The health status of children adopted from Romania by American families reflects years of government-sanctioned neglect and abuse, placing them in a medically "high risk pediatric group," according to a study released Tuesday.
Researchers studied 65 Romanian children now living in this country--children who came from among those considered the "most vital and attractive" available for adoption--and said that only 15% had been physically healthy and developmentally normal since their arrival. Many also suffered from severe emotional and social deprivation.
This means that tens of thousands of children who remain institutionalized in Romania are in much worse shape, they said. The report appeared in today's Journal of the American Medical Assn.
Many of the children were adopted after the 24-year regime of Nicolae Ceausescu came to a violent end in December, 1989. After the country was opened to the Western press, one of the revelations was the state-run orphanage system for abandoned children, which housed an estimated 100,000 to 300,000 youngsters under "dreadful" conditions, the authors wrote.
The orphanages became repositories for "the diseased and severely damaged," as well as for normal children whose families could not support them, the researchers said.
"These are pediatric gulags ," said Dr. Dana Johnson, head of the University of Minnesota's International Adoption Clinic who evaluated the children with his counterparts at International Adoption Clinic of the New England Medical Center, Tufts University.
"The Ceausescu government had a very utilitarian view of children," Johnson said. "The orphanages there were designed to weed out the kids who would not go on to be workers, and who weren't worthwhile supporting. The ones who were deemed strong and vital were placed in the so-called 'good' orphanages. The others were put into concentration camps for babies."
The Minnesota and New England clinics studied children who were brought to the United States during a 12-month period beginning in October, 1990. They ranged in age from 6 weeks to 6 years.
They all came from the so-called 'good' orphanages, but nevertheless showed serious signs of ill health, neglect and abuse, the researchers said.
Fifty-three percent had evidence of past or current infection with hepatitis B, and 33% had intestinal parasites--with 45% showing two or more types of pathogens, the researchers said. All of the children tested negative for the human immunodeficiency virus (HIV), which causes AIDS, they said.
Many of the children suffered from growth failure, and only 10% of those children older than 1 year were developmentally normal, the researchers said.
"Two patterns of growth failure were observed that resembled (those associated) with prolonged psychological harassment or emotional deprivation," they wrote. "Infants' length, weight, growth circumference and weight-for-height were adversely affected by institutionalization. Older children's height was" shorter than normal.
The researchers described the long-term outcome for these children as uncertain, but said "it appears that many respond well to a loving family environment, improved nutrition, and medical and developmental intervention."
Johnson said those children who were young when they arrived in the United States and did not spend much time in the Romanian system "bore up pretty well." Others, however, "have significant problems."
"The kids who were maybe 4 or 5 years old and had not had the ability to socialize and make normal attachments are having terrible problems with speech and language," Johnson said. "Their social skills are infantile. They have missed critical points in their development."
Nevertheless, Johnson said, the researchers remained hopeful that the children's new environment would ultimately reverse the damage.
"They are in wonderful homes," he said. "These are parents who will do anything for these kids. So it will take time, and intervention. I'm optimistic."
In an accompanying article, Dr. David R. Rosenberg of the department of psychiatry at Western Psychiatric Institute and Clinic in Pittsburgh, who visited an orphanage in Babeni, Romania, called for "an immediate international response" to the orphanage situation in Romania--preferably, he said, from the United Nations and the World Health Organization.
"Time is of the essence if the thousands of institutionalized Romanian orphans are to have any chance of leading normal, productive and healthy lives," he wrote. "Merely housing and feeding these children is insufficient. Their welfare depends on well-thought-out, long-term solutions that provide for their basic needs and protect their social, environmental and human rights."