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V. Government Response and Failures to Protect Children

In the more than a decade and a half since the fall of the Ceauşescu government, Romania has made surprisingly few advances in creating effective responses to the stigma and discrimination faced by people living with HIV. Children and youth living with HIV face an additional disadvantage, because those charged with their care and protection—educators, medical personnel, agencies administering subsidies, caregivers in and out of institutions, and even child protection staff—too often share the biases and ignorance about HIV of the broader society, while too many children and youth living with HIV lack the skills, information, and resources to demand their rights without assistance. Even more puzzling is the government’s failure to plan for the coming of age of a population in which it has invested so many resources: after years of committing government and foreign funding to keeping these children alive, the government now seems unwilling to provide the last bit of assistance that some will need to help them become and remain integrated, productive adult members of society.

Inadequate Complaint Mechanisms

County Directorates of Child Protection

The last complaint we made [to the Directorate of Child Protection] was in January 2006. It was a case of two girls in an extended family who said they were medically neglected. The family didn’t want them to go to the hospital and didn’t believe them when they said they were sick. I made a complaint to the DPC and was told that “Your NGO doesn’t monitor that case so we will have to do the follow up with the NGO that does.” But then they never did make a home visit.
—Ştefania Mihale, social worker, Romanian-American Children’s Center, Constanţa, February 14, 2006

Under Romanian law standards for child protection are set at the national level by the National Authority for the Protection of the Rights of the Child, and implementation of these standards is the responsibility of county (or in the case of Bucharest, sector) Child Protection Commissions, primarily through their Directorates of Child Protection (DPCs).138 County Directorates of Child Protection have the primary responsibility for intervention in cases of child abuse and neglect, and are required by law to start an inquiry whenever learning of suspected abuse or neglect, to provide the child with appropriate services, and to take the child into temporary placement in cases of confirmed abuse or neglect.139 However, these directorates frequently lack the staffing, vehicles, and other resources necessary to adequately monitor children at risk of abuse or neglect, and to investigate allegations of abuse and neglect. Employees of public and private institutions working with children are required by law to immediately notify child protection directorates of suspected abuse, neglect, or ill-treatment, but the law does not sanction failures to report.140 Children can also make complaints of abuse to police, but police lack training in the needs of children living with HIV and do not appear to provide effective recourse in cases of child abuse and neglect.

Ciprian M. (not his real name) told Human Rights Watch that no one had investigated his allegations of beatings and neglect by family members, even though he had made complaints to an NGO social worker and the Constanţa Directorate of Child Protection. The soft-spoken sixteen-year-old said the abuse began a year earlier, when after years in a state institution government officials found and returned him to his birth family. “Honestly they only took me because of the money…. I had the choice to go back [to my birth family] and ever since I went back they were pleased to see me because they get my allowance, but I don’t get any of it. If I ask my mother for 10 RON (U.S.$3.60) she pretends not to hear me. I asked her to buy me socks but she pretends not to hear… I should get at least something sometimes.” Ciprian said that as a result of his mother’s refusal to provide him with spending money and basic necessities he had begun working in construction, although the work was ad hoc and provided little income. “I work like an adult but I am not paid like an adult. I go wherever I see a construction site and ask for work.” In addition to this neglect, Ciprian told us that his older brother began beating him when he questioned the brother’s treatment of their mother. “My older brother beats me up since last year. Sometimes I saw my mother crying and I asked her why and I found out it was because my [older] brother was preventing her from doing things. [He] fights with me with fists.” Ciprian said an NGO social worker helped him make a written complaint about the abuse to the Constanţa DPC but “no one has come to ask about it…. I want the DPC to come and investigate when I am there because I don’t want to be left alone with them afterwards, because they will beat me. I don’t want to stay there anymore. I want to live in a center again. I don’t want to think about my family again.141

Laura K. (not her real name) an eighteen-year-old from a southeastern county, told Human Rights Watch that she had put up with violent beatings by her alcoholic mother for more than a year:

My mother doesn’t treat me right. She beats me with a poker, and she hit my head against a stove. I didn’t complain until recently because I thought, “She is my mother.” Then I told [a doctor at a regional monitoring hospital] but she said that she couldn’t help me because I was over eighteen and she could have helped if I were younger. My mother has a drinking problem. My mother doesn’t want to give me my papers for my subsidies. As far as I know I should be able to sign for myself because I am eighteen. I spoke to a social worker at [an NGO], and she said she would help, and both my sisters say they will help me if I leave. I have run away many times.… There are people who would help me but my mother won’t give me the papers so I can’t leave. I need the disability certificate, the birth certificate, papers for subsidies, she even had my ID but I found it. It has been going on for a year.”142

No national database of complaints of child abuse and neglect exists, making it difficult to identify patterns of abuses and responses to reported incidents. However, based on our interviews, it appears that failures to investigate and intervene in cases like the ones cited above are common. The lack of effective and accessible complaint mechanisms is aggravated by a lack of clearly understood and enforced roles and responsibilities among the various bodies that could take complaints from children. For example, many directorates of child protection rely heavily on NGOs working with children living with HIV to monitor conditions for these children and investigate instances of suspected abuse, although in many instances these NGOs are limited in their ability to reach all children in the areas they work, or to follow up with children who move outside their geographical area. The reliance on NGOs also creates the possibility of a conflict of interest should the alleged abuse or neglect implicate the NGO, as it could in the case of children living in NGO-run group homes. Children living with HIV could conceivably access directorate of child protection general telephone hotlines, or take their complaints to police, or to municipal social workers or school psychologists. But telephone hotlines do not exist in all counties and are not well publicized, police, social workers, and psychologists are rarely trained to recognize and intervene in cases of abuse and neglect of children with HIV, and social workers and psychiatrists are in short supply.143

This mishmash of inadequate complaint mechanisms particularly disadvantages children with educational and cognitive deficits, and children isolated in rural and other underserved areas. Save the Children Romania program coordinator Simona Zamfir told Human Rights Watch, “Some children returned to birth families complain that they are abused, sent to beg, but I don’t know where children would go with such a complaint. We thought about handling complaints for them but we realized that we lacked the financial and human resources. There has to be someone whose voice is heard—a complaint from an NGO doesn’t have impact. There are many cases and one NGO cannot do this work alone.”144 Violeta Clefterie of the National Authority for the Protection of the Rights of the Child told Human Rights Watch that “there are possibilities for interventions but the children don’t know about them and people around the children do not intervene [to stop abuse and neglect].” Clefterie, a member of the National Authority’s control unit, described the complaint mechanisms available to children as telephone hotlines, written complaints to the directorate of child protection, or written complaints to the National Authority for the Protection of the Rights of the Child, although according to her the National Authority had not received any complaints from children. Acknowledging that not all areas have hotlines and that “it is very difficult for a child in rural areas to contact the directorates of child protection directly,” Clefterie suggested that children “could also go to the municipality social worker or to the police” although it was unlikely that rural children would have this option because “there are only social workers and psychiatrists in large schools in large cities,” and “it also depends on the child’s age and what the child knows. The child may be afraid to go to the police because they will be returned to the same environment.” Clefterie added that in cases were the police do learn of child abuse they generally only “write a form and parents pay a fine. The police may or may not notify a social worker. In rural areas the police try to counsel families and only notify the Directorate of Child Protection if there is severe abuse. There is no provision in the law that says, for example, if a parent slaps a child every day there has to be an intervention.” 145

The absence of effective measures to protect children from abuse raises real questions about Romania’s compliance with its obligations under the European Convention for the Protection of Human Rights and Fundamental Freedoms (ECHR) to protect children from abuse and to provide an effective remedy for children who are at risk of abuse.146

The National Council for Combating Discrimination

As part of its efforts to bring its laws into compliance with European Union standards, Romania was the first country in Central and Eastern Europe to adopt specific anti-discrimination legislation and to create a body charged with combating and preventing discrimination—the National Council for Combating Discrimination. The Council’s mandate allows it to investigate individual cases of discrimination and to propose “affirmative actions and special measures for the protection of persons… confronted with rejection and marginalization,” but thus far it has limited its actions to individual cases.147 Council staff complained to Human Rights Watch that its budget of “about 700,000 Euro per year” was insufficient to allow it to have “a proper staff” and to be able to open local bureaus so that it would be accessible to people living outside of Bucharest.

Individual victims or an NGO working in the field can file a complaint with the Council in cases of discrimination in a wide variety of fields, including the right to work, the right to health, and the right to education. 148 If in such individual cases the Council finds that the discriminatory act amounts to an administrative contravention (misdemeanor) it can levy a fine or issue a warning.149 However, a review of Council annual reports reveals a failure to address systematic discrimination against people living with HIV and to provide adequate redress to individual victims. For example, in 2004 the Council intervened in only one case of discrimination based on HIV status and did not resolve it.150 In 2005, the Council received ten petitions claiming discrimination on grounds of HIV status and resolved four of them, and started the investigation ex officio in four other cases and resolved two of them.151 In most of these cases the Council’s intervention consisted of mediation efforts resulting in solutions arrived at at the local level without decisions and fines being issued.152 What fines the Council did issue typically were small and, by law, go to the state budget and not to the victim of discrimination.

The remedies provided in a 2005 case mentioned earlier in this report bear witness to the inadequacies of this approach. Following a petition filed by an NGO, the Council started its own investigation and confirmed that the headmaster of a school in Singureni, Giurgiu county, had written the HIV status of HIV-positive children graduating from his school on their school files, and that during the final exams, “HIV” was listed next to the names of these children on the public lists of exam results. The Council also found that the headmaster had threatened that if fined he would retaliate against the NGO providing care to these children by requiring it to provide at the beginning of the school year documents showing parental consent to school registration, thus making impossible the registration of abandoned children whose parents could not be found or who refused to complete the paperwork to formally severe their parental rights. In its decision, the Council found the inclusion of the children’s HIV status on the public lists for the graduation exams to be discriminatory but limited its response to fining the school inspectorate ROL4 million (U.S.$145) and issuing warnings to the headmaster and to the president of the testing commission who had published the lists with the names.153

In another case also from 2005 the Council found that statements to the media by the director of the Vrancea county general directorate for social assistance and child protection, that the solution for sexual activity in the case of children living with HIV is sterilization, were discriminatory but issued only an administrative fine of ROL5 million (U.S.$181.).154 Council president Csaba Ferenc Asztalos told Human Rights Watch, “The sanctions we have are not sufficient. In most cases they are symbolic. Our sanctions are appealed and we usually win. The fact that we establish proof of discrimination is the main sanction.” 155

A January 2006 National Council for Combating Discrimination decision issued following a complaint filed by ARAS, the Romanian Anti-AIDS Association, found that there was no discrimination in the case of a woman whose HIV status became known to her entire community after a maternity hospital in Vaslui was put under quarantine because the woman, who had just given birth there, was HIV-positive.156 When Human Rights Watch asked why there was no finding of discrimination in this case, Council president Asztalos told us, “we don’t have the medical expertise to know if this kind of quarantine is necessary, or routine, or not.” Asztalos added, “Sometimes we ask for help from expert doctors at the Ministry of Health [expert commission on HIV] but they don’t help us much because some of the cases we receive are complaints against them—complaints against doctors on the commission.”157

Inadequate Monitoring and Investigations of Abuse and Neglect

One of the biggest barriers to the adequate functioning of the child protection system is lack of sufficient numbers of skilled social workers at the directorates of child protection and municipalities. This shortage reflects in part a nationwide shortage of trained social workers and psychologists, and low salaries and heavy workloads at directorates of child protection. A 2004 study of the Romanian child protection system found that protection services were “concentrated in large urban areas, while small localities throughout the county are still uncovered,” and that staff at directorates of child protection were “totally out of their league” in providing required services. As a result,

[c]ase monitoring, assistance and closing procedures are poor and often conducted by people with too little training. Moreover, protection measures may sometimes be applied following a single visit by a social worker, concluded with the 7-minute presentation of a summary report before a Commission that has listened to some 100 or more cases that same day. Furthermore, there is no continuity in the monitoring of cases, but rather by type of institution. A case is not monitored by a single case manager or institution, but by a string of social workers from different institutions, according to whose competence the case moves at different stages. Data gathering and reporting are not accurate enough. No viable indicators are developed and used in monitoring the system and the quality of services.”158

Delia Goia, a social worker for an NGO working with children living with HIV, told Human Rights Watch,

The Directorates of Child Protection need more staff. A single social worker could be responsible for one hundred children, some institutions, and three group homes, for example. Social workers’ work is superficial because their case load is high and there is a lot of staff turnover so they don’t get to know the children in their case loads. A foster family in the third district [of Bucharest] has had their social worker change every two months! The social workers get low pay and work in a rigid environment so they either quit or get promoted, and the promotions are not necessarily based on competence. The children at the Vidra orphanage were never actually visited by the DPC—we NGOs are the only ones who visit them.159

Staff at the National Authority for the Protection of the Rights of the Child agreed with this assessment, but blamed county council resource allocation decisions for exacerbating the situation in some counties. Violeta Clefterie told us that existing legislation did not clearly specify the types and numbers of specialist staff for all types of services, and even where staffing was specified, it was not implemented. For example, according to Clefterie, social work standards for foster care set a maximum case load of twenty-five foster parents and thirty foster children per social worker, “but not all the counties can comply with this standard.” She added that the National Authority had met with directors of local councils to try to explain the law, and had met with directors of the two schools of social work “to recommend that social work graduates can be informed about Directorate of Child Protection vacancies and sign agreements for training and internships,” but that low salaries and other disincentives remained a serious problem in attracting and keeping skilled social workers.160

Several NGOs and parents Human Rights Watch spoke with described social workers and directors at the Constanţa directorate of child protection as well-intentioned and helpful, but limited by resources in what they could do. Ştefania Mihale, a social worker at the Romanian-American Children’s Center, told us, “The Directorate of Child Protection here has a lot of problems with money so they aren’t able to help a lot of our children. We help them with social inquiries because they don’t have money for gas so they can’t do family visits. Sometimes we help them assessing the situation of children in extended families too.” 161 Constanţa directorate deputy director Mirela Cornelia Gene described an extremely limited role for her agency, saying,

We don’t have the staff to find out directly about abuses against children…. We don’t have the means to evaluate what is going on for children in biological families and we have no legal obligation to monitor children in families and NGO centers. We would need a well defined system to assess it very accurately…. We have one social worker on residential care and five social workers for extended family placement. We would need to have a separate unit to do monitoring and evaluation but the legislation in force does not give me the authority to hire the necessary staff.162

Gene blamed the shortfalls in staff and funding on the law’s failure to set clear guidelines on minimum staffing and funding for child protection activities, saying,

We have a list of standards to protect children’s rights but we don’t have the staff to implement it. Our funding comes from the National Agency for Child Protection and the National Authority for Persons with Handicap. The local county council also pays but not all that it should and the money from the national government is also less than we need. Every year we propose a budget that would cover all foreseen expenses but what we get is far less.... Last year we had collective dismissals at the level of the entire directorate. More than 300 people lost jobs, and for three months salaries were not paid.163

Staff at the National Authority for Protection of the Rights of the Child and the National Authority for Persons with Handicap questioned aspects of this account, and Human Rights Watch is not in a position to assign responsibility for the funding crisis.164 Regardless of funding, what is clear is that the Constanţa Directorate of Child Protection has an extremely limited view of its role, and this limited vision contributes to its failure to adequately protect children living with HIV. One particular weakness is the Directorate’s relationship with NGOs providing services to children living with HIV. The Constanţa DPC, like many others, relies heavily on NGOs to provide social work services, but this relationship is not well defined. NGO social workers in Constanţa and other counties told us they sometimes made ad hoc interventions in cases of abuse and neglect, but that no standards existed to define the role and responsibilities of non-Directorate social workers. As the director of the Romanian-American Children’s Center in Constanţa put it, “They need to standardize the social work by the DPC and NGOs to make sure they are doing the same thing. One of the pitfalls is that different NGOs work differently.”165 Romanian-American Children’s Center social worker Ştefania Mihale added, “The law allows for the DPC to make an NGO a case manager. We talked to NGOs in Bucharest where this works. Our DPC lacks personnel but so far does not let us be case managers even though we do a lot of the case manager work. This is the case for the Flower House [group home] children—we do the work and the DPC case manager only signs the documents.”166

Inadequate Support for Caregivers of Children Living with HIV

There are many families who took children with HIV and they were not trained about HIV so when there were many problems their first impulse is to return the child. It is one thing to go through this knowing what you are expected to do and another for it to be a surprise.
—Regina M. (not her real name), mother of an HIV-positive child, Constanţa, February 15, 2006

Romania’s child protection system offers few services to help the caregivers of children living with HIV understand their children’s disease and cope with the problems caused by discrimination. The problem is especially acute for children reintegrated in birth and extended families after periods in state institutions, as many of these families are still struggling with the issues that led them to abandon their children in the first place.167 As in the cases of Ciprian M. and Laura K., mentioned above, children and NGO social workers described instances of children suffering physical abuse or educational and medical neglect after being “reintegrated” into birth or extended families without adequate monitoring and support.

Natalia L. (not her real name), recently turned eighteen, was returned to her mother in Bacău a few years ago after years in orphanages. She told us,

[My mother] beats me, every time she feels like it she starts hitting me. In the summertime I run away from home. She uses a belt or a rubber strap to beat me… She told me that when I am an adult I’ll have to pay rent if I stay with her… I’ll find a different place. But she receives the subsidy now, ROL2,020,000 [U.S.$73]. She says, “This is my money because I take care of you.” I’ve never touched that money, I have only the school subsidy which is ROL1,800,000 [U.S.$65].

 Natalia L. told Human Rights Watch that she had complained to the municipality and to the police about the beatings, but the situation had not improved and she didn’t know what to do.

How long should I allow her to beat me?… I told the woman [social worker] at the municipality and she said that I did something to deserve it. In the summer I was outside with my friends and [my mother] called me inside for dinner. We started fighting and she threw a marble plate at me. I left. The mayor’s office was closed and I had to go to stay with my father and with my grandparents for a week. After a week she was the one coming to grab me. When it happened again I called the police and the policeman said that I should wait on the street. We met and we went together but she did not want to open the door. The policeman spoke with her and eventually she opened the door and she was fined with ROL2 million [U.S.$72.50]. She paid the fine with my [subsidy] money. After that she threatened that she will take me back to the orphanage. I don’t want to go back there.... It is like a prison there.168

Ramona Ferenţ, executive director of ARAS’s Bacău office, told Human Rights Watch,

Many of the de-institutionalized children had been taken back due to financial reasons in the original families. They went to ask to get the children when they found out about the benefits they could receive. One of the boys taken for money by the mother is abandoned months at a time in the hospital. We cannot really do anything, we keep on threatening the parents and sometimes it works. I don’t know if the social workers from the municipality fail to monitor these cases because they don’t want to or because they can’t. There is a lack of motivation for sure.169

De-institutionalization on the Cheap: The Case of Vidra Orphanage

Vidra Placement Center 7 is one of three large residential placement centers created in the late 1980s and early 1990s to care for children living with HIV.170 Human Rights Watch toured the facility on February 15, 2006, and also interviewed former and current residents, center staff, and staff of NGOs with regular and ongoing contact with current and former residents. The center housed about one hundred children until a formal push for de-institutionalization began in 2001. At the time of our visit there were twenty-two children and youth ages eleven through nineteen living at the facility, including eight living in a separate building for children with severe disabilities or behavior problems. The placement center is scheduled for conversion to a hospital for the elderly, and efforts have been underway for over a year to move the remaining children and youth to other facilities. According to Vasile Marin, deputy director of the Ilfov county General Directorate for Social Assistance and Child Protection,

It was a process of taking them from these institutions and sending them to the original families or to the counties of origin. We have here now only the children from Ilfov [the county where Vidra is located] and from other counties for whom we could not find the parents. None of them had been visited by the parents, or they come from disorganized families. Most came from poor families and had been abandoned in the hospitals.171

NGOs familiar with the de-institutionalization described a much more haphazard process, with placement center staff actively attempting to sabotage the transfer of children (allegedly to save their own jobs), and children sent with little or no warning to birth or extended families unprepared to accept them.

Health Aid Romania told Human Rights Watch that it had placed three children from Vidra in its group homes, and is under pressure from the Directorate for Child Protection to accept the remaining children. Executive Director Ernestina Rotariu described the de-institutionalization process this way:

First the Ilfov Directorate of Child Protection looked to see where the children were born—the government never adjusted their status to register them in Ilfov county—so they passed the responsibility to the county of birth. Some children were told, “you, you, you, pack because tomorrow you will go.” Some parents got letters while they were not home or had messages left with neighbors saying, “You have to come to Bucharest because you have a child in Vidra who has HIV.”172

The Foundation for the Development of People has worked with children from Vidra since 1998, providing services to children still living at the facility and to more than thirty children and youth whom the NGO has helped de-institutionalize. Program coordinator Claudia Terragni told Human Rights Watch,

It is hard to say this but there was an entire organization living from these children. They kept telling us everything was fine and that the families visited these children but when we spoke with them the children said no, it wasn’t true. There was only a kindergarten there even though some of the children were ten or twelve years old. We could only find two or three [birth] families and none of them wanted the children back…. This was when the authority passed from the Ministry of Health to the Directorate of Child Protection so it was a difficult time. Social services wanted the children out of the institution but the local staff at the Ministry of Health wanted them to stay and kept saying that the children were terminal stage to prevent them from leaving—saying that we were not organized to care for them properly. In some cases children were threatened to keep them from coming with us. People at Vidra told some children not to come with us because we would not treat them well, we would leave them to die, etc, so some children who had agreed to come to our group home changed their minds…. We were supposed to work inside Vidra with the children to decide which children to move out but we were not given enough time so we used criteria like friendships [amongst the children] and psychological strength to decide which children to move. We took thirty children, two went to Health Aid, and four went to another NGO. The rest were sent home or to other smaller institutions. Those who remain have a serious handicap. Some were sent to a DPC house. UNICEF commissioned us to look into what happened to the children at Vidra but the report is not finalized yet. One big problem [we uncovered] is that local authorities worry about a child if the child is in their territory, but don’t follow what happens if the child leaves their area. I am sure that any place a child goes is better than Vidra because Vidra was very, very, very bad. We try to follow up but it is very, very hard. In the last few years we saw that local social services are trying to do their best but many times they didn’t have a strategy and didn’t understand what the government wanted from them, even though Vidra was at the center of attention. I never saw a clear strategy. For us it was good, because they left us alone. The government asked for the UNICEF study on Vidra but now the government says that “we don’t have the money to implement the findings so stop the research,” and now our group is the one pushing for the study.”173

Delia Goia, a Foundation for the Development of People social worker who is also a researcher on the UNICEF study told Human Rights Watch,

Only a few children were reintegrated in birth families by the public authorities. Some went to other institutions and some went to NGOs. Some we monitored but we are not aware of state authorities following up on the children who were de-institutionalized from Vidra. Many times birth families came to us to find information on what to do to get benefits. If we knew the family beforehand the situation was better but in many cases the child was sent in a bus to families who were not prepared for them. We had two such cases with serious reintegration problems: the families were not informed about treatment or how HIV is transmitted, and the kids did not feel well but the families did not know what to do. The state did not provide any help to the families who had their children returned. These are poor families who are not well treated by the state. They don’t know what questions to ask when dealing with officials, and they get sent from office to office.174

Most of the NGOs and children we spoke with told us that conditions had improved at Vidra over the last two to three years under the direction of Dr. Monica Bîrlodeanu, but that serious problems still existed, particularly with violence among children. Delia Goia told us, “Violence in Vidra is now a huge problem because the children are bigger, and they are panicked because they don’t know where they are going to go. There used to be a problem of staff being violent but now the problem is that the children are violent among themselves or to staff.” Goia said that under Bîrlodeanu staff had begun to intervene to prevent violence among children but with limited effect, adding,

I don’t think that this center can be fixed—life has always been like this in this center. It is a fight for survival and the most violent of all got the treats and all the trips. That is life in large institutions and the staff has gotten used to it. The children must be separated into smaller facilities—group homes, foster families.175

Of special concern is the building for children with severe disabilities and behavioral problems, officially called Casa Noastra (Our House) but known among children and staff as “Quarantine.” At the time of our visit it had more staff present than the main building, and Vidra staff described the children living in Quarantine as “those who cannot take care of themselves or are too violent and put other children in danger.”176 One individual to whom Human Rights Watch spoke who had regular access to Vidra told us that the only clear feature distinguishing all of these children from those in the main building was that “none of them were verbal, although some can communicate in other ways.”177 Children living in the main building described the children in Quarantine as violent, and said that sometimes other children were sent to Quarantine as a form of discipline. Stephan P. (not his real name) has lived at Vidra “for a long time, for as long as children have been there.” He told us, “There are problems in the Quarantine. The children there have problems or defects. They beat each other and cause trouble. The staff separates them and gives them something to calm them down—pills. Sometimes children get hurt, on their heads, faces, everywhere. It is mostly bruises.” Asked what would make Vidra better, he added, “Bigger children should not beat smaller ones. It happens a lot. The staff splits them up and tells them not to break things.”178 Ivan N. (not his real name) has also lived in Vidra most of his life. He told us, “The younger children have a separate building. They beat each other and can’t eat by themselves.” Delia Goia told us that Quarantine was also used to punish children “for stealing from the staff,” or, in one case, “for throwing stones at the car of a neighbor who had taunted them. That was two or three years ago and all the children who had thrown stones had their heads shaved and some were sent to Quarantine.”179

While staff at Vidra told Human Rights Watch, “We take [the children in Casa Noastra] for medical assessment every three or six months and every time it is required,” accounts by others familiar with the children suggest that this in not the case. 180 A  social worker at the Foundation for the Development of People told Human Rights Watch, “Some children have been moved out of Quarantine and have done better intellectually after the move. I don’t visit Quarantine often but when I do the staff there seem more caring than the rest of the staff. The children in Quarantine have the worst CD4 counts [a measure of the health of the immune system], but therapy isn’t working for them. Also, the children in Quarantine don’t go for monitoring every six months because Colentina [the colloquial term for Balş Hospital] doesn’t have capacity to have a nurse assigned to them twenty-four hours a day so they prefer that the children not come. Some children have not gone for treatment for two or more years.”`181

Aging Out of the Child Protection System

Tell the president to not let kids live in the street. It is true that if you are eighteen you have to fly away but you need some kind of support. Help us get a flat. It isn’t just me it is all the abandoned kids. We are all asking, where will I go when I won’t be able to live here anymore? I don’t need anything else. I just need the roots and I can handle the branches.
—Mădălina D. (not her real name), age twenty, Bucharest
The government is not planning for the future. They just want to wash their hands when the child turns eighteen. Some children don’t want to go to school. It is important that they should have a job, and not just stay as a patient.
—Dr. Dan Duiculescu, head of pediatric AIDS, Victor Babeş Infectious Diseases Institute

The bulk of the 1987-1991 cohort of children living with HIV is now between sixteen and nineteen years old and quickly aging out of social protection services for children. Yet no coordinated plan exists for their transition to the more limited services available to HIV-positive adults, or for the transition to appropriate assisted-living arrangements for those who may need them. The problem is especially acute for children living in foster, group home, orphanage, or extended family placements, and for formerly institutionalized children who were returned to impoverished and often dysfunctional birth families without adequate monitoring and support for those families. In such cases there is a significant risk that children may be rejected by their caregivers once monetary incentives are reduced or eliminated, or in the case of NGO-run group homes, that diminished foreign funding may make it impossible for some NGOs to provide long-term support to young adults who cannot support themselves because of ill-health, educational or developmental deficits, or employment discrimination.

Generally speaking, Romania’s child protection services end at eighteen, although some measures of special protection may continue until age twenty-six if the young person remains in enrolled formal education.182 In addition, the Law on Protection of the Rights of the Child provides up to two years of social protection to a young person who was the beneficiary of a measure of special protection and who is not enrolled in formal education but who on turning eighteen finds him or herself at risk of social exclusion and does not have the possibility to return to his or her own family. However, this social protection net has many holes that vulnerable young people can fall through: the two-year extension is not automatic, is not widely known, and no procedures exist to help the young person in making the application. The extended protection measures also end if the young person rejects offered employment or housing, even if the offered housing or employment are not suitable to the individual’s needs.

Considerable confusion exists over what will happen as children living with HIV age out of the child protection system. Several NGOs working with children living with HIV told us that neither they nor the children they served knew of any government plan for children who turned eighteen. Staff at the Romanian Angel Appeal office in Bacău told us, “Turning eighteen? We don’t know what will happen with them and nobody talks about it. We don’t know if they are going to be protected by the same legislation or if they will benefit from preferential treatment. We have a huge wave [turning eighteen] this year and there will be another one next year.”183 The deputy director of the Constanţa Directorate for Child Protection told Human Rights Watch, “At age eighteen the protection measures end if the child is no longer in school. Normally they should be taken over by the adult protection directorate but we haven’t developed that here. We don’t have specialized services for adults and NGOs have to do that…. Not everyone can acquire the skills for independent life. That is the problem we are facing. We are going to have a reform and hope to set up centers to provide real protection for adults. Otherwise they will be in a risky situation.”184

Under law, young adults living with HIV who do not qualify for extended child protection measures are nevertheless eligible for some state subsidies. However, these subsidies will in many cases be much less than those they received as children and insufficient to cover housing costs. Program coordinators at ARAS in Bucharest told Human Rights Watch, “We work with a lot of adults with HIV in Bucharest and they have very serious problems because there are almost no placements for adults…The housing market is very bad—in Bucharest it is impossible to pay rent out of the state subsidies if you don’t also work, even though a person living with HIV gets more than twice [as much as] those with other disabilities.”185 Ştefania Mihale, an NGO social worker in Constanţa, told us that finding housing for young adults who had been living in NGO group homes was a challenge. “Some NGOs have moved children to extended families after they turn eighteen. [As adults they] get about ROL4 million [US$ 145] per month so it is very hard to pay rent. In some smaller towns there may be support from the municipality. In Constanţa the situation is very bad because some families had been in state-owned houses that the state is now returning to the rightful owners and they are having a hard time finding new housing. Some young adults are in hostels but there are really no spaces now so it isn’t an option.”186

An expert at the National Authority for Persons with Handicap told Human Rights Watch that by law young adults living with HIV who had received certificates of disability would be eligible for subsidized housing provided by local councils “but we cannot push the local authorities to provide housing for this category over other [eligible] categories.” He added,

The problem is with those leaving the child protection centers. The legislation is not clear [about what happens to them]—they can only be in the center for two years after turning eighteen. We financed NGOs to set up houses for them but the money is never enough. We have a new approach now. We proposed a law to increase subsidies if the person does not have other income, and also to quantify the monetary value of the benefit—assume that the person doesn’t want the radio and television subscription but would like to have cable instead, or wants to go by bus and not by train. We proposed an additional 80 RON (US$ 28.99) for the person to manage. If it is approved it won’t go into force before January 1, 2007.187

While many youth living with HIV would welcome an increase in cash payments, the subsidies are not designed to meet the needs of those young adults who have led highly sheltered lives, may have significant educational and developmental deficits, and are not now and may not ever be able to live independently. For example, one person familiar with the children still living at the Vidra placement center described them as “very ill-prepared for life—they don’t read and write well, and they aren’t consulted so they don’t have good decision-making skills.”188

The need for support in transitioning to independent living is not limited to institutionalized children and youth. Dr. Lumina Enz, a pediatrician at Babeş Institute for Infectious Disease told us, “Some children are not ready. They don’t want to move to a job even if clinically they could because they are afraid. Sometimes they try to do things and come back saying they can’t when I think it is that they are afraid to do it.”189 A few NGOs have developed small assisted living and sheltered workshop programs for youth in their own group homes, but no government plan exists to provide these services more broadly, or even to provide children and youth living with HIV with information on and assistance in applying for adult subsidies.

Ioana A. (not her real name), the foster mother of a youth living with HIV in Constanţa, described her frustration at being unable to secure assistance for her foster son, or even clarify his status after turning eighteen:

The NGO my foster child had been in used to come to make visits to see the child but now that he is eighteen no one comes to visit. I would have wanted help to make long-term solutions. The NGO had a support group for foster mothers but the psychologist and social worker just listened and didn’t provide solutions so some families just took the children back to the foundation when things got difficult. When I went to the DPC they said the child will end up on the street if I don’t keep him. 190

Some infectious disease doctors told us that they sometimes hospitalized children and young adults living with HIV when they become homeless after being rejected by their families or caregivers and have no other place to go. Dr. Dan Duiculescu told us, “I had an eighteen-year-old who was crazy, he was making problems with the staff and beating smaller children and I had to keep him here because he didn’t want to go home and I preferred to keep him than to have him on the street. I finally found an NGO to take him. The hospital is not the solution. There should be group homes to give them somewhere to stay. The second step should be to put them to work or send them to school.”191 Dr. Duiculescu later returned to this theme, saying, “You need to stress that we only have a short time—one or two years. I am not afraid of sexual transmission. I am afraid of intravenous drug use because that will be on the street and it will explode. The reason we have not so many HIV-positive people among intravenous drug users is because drugs are expensive and the users are so far fairly well-off and educated. But prices will come down.”192

While Ioana A., the foster mother quoted above, had thus far managed to continue to support her foster son, she told us that other children’s situations were precarious:

The children turn eighteen but they don’t know the value of money or how to take care of themselves, and the state no longer provides the salary for a personal assistant, and now the family has another child of their own and doesn’t know what to do so what does the foster family do? Leave the child in the street? The authorities just shrug their shoulders and the child becomes like luggage left at the door of the NGO [who had previously cared for the child]. What is the child to feel in this situation?…

The local council and the DPC need to do more. The people at the upper level don’t know what is happening at the lower level. The placement department could do more—so many things move so slowly, you feel that they don’t care. Life doesn’t wait for these children. The Department of Child Protection should have thought things through from the beginning. Even if they didn’t, let’s make a plan now. What happens next? We understand that this country has problems but we are one of the problems and we need a share of the attention. We need them to listen to us.193

Arbitrary Procedures for Receiving State Subsidies

Romania provides a variety of subsides and other benefits for children living with HIV, but arbitrary and inefficient implementation of these benefits, breaches of confidentiality, and burdensome bureaucratic requirements prevent some children and families who need these benefits from receiving them, and may cause situations that place children’s health at risk. The procedures for accessing disability benefits for adults are even more complex and arbitrary than those for children.

The majority of Romanians living with HIV are poor, and may require assistance to meet the increased nutritional needs associated with HIV.194 In recognition of these needs, Romanians living with HIV are eligible for a nutrition subsidy of ROL67,000 (U.S.$ 2.40) per day for children and ROL90,000 (U.S.$ 3.30) per day for adults.195 In addition to the nutrition subsidy, people living with HIV are also eligible to apply for benefits for persons with disabilities. The criteria for the disability benefits for children with HIV are broad and the benefits include the salary of a personal assistant even if the child’s medical condition does not require one.196 In most cases the child’s personal assistant is a mother or other family member, and many families have come to rely on these combined subsidies, which may constitute a significant portion of the family’s income.

Both nutrition and disability subsidies are administered by local municipalities, which has led to wide variations in implementation, and in some cases to significant delays in payments. Paulian Sima, the AIDS expert at the National Authority for Persons with Handicap, told Human Rights Watch that a child’s benefits are based on an assessment (“social inquiry”) by a social worker for the local authority but “[t]he problem is that it depends on how well informed the person who does the social inquiry is.”197 Project coordinators at ARAS told Human Rights Watch, “The nutrition subsidy is not provided in all municipalities and in some municipalities is provided twice because of a variation in the name of the subsidy in two laws.”198 The foster mother of an HIV-positive child in Constanţa told us,

It has taken the county council half a year to understand the law on the nutrition subsidy. We heard about the law on the Internet and in other places it was enforced immediately but it took six months to be enforced here. So there was an interruption in payments. Mothers took a petition to city hall and no one at the upper level knew about the law and the social workers were stalling and saying they didn’t know. We pressured the vice prefect to call Bucharest and then he filed an order for money to be given to all the HIV-positive persons.199

A parent of a child living with HIV in Bacău told us, “The funding for the subsidies came late last year because the person in charge was transferred and there was a new civil servant in charge.”200

Burdensome administrative requirements for the nutrition subsidy can create negative incentives that put children’s health at risk. Members of the Lizuca Association in Bacău, told Human Rights Watch,

In order to get the food subsidy from the municipality you have to bring a certificate from the hospital stating that the child was not hospitalized or if hospitalized, that number of days is deducted from the final amount. Such a certificate should be issued every single month together with a statement of the parent that the child was not hospitalized. [It takes] one day to get the certificate from the hospital, one day in the municipality, one day at the General Directorate for Social Assistance and Child Protection. It takes less time if you are from the city but even so, it takes about ROL300,000 [US$ 11] to go from one place to the other. We had a case of a boy who was brought to the hospital in a very bad condition, when we asked the mother why was he brought so late she said “if I brought him to the hospital earlier I would not have received the food subsidy.”201

Doctors we spoke with in Bacău concurred, saying,

The fact that every month there is a list in the municipality with the names [of children with HIV] and specifying if they had been hospitalized or not creates problems. We have had parents who call us only in an emergency and even then they do not bring the child in because they did not want to lose the [nutrition subsidy] money. The [municipality’s] justification is that the families do not need the money for the nutritional supplement because the child is in the hospital. It is a saving for the state because the money for the children who are hospitalized does not come to the hospital to supplement their food here. This is not reasonable because even when the child is hospitalized the parent still has to bring food and supplement the alimentation of the child.202

Adult Complex Assessment Committees

In order to continue to qualify for subsidies for persons with disabilities, a young person living with HIV must be reassessed by an adult complex assessment committee. Like the children’s committees, there are forty-seven adult complex assessment committees, one in each administrative district (county or Bucharest city sector), and the committees assign a degree of disability between one and three, with a first degree disability (gradul de handicap grav) carrying the greatest benefits. While all children living with HIV automatically qualify for a first degree disability, adults must meet a stricter criterion that should also take into account any opportunistic diseases.203 Those who no longer qualify for a first degree disability after turning eighteen lose the right to have a personal assistant.204

According to Paulian Sima, the HIV expert at the National Authority for Persons with Handicap, children living with HIV who need continuing support should apply for an adult certificate of disability twenty to thirty days before turning eighteen, a process that begins with the individual going to a medical center for a referral to the complex assessment committee, which then orders a “social inquiry,” and finally an in-person review. 205 Sima told Human Rights Watch that the adult process is shorter than that for children because the adult committee meets “three to four times a week,” and “an average period is ten days at a minimum, and thirty days at the maximum if the person understands what documents are required and if they come when they have an appointment—some don’t and they disappear.” He added, “If they have mental problems it takes longer.” 206

In two cases that Human Rights Watch investigated the process did indeed appear to follow these general outlines. In both instances the young adults lived with educated, involved parents who knew how to navigate the bureaucracy. Eighteen-year-old Călin S. (not his real name) told us, “The process for the complex assessment committee took about two weeks. It is faster if you bribe the doctor. Not all doctors require bribes. The medical records for my mother to be a personal assistant need different tests and stamps from specialist doctors and if you don’t bribe them they just send you back and forth.”207 In the second case the mother of an eighteen-year-old told us, “I went to the Sixth District DPC. There was an extraordinary woman there who has promised to help. So there is understanding. I will wait to get it this month. I will have a first degree disability certificate for my daughter for an unlimited period of time and they told me that my daughter will receive a pension and nutrition allowance and I can be her personal assistant.”208

A more typical experience is for the Adult Complex Assessment Committee to issue a lesser degree certificate of disability, with fewer associated benefits. In some cases such decisions may be appropriate; many people taking antiretroviral therapy can and should be encouraged to work or attend school. The problem is that these decisions often appear to be based on mistaken assumptions of what a person living with HIV should look like and be able to do, tainted by moral judgments about people living with HIV, or the decisions arbitrarily reject the assessments of degree of medical disability provided by infectious disease doctors.

Psychological support staff at the Balş Institute for Infectious Diseases told Human Rights Watch that they often helped young adults who were given lesser degrees of disability by the Adult Complex Assessment Committee, saying “we advise them to challenge the decisions and after a while the degree of disability is changed.”209 Staff at ARAS in Bucharest told Human Rights Watch that their clients regularly faced problems with Adult Complex Assessment Committees that appeared to know little about HIV:

One girl who was switched to the Adult Complex Assessment Committee was asked how many people she slept with because they associate HIV with sex. The committee should not be asking these questions. The law says there should be a president, two specialist doctors from an appropriate medical specialty, a psychiatrist, and an NGO representative on the committee to assess the person’s work capacity, but so far none of our cases have had an infectious disease specialist and the NGO representative is the same in all cases, and not from an HIV NGO. Sometimes the Committee’s doctor’s decision goes against the diagnosis of the infectious disease doctor. 210

Anica M. (not her real name), nineteen, told Human Rights Watch, “The children’s commission was good. Now in the adults’ commission the doctors ask you “How do you feel?” Of course I said that I am fine, I am under treatment and I am not dying! They concluded that I have degree two. I’ve appealed the decision. I have been taking pills for ten years—of course I look good.”211

While decisions to grant a lesser degree of disability can be challenged, the process is time consuming and would be nearly impossible for someone with limited education and life skills to navigate without assistance. More importantly, this arbitrary and lengthy system creates a perverse incentive for people living with HIV to attempt to obtain the highest degree of disability even if their health would permit them to work, because the potential repercussions of not being able to obtain that certification quickly should their health deteriorate are so severe. Staff at ARAS told us,

In Romania the most severe degree of handicap should go to those who cannot move, feed themselves, etc. With HIV the person may not have that level of disability at the moment but it takes three to six months to get a determination of disability and in the meantime emergency social services are not developed.212




[138] Law No. 272/2004 on the protection and promotion of the rights of the child, art. 100. The system has been criticized for, among other things, an incoherent plan for funding, poorly defined and conflicting roles and responsibilities, shortfalls in the numbers and professionalism of child protection staff, haphazard implementation of deinstitutionalization policies and continuing high rates of institutionalization of children with special needs, and a failure to prepare institutionalized children for independent living. For a detailed discussion of the government bodies responsible for child protection and their shortcomings, see Institute for Marketing and Polls (IMAS), Child Care System Reforms in Romania (Bucharest: National Authority for Child Protection and Adoption, and UNICEF, 2004).

[139] Law No. 272/2004 on the protection and promotion of the rights of the child, arts. 91, 92, 94.2.

[140] Ibid., arts. 85(3) and 91.

[141] Human Rights Watch interview with Ciprian M. (not his real name), Constanţa, February 14, 2006.

[142] Human Rights Watch interview with Laura K. (not her real name), Constanţa, February 15, 2006.

[143] According to National Authority for the Protection of the Rights of the Child staff, only thirty-nine of the forty-two directorates of child protection have telephone hotlines, and social workers are in short supply because Romania had no schools of social work between 1969 and 1993, and even now graduates only a few social workers per year. Human Rights Watch interview with Ioana Nedelcu, under-secretary of state, Ali Cranta, ANPDC expert on the National HIV/AIDS Commission, and Violeta Clefterie, member of the control unit, National Authority for the Protection of the Rights of the Child, Bucharest, February 17, 2006

[144] Human Rights Watch interview with Simona Zamfir, program coordinator, Save the Children Romania, Bucharest, February 9, 2006.

[145] Human Rights Watch interview with Ioana Nedelcu, under-secretary of state, Ali Cranta, ANPDC expert on the National HIV/AIDS Commission, and Violeta Clefterie, member of the control unit, National Authority for the Protection of the Rights of the Child, Bucharest, February 17, 2006.

[146] Article 3 of the ECHR prohibits torture and inhuman and degrading treatment or punishment, and article 13 requires that there is an effective remedy for anyone who may be a victim of a violation. The European Court of Human Rights has consistently held that States are required to take measures designed to ensure that individuals within their jurisdiction are not subjected to torture or inhuman or degrading treatment or punishment, including such ill-treatment administered by private individuals and that children and other vulnerable individuals, in particular, are entitled to State protection, in the form of effective deterrence, against such serious breaches of personal integrity. The Court has found violations of article 3 in the form of state failure in laws and practice to protect children from abuse by adults and in state care in A v. United Kingdom, judgment of September 23, 1998, Reports of Judgments and Decisions 1998-VI; Z. and Others v. United Kingdom, judgment of May 10, ECHR 2001-V; and E. and Others v. United Kingdom, judgment of November 26, 2002.

[147] Governmental Decision 1279 /2003 on modifying and completing the Governmental Decision 1194/2001 on the organizing and functioning of the National Council for Combating Discrimination, Official Gazette No. 805/2003.

[148] Article 22 states “(1) Human rights nongovernmental organizations can appear in court as parties in cases involving discriminations pertaining to their field of activity and that prejudice a community or a group of persons. (2) The organizations provided in the above paragraph can also appear in court as parties in cases involving discrimination that prejudice a natural entity, if the latter delegates the organization to that effect.” Law No. 48/2002 on approving the Ordinance 137/2000 on preventing and sanctioning all forms of discrimination, Official Gazette 69 from January 31, 2002, arts. 1(2)(e)(i), 6(7), 1(2)(e)(iv), 11, 1(2)(3)(v), 15, 22(1).

[149] Ibid., art. 20.

[150] National Council for Combating Discrimination, Report January-June 2004, available at http://www.cncd.org.ro/images/rapoarte/raport%20ian-iun%202004.pdf .

[151] National Council for Combating Discrimination, Annual Report 2005, available at http://www.cncd.org.ro. In 2005 the Council received 382 petitions and started investigations ex officio in seventy-four cases.

[152] National Council for Combating Discrimination interventions in cases involving HIV appear to have been more effective in cases of discrimination in schools in Bucharest, when the registration of pupils living with HIV was refused or when the teachers, school authorities, or other parents harassed children living with HIV with the intent of forcing them to drop out. Human Rights Watch interview with Claudia Terragni, program coordinator, and Delia Goia, Gabriela Georgescu, Justina Haralambescu, and Marius Pawradu, social workers, Foundation for the Development of People, Bucharest, February 7, 2006.

154 National Council for Combating Discrimination, Decision 289 from August 8, 2005.

[154] National Council for Combating Discrimination, Decision 66 from April 1, 2005.

[155] Human Rights Watch interview with Csaba Ferenc Asztalos, president, and Corina Macoveanu, steering committee member, National Council for Combating Discrimination, Bucharest, February 21, 2006. According to Asztalos, the senate was considering draft legislation “to increase the sanctions and reverse the burden of proof.”

[156] National Council for Combating Discrimination, Decision 37 from January 19, 2006.

[157] Human Rights Watch interview with Csaba Ferenc Asztalos, president, and Corina Macoveanu, steering committee member, National Council for Combating Discrimination, Bucharest, February 21, 2006.

[158] IMAS, Child Care System Reforms in Romania, p. 30.

[159] Human Rights Watch interview with Claudia Terragni, program coordinator, and Delia Goia, Gabriela Georgescu, Justina Haralambescu, and Marius Pawradu, social workers, Foundation for the Development of People, Bucharest, February 7, 2006.

[160] Human Rights Watch interview with Ioana Nedelcu, under-secretary of state, Ali Cranta, ANPDC expert on the National HIV/AIDS Commission, and Violeta Clefterie, member of the control unit, National Authority for the Protection of the Rights of the Child, Bucharest, February 17, 2006.

[161] Human Rights Watch interview with Ana Maria Schweitzer, director, and Ştefania Mihale, social worker at the Romanian-American Children’s Center, and Dr. Cambria, an infectious diseases specialist at the Constanta Municipal Hospital who also sees patients at the Romanian-American Children’s Center, Constanţa, February 14, 2006.

[162] Human Rights Watch interview with Mirela Cornelia Gene, deputy director, Directorate for Child Protection, General Directorate for Social Assistance and Child Protection, February 13, 2006. In a subsequent telephone interview Gene corrected herself, saying that DPC staff also included “three social workers who do files for disability determinations.” Human Rights Watch telephone interview with Mirela Cornelia Gene, February 15, 2006.

[163] Human Rights Watch interview with Mirela Cornelia Gene, deputy director, Directorate for Child Protection, General Directorate for Social Assistance and Child Protection, February 13, 2006.

[164] Violeta Clefterie told Human Rights Watch that the Constanţa DPC “got money from the national government but there were problems with money from the county council and how they spent it. Money for the entire year was spent in four months and from our point of view the money was spent on programs that were not a high priority.” Human Rights Watch interview with Ioana Nedelcu, under-secretary of state, Ali Cranta, ANPDC expert on the National HIV/AIDS Commission, and Violeta Clefterie, member of the control unit, National Authority for the Protection of the Rights of the Child, Bucharest, February 17, 2006. Paulian Sima told us, “Many municipalities decide that money from the central government can be spent on anything they want so they go and build a bridge or repair a road. That is what happened in Constanţa. The authorities used the funding from the state budget for other purposes.” Human Rights Watch interview with Paulian Sima, expert, National Authority for Persons with Handicap, Bucharest, February 20, 2006.

[165] Human Rights Watch interview with Ana Maria Schweitzer, director, and Ştefania Mihale, social worker at the Romanian-American Children’s Center, and Dr. Cambria, an infectious diseases specialist at the Constanta Municipal Hospital who also sees patients at the Romanian-American Children’s Center, Constanţa, February 14, 2006.

[166] Ibid.

[167] Reintegration of institutionalized children into families still facing difficulties, and inadequate support for these families, is a broader problem in Romania. A 2004 study of 141 families who had taken children back found that only 25 percent reported receiving any counseling, and 50 percent reported receiving no assistance at all. Most of the families were very poor, were headed by persons with below average education, and had three or more children under eighteen. In many cases the family’s school age children were not attending school, and 60 percent said they had difficulties raising the reintegrated child. IMAS, Child Care System Reforms in Romania, pp. 54-56.

[168] Human Rights interview with Natalia L. (not her real name), Bacău, February 14, 2006.

[169] Human Rights Watch interview with Ramona Ferenţ, executive director, Romanian Association Against AIDS, Bacău, February 13, 2006.

[170] The other two were in Constanţa and Bucharest.  Human Rights Watch interview with Claudia Terragni, program coordinator, and Delia Goia, Gabriela Georgescu, Justina Haralambescu, and Marius Pawradu, social workers, Foundation for the Development of People, Bucharest, February 7, 2006; Human Rights Watch interview with Dr. Monica Bîrlodeanu, director, and D.l. Medeleanu, administrator, Vidra Placement Center No. 7, Vidra, February 15, 2006.

[171] Human Rights Watch interview with Stephan P. (not his real name), Bucharest, February 8, 2006.

[172] Human Rights Watch interview with Ernestina Rotariu, executive director, Health Aid Romania, Bucharest, February 9, 2006.

[173] Human Rights Watch interview with Claudia Terragni, program coordinator, and Delia Goia, Gabriela Georgescu, Justina Haralambescu, and Marius Pawradu, social workers, Foundation for the Development of People, Bucharest, February 7, 2006.

[174] Ibid.

[175] Ibid.

[176] Human Rights Watch interview with Dr. Monica Bîrlodeanu, director, and D.l. Medeleanu, administrator, Vidra Placement Center No. 7, Vidra, February 15, 2006.

[177] Human Rights Watch telephone interview with an individual familiar with the situation of children at Vidra over a number of years (name withheld by request), February 7, 2006.

[178] Human Rights Watch interview with Stephan P. (not his real name), Bucharest, February 8, 2006.

[179] Goia told Human Rights Watch that she was not aware of head shaving as punishment taking place since Dr. Bîrlodeanu became director. Human Rights Watch interview with Delia Goia, social worker, Foundation for the Development of People, Bucharest, February 8, 2006

[180] Human Rights Watch interview with Dr. Monica Bîrlodeanu, director, and D.l. Medeleanu, administrator, Vidra Placement Center No. 7, Vidra, February 15, 2006.

[181] Human Rights Watch interview with Claudia Terragni, program coordinator, and Delia Goia, Gabriela Georgescu, Justina Haralambescu, and Marius Pawradu, social workers, Foundation for the Development of People, Bucharest, February 7, 2006.

[182] Law No. 272/2004 on the protection and promotion of the rights of the child, art. 51(3).

160 Human Rights Watch interview with Gabi Mareş, psychologist, and Anca Grigoraş and Flavia Olaru, social workers, Romanian Angel Appeal, Bacău, February 13, 2006.

[184] Human Rights Watch interview with Mirela Cornelia Gene, deputy director, Directorate for Child Protection, General Directorate for Social Assistance and Child Protection, February 13, 2006.

[185] Human Rights Watch interview with Monica Dan and Liana Velica, project coordinators, Romanian Association Against AIDS, Bucharest, February 17, 2006.

[186] Human Rights Watch interview with Ana Maria Schweitzer, director, and Ştefania Mihale, social worker at the Romanian-American Children’s Center, and Dr. Cambria, an infectious diseases specialist at the Constanta Municipal Hospital who also sees patients at the Romanian-American Children’s Center, Constanţa, February 14, 2006.

[187] Human Rights Watch interview with Paulian Sima, expert, National Authority for Persons with Handicap, Bucharest, February 20, 2006.

[188] Human Rights Watch telephone interview with an individual familiar with the situation of children at Vidra over a number of years (name withheld by request), February 7, 2006. This problem is not unique to children living with HIV: A 2004 evaluation of the child protection system found that child protection institutions did not adequately prepare young people for independent living, saying residents of these institutions “lack self-confidence and have little confidence in others. They have not completed their education, have poor career orientation, are incapable of planning their future in a practical manner, and are sometimes emotionally unstable.” IMAS, Child Care System Reforms in Romania, p. 57.

[189] Human Rights Watch interview with Dr. Luminita Enz, Victor Babeş Infectious Diseases Institute, Bucharest, February 18, 2006.

[190] Human Rights Watch interview with Ioana A. (not her real name), foster mother of an HIV-positive youth, Constanţa, February 15, 2006.

[191] Human Rights Watch interview with Dr. Dan Duiculescu, director of pediatric AIDS, Victor Babeş Infectious Diseases Institute, Bucharest, February 16, 2006.

[192] Ibid.

[193] Human Rights Watch interview with Ioana A. (not her real name), foster mother of an HIV-positive youth, Constanţa, February 15, 2006.

[194] According to the 2004-2007 National Strategy for HIV/AIDS, “a great part of the families having children living with HIV and a large part of the adults live at the poverty line (about 83% of them according to some studies.” Government of Romania, National Strategy for surveillance, control and prevention of HIV/AIDS cases, 2004-2007, p. 33.  A 2003 World Health Organization study estimated that energy requirements were likely to increase by 10 percent in asymptomatic individuals living with HIV, and 20 to 30 percent in symptomatic individuals. In cases of children experiencing weight loss, energy requirements could increase by 50 to 100 percent. The study also noted that “HIV-related infections, such as tuberculosis and diarrhoea, not only have nutritional status as a significant determinant of their incidence and severity, but they also have severe nutritional consequences that commonly precipitate appetite loss, weight loss and wasting.” WHO, Technical Consultation on Nutrient Requirements for People Living with HIV/AIDS (Geneva, 2003), pp. 4-5.

[195] Article 7 of Law No. 584/2002 provides for a nutrition subsidy, with the amount and agency responsible for distribution specified in Governmental Decision No. 839/2004. Governmental Decision 839/2004 for modifying the Governmental Decision 1177/2003 on the approval of the amount for the monthly nutritional allocation for the persons infected with HIV or suffering of AIDS, Official Bulletin No. 732 from October 20, 2003, arts. 1, 2; Law No. 584/2002 on measures to prevent the spread of AIDS in Romania and to protect persons infected with HIV or suffering from AIDS.

[196] Article 2 of Law No. 519/2002 provides for a first degree disability pension for all children and some adults living with HIV/AIDS. In addition to these benefits, under article 17 of Law No. 519/2002 children living with HIV/AIDS are also eligible to receive double the child allocation, a 50 percent increase of the allocation for children with disabilities, free summer camps once a year, free urban transportation, and twelve free tickets for trains and buses per year. Law No. 519/2002 of July 12, 2002, on approving the Emergency Ordinance 102/1999 on special protection and the employment of persons with handicap, Official Bulletin No.555 from July 29, 2002. Children and youth who are enrolled in school are also eligible for an education subsidy until age twenty-six. Law  No. 272/2004, art. 51.

[197] Human Rights Watch interview with Paulian Sima, expert, National Authority for Persons with Handicap, Bucharest, February 20, 2006.

[198] Human Rights Watch interview with Monica Dan and Liana Velica, project coordinators, Romanian Association Against AIDS, Bucharest, February 17, 2006.

[199] Human Rights Watch interview with Ioana A. (not her real name), foster mother of an HIV-positive youth, Constanţa, February 15, 2006.

[200] Human Rights Watch interview with Ana Vătavu, executive director, Mihaela Ondu, member, and Eugenia O. (not her real name), member of the Lizuca Association, a member organization of UNOPA, February 13, 2006.

[201] Ibid.

[202] Human Rights Watch interview with Dr. Liviu Prisăcariu (from Iaşi) and Dr. Delia Grigoraş, head of the Bacău Hospital Infectious Diseases Unit, Bacău, February 14, 2006.

[203] See Ministry of Health Order 726/ 2002 of 01/10/2002, Official Bulletin 775 from October 24, 2002.

[204] Law No. 519/2002 of July 12, 2002, on approving the Emergency Ordinance 102/1999 on special protection and the employment of persons with handicap, Official Bulletin No.555 from July 29, 2002, art. 17(h).

[205] Human Rights Watch interview with Paulian Sima, expert, National Authority for Persons with Handicap, Bucharest, February 20, 2006.

[206] Ibid.

[207] Human Rights Watch interview with Călin S. (not his real name), Bucharest, February 18, 2006.

[208] Human Rights Watch interview with Silvia B. (not her real name), Bucharest, February 16, 2006.

[209] Human Rights Watch interview with Odette Chirilă and Carina Jalbă, members of the team providing psychological support to patients with HIV/AIDS at Matei Balş Institute, February 8, 2006.

[210]Human Rights Watch interview with Monica Dan and Liana Velica, project coordinators, Romanian Association Against AIDS, Bucharest, February 17, 2006.

[211] Human Rights Watch interview with Anica M. (not her real name), Bucharest, February 16, 2006.

[212]Human Rights Watch interview with Monica Dan and Liana Velica, project coordinators, Romanian Association Against AIDS, Bucharest, February 17, 2006.


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