More Help Needed to Feed Russian Orphans

Written by Stephanie Kriner, Staff Writer, RedCross.org

Irkutsk oblast, Siberia, February 1, 2001 — The 16-year-old mother gave no clues why she left the child, but the Court Note made one thing clear: she was never coming back to the hospital to take her baby home. Doctors had yet to figure out why the child could not move his arms or legs, or why he was conspicuously sullen and unresponsive compared to the other squirming newborns in the maternity ward. Regardless of the diagnosis, the abandonment compounded an already bleak future for the week-old baby.

Hundreds of babies have been abandoned by poverty-stricken Russian parents.

Abandoning children is a distressingly common occurrence in Siberia — where babies are often left in hospitals, on the street or at the doorsteps of struggling orphanages. So hospital officials were not surprised when it happened again. Inured to this behavior, they shrugged and assumed that the young mother was poverty stricken, unable — or even ashamed — to raise a sick or possibly disabled child.

The nameless baby boy was not alone. Russia's most vulnerable children — the most severely sick, disabled or mentally retarded — are often deserted by parents who cannot afford to help them. Sometimes, they are even left because abnormal children are not socially accepted.

At the Sludianka Orphanage for Disabled — home to more than 100 children from infants to 4-year-olds with physical, mental, neurological or development disorders — only two of the children are true orphans. Sixty-five percent of them were abandoned. The rest were placed there because their parents lost their rights to raise them — mostly due to drug or alcohol abuse, orphanage officials say. "In most cases, the father is not known, and the mother has left the child in the maternity ward or on the streets," said Andrei Patrushev, the orphanage's head doctor and director.

The most severely mentally or physically disabled children receive little help in Russia's orphanage system.

Unhealthy children who are abandoned or taken from their parents have long and uncertain roads to recovery. The Russian orphanage system — home to more than half a million children who were totally supported by government funding during Soviet times — now struggles just to care for the healthy. To meet the basic day-to-day needs of its children, such as clothes and food, the Sludianka orphanage must plead for donations and sponsors — a near impossible task in Siberia, which is still struggling to overcome the 1998 crash of the ruble and drop in government pensions.

For the most severely mentally or physically disabled children, there simply are not enough resources and little hope that they will receive all the help they need.

Orphanages Can't Meet all the Needs

The Sludianka Orphanage for disabled children rarely has extra beds available.

Doctors at the hospital determined that the abandoned baby's sluggish behavior was due to hypertensive-hydrocephalic syndrome, an enlargement of the ventricles, or normal spaces in the brain. Cerebrospinal fluid is produced in the ventricles and must drain to the outside of the brain, where it is absorbed into the blood. When the fluid can't drain, pressure inside the brain rises and hydrocephalus occurs. Many things, such as a congenital malformation or bleeding within the brain, can obstruct drainage and cause hydrocephalus. Hydrocephalus is the most common reason for a newborn's abnormally large head and can lead to mental retardation or slow development.

After treatment, the infant's head was only slightly enlarged, but he still was not well. The sickly baby would barely drink his milk, had constant bouts of diarrhea and would not gain weight. Doctors were bewildered by his illness and couldn't identify the cause. Not knowing what else to do, they transferred him to Sludianka as soon as a bed opened.

Sludianka is home to more than 100 children who were abandoned or whose parents lost their rights to raise them.

By then, the baby had spent 5 months alone in a crib with little human contact —l there was no one to hold him or play with him. His predicament was not unusual. Presently some 200 abandoned babies — some of them perfectly healthy — lie virtually unattended in hospitals throughout Irkutsk oblast, the state where Sludianka is located. They are waiting for beds to open up in the oblast's overcrowded orphanages.

When they arrive at the orphanages, some are as old as a year and a half and lag behind in mental, social and learning skills, because of the inability of an overworked staff to donate sufficient time to each child. Some are even malnourished because the hospital could not afford to feed them adequately.

"It takes time to get them to speak and walk, and they are slow in learning skills. Our goal is to help them catch up with their peers," said Patrushev.

The American Red Cross feeding program has benefited more than 2,000 Russian orphans.

When the baby (whom Sludianka staff named "Igor" — a common Russian name that is shared by many of Sludianka's "orphans") arrived at the drafty and dimly lit orphanage in Sludianka, more than 3,000 miles to the east of Moscow, he weighted just 11 pounds. His sad blue eyes bulged from a bony face, and his skin was pale and thin. He did not smile or laugh when coaxed by the nurses who cared for him and refused to drink powdered milk — a poor substitute for formula, which has the nutrients a baby needs to develop and grow.

After some tests, orphanage doctors learned that his troubles stemmed from lactose intolerance. Igor's body would not break down the powdered milk orphanage and hospital staff tried to give him. As a result, he was so malnourished and weak that he could barely move, let alone crawl or begin to stand up like most children his age.

Igor lives in a "family group" of 10 toddlers who eat, sleep and play together.

The relatively simple problem would require an easy solution elsewhere. However, there was nothing the orphanage could do to help Igor. It would cost 600 rubles ($21) to make the 70-mile drive to Irkutsk and purchase a special formula with soy milk especially for him; dedicating such great resources to one child when so many others were ill and malnourished was unrealistic. Because of Russia's 1998 economic crisis, the orphanage could no longer allocate $1 per day to feed and clothe each child.

Instead, they were forced to scrape by on a mere 33 cents per child per day. All that doctors could do was hope that Igor's body would eventually learn to make due without the nutrients it craved.

After two and a half months at the orphanage, Igor was nearly a year old and still looked like an infant. His frail and skeletal body had lost all its defenses. He developed pneumonia in both lungs and was sent back to the hospital, where doctors pumped antibiotics and fluids into his body. After two weeks, Igor miraculously recovered from the deadly illness, and returned to Sludianka even thinner than before. His fight was not over — the strong dosages of antibiotics had caused bacteria to form in his digestive system.

Already weak from his battle with pneumonia, Igor quickly succumbed to the infection. Too weak to drink from a bottle, he was fed through tubes. At 11 months, his body — weighing barely 9 pounds — was slowly shriveling away, and doctors feared he was going to die.

American Red Cross Supports Russian Orphanages

During an assessment of Russian orphanages to receive possible assistance as part of a major food program, the American Red Cross and Russian Red Cross recognized the urgent need at Sludianka. "When we first got to this orphanage, the staff was bringing food from their own homes to feed these children, and they don't make much," said Jennifer Sparnicht, an American Red Cross delegate in Siberia.

Many disabled orphans spend much of their days in cribs.

The orphanage was among 11 that the Red Cross identified in Moscow and eastern Siberia to receive food distributions of fruits, vegetables, dairy products and meats. The program, which began in April 1999, was first made possible by a donation from the Indy Racing League, and CHS Cares, a nonprofit organization established by technology company CHS Electronics. This year, a contribution from an anonymous donor allowed the program to continue. Depending on their needs, orphanages have also received medications, vitamins, winter clothes and footwear, while others have received toys, funding for building repairs, furniture or school supplies.

As a result of the Red Cross program, Sludianka was able, for the first time, to give Igor the special formula he needed. After only a few weeks of Red Cross-supplied formula, Igor smiled for the first time. He began to gain weight, and by the age of a year and 5 months his wobbly legs supported him when he tried to stand.

Throughout the orphanage today, many children's growth remains stunted by as much as two years from a lack of nutrients early in their lives. However, the Red Cross food helped them gain weight and reduced the number of illnesses, such as gastro-intestinal diseases, hypotropai and respiratory diseases. The children have more energy and are more alert than they were before, staff says.

Igor lives with a group of nine other children his age, suffering similar developmental problems. Throughout the orphanage these "family groups" are "adopted" by a team of caregivers and a doctor who look after them. Each group has a kitchen, bedroom full of cribs and playroom with a few worn toys where they spend their days.

Igor weighs about 7 pounds less than normal children his age, but Patrushev says that he eventually will catch up. He appears normal next to the other children in his family group because they all have been physically and mentally delayed - either from malnutrition or a congenital disorder.

The Red Cross assistance came at a crucial time for the orphanage, but the program is small in comparison to the need. With additional donor support, the American Red Cross would be able to expand the food assistance to more orphans.

Hope Emerges for Igor and His Playmates

It's 3 p.m. at the Sludianka orphanage, and Igor's family group is just waking up from the day's afternoon nap. Women dressed in white lab coats scoop up the wet, sobbing toddlers from the 10 cribs packed into a foul-smelling room. They plunk them onto small plastic toilets and change them into dry stockings. Igor is a fuzzyheaded blond who stares blankly ahead, oblivious to the commotion of crying children and bustling women around him.

After "potty time," the children walk to their miniature tables for snack — mashed pastry in milk, which is gobbled up in a matter of minutes. Igor is placed in a highchair and fed by one of the women. He receives a little extra attention because of his troubled past, she explains.

One-by-one, the women escort the children to the playroom. In the barren room, Igor takes a few steps in his walker, then stops to observe the activity around him. A little boy with Down syndrome is placed in a crib, while another one with infantile cerebral palsy runs in circles, clapping his hands to his face. Still another bawls in the corner. An accident is wiped quickly with a towel, the child lifted up and taken to have his diaper changed.

In another room where the "worst cases" are kept, the scene is more grim. A group of deformed and mentally handicapped children lie on their backs on stained sheets in playpens or cribs. The slightest human touch brings smiles to their normally apathetic faces. Patrushev points out their deformities. In a playpen, one boy with hydrocephalic syndrome has an oversized head. "That's what would have happened to Igor if he didn't receive treatment," Patrushev said.

Another child was born with a head that is too small. A girl with Down syndrome seems not to notice when the doctor snaps his fingers in front of her face. Some children are kept separated from the others. "They can hurt the others, or even themselves," Patrushev said.

The fate of this group of children remains the most uncertain. In Russia's struggling orphanage system, there's no guarantee that they will continue to have their basic needs met, let alone receive the medical attention they need. Eventually, they will be transported to another crib in another dark, gray room. "When they get older, they will go to a home for handicapped children," he said. "It they get proper care, they'll live. If not, they'll die."