Working children are visible everywhere in Kampala. Even babies, too young to walk and wearing fouled, ill-fitting clothes, sit among the rubbish and hold out their hands as cars and people stream around them. Social work colleagues travelling in a taxi with me explain the babies are born into slavery. They tell me that the older children begging are also trafficked, and bring my attention to the men standing nearby, like shadows watching over their human property.

As we drive from one social service to another, Ugandan social workers point out realities that outsiders may not understand or even see. We pass a busy market with signs and stalls for fruit, vegetables and furniture – but just out of sight, I’m told, there is a stall with no advertisements, where desperate parents can sell their children to traffickers. The trafficked child can then be bought by anyone. The top price, the social workers say, is $15 per child.

In countries without strong social protection systems, children are extremely vulnerable – not only to trafficking, but also in institutions that do advertise: orphanages.

Orphanages are prolific in Uganda. Fuelled by families facing impossible choices, children are placed or sold into an agency that promises to secure a better life for them. But the promises are rarely kept. Most orphanages in Uganda profit through well-meaning overseas donors who make regular payments towards the child’s wellbeing, yet in reality little of this money is spent on care or education.

Children in typical orphanages become institutionalised by the loveless environments. They often suffer from developmental delay, show little emotion (with the exception of aggression), don’t speak and trust no one. Like the trafficked children on the streets, they too are forced into unpaid labour, thereby earning a double income for the orphanage owners. Consequently, the number of orphanages keeps going up.

But changes are taking place. Social workers across Uganda have been advocating for new systems of welfare to replace the longstanding culture of orphanages, and now the government is reviewing their operations. “Simply closing the orphanages isn’t enough,” Michael Byamukama, president of the National Association of Social Workers in Uganda, explained to me. “Transformational social service systems must be created that support families to keep and care for their children.”

Social workers have been showing how this change in the law may work even when resources are limited. Social workers at the Child’s I Foundation have built multifocused services that address the underlying poverty issues and assist with the reintegration of the babies, children and young people returning back to a loving family environment. Their role includes giving guidance on family income generation planning, providing education on the realities of orphanages and the developmental needs of children, and the formation of community child protection centres in every neighbourhood.

Supported by social workers, these centres are run for and by community members. Each is based on a charter of child rights and provides training on parenting skills, nutrition and building support within and between families, as well as focusing on children’s needs for safety, love, security and education. They also act as advocate bodies to shape government policy and social service delivery to meet the real needs of their communities.

“The centres are working,” explains Eric, a manager from Child’s I Foundation. “We have a very long way to go but families want their children to be healthy, happy and loved. Slowly, along with other committee professionals, we are transforming the social services sector.”

Social workers in Uganda, and in many other places across the world, are building social services from the bottom-up and transforming state services to meet the aspirations of those they serve. The approach relates to the profession’s global principle of self-determination and international practice wisdom, which consistently illustrates that engaged and active communities thrive and make the best decisions for this and future generations.

• Rory Truell is secretary-general of the International Federation of Social Workers (IFSW). The IFSW African regional conference, hosted by the National Association of Social Workers Uganda, takes place between 28 and 31 October. Practice examples from across the region will be presented, along with multisector discussions on the challenges of trafficked children

• This article was amended on 16 October 2019 to correct the name of the manager from Child’s I Foundation. In addition, an earlier version said that last year Unicef estimated the number of children living in orphanages in Uganda to be about 2.7 million. However, there is not a definitive number for the country; that figure is from a 2017 Unicef report, and is an estimate of the number of children in residential care globally.