UST-IZHORA, Russia, May 15, 2006 (RFE/RL) -- Every day in Russia, some 20 babies are born to HIV-positive mothers. Two of those, on average, are abandoned at birth.
But Russia -- partly because it was belatedly hit by HIV -- still lacks a comprehensive care plan for orphans with HIV, the virus that causes AIDS.
As a result, most of these children face a bleak, lonely future.
Six-year-old Masha, with her blond locks, big blue eyes, and quiet manners, seems the perfect child all parents dream of having.
But Masha has HIV. She was abandoned by her mother in the hospital where she was born and, after being diagnosed with the disease, she was moved to the Republican Hospital for Infectious Diseases in Ust-Izhora, outside St. Petersburg.
Public fear of HIV/AIDS means that many orphanages turn away children born to HIV-positive mothers, leaving them to linger in hospitals.
Masha is lucky to have received a place at this clinic, Russia's only institution for HIV-positive orphans. It has 40 places for the entire country.
Under Russian law, abandoned babies must be sent to so-called "baby houses" -- orphanages for children aged three and younger.
But public fear of HIV/AIDS means that many orphanages turn away children born to HIV-positive mothers, leaving them to linger in hospitals where nurses are too busy -- or too scared -- to play with them.
Yevgeny Voronin, the clinic’s founder and director, says this lack of affection and intellectual stimulation can result in lifelong handicap:
"We've started receiving HIV-positive children who have been isolated until they were 1 1/2 or two years old in regional hospitals where the personnel were afraid to approach them," Voronin said. "We noticed that while we could help these children medically, they no longer had any hope of adapting to life because they were so neglected socially. These children resemble each other -- they don't show any emotion, their face is mask-like, they don't smile, they sit in one place."
Most babies born to HIV-positive women do not carry the virus. Those who are free of the virus are usually sent to orphanages after 18 months -- the times it takes in Russia to officially diagnose whether the child has HIV.
But those who do turn out to have the virus, however, can remain in hospital wards for years.
Human Rights Watch last year expressed outrage at the treatment of HIV-positive children in Russia, accusing the authorities of "lamentably failing" to guarantee the rights of children and mothers with HIV.
The staff at Ust-Izhora's clinic, by contrast, is loving and attentive.
Medically, the children are also well cared for. They receive antiretroviral therapy drugs paid for by the state. Here again, they are lucky -- according to a United Nations report released last year, fewer than 10 percent of Russia's HIV-sufferers have access to treatment.
But these children know enough about the outside world to understand that the caresses and the kind words bestowed by the nurses cannot replace a real family. Their chances of finding adoptive parents, unfortunately, are slim. Of all the HIV-positive children born since the virus took root in Russia, only five have been adopted.
Voronin says even the clinic's less disturbed children show alarming signs of loneliness.
"We have this boy, Sasha, we call him 'the artist' because he can make anyone laugh and always has many friends," Voronin said. "I once asked him: 'Sasha, who are your friends?' and he answered: 'My best friend is grandmother.' But he doesn't have any grandmother. It turned out that one year before, the grandmother of an HIV-positive child had given him a chocolate. So he started considering her his grandmother. He asked: 'Why is she not coming to visit me? Find me my grandmother.'"
Voronin says that the attitude of the authorities towards HIV/AIDS patients has improved in recent years.
If five years ago half the children abandoned by HIV-positive women were segregated in hospitals, Voronin says "baby houses" are gradually overcoming their reluctance to take in these children.
The government has also stepped up the fight against HIV/AIDS, with President Vladimir Putin earmarking $105 million for fighting HIV/AIDS in 2006 -- a 20-fold increase from the previous year.
Public misconceptions and discrimination against HIV sufferers, however, are still deeply ingrained in Russian society.
Vornin says it will take many more years before children with HIV are no longer treated as outcasts.
The government has stepped up the fight against HIV/AIDS by drastically increasing funding for combating HIV/AIDS in 2006.
"People are still scared, they think these children have no future," Voronin said. "They [children] are denied opportunities because of prejudices that they won't live long, that they are easily infectious. In reality, this is absolutely not true. New medicines are available now. But what was in people's head 20 years ago has not changed. The worst punishment for these children is not HIV, it is society's prejudice. This is the most terrible punishment."
After 15 years of work at Ust-Izhora, Voronin is well placed to speak about the prejudice against HIV.
When the Republican Hospital for Infectious Diseases was launched in 1991, local residents actively lobbied to have it either closed down or moved to Siberia.
The clinic was created after 270 children were infected with the virus in hospitals in southern Russia, in what remains the country's most shocking HIV scandal.
The United Nations has issued its annual report on the AIDS epidemic. Here are some of its findings:
- There are currently an estimated 40.3 million people living with HIV, the virus that causes AIDS. Of those, 17.5 million are women and 2.3 million are children under the age of 15.
- There were an estimated 4.9 million new HIV infections in 2005, including 700,000 children under the age of 15.
- An estimated 3.1 million people, including 570,000 children, died of AIDS in 2005.
- According to the report, more than 25 million people have died of AIDS worldwide since the disease was recognized in 1981.
- In Eastern Europe and Central Asia, the number of HIV-positive people reached 1.6 million in 2005, up from 1.2 million in 2003. The bulk of people living with HIV in the region are in the Russian Federation and Ukraine. "Ukraine's epidemic continues to grow, with more new HIV infections occurring each year, while the Russian Federation has the biggest AIDS epidemic in all of Europe," the report states. A private Russian survey cited in the report found "no postive changes in sexual behaviour, with condom use decreasing slightly among people in their twenties."
- In Central Asia, Uzbekistan and Kazakhstan have seen the most dramatic increases of HIV infections. In the Caucasus, the situation is described "relatively stable."
Central Asia: AIDS Project Seeks To Avert Epidemic
Eastern Europe: European Commission Warns Of 'Resurgent' HIV/AIDS Epidemic
Listen to a short interview by RFE/RL's Tajik Service with Gregory Henning Mikkelsen, director of EU team for a joint EU/UN AIDS initiative. In the November 21, 2005, interview, Mikkelsen describes the epidemic in Central Asia.Real Audio Windows Media