I think it's partly because there's nowhere for them to go, they have precious little in the way of resources.
However the biggest reason seems to be that they are institutionalised. It doesn't occur to them that they could run and there's almost a bizarre pride in caring and donating; certainly for some. Tommy even says himself that he feels he's made a 'good donor'.
They've been drip fed the fact that they are 'special' and that they are doing such good, and they are looked after and provided for. Raised in schools then fed and provided with their basic needs in the cottages, then looked after in completion centres and hospitals. They aren't amazingly self sufficient and have been taught to accept their fate and be grateful for the time they've had and each donation they survive.
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