The forgotten children
IN THE grim hospital room in Paediatrics I, an 18-month-old boy is lifted out of his cot and placed on the floor. He leans forward on his chubby fists and casts an inquisitive eye over the strange adults gazing down on him. He cranes his neck, looking to theleft and right, but his limbsremain immobile.
After much encouragement, he pushes one tentative fist in front of the other. More minutes pass, and he manages a minuscule advance by shuffling one knee ahead of the other. It's a movement that most normal children would have mastered by that age, but this child's movements are awkward and uncertain. An otherwise vibrant toddler, he's apparently not used to feeling an expanse of floor beneath his limbs. But then, Maxoum Mustafa is enjoying a rare moment of freedom. This perfectly healthy baby has spent the bulk of his short life in the confines of a cot in a small room on the ninth floor of the concrete hospital in Constanta, a once-grand city on the Black Sea in eastern Romania.
He has never been outside. On occasion, during the summer, a nurse with a spare moment might bring him to the balcony. Otherwise, his daily routine starts with a shower, followed by a change of nappies, and for the rest of the day he is confined to his cot.
There is not a toy in sight. His hours are punctuated by mealtimes - he is fed a largely milk-based diet of rice, sometimes egg, occasionally a piece of meat.
He is one of 40 abandoned babies who live in the hospital, and one of 10 on Dr Adriana Apostol's ward on the ninth floor. He shares a room with four other babies in battered-looking cots crammed together into the small room, but Maxoum has been here longest. They lie on bedclothes that have seen better days.
Dr Apostol checks Maxoum's records: "Three days with his mother and after that only here," shesays wearily.
The nursing staff know little about the babies' backgrounds: some, like Maxoum, appear to have been totally abandoned. Others have been temporarily left behind by mothers struggling with poverty or psychological problems.
Rashim, a beautiful dark-haired baby who shared a room with Maxoum, was referred to Constanta from another hospital. The medical staff know nothing much about him because he has no birth papers. They do not even know how old he is. "His name will be put on the list and we will wait."
Another baby, Demirel, is one of 11 children. He has been in the hospital for less than one month. Nurses are hopeful that his mother will take him home. She has already visited her baby son at the hospital. They say that's a good sign - at least she has not abandoned him entirely.
Other children have disabilities: Shaban Atisha, a dark-curly-haired baby, has a cleft palate and heart problems. The baby's mother could not cope. "It is a very, very social problem," said Dr Apostol.
Maxoum is one of an estimated 700 abandoned babies who live in hospital wards across Romania. They are forgotten children who have fallen between the cracks as Romania rushes to shed its notorious childcare record to win coveted membership of the EU.
Nicolae Ceausescu's regime banned both contraception and abortion and turned State orphanages into dumping grounds for 100,000 unwanted children, many of them disabled. Intent on adhering to best practice to satisfy Europe, more than a decade later the Romanian government has promised to tear the orphanages down.
Children can no longer be adopted by foreigners, after the adoption process was found to be corrupt. Older children are being fostered or kept in smaller institutions. Since January, babies under the age of two have been banned by law from living in institutions.Instead, they are placed in foster care with families who receive the equivalent of a monthly wage and food allowance. On paper, it seems an ideal solution. But, as with much in Romania, there is abig disparity between theory and practice. The culture of abandonment continues.
In a country as abjectly poor as this, local authorities run out of money. Foster families cannot be paid. Abandoned babies cannot be adopted because they have no identity papers or because their parents cannot be found. Many are Roma babies, spurned because of their gypsy pedigree. With nowhere else to go, they are piling up in Romania's hospitals.
John Mulligan, Mairie Cregan and Joan Tuthill first came across the babies' plight in June 1990. The three Irish aid workers were among the first wave of volunteers in Romania after the collapse of Ceausescu's regime. The dictatorship's edifice crumbled to reveal 100,000 abandoned children and adults with disabilities or developmental problems, living in filthin decrepit institutions, eating their own vomit, crippled with"cot legs" and stunted, malnourished frames.
The images that unfolded on our TV screens in the aftermath truly shocked the world. Thousands of hungry children were living in squalor, with shaven heads and misshapen bodies, and many were infected with Aids. Ireland responded with a huge humanitarian effort. Convoys of food, toys, medicines and clothes set off for the poverty-stricken country. Many who helped ended up trying to rescue broken children: more than 700 Romanian children were adopted by Irish parents up until 2000.
Now, five years on, the world's media has moved on - but John, Mairie and Joan continue to return at least twice a year. They put pressure on the government to improve the lot of disabled and mentally retarded adults, through their charities Aurelia Trust and Focus on Romania (FOR).
Mr Mulligan is a former property manager for the ESB; Mairie Cregan is a psychiatric social worker and foster mother for 22 years; Joan Tuthill is a business woman in Dublin.
Their aim is to speed up the closure of Romania's infamous institutions in which 20,000 adult mentally and physically handicapped still live. They have had some success: Negro Voda, a once-notorious institution outside Constanta, and highlighted by Mr Mulligan in the media, will be closed - probably in January - and its inmates moved to supervised community homes and a pilot, state-of-the-art residential centre; FOR and Aurelia Trust are funding two of the homes, the Romanian authorities will fund the remainder.
While working on this project, the Irish trio began to wonder what happened to the babies abandoned since the orphanages shut down. "A Unicef report said that 1.8 per cent of all newborn babies in Romania were being abandoned," said Mairie Cregan. "We asked, 'Where are they?' We wanted to know where the abandoned babies were going. The government said that no baby under two was in an institution. But we knew there weren't enough foster parents to go around. We wanted to know: where were the abandoned babies?"
They asked the question routinely of Romanian officials, and received an unexpected answer at a council meeting in Constanta last June. Petru Dinica, the head of social protection, admitted that 50 babies were abandoned in maternity units in Constanta. Asked why, Mr Dinica said that it was difficult to find adoptiveparents for gypsy or handicapped children.
LAST MONTH saw Mr Mulligan, Mairie Cregan and Joan Tuthill return to Constanta with Mairead McGuinness, the Fine Gael MEP, and the press in tow. The frustrated staff of the local hospital threw open their doors to display the latest problem besetting Romania's efforts to get its childcare in order.
Standing amid cots of gurgling babies, Dr Apostol is happy toelaborate on the difficulties encountered by her nursing staff in trying to juggle tending to sick babies while also caring for 10 healthy ones.
The nurses can only do so much. "Most of them [the babies] have never been outside. You can't go with them. You have one nurse. You try to feed them. You start there; everyone cries here. When you finished feeding, they are pee pee and ca ca and you have to change them. And when you finish, the other meal is coming," saysDr Apostol.
"In the past, when babies were abandoned in the hospital, we would keep them here and they would go to an orphanage. When a place was free in an orphanage they'd call us and we send them. We don't have any orphanages any more. No foster mother, no foster care, no orphanage. The hospital is the only solution for them."
Mairie Cregan holds up a little baby in a pink babygrow who is clearly ill. The baby makes no sound, her head lolls on her neck and her eyes struggle to focus.
"It's this little one that worries me," she says. The baby has neurological problems, but at 14 months old, she does not qualify fortreatment because she has no identity papers. Abandoned by her mother, she was briefly in foster care but was returned because ofher illness.
"When you make any procedure for the child, they ask for certificate, you know. If not, they are actually not paid by the insurance. So they prefer not to do anything," says Dr Apostol. "Officially, she exists only for us."
Mairie cradles the baby, saying: "She's beautiful really. I don't think she is going to live."
On the floor below is Paediatrics II, where Professor Dr Valeria Stroia cares for 17 babies on her ward. She spoke in halting French and English: "Chaque enfant, pour chaque enfant, il y a une histoire." For every child, there is a story. But most stories were similar.
One baby, aged a year and one month, had never been outside the hospital. There once was a playroom, now closed. Another baby, Shaban Atisha, has a cleft palate. She cannot be adopted because her mother cannot be found. As a result, she cannot be declared officially abandoned. She is on a long list for foster care.
Eleven more babies are found in the maternity section on the seventh floor. The stories are similar: unexpected babies, unwanted babies born to teenage mothers, babies born into poverty. Some have been there since April. Another baby, Memet Tarcan, was hospitalised after his birth on June 26. He is now well, according to the nurse, but "since then nobody has come for him".
Mairie Cregan leaves the wards with serious concerns for the babies' welfare. She believes their liquid diet could delay their language development. The muscle tone of some is weak because they're not getting out of their cots to crawl. She suspects that some babies are being prop-fed in their cots rather than held properly in the arms ofa nurse.
"They were wet: but that won't kill them as long as they are cleaned properly in between. They don't have nappies, they [the staff] told us that. They were using rags and anything they could get their hands on," she said.
"For every three months a child spends in an environment like that, they lose a month of development. They are getting the best care physically that they can.But the fact that they are beingfed through bottles is going to cause problems.
"The other thing is, they are getting no stimulation whatsoever. The nurses are doing their best but they are totally overwhelmed. These babies are not getting anything like the kind of stimulation they need."
NO ONE is happy with the situation. In his ground-floor offices, Dr Nicolae Grasa, the hospital's director, appears to be at the end of his tether. "The problem is, they modified the legislation. Before this modification there were somesocial buildings [for babies]. The possibility to take the childrento these buildings is not possible anymore."
And so the babies mount up in his hospital wards. He tots up the numbers in the various paediatric and maternity departments to 40. He complains that apart from living in a totally unsuitable environment, the babies clog up much-needed bed space in the overcrowded 1,100 bed hospital; they eat into his nursing staff and his budgets. He claims that most of them are Roma babies.
"These children - many are not identified. They have no vaccination and are coming in contact with other children. And it is possible to spread disease. Economically, we must spend money for food. We don't have enough places here," he says.
At the Constanta County's council offices the following day, Marianna Belu, the secretary general, is equally frustrated.
The government had done much to overturn Romania's appalling child welfare record, she says. Social workers encourage new mothers at risk of abandoning their children; foster parents are offered five million lei (?140) per month - the equivalent of an average salary - for taking in abandoned children; of about 4,600 children abandoned last year, more than half were returned to theirextended families. But now the policies were floundering on a shortage of cash. The babies were the responsibility of the council's Child Protection department, she says.
According to Mrs Belu, the babies left behind in hospitals belong in foster care; foster families have to be paid, and her council has run out of money.
A translator speaking on her behalf says: "She wants to make clear that kids would not stay in the hospital if they have the money to cover all the costs for the foster families to take them, but they don't have the money at the moment. That's why they are there."
Mrs Belu disputes the Constanta doctors' complaints that babies have been living for up to a year and a half on their hospital wards. She insists that they'd normally spend no more than a month or two there.
Even if the money did materialise, Mrs Belu has other priorities to juggle: hundreds of families are homeless after the the floods that devastated huge tracts of Romania during the summer. Others live in abject poverty. And 20,000 physically and mentally handicapped adults remain in 50 institutions that are earmarked for closure.
Mairiead McGuinness is preparing a report for the European Union on the findings of her trip to Romania. It is likely to be considered by the EU for its next report, due this month, on Romania's progress towards accession. She believes Europe must work closely with Romania to effect change.
John Mulligan takes a less tolerant view: he looks at the plight of the babies as more evidence of what he views as the Romanian government's obfuscation of figures to satisfy its craving for EU membership. He wants Romania's EU membership to be conditional on a whole slew of reforms, with its target date for entry pushed back another year if necessary.
"The European Commission's contention that there are no more children under the age of two in institutions in Romania is not strictly true - they are actually piling up in maternity hospitals again," he said.
"While the commission is technically correct that they are not in institutions, they are allowing a serious deception to be perpetrated by allowing these children to stay off the radar."
Aurelia Trust, Sutherland Centre, North Street, Skibbereen, Co Cork