Chicago John:
I left out a few steps in my very brief analysis of the 19th century (and the twentieth, pre-social programs): Because the only aid available was from religious and charitable organizations, who by themselves were not able to help everyone, people suffered from the ills mentioned earlier. Poverty bred poverty, and children and others were forced into labor. The elimination of TB was accomplished mainly through large government-mandated r(ooohh!) programs of testing and treatment, and the realization that crowded and filthy living conditions were a major contributing factor.
As for the remark about foster homes: I'm speechless. No, the system isn't perfect. I have never yet interviewed a single kid who was sexually abused in a foster home. I have interviewed many who were abused by daddy or mom's boyfriend. I suspect you have not ever met any foster parents personally, or you would not have said this. We have foster parents on this forum who do some excellent work.
I suppose that you believe that birth parents never abuse their children, either? Shall I tell you about a few cases that I've been involved with firsthand?
As to orphanages: Landmark studies (in the sixties, I believe) showed that the intellectual and emotional development of children raised in orphanages was dreadful, compared to their peers raised in foster homes. The current concept of placing a child immediately into a private home came from this research.