a service that no one really wants in a system that is “crook”?
Disclaimer: This issue is more nuanced than it may appear. The intent of the blog is to show how deeply listening and unravelling just one story can reveal a system, power relations, actors and processes, and show us opportunities for change from a service design perspective. This blog is not meant to criticize the New Zealand health and social care system, nor any people who work in it — especially not the social workers and police officers whose identities imo should be protected. This blog is written without any further knowledge of this specific case other than watching the documentary and reading news articles (2019).
The context
Commonly the primary aim of ‘uplifting’, ‘removing’, ‘taking’ or ‘apprehending’ a baby or child from its parents and putting him or her in out-of-home care is to keep them ‘safe’. But what is ‘safe’, and who determines who or what is ‘safe’?
In countries like Canada, Australia and New Zealand the numbers of Indigenous / First Nations / Aboriginal children in foster care much surpass the numbers of non-indigenous children. In New Zealand three Māori babies a week are being ‘uplifted’ from their mothers. Of the 283 babies taken into care last year, more than 70 percent were Māori or Pasifika.
In Canada Indigenous children under the age of 14 comprise 7.7 per cent of all children in the country, but represent 52 per cent of all children in foster care. In British Columbia, where I live, two-thirds of the 6500 children in foster care — are First Nations, Inuit or Métis; and 45 percent of the 185 babies under 31 days taken into care last year in the province were Indigenous. In Manitoba the situation is especially desperate, as astoundingly 90 percent of children in care are of Indigenous and Métis descent. In January this year a video of a similar apprehension of a baby from an Indigenous mother in Winnipeg caused a public outcry.
Why are the numbers so high? A short blurb here does not do justice to the complexity and interconnected root causes that are at play. Intergenerational trauma — especially in Canada where residential schools and adoption of Indigenous children into non-indigenous families disconnected people from their culture, language and families — poverty, poor housing and underfunding of Indigenous welfare have led to high rates of imprisonment, substance use, non-accidental child mortality, suicide and domestic violence amongst Indigenous populations. A baby born with Indigenous roots is nearly de facto born into an ‘unsafe’ environment, either by association or under physical circumstances. That vicious cycle is hard to escape.
“The system is crook”
But, as midwife Jean points out in the documentary, there’s something else, more invisible, at play. “The system is crook. None of them [parents, whānau] had a chance to defend themselves against the allegations laid against them by one caseworker”, she says. In this particular case the family court ‘rule 34’ was applied: an ‘uplift without-notice’. A social worker, police officer or sometimes a family member can apply for an uplift if they are concerned for the baby’s safety. The request is sent to a judge on e-duty, who reviews the letter and decides whether or not there are sufficient grounds to take the baby away from its family until the case can be before the court. An ‘uplift without-notice’ usually happens on the same day, to prevent the family from knowing and possibly going into hiding.
In this case the midwives somehow got wind of the upcoming ‘uplift’. They had their lawyer file for an injunction to rescind the order (under court rule 34), stating that ‘there are no grounds to remove this baby’. Confusion arose with the social workers. Families usually have no lawyers lined up to defend themselves. Despite the injunction, the social workers still proceed with attempts to uplift the baby, while circulating a string of misleading information. A family group conference is set up by Oranga Tamariki, where the whānau is secured that mum and baby will stay together for now. Everyone goes home.
“Hold on to your baby.. don’t you let him go”
At night things get grim. Social workers try and ‘uplift baby’ again. This time the midwives’ swipe cards are disabled, journalists and family are denied access to the hospital and a heavy police enforcement is installed. The young mother, tired and separated from her support circle, uses her only beacon: her cellphone. She calls her family, who tries to keep her awake. ‘Hold on to your baby’ .. ‘don’t you let him go’, they say. In the dim lit hospital room we see the car seat looming in the background, this time it’s placed on the mother’s bed. Everything is being recorded. The family and midwives desperately speak to the journalist team, and they call in an iwi (local political Māori leader). The family decides to sleep out by the hospital door. Eventually it’s the iwi and a senior police officer who broker ‘a deal’ with the regional manager at the Ministry: the mother and the baby can stay together. It’s 2 AM at night. Everyone can finally go to sleep.
Visualizing the system
“There is no hope for our mums, for our families, if this is what they have to put up with.”, says one of the midwives. This documentary indeed leaves us with a very daunting question: what if in these cases the system, not the mother, endangers the interests and safety of the baby? What if the system deepens trauma, for the child, the mother and the extended family? Let’s take a closer look at the child welfare system and its procedures, especially the ‘without-notice-application’.
What if the system, not the mother, endangers the interests and safety of the baby?
To do this I like to draw systems into maps. System maps show how power is distributed, and reveal which connections and disconnects we can decipher from just watching the documentary (btw, this is a great exercise that any government team can do to spark a conversation!). I like jotting down relationships, artefact-things, and used strategies as I go, as these often hold ideas and opportunities for change.
NB: this systems map is based on knowledge derived from the documentary ‘the Uplift’ and therefore most likely incomplete.
Now that we have drawn the system into a map, we can see things more clearly. An important note on systems maps: they are never perfect, never complete and only show what we, the systems mapper(s), can see.
Here are some observations:
The power of storytelling
There seemingly is little to no direct human connection between the people living their lives ‘on the ground’ (mother, baby, family) and the people operating in the powerful top institutions. Stories are often put away as ‘anecdotal evidence’. If it wasn’t for the excellent storytelling by journalist Melanie Reid, and the recording of this story on the family’s cellphones, this story would have likely not made it all the way up to the top tier of government, where legislation, procedures, policies and regulations are created and regulated. But as Reid says: “These stories are near impossible to report”. How to better connect humans over human-designed and human-delivered social services?
Compliance in the middle
A system operates by having people in the middle segment of the pyramid comply with laws, protocols and orders imposed by institutions. In this story you can hear examples of what that sounds like on the ground.
Social workers: “We can only follow our process”, “I have the papers here”. “Can we go through the [care] plan that we had written?”
Police officers: “This is an order to uplift baby and that is what we are enforcing. We just have to do that.”
Hospital police liaison officer — Oranga Tamariki: “I’m just here to make sure that we’re doing the right things at the right time.” “Have you read the documents? Because everything about why we’ve made the decision is in those documents.”
Whenever we hear these kind of sentences in systems we have to be on our tippy toes. What is ‘the process’? What do ‘the papers’ look like? What are ‘the ‘right things’? These artefacts, items, rules or cultural practices hold ideas for service design and re-design.
Change brokers
When breaking systemic issues it is not helpful to name, blame or shame this middle segment of systems. This is where systemic and cultural breakthroughs can and need to happen. Eventually, it was a local iwi (political and spiritual Māori leader) who negotiated until 2am at night with a senior police officer who went “above and beyond” to broker a deal with the Oranga Tamariki regional case manager to stop the uplift of the baby. This and the actions of the Māori midwives, the journalists and the family eventually led to an exception on the rule, and for this story to emerge.
When looking at the system you are looking at or working with: who have been or could become change brokers? These ‘places of change’ and ‘change brokers’ play an important role in system shifts and form starting points for re-designing services.
Budget flows
To see where system shifts could happen we have to look at where the money is not. I don’t have sufficient knowledge on how budgets are distributed in this child welfare system, but I think it’s safe to say that the current system is invested in paying social workers, police, the justice system and foster care families, while the alternatives (support for homes like Te Whare, support for whānau) are underfunded. The Māori midwives surely went above and beyond their (paid) mandate and time to protect the mother and baby, the journalists were paid by an outsider news agency (Newsroom), and the local iwi/kaumātua were acting pro bono.
When re-designing services it is important to have someone on the team who can make these (rough) calculations. Seeing the rough numbers can hold clues for system’s change and shifting budgets.
Seeing service design opportunities: designing for trust
Since the publication of this documentary (June 11, 2019) the national ombudsman, the Children’s Commissioner and Oranga Tamariki have all launched inquiries into the uplifts of children in New Zealand. Many local people have written insightful responses about the documentary at Newsroom’s “Taken by the State”.
High level investigations are a natural first response of top level institutions. It will be valuable to know how often and how the ‘without-notice uplifts’ of children, especially Māori children, and on which grounds. But how to move beyond the status-quo? How to foster change in post-colonial systems and (re-)design for a service that apparently no one really wants, in a system that is ‘crook’? One author (Ruth Herbert, Backbone Collective) points out that these 3 separate inquiries will lead to the Ministry and the Court pointing at each other, and to “plastering over the cracks”. According to Herbert only a “Royal Commission of Inquiry” would look at the entire system.
How to foster change in post-colonial systems and (re-)design for a service that apparently no one really wants, in a system that is ‘crook’?
But inquiries will remain inquiries. How do we actually overhaul and re-design an entire system, on the fringes or outside the system that has produced these outcomes? We have to start somewhere. How about we ask ourselves: how to design for trust? How to design and build for trust between (Māori) communities and the institutions that should support them? In this case trust in government agencies has severely eroded, and rightly so. Throughout the documentary we hear family members commenting on Oranga Tamariki’s actions: “We don’t trust them at all, with what they’re saying”, “we’ll stay here [hospital], until they lock us up, probably.” (grandmother), “Are they gonna lie about it? Set the plan, and then change it?” (whānau). But where to begin? Here I offer 5 starting points.
1. Install community-led research and design
First and foremost research and design of new policies and services can not be led by the establishment — to build trust they have to be community-led. As the local Māori leader who brokered the deal at 2am at night mentions: “Yes, we need change, but the solutions should be local, the solutions should be Māori, and the solutions should be resourced and supported by government. I think then we’ll see transformational change.” In practice this means communities on the ground design the framework and set the conditions in which this work will be produced. This might mean installing researchers and policy analysts with a Māori background or with sufficient Māori knowledge, including iwi leaders on the boards, introducing culturally safe and appropriate methodologies that respect whakapapa / mana (Māori world views), making use of paid peer researchers with lived experience in dealing with the foster care / child welfare system etc. These practices go beyond an invitation to ‘participate’ [in the inquiries] and reduce the risk of reproducing post-colonial practices and outcomes.
2. Reframe the question
In this matter I hope that the discussion is not going to get stuck on questions about a single service: how apprehending children into state care should or shouldn’t happen, or whether it should happen at all. To overhaul an entire system one has to cast a wide net. The very basic question could be: how to support children and their families in their wellbeing, how can the state support child- and family centred communities to flourish? The post-colonial view and belief system on how to take care of children is still centred around the Western idea of ‘rescuing’ vulnerable children as individuals who are or should be disconnected from their families. This is different from the Maori view, which is focussed on both the spiritual and physical wellbeing of both the child and their whānau.
3. Retire hurtful language and stop using threatening cultural rituals and artefacts
There is nothing uplifting about the apprehension or ‘uplift’ of a baby. “Research shows that children who have been apprehended experience grief and loss throughout their lives”, while “mental health outcomes of mothers whose children were placed in care are worse than mothers who experienced the death of an infant” (research by Elizabeth Wall-Wieler, University of Manitoba, in ‘Herizons, Vo. 33, No 1, 2019’). The term is associated with trauma and threat and should not be used in professional service settings any longer. What it should be replaced with will reveal itself as new child and family services emerge. Another item that is associated with trauma, threat and pain is the carseat. What is the function of that carseat? For some it has become an institutional symbol of presumed safety, and is part of a cultural ritual that whisks the baby away to ‘a safer, better place’. But for the mum, baby and whānau the car seat has become a cultural artefact that embodies a power imbalance, repression, trauma, mistrust and threat. Stop using it.
4. Include service providers in research, design and prototyping of new services
As we have learned from systems mapping the middle segment of a system can make or break systemic change. The knowledge and practical experience of service providers — ranging from social workers, police, hospital staff, midwives — are crucial in understanding and redesigning public services. What do they see happening in their workplace? What helps them, what hampers them? What role do their managers play? Which work cultures, protocols, procedures help reproducing the same outcomes? What are their ideas for change? In service design processes it is often overlooked to make time and budget available for service providers to take part in this process. Too often the invitation to co-design services comes halfway through the process and on top of their already busy work schedules. Make time and budget available upfront to execute this important part of service design and systems change.
5. Make public costs insightful
How much does foster care cost? How much does it cost to keep mums and babes together? How much is currently spent on both? These are the simple questions. How much does intergenerational trauma cost society in the long run? How much does it cost to improve interrelated root causes (ie. poor housing, underfunding of mental health support etc.)? These are the hard, systemic questions.
Both types of questions should be answered because realistic figures can convince the public on big government spending for new solutions. Therefore it is important that the investigations also focus on the monetary side of things. Make the public service costs and gains insightful, even if you can only yield rough figures.
Where would you start? Let me know!
“Ehara taku toa i te toa takitahi engari he toa takimano” — “My strength is not that of mine alone, but that of many” - Maori proverb
I am currently on mat leave and write blogs when my baby naps. Views and typos are my own. I use system maps and systems thinking to design better policies and services in B.C., Canada. Check out the systems map we made to better understand the opioid crisis in B.C. Just to be clear, I think systems mapping is just a tool to build new relationships and connect different ways of understanding complex problems. In the end, that is what really matters in ‘solving’ complex social issues.
Please contact me on Linkedin or Twitter if you’d like to have the design files of the system map. Or just to say hi!
