Vietnam

Holt Vietnam recently hosted a three-day Roots to Grow training for 20 children, ages 14-18, in Dong Nai Province. The Roots to Grow training focuses on exploring nutrition, hygiene and sanitation, and budgeting presented through fun and interactive games, activities, meal preparation and cooking.

The recent training brought a lot of fun for the children and helped them to feel confident in the kitchen. They learned about how different foods protect your body, help you grow and give you energy. Through hands-on time in the kitchen, they also learned practical skills like handling kitchen knives, keeping utensils clean and even how to cook new recipes, like omelets, focaccia bread, bulgogi and apple crisp!

Without learning these essential life skills, it can be extremely difficult for children growing up in poverty to make their way as independent adults. Through the support of sponsors and donors, children in Holt’s programs learn life skills that they need to live healthy, successful lives.

Uganda

In Uganda, maternal and child health camps were recently held at four health centers as well as Holt sponsor and donor-supported early childhood care and development centers. These donor-funded camps offer crucial medical care to children, families and caregivers living in impoverished communities.

The recent maternal and child health camps served 8,250 children and 694 adults, providing interventions such as Vitamin A supplementation, deworming and health education through Holt’s Child Nutrition Program. Children and families also received treatment for prevalent conditions including malaria, chronic coughs, influenza and skin infections. Children with more complex health issues were referred to health specialists.

Thanks to the support of sponsors and donors, families receive one-on-one support and benefit from community events— like camps — that provide training to help them nurture their child’s growth and development. When children are healthier, they are more likely to meet developmental milestones, perform better in school and their families miss less work — enabling them to earn more income for their household!

China

In China, Holt’s family strengthening programs focus on education to lift children and families out of poverty. Child sponsors and donors provide the critical support needed to help children attend school for as long as possible — creating generational change for thousands of families.

During August, ten students from the Shangyi Family Strengthening (FS) program attended a five-day summer camp held by the Chinese Society of Aeronautics and Astronautics in Jiangxi Province. Through the generosity of Holt donors, these students attended the summer camp free of cost.

The field trip included hands-on aeronautic and astronautic experiences, inspiring the students to develop their professional skills and explore possible career paths. For children in Holt programs, experiences like these help broaden their horizons beyond the limited career opportunities they witnessed growing up in impoverished communities.

Cambodia

According to Holt-supported students in Cambodia, donors and sponsors are making a big difference.

Recently, students were given an assessment through the Educational Support Program (ESP) in Phnom Penh. All students reported that Holt Cambodia’s ESP has helped them remain in school, with 86.96% strongly agreeing and 13.04% agreeing. Furthermore, almost all children (91.3%) who participated in the assessment strongly agreed and 8.7% agreed that ESP support has motivated them to pursue higher education.

In late July, 83 children in the ESP completed their Grade 9 National Diploma Exams and 71 successfully passed to Grade 10. Without support from Holt sponsors and donors, many of these children would have dropped out as early as in primary school. For children growing up in poverty around the world, education is the key to a brighter future.

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The post Notes from the Field: September 2025 appeared first on Holt International.

Tselmuun is a 4-year-old girl who lives in Mongolia with her family. She was born with cerebral palsy, a condition that impairs her body movement, muscle tone and coordination. Tselmuun is small for her age and has trouble feeding herself and eating certain foods. But thanks to your generosity, she is now getting all the help she needs to grow and thrive!

These days, Tselmuun attends a wonderful daycare center near her home, where the staff has received Holt’s Child Nutrition Program training. Because of your support, the teachers have learned how to properly feed and nourish children with disabilities, as well as help them eat and drink on their own. While Tselmuun is in their care each day, her teachers ensure she gets balanced and nutritious meals to support her optimal growth and development.

Tselmuun enjoys going to daycare and engaging with the other children. She plays with toys and listens to music, often trying to sing along and move rhythmically. Even though she has trouble speaking, Tselmuun smiles and uses short phrases to express her joy and happiness.

Tselmuun shares a strong emotional bond with her family members, who provide her with consistent love and care. Both she and her family are grateful for all the support Tselmuun receives from her sponsors, and to thank them, Tselmuun created a colorful finger painting!

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Connect with a child. Provide for their needs. Share your heart for $43 per month.

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The post Tselmuun Is Growing Strong, Thanks to You! appeared first on Holt International.

Altan is a happy little boy who spends his days at school, playing with friends, learning new skills and thoroughly enjoying mealtimes. But just a few years ago, Altan’s life — and future — looked quite different.

When Altan was born to his family in Mongolia, he had a twin sibling. But shortly after birth, Altan’s twin passed away, and his father abandoned his mother — leaving her to care for her infant son alone. Enduring loss and abandonment, Altan’s mother faced yet another challenge: Altan was born at just 4.8 pounds and was diagnosed with cerebral palsy, a condition that has impaired his muscular growth and development. By the time he was 18 months old, Altan could not sit up on his own, roll over or crawl, and he needed support to eat. Ultimately, his delays affected his ability to receive the nutrition he needed to stay healthy and grow.

Altan’s mother tried everything she could to help her little boy, but he was constantly sick and severely malnourished. With little support, she began to feel physically and emotionally exhausted. The demands of being a single mother caring for a young child with a disability were adding up. Feeling ill-equipped to meet his needs, Altan’s mother considered placing her son in an orphanage. But with a final ounce of strength, she continued to search for help.

Finding Help — and Hope

One day, Altan’s mother discovered a daycare center in her community that cared for children with disabilities. Partnering with Holt Mongolia, the daycare staff had received Holt’s innovative Child Nutrition Program (CNP) training, through which they had learned how to properly feed and nourish children with disabilities. Because of this training, the daycare center was able to welcome Altan and recognize the window of opportunity and interventions he needed to grow and thrive.

Like Altan, many of the children who enter Holt’s CNP are malnourished, anemic or struggling with feeding difficulties. Many have disabilities or chronic conditions, putting their health and development in jeopardy. But since it began in 2014, Holt’s child nutrition program has reached thousands of children with holistic nutrition and feeding interventions uniquely designed to meet their needs.

“Our targeted approach focuses on reaching the most vulnerable children early in life,” says Emily DeLacey, PhD, RDN, LDN, Holt’s director of nutrition and health services. “About 25% of the children we serve have a disability, and more than 60% are under the age of 5 — a crucial developmental period for growth.” Unless they receive the essential nutrition they need during this critical period, children face irreversible consequences to their development and overall wellbeing.

The CNP embraces the philosophy that how children eat is just as important as what they eat. While eating may seem intuitive to many, it can be far more complex for infants and children with disabilities. Through CNP training, our feeding specialists empower caregivers with safe feeding techniques tailored to children of different ages and abilities. This approach encourages caregivers to consider key factors, such as positioning, sensory needs and the feeding environment. Additionally, caregivers learn to conduct nutrition and health assessments, enabling them to monitor each child’s unique nutritional needs, track growth and provide personalized support.

Caregivers at the Holt-supported daycare center in Mongolia used these skills to assess Altan. They realized that every time he ate, he was experiencing aspiration as bits of food and fluid entered his lungs. Unsafe feeding practices can have many severe consequences, from aspiration and poor nutrient absorption to pneumonia, choking, emotional trauma and other psychological and developmental ailments. That’s why improving feeding practices — or changing how children are fed — is critically important. Like many children with disabilities, Altan became chronically ill due to being fed in unsafe positions. But with hands-on training, ongoing expert support and resources like Holt’s Feeding and Positioning Manual, teachers and caregivers knew that they could help Altan — and empower his mom with training and support to help her son thrive.

Recognizing that Altan needed immediate care, the CNP team in Mongolia quickly took action. They helped him sit upright in supportive seating and introduced safe feeding techniques to prevent choking or aspiration. Ensuring he had access to nutritious foods, including plenty of fruits and vegetables, they provided the foundation for his growth. With the right support and therapy, Altan gradually developed essential skills like chewing, swallowing, crawling and walking. Over time, with the dedication of his care team, he grew stronger. Eventually, he could sit up on his own, stand independently and even communicate with his mother, caregivers and friends, marking incredible progress on his journey.

About 25% of the children we serve have a disability, and more than 60% are under the age of 5 — a crucial developmental period for growth.

Emily DeLacey, PhD, RDN, LDN, Holt’s director of nutrition and health services

Altan also was able to thrive thanks to the generous support that Holt donors have provided to the Molly Holt Fund. The Molly Holt Fund is named in honor of Molly Holt, daughter of Holt’s founders and a nurse who dedicated her life to caring and advocating for children and adults with disabilities and special needs around the world. Donations to the fund go toward everything from life-changing surgeries and medical care to rehabilitative therapies and special education to Holt’s innovative child nutrition program trainings for children in orphanages, foster families or living with their birth families in the countries and communities where Holt works. In short, your generosity has made a world of difference to children like Altan.

Full of Smiles and Laughter

Today, after two years in the child nutrition program, Altan is healthier and stronger than ever before. Not only is he getting the proper nutrition to stay healthy, but he is also enjoying mealtimes! Full of smiles and laughter, he eagerly exclaims, “Let’s eat!” before digging into his favorite dishes. Fueled with good nutrition and stronger than ever, Altan enjoys being an active 3-year-old, going to school and playing with his friends.

Thanks to Holt’s generous donors who support the CNP, Altan’s life has been forever changed, and he’s not alone. Each year, thousands of children benefit from this life-changing program. From simple, cost-effective changes to improve the position of children during mealtimes to caregivers using our growth and health monitoring system to accurately meet each child’s needs, these interventions dramatically impact the health and wellbeing of children across the globe. Over the past 10 years, Holt’s innovative child nutrition program has expanded its reach to more than 110 sites in eight countries.

For a child like Altan, the entire trajectory of his life has changed, allowing him to soar beyond his limited beginnings and experience all of the joys that life can bring. Not only that, but his improved health has contributed to a stronger, more stable family. His mother is no longer fearful and stressed about Altan’s health and her ability to care for him. Instead, she is proud of the progress her son has made —and confident in their future together!  

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The post Altan is Thriving, Thanks to You! appeared first on Holt International.

Hai cranes his neck to look through the doorway of his room. His eyes light up and his smile widens when he sees that there are visitors here to see him.

Every day, Hai spends most of his time in his crib. The crib is made of metal, with wooden slats on the bottom covered by a thin woven mat. Caregivers come in to help him eat, get dressed and go to the bathroom. Twice per day, he’s placed in a special chair and wheeled out to the courtyard to sit in the sun.

Hai has severe cerebral palsy, and very limited mobility. He can lay on his back, and turn his head from side to side, but his legs and arms are twisted tightly, and very thin for a 16-year-old boy.

“It breaks my heart,” says Hang Dam, Holt’s U.S.-based director of programs for Vietnam. “When he was in his former room, he used to have a television so he could at least watch cartoons and interact with younger children.”

Now that he’s older, Hai shares a room with a 22-year-old girl with a severe mental disability. This girl has only been here a few months, and before that she spent her whole life locked in her family’s home — because they had no resources to teach her how to function in public. This is heartbreakingly common for children with disabilities who are born into poverty. Now that she’s at the center, she has to be on medication to help her stay calm. She isn’t able to speak, and cannot interact with Hai at all.

Hang pulls stickers out of her bag and puts them on the bars of Hai’s crib. His smile widens, and he can’t take his eyes off them. He asks her to give him the rest of the sheet of stickers. He doesn’t want to use all of them up right away.

Child Welfare Centers in Vietnam

The orphanage where we meet Hai is located in a province several hours south of Ho Chi Min City in Vietnam. In Vietnam, orphanages are called “child welfare centers,” and they are directed and employed by the local government.

This child welfare center is a large, white two-story building centered around an open-air courtyard. The rooms, coming off of the courtyard, have white painted walls and white tiled floors.

From the outside, you wouldn’t immediately know kids live here. Not until you see the small plastic play structure in one corner of the courtyard, or the sports court lines painted on the ground outside.

The facility is clean, orderly and well-run. The caregivers and orphanage directors have strong relationships and bonds with the children, and they work hard every day to make sure the children’s needs are met. With the support of Holt sponsors and donors, Holt’s team in Vietnam helps provide medical care, more nourishing food for the children, nutrition and feeding training for the caregivers, and helps advocate for the children to ultimately join families through reunification or adoption.

But not every child will leave to join a family. And even though Holt has helped improve the quality for care at this orphanage, even a “good” orphanage is no place that a child should grow up.

No Place to Grow Up

The reasons children come to live in child welfare centers in Vietnam are because their families can’t care for them — either because they are truly orphaned, or their parents or extended family are incapable of caring for them due to mental illness, disability or imprisonment. Some infants, and even older children, are left at the gates of the center — and found and brought in by the staff.

This is a safe place for a child to live. But it’s meant to be temporary.

“The government strategy is now to deinstitutionalize,” says Huong Nguyen, Holt’s Vietnam country director. Deinstitutionalization, or transitioning children out of orphanage care, is Holt’s goal in every country where we work. We believe children are meant to grow up in a family, not an institution.

Huong explains that the government has strict criteria for who can and can’t be enrolled into orphanage care. “First [the government] sees if the child has any kind of relatives who can take care of them,” she says. “And even if a child does come to live at the center, they have a plan for reaching out to the family to discuss when they are able to reunite the child and the family.” 

Around the world, Holt advocates for every child to thrive in the love and care of a permanent, loving family. Whenever possible, a child should be reunited with their birth family. But if this isn’t possible, we next pursue domestic and then international adoption. But each of these paths can be complex, and the reality remains that thousands of children around the world live in long-term orphanage care settings.

Holt-Supported Orphan Care

Holt sponsors and donors have supported this particular child welfare center in Vietnam for over ten years. The youngest children in the center, and those with special needs, have Holt sponsors who help provide for their nutrition and educational needs. And over the years, Holt has provided supplemental funding to hire additional caregivers, as well as nutrition and feeding trainings for the staff through our Child Nutrition Program.

One of the caregivers, Le Leiu, has worked here for nine years. Her background was in nursing, which she said has been a perfect fit for taking care of the children, especially those with medical needs. She walks around, holding 22-month-old Vy on her hip, balancing the child around her own pregnant belly. Le Leiu says Vy has bonded especially closely with her. Vy isn’t walking yet, and is small for her age — it’s possible that she has dwarfism, and the caregivers and medical staff are continuing to assess her as she grows. She snuggles into her Le Leiu’s arms, giving a shy and small grin.

“This job is very hard work,” she says, “but seeing the children grow and develop every day gives me motivation.”

In 2019, Le Leiu took part in a training from Holt’s Child Nutrition Program. During the training, she and the other caregivers learned how easily children with disabilities can choke and get injured during meals, how to position them properly, and about the specialized formula or food they need to grow and develop. She says this training made a big difference for the children.

“Phillip,” for example, has cerebral palsy, and has benefitted greatly from the nutrition training.

His caregivers received the training when he was just a baby, so his whole life he’s been fed upright with the proper chair, utensils and technique. He hasn’t experienced as much aspirating, and the lung infections that can follow, like some of the other children have had to suffer.

Philip’s eyes are bright, and he smiles freely as he moves around in his crib, playing with a toy. Properly trained caregivers, and having enough of them employed at the center, have made all the difference for him. But this is a constant struggle for orphanages, which are chronically understaffed. Despite Holt’s efforts to bring in more caregivers, this problem persists due to Vietnam’s complex bureaucracy and strict policies.

Right now, for example, there are six caregivers who take care of the youngest children and those with special needs. But Le Leiu will soon go on maternity leave, and another caregiver recently got injured and is unable to come to work. So for the foreseeable future, there are just four caregivers – split up over three shifts – caring for 14 children with disabilities. The orphanage is doing its best to fill the gap by assigning one or two additional administrative staff to support the caregivers during meals and bath time, and by allowing older children to play and interact with the toddlers after school hours. 

Many of the children here — like Philip, Hai and Vy — have disabilities or special needs. But many others who live here are perfectly healthy, both physically and mentally. Some children live here for a short while, just several months or years until the can be reunified with their birth families. But many others, like Hai, will likely live here for their entire childhood, until they either age out and go out into the world on their own, or are transferred to a center for adults with disabilities sometime in their mid-20s.

Aging Out, or Adoption

What happens when a child moves to an adult facility?

“They stay there forever,” Huong says.

But thankfully, many of these children have another option — international adoption. That is, if a family comes forward before they age out of eligibility at 16.

While Hai is too old to be adopted internationally, there is still hope for 6-year-old Phillip, who has been on Holt’s waiting child photolisting for years.

“They see international adoption as very good for children.” Huong says of how intercountry adoption is perceived in Vietnam. “Because [the child] will have a better life, and they will be cared for better, and they will have more opportunities to develop themselves.”

This is because at even the best orphanages, they rarely have the specialized resources needed to help a child with disabilities and medical needs.

“What I’ve seen, and what makes me so sad,” Huong says, “is that for children with cerebral palsy, or autism or other disabilities, if they have enough therapy, their functions can be improved.”

But while they continue to live in the orphanage, their development is slow. While the resources provided by Holt donors address the most basic needs of the children — nutrition, education, medical care, even some therapy — their psychosocial and emotional needs can never fully be met in an institutional setting.

That’s why international adoption offers so much hope — in the care of a loving family, children can receive the medical care and therapies that are simply inaccessible in an orphanage.

Domestic Adoption in Vietnam

At Holt, our priority is to reunite children with their birth families. If that’s not possible, domestic adoption is explored for a child, and this option is always pursued first before international adoption.

However, domestic adoptions, Huong explains, really only happen for the youngest and healthiest children.

For the children who are eligible for domestic or international adoption, they live each day, month and year in hopeful waiting for a family to adopt them.

The Complexity of Reunification

For some children, it’s a different kind of waiting. These children are waiting for their birth family to become stable enough to bring them back home.

“I felt scared when I first came here to live,” says Thuy. Today she’s 16, but she started living here at just 6 years old. She’s a beautiful young woman, petite with an athletic build. Glasses frame her deep, bright eyes, which fill with tears as she shares her story.

“He can take care of me,” she says about her father, who lives just a couple miles away from the center. But the heartbreaking, unspoken implication is that he’s not truly capable of caring for her…

Thuy says her father used to come and visit her, as well as her older biological sister who lived in the center. But he visited less and less frequently as she grew up. Now, she mostly sees him on holidays.

“I wanted to live with my father, but he often drinks,” she says. “He goes out and gets drunk all the time, and comes back violent… So I feel safer here.” She cries softly as she shares this, and the orphanage staff who sit with her fail to hold back their tears as well.

Thuy says that in the future she wants to graduate and get a good job, so that she can help support her father and biological sister.  

Despite her father’s abuse and unhealthy lifestyle, it’s evident that she still cares for him deeply. It’s a complexity that shows a child’s deepest desire – to be loved and wanted by family. And while the children live here at the center, the caregivers try to operate as close to a family as they can.

Orphanage Family

The children who live here refer to each other as brothers and sisters, and to their caregivers as mothers. Because for the time being, they are each other’s family.

Caregivers will take the older children out for coffee, to talk with them and offer support. And even when children age out of the center, they often come back to help take care of the younger children — or to receive support from the staff as they learn how to find an apartment, apply for a job, budget their money and learn how to cook.

“I’m both happy and sad when I’m living here.”

Thuy walks upstairs, down an open-air hallway to a room that she shares with six other girls. Above the entrance to their room is a brightly colored, handmade sign that reads “Tiem Salon” with drawings of hearts and stars around it.

The room consists of three bunk beds, and in one corner are several clothes racks that hold the girls’ school uniforms and outfits.

Thuy shows us her bunk, but then points to a different bed across the room.

“I sleep here, though, with my sister,” she says.

“They love each other,” her caregiver says smiling. These girls aren’t biological sisters, but have bonded closely as sisters while they’ve lived here.

“I’m both happy and sad when I’m living here,” Thuy says.

This sentiment could describe every child who lives here. Each of them has experienced the heartbreak of illness, poverty, family loss and more. But they live every day with hope.

Here at the center, they are safe, they have enough food, go to school and have their basic needs met. Their caregivers do all they can for them, and are constantly striving to make their lives better.

They hope for a family — whether that means going home to their birth family or joining a family through adoption. And they embrace their “family” in the orphanage as they wait.

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The post Growing Up in an Orphanage appeared first on Holt International.

You’re amazing! Through your heartfelt giving in 2024, you helped make a tremendous difference in the lives of over one million children, families and individuals around the world. Whether you provided regular support as a monthly child sponsor, gave on Giving Tuesday to help a girl go to school and stay safe from child trafficking and early marriage, helped a child with special needs receive the care they need to thrive through the Molly Holt Fund or helped meet one of our president’s year-end priorities for children in greatest need, you brought hope and opportunity to the lives of many of the world’s most vulnerable children and families. Keep reading to learn about some of the specific ways that your gifts to Holt made a difference in 2024!

While much of Holt’s work is community-based, your gifts also provided direct care and services to over 431,000 children this past year. Designed to provide the exact help a child needs at the time they need it, this kind of direct care includes everything from emergency food and safe shelter for a family in crisis to surgery or needed medical treatment for a child with special healthcare needs to foster care and social work support to help a child reunite with their family or join a family through adoption.

In 2024, you helped 181 children join permanent, loving families through adoption — 110 of them through international adoption, and 71 through domestic, in-country adoption to families living in the child’s country of birth. Overall, 95% of children adopted internationally were older than age 5, part of a sibling group or had at least some minor special needs. This past year, 65% of children placed internationally had moderate or major physical, cognitive or developmental disabilities. And while the number of children with complex special needs joining adoptive families internationally has increased, so has the number of older children. This past year, 64% of children were older than 5 at the time they joined their families — and 29% were between the ages of 10-18! This shift is a truly wonderful development for children who in prior years would watch as younger, healthier children left the orphanage to join families, while they stayed behind with little hope of ever being adopted. Your support of advocacy programs for older children like Holt’s Thailand and Philippines special needs programs — and the Colombia hosting program — has helped make this shift possible.

Today, the overall cost of international adoption exceeds the actual fees and expenses required to complete the process. This is one key reason why so many agencies have closed their doors in recent years. It’s only through the generous support of donors like you that Holt is able to continue this vitally important practice for children who cannot remain or reunite with their birth families, or join domestic adoptive families in their country of birth Thank you for supporting this vitally important path to a family for children who would otherwise grow up in, and age out of, orphanages overseas.

Visit our waiting child photolisting to learn about the more than 200 children waiting for families who are older or have complex special needs — and how you can begin the process to adopt, or support their journey to a family!

For children growing up in orphanages around the world, Holt stands by our belief that joining a family through adoption is the last, best option for them. For these children, an adoptive family provides the attentive, nurturing care that they need to achieve critical developmental milestones and to reach their potential in life. Countless studies have shown the detrimental emotional and developmental effects that long-term institutionalization has on children, and this is compounded for children who already have special medical or developmental needs — as is the case for many of the children growing up in orphanages overseas. This is why we stand by our commitment to continue international adoption for children in an ever-changing and increasingly challenging landscape.

But we also firmly believe that every child should have the chance to grow up in their birth family, and birth culture, whenever possible. Before we ever pursue adoption for a child, we first strive to help them grow up in the loving care of their birth family.  For children living in orphanages, this often means a long social work process to identify their immediate or extended family and explore the possibility of reunification. And in 2024, with donor support, Holt teams around the world helped reunite 302 children with their birth families — a significant number when you consider the time and resource-intensive work that goes into identifying relatives and ensuring children can thrive in their care.

But everywhere we work, our first goal is always to prevent family separation in the first place. And with the generous support of sponsors and donors, 29,023 children who were at risk of separation were able to remain in the loving care of their families in 2024. With support tailored to each individual child and family, you helped provide everything from clothing, warm bedding, safe housing and school supplies to livestock for nourishing food and income. In 2024, 4,405 individuals also participated in Holt-supported economic empowerment programs, including job skills training, education in how to grow gardens or tend livestock, financial literacy training, village savings and loan groups and other innovative programs that empower families to generate a stable income and independently support their children.

With generous donor support, 4,817 adoptees and families received support from Holt’s post-adoption services team in 2024 — 1,264 more than in 2023. While this shows greater success in outreach to those needing support, it also underscores the tremendous need for post-adoption services among those touched by adoption. In 2024, we saw an increased need for assistance with citizenship and documentation, in addition to other services such as birth search support, counseling referrals and post-adoption parent education through our PACE program. Over the summer, over 180 campers attended Holt Adoptee Camp in Oregon, Wisconsin and New Jersey — a unique program designed to build adoptee community and help adoptee youth explore their identity alongside campers and counselors who share the unique experience of growing up adopted. After a five-year hiatus due to the Covid-19 pandemic, we resumed our counselor-in-training program to help recruit more Holt Adoptee Camp counselors. Our post-adoption team also held an adoptee networking event designed to introduce adoptees to each other and local adoptee organizations that hold events, community support groups and education. With more than 50 attendees, this event also gave adoptees the opportunity to access and review their original adoption file with a member of Holt’s post-adoption team — rather than sending them a digital copy. Returning original documents is a great step for adoptees to reclaim and honor their identity and history.

In many countries around the world, an education is not a right. It is a privilege. Children living in poverty do not have access to a free public education system and equal opportunity to achieve their goals. The cost of fees, uniforms and supplies required for school mean that parents may have to choose between feeding their child — or giving them the opportunity to learn and one day, escape the cycle of poverty. Often, children drop out of school to work and help earn income for their family. In some cases, girls as young as 12 or 13 are married off and when they do, their formal education ends. But for over 22,500 children and young adults this past year, you helped them stay on the path to completing their education, leaving a life of poverty, and following their dreams.

Whether you provided monthly support for school fees and supplies as a child sponsor, gave a scholarship through Gifts of Hope or supported our Giving Tuesday campaign to help girls go to school, you helped provide the support and resources needed for 21,356 children to receive an education in 2024! Additionally, donors like you helped 1,211 young adults growing up in poverty or in orphanages to pursue higher education — including through our ILEA program for children aging out of orphanage care in the Philippines. By empowering children through education, you also help protect them from trafficking, abuse, child labor and other dangers that increase exponentially when children are out of school. Thank you for keeping children safe and making their dreams possible in 2024!

In the impoverished communities where you support children, food security continues to be a major concern. Children arrive at school hungry and tired, without lunch, and go home unsure if their family will eat a full meal before bed. But because of you, over 195,000 children received the nourishing food they need to thrive in 2024.

Whether you gave emergency food to a family in crisis, supported a preschool program that provides free lunch or provided a cow, goat or garden for a family to produce their own food, your gifts provided the essential nutrition that children and families need to grow strong and healthy and work toward a better life. In total, Holt sponsors and donors provided a staggering 2,361,064 meals to hungry children and families in 2024.

In 2024, Holt also celebrated 10 years of our Child Nutrition Program, a multifaceted effort that seeks to strengthen nutrition and feeding practices for vulnerable children living in orphanages, foster homes and impoverished communities across the globe. What started as a pilot program in two locations in India has since expanded to eight countries, serving more than 55,000 children over the past decade.

Holt’s specialized care and support for children with disabilities is one way that our programs are unique from other organizations around the world. Many of the children you support through Holt programs have special healthcare needs or disabilities. In 2024, you helped 2,280 children with disabilities to live fuller, happier lives. In Vietnam, you provided special education and an outreach program in a community where children with disabilities would otherwise stay home all day. In Mongolia, you helped support a program that helps children with disabilities living in impoverished communities to access the specialized resources they need. Through Gifts of Hope, you helped provide adaptive equipment like wheelchairs and hearing aids. And through Holt’s pioneering Child Nutrition Program, you provided the resources to train 15,554 caregivers and parents in how to properly feed children with disabilities so that they are able to receive the full nutrition they need to thrive. 

Through your kind and generous donations in 2024, 3,692 children living in orphanages, group homes, kinship or foster families received the essential food, clothing and medical care they needed, in addition to safe places to live and nurturing care from devoted caregivers.

Holt’s kinship and foster care programs provide more nurturing, family-like care for children who would otherwise live in institutions. Through kinship care, sponsors and donors provide the support children need to live with a family member —  if not a birth parent, then possibly an aunt, uncle or grandparent who can provide loving, attentive care. In many cases, children living in foster care are waiting to rejoin their birth families or join a family through domestic or international adoption. These highly trained and loving foster families provide the one-on-one care, attention, and social and physical development children need to reach critical developmental milestones — and thrive once they join a permanent family.

Whether you helped provide routine health screenings through Holt’s Child Health Days in rural Uganda or a life-changing surgery for a child with a special medical need, your generous donations helped provide vital healthcare for 131,914 children in 2024. As children need caregivers who are healthy and equipped to give them attentive, engaged care, your donations also helped provide medical care for 111,215 parents and family members.

Around the world, children are often sick when they first enter orphanage care. Sometimes this has to do with underlying medical conditions or special needs. Sometimes it has to do with the impoverished conditions they lived in before coming into care. Sometimes it’s because they routinely experienced hunger. Often, it’s a combination of all three. This was true for one 2-year-old girl living in an orphanage in India who donors helped this past year. But thanks to Holt sponsors and donors like you, she received the medical care, nutritious food and therapies she needed to become healthy again.

In 2024, you and your fellow donors gave 5,456 Gifts of Hope to children and families in need around the world. You gave food for hungry children, shoes to keep children’s feet warm, dry and protected on their long walk to school, an egg a day to provide vital protein to growing kids, and livestock likes goats, chickens and cows to nourish families and provide vital income when they sell the offspring. You provided school scholarships for children who might not otherwise go to school, as well as the books and supplies they needed to succeed. You gave the gift of nurturing foster care to children waiting for a permanent, loving family, and urgently needed orphanage supplies like diapers, cribs and blankets. You empowered single mothers to earn income for their family through the gift of job skills training or a small business microgrant. You gave Christmas and birthday gifts to children whose families or caregivers can’t afford to provide gifts on these holidays. And you gave to Holt’s Where Most Needed fund to make it possible for our staff and partners in the field to meet immediate, vital needs of children and families that might otherwise go unmet.

Thank you for your heartfelt gifts to children and families in need in 2024. We can’t wait to partner with you again in 2025!

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In the past two decades, rapid development in China’s urban centers have lifted millions of people out of poverty. Today China — a nation of 1.4 billion people — boasts the world’s second-largest economy. But the nation’s wealth is not distributed equally. In fact, many children and families in rural communities struggle to get by. Out of desperation, young people living in these communities often migrate to cities in search of work, many of them leaving their children behind in the care of elderly grandparents or relatives. Often, these relatives struggle to provide for them on their own meager resources, placing children at risk for malnutrition, poor growth and impaired development. Infants and children with disabilities are among the most vulnerable to these conditions.  

But with the support of Holt donors, one global program is empowering families in China to safeguard children in their care.

Holt Targets Nearly 3,000 Children and Their Families

In 2014, we developed the Holt International Child Nutrition Program (CNP), an innovative nutrition and feeding program that helps children living in orphanages, foster homes and impoverished communities become healthier and experience a better quality of life. This donor-funded program has since been implemented in eight countries, including China, and offers education and community outreach among its many services.

“I think the flipbook is very interesting and innovative. There are pictures and words in it, [and it is] very visual.”

Social Worker in China

In 2021, the CNP team created the Child Nutrition Program Community Flipbook as one of its community outreach tools. The flipbook is just that — a book that social workers can flip through when visiting with families to teach proper nutrition and health practices. It provides answers to questions and engages families in activities on topics such as general nutrition, health conditions, women and infants, nutrition by age, feeding support and mealtimes, and hygiene and sanitation. Using simple pictures and storylines, the flipbook is geared toward the participatory engagement of audiences of various literacy levels.

Although initially produced in English, in 2022 Holt’s U.S.-based CNP team worked closely with our team in China and in strong partnership with the Chinese government to create a Chinese version of the flipbook. This past April, 357 flipbooks were distributed to social workers in Xinxiang, a city in Henan province with nearly 3,000 vulnerable children. Holt’s CNP team trained the social workers in how to use the flipbooks when they visit children and their families in their homes to learn more about their needs, help them gain access to essential services and offer fundamental nutrition and health education. “I think the flipbook is very interesting and innovative,” shared one social worker who attended a training. “There are pictures and words in it, [and it is] very visual.”

Holt China plans to reach nearly 3,000 children and their families in Xinxiang with education and support. Once the initial program is implemented and assessed, the team will extend its reach to other provinces. “We are so happy to see that the CNP program can go into Chinese communities, especially in rural areas,” says Kate, a staff member at Holt China. “Scientific nurturing is not only a kind of skill, but also a mindset, and we hope that such a good mindset will reach the hearts and minds of more vulnerable and ‘left-behind’ children and their parents.”

Nutrition and health education strengthens families and improves lives. Thanks to the generous support of Holt donors, the CNP and its Child Nutrition Program Community Flipbook are reaching those who need it most — and making this dream a reality.  

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Nearly 250 million children around the globe suffer from malnutrition. Today, malnutrition and hunger-related diseases are the biggest killer of children under age 5 in the developing world. Even if they survive, children who experience hunger or malnutrition are less likely to thrive or reach their potential in life. They are often sick, routinely miss school and experience long-term effects on their overall health and wellbeing. Children living in institutional care are among the most vulnerable to malnutrition.

“Most children who enter the program are under the age of 5. Since the early years are the most critical for a child’s nutrition and development, we try to reach and help children early in life.”

Emily DeLacey, Holt’s director of nutrition and health services

In 2014, Holt worked to establish an innovative nutrition and feeding program to help address these issues among the children we serve alongside our dedicated sponsors and donors. The Holt International Child Nutrition Program (CNP) is a multifaceted effort that seeks to strengthen nutrition and feeding practices for vulnerable children living in orphanages, foster homes and impoverished communities across the globe.

 “Most children who enter the program are under the age of 5,” says Emily DeLacey, Holt’s director of nutrition and health services. “Since the early years are the most critical for a child’s nutrition and development, we try to reach and help children early in life.” As so many children living in institutional care have disabilities or medical needs, the CNP also takes a special focus on meeting the nutrition and feeding needs of these children. In many cases, the reason children with disabilities are malnourished is due to incorrect feeding practices — for example, feeding children with cerebral palsy while they are laying down, which can cause them to choke on their food. But through training with feeding specialists provided by Holt’s CNP, caregivers around the world have learned correct feeding and positioning practices, significantly reducing malnutrition and hunger-related illness among the children in their care. Currently, a quarter of the children in the program — including children living in orphanages and with their families – have a disability or medical need.

What the CNP Has Achieved

Over the past 10 years, the CNP has reached a number of significant milestones:

• The CNP was initially launched at two pilot sites in India, serving 267 children. Since then, the program has expanded to more than 110 sites in eight countries. Over the past decade, we have reached more than 55,000 children in China, Ethiopia, Haiti, India, Mongolia, the Philippines, Uganda and Vietnam.

• Over the past 10 years, this donor-funded program has provided approximately 287,780 nutritious meals to children. For example, students at a kindergarten for children with disabilities in Mongolia receive a healthy lunch every day. The program also has distributed more than 172,000 essential vitamins, minerals and supplements to children, including those in rural Vietnam who are at risk for malnutrition due to anemia.  

• Since its inception, the CNP has conducted multiple-day, in-person training sessions with on-the-ground staff and caregivers at community centers, foster care homes, health centers, residential care sites and daycare facilities for children with disabilities. To date, more than 7,000 caregivers have been trained in life-changing nutrition and feeding practices! Once caregivers are trained, they become CNP champions who are then able to train others. “This allows the program to grow exponentially,” says Emily.

• In 2019, the CNP team created Holt International’s Feeding and Positioning Manual: Guidelines for Working With Babies and Children. Used widely by caregivers involved in Holt’s CNP, the manual has been translated into nine languages. It provides information on safe feeding practices as well as general information on infant and child development, critical milestones for caregivers to monitor, and helpful strategies that support and enrich the overall wellbeing of every child.

• Following the release of its feeding and positioning manual, the CNP team began to publish peer-reviewed research papers on the needs of vulnerable children around the world in an effort to share its findings. The first paper on the nutritional status of children living within institutionalized care was published in 2020. Since then the team has published 15 more papers in addition to 10 technical resource manuals, including the Child Nutrition Program Community Resource Manual.

• In 2021, the CNP team created the Child Nutrition Program Community Flipbook to further its community outreach efforts. Soon to be available in nine languages, the flipbook is designed to support education for families on proper nutrition and health practices. It offers questions and activities on topics such as general nutrition, health conditions, women and infants, nutrition by age, feeding support and mealtimes, and hygiene sanitation. Because of its emphasis on simple pictures and storylines, the flipbook is geared to participatory engagement of audiences with various literacy levels.

Recently, 357 flipbooks were distributed to social workers in Xinxiang, China, a city with nearly 3,000 vulnerable children. The social workers will visit children and their families at their homes to learn more about their needs, help them gain access to essential services and offer fundamental nutrition and health education through use of the flipbooks.

The CNP Has a Lasting Impact

As the CNP team looks to the future, it can reflect on its success over the past 10 years — as it plans to expand its programs. Here are some of its achievements:

• Malnutrition has been substantially reduced! Of the children who entered the CNP malnourished, 38% are no longer malnourished after one year of participation. This includes 42% of children with disabilities and 28% of those without disabilities. Before entering the program, malnourished children may have experienced stunting (they were too short for their age) or wasting (they were too thin for their height) among other issues.

• With support from their trained caregivers, many children see their feeding difficulties resolve after one year in the program. About 33% of children with disabilities and 54% of children without disabilities no longer have feeding difficulties after participating in the CNP.

• At every evaluation, site directors have shared that since the implementation of the CNP, children are less sick less often, have more energy and seem happier. In short, their quality of life has improved! According to one caregiver in the Philippines, “We’ve seen many positive changes in children’s health and development since implementing the CNP at our site. Children’s nutritional intakes and feeding quality were much improved and so their health condition became better.”

“Programs like the child nutrition program have a lasting impact on the lives of children,” Emily adds. “By early intervention and prevention or treatment of malnutrition, we change the entire trajectory of a child’s life. When children are well-nourished, they can grow to their full potential!”

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The post Celebrating 10 Years of the Holt International Child Nutrition Program! appeared first on Holt International.

Two-year-old Kashvi was sick when she first came into care at our partner orphanage in India.

She was small for her age due to malnutrition and was behind in development when it came to talking and walking. But she was soon diagnosed with something even more serious, something that would require lifesaving care…

When Children Come to the Orphanage

Kashvi and her sister first came to our partner organization in Pune, Bharatiya Samaj Seva Kendra (BSSK), because their mother has an intellectual disability that made her unable to safely care for them and meet their basic needs. Children come into orphanage care for a myriad of reasons, each reason heartbreaking. While Holt and Holt’s partner organizations always strive to first keep a child in the care of their birth family, this is sometimes not possible — as was the case for Kashvi and her sister.

Many children are sick when they first enter orphanage care. Sometime this has to do with underlying medical conditions or special needs. Sometimes it has to do with the impoverished conditions they lived in before coming into care. Sometimes it’s because they routinely experienced hunger. Often, it’s a combination of all three. 

“We see that upwards of 40% of children are malnourished when children come into care,” says Emily DeLacey, Holt’s director of nutrition and health services, “with an even higher prevalence of malnutrition among the 25% of children who come into care with a medical need or disability.”

This was true for Kashvi. But thanks to Holt sponsors and donors, there was a place ready to provide her with the medical care, nutritious food and therapies she needed to become healthy again.

High-Standard Medical Care for Orphaned Children in India

BSSK has cared for children for more than 44 years and has high standards of care for the children at their facility. Donors help make it possible for BSSK to maintain a low caregiver-to-child ratio, ensuring that children’s individual needs are noticed and met. Trained cooks prepare nutritious meals. Orphanage staff track children’s nutrition and growth through Holt’s Child Nutrition Program, providing interventions when needed. Safe indoor and outdoor play areas give children a fun place to play and develop. And each child regularly meets with occupational therapists who assess their needs and help them work toward their physical, emotional and developmental goals. There’s even an intensive neonatal care unit on site for the smallest, most fragile babies.

With this attentive care, Kashvi’s health began to improve.

“She not only gained weight, but also started to thrive socially and emotionally,” says Prajakta, BSSK’s childcare program director. “Her integration into age-appropriate activities and interactions with other children reflect her growing confidence and comfort in her surroundings.”

But she still seemed easily tired and out of breath when she played with the other children. Her caregivers took these concerns to Kashvi’s doctor, who quickly found out what was wrong — Kashvi had a hole in her heart.

It’s not uncommon for children to be born with a small hole in their heart, although it often resolves itself within a couple of years. But Kashvi’s heart defect was large, and would need surgery to repair.

Kashvi’s Heart Condition

Kashvi’s heart condition also likely played a large role in why she was malnourished. Her heart was having to work harder than it should – increasing her metabolism and energy requirements. The reduced blood flow can also slow gut motility and decrease stomach size. Her heart’s inefficient pumping also causes fluid to back up into other organs. Often children with heart issues will need specialized diets (such as low fluid or salt), which can also make it hard to ensure a child receives adequate intake.

Because of her heart condition, Kashvi was more at risk for decreased food intake, frequent illnesses, infections, impaired nutrient absorption and increased energy and protein needs. If her condition was not treated early, she would be permanently impacted from malnutrition and poor growth…

But thankfully, with support from generous Holt sponsors and donors, the resources were available to help Kashvi right away.

“Our team, supported by Holt’s generosity, immediately sprang into action,” Prajakta says, “ensuring she received the necessary medical attention and support.”

Medical Resources, Nurturing Care

In order to have a successful surgery, Kashvi needed specialized medical care in the days leading up to the procedure. She had a cardiac catheter that helped determine exactly what was going on in her heart, as well as daily four-hour-long oxygen treatments. But her dedicated orphanage caregivers were there with her every step of the way.

Kashvi received open heart surgery to repair the hole in her heart, and it was successful! Her caregivers say she was strong and in good spirits throughout the whole process. Although her journey was not yet over.

“None of this would have been possible without the steadfast support of Holt [donors]. Their generosity has enabled us to provide Kashvi with the love, care and support she deserves.”

Next came 15 days of intensive post-operative care in the hospital, as Kashvi’s doctors strived to ensure she recovered well. Her caregivers remained at her side while she recovered, and then helped her adjust back to life in the orphanage as soon as she was able to return.

Today, Kashvi is 4 years old and doing so well. Her caregivers and doctors keep close watch on her health, and ensure that she receives the care she needs to continue to recover and grow. She and her sister are both matched with adoptive families, and will unite with them as soon as the adoption process is complete.

“None of this would have been possible without the steadfast support of Holt [donors],” Prajakta says. “Their generosity has enabled us to provide Kashvi with the love, care and support she deserves.”

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Uganda is a nation in East Africa where nearly 20% of the population lives in chronic poverty. Holt has been working in Uganda since 2001 to help vulnerable families and children, particularly those affected by HIV/AIDS.

In 2023 alone, Holt Uganda provided nutrition and health screenings, vitamin supplements and treatments to more than 165,000 children, thanks to local partnerships and Holt donor support. Holt also provided prenatal services to more than 4,000 pregnant women and served a nutritious meal each day to 915 children at early childhood care and development centers in rural areas.

But there’s still more work to be done.

In 2021, Holt Uganda conducted a large-scale survey of more than 7,000 households in three districts in central Uganda. Some of these households participate in Holt’s family strengthening or sponsorship programs and some do not. In addition, about 4.4% of these households have at least one child with a disability.

The survey questionnaire, designed by Holt as part of its routine programming and data collection in Uganda, asked families about their access to health, water, sanitation and hygiene (WASH) services, as well as their dietary and nutritional needs. It was conducted to inform and improve Holt’s work in Uganda, with a particular focus on children with disabilities. “These families are typically excluded from most research and population counts — but Holt is committed to providing disability-inclusive services in all the countries where we work,” says Emily DeLacey, PhD, RDN, LDN, director of Holt’s Nutrition & Health Services and the senior researcher on the study.

As a result of the research, Holt was able to determine the following:

• Only 57.9% of Ugandan households surveyed have access to the nutrition and health services they need. Deworming and vaccination services were reported as the most important — yet difficult — to access. One reason for this challenge is that nearly 30% of the population in Uganda must travel more than 5 kilometers (about 3 miles) to reach a health facility. A lack of transportation in rural and remote areas creates an additional burden for these families.

• Access to health and nutrition services were reported as 30% lower for households with children with disabilities. These households often face barriers to receiving adequate care due to inaccessible health facilities or transportation, medical professionals not trained or healthcare programs not structured to provide services for these children, or even stigma against disabilities, resulting in children being unwelcome or deemed a lower priority for health services.

• When children with disabilities have access to clean water, sanitation and good hygiene, their access to nutrition and health services also improves.

•  Improved and inclusive access to nutrition, health and WASH services for people in Uganda, including children with disabilities, needs to be prioritized as Holt creates more targeted programs in the future. “This research enables us to better advocate for improved access to nutrition and health services for vulnerable families in Uganda, especially for those with disabilities,” says Emily.

To learn more about the survey and its findings, check out Holt’s recent publication in the scientific journal “Maternal and Child Nutrition” and view the Infographic below.

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The post Infographic: Children With Disabilities Lack Access to Nutrition, Health and WASH Services appeared first on Holt International.

This last month, my team and I traveled to India to provide a training on the Holt International Child Nutrition Program (CNP) for our long-term, wonderful partner, Vathsalya Charitable Trust (VCT). Some of the most active participants in the training were parents and caregivers from a new site that is supported by VCT, Grace Foundation. These parents, therapists and caregivers were some of the most active and vocal participants, finding immense value from the training for their work and the children they care for. At the end of the training, we visited Grace Foundation with a core group of CNP leaders to complete the training practicum and learned so much more about the site and how it is changing lives.

Grace Foundation is a center in Bangalore that provides care and respite services for children with disabilities. Supported by our partner Vathsalya Charitable Trust, this center offers an impactful way to ensure children with disabilities have the opportunity to live full lives. For many children and families living in underprivileged communities of Bangalore, this is the first time they have felt welcomed or accepted and it makes all the difference. These families care so much about their children and the center empowers them to continue caring for their children instead of relinquishing them to orphanages. Through Grace Foundation, they can ensure their children receive nourishing meals and educational experiences they would not otherwise receive.

Grace Foundation has a unique setup. Based on a rotating schedule, 15 parents take turns providing care to the 44 children and young adults at the site, which allows the other parents to work on the days they are not at the center. The site offers resources, daily occupational therapy, nutritious meals, a safe place to play and learn, and socialization with other children. They have a visiting physiotherapist, speech therapist and special trainer who teaches activities of daily living and vocational training to the children. The Grace Foundation team also takes the children to a local hospital for monthly check-ups.

As a result, the center has changed the lives of the children and families who participate.

When we met with mothers and fathers at the site, many were in tears telling us how hard their lives were before they found the center. They shared about how they often had to lock their children in the house — some of whom have severe disabilities — for 12 hours a day so that they could go to work. When they would get home, they would just have to clean and feed their children who would have soiled themselves during the long day inside. Most of their homes in the slum communities in the surrounding areas do not have bathrooms and many of the children were not able to cook or feed themselves. This tortured existence led many to consider placing their children in orphanages.

Some of the children also experienced sexual and physical abuse when they were left unsupervised during the day. One child was lit on fire by community members who thought her disability was a demon to be exorcised.  The parents shared their guilt and heartache over their circumstances, which left them without options or hope and put their children in high-risk situations.

Many also mentioned how they were excluded and stigmatized because their community members did not accept their children, how their neighbors were unkind, pubic transport was impossible and schooling inaccessible. Some parents described losing spouses to suicide or abandonment because of the challenges associated with caring for a child with disabilities. But they loved their children so much, they just continued to do the best that they could do. 

When they found Grace Foundation, their whole lives changed! They found other parents who loved their children, regardless of their disabilities, and wanted them to have full lives. Their children found friends, regular nutritious meals, daily therapy and educational or career activities.  

As most of these children will stay with their families for their entire lives, the free day center creates a long-term solution — helping families to earn an income and continue caring for their children as they grow instead of placing them in an institution. The parents who work are also paid by the center on the days that they care for all the children. Empowered by the resources and support at Grace Foundation, some of the families have even been able to adopt other children with disabilities who were abandoned by their families.

Despite its successes, this center is not without challenges. Children with disabilities continue to face stigma held by community members who don’t want them in their neighborhoods, and as a result, the center has had to relocate and is in an unstable lease. Superstition and misinformation persist, and many believe disabilities are contagious or bad omens that put their own children at risk. The center often faces funding shortages for adequate nutritious food and child education resources, as well as poor access to clean water and an inability to wash laundry.

But with funding from local donors as well as Holt sponsors and donors, this site will support the children as they grow into adulthood and continue to ensure their families have the respite and resources they need. With Holt funding, VCT provides nutritional supplements, ongoing food — especially fresh vegetables – nutrition and health screenings through Holt’s child nutrition program and last month provided refrigeration for their kitchen.

Despite the many challenges they face as parents — often single parents — living in poverty and caring for children with disabilities, the families are committed to the success of the center because this is their only hope for their children to live full lives.

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