Almost every poor country, by contrast, still puts children in institutions, even though the vast majority of those children have families. Wealthy countries, who consider orphanages harmful for their own children, nonetheless provide a stream of charitable giving that makes orphanages viable businesses abroad. And orphanages need “orphans”. Parents may hand over children because they have special needs, or because the family can’t afford to send them to school. “It’s a huge pull factor: if they can get food, health care, education, specialised services, parents make a decision they think is in the best interests of the children,” says Shannon Senefeld, senior vice president for overseas operations at Catholic Relief Services. Save the Children looked at orphanages in Sri Lanka in 2005 and found that 92% of children had a living parent. A 2006 survey by Unicef in Liberia found that 98% of children living in orphanages were not orphans. Donors from wealthy countries – most often, religious groups – often establish orphanages in response to a crisis. But after the crisis is over, donations keep arriving, so the institution stays open. In Aceh, Indonesia, after the 2004 tsunami, hundreds of institutions for children were opened. But Maestral found that more than 97% of the children in them were brought by their families so they could get an education. “Very few of the children had been affected by the tsunami at all.