UNICEF Report – Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia

Alexandra - 17 months. Copyright UNICEF/NYHQ2004-0698/G. Pirozzi

The following are some excerpts from the UNICEF Report – Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe & Central Asia. Emphasis added to highlight the areas I find most relevant to this blog topic.

“This report brings to life the experiences of children, families and young people living with HIV.  It gives voice to their stories of despair, stigma and social exclusion, as well as to their courage and hope.

Access to antiretroviral treatment is still among the lowest in the world, and stigma and discrimination that violate the basic rights and dignity of people living with and affected by HIV, including children, are hampering further progress in prevention, care and support.

Eastern Europe and Central Asia are the only parts of the world where the HIV epidemic remains clearly on the rise. Increases of up to 700 per cent in HIV infection rates have been found in some parts of the Russian Federation since 2006. Women, who now account for some 40 per cent of new cases compared to just 24 per cent under a decade ago are increasingly affected by HIV, as are children. The total number of HIV-positive pregnancies has doubled during the past five years.

Children born to HIV-positive mothers suffer the consequences of these prejudices, experiencing a much higher likelihood than other children of being abandoned at a hospital, or being left to live in isolation at a specialized care institution. Across Eastern Europe, children born to HIV-positive mothers have a much higher risk than others of being abandoned at or soon after birth. Their removal from their mother, their family and community is an expression of both the stigma surrounding the HIV disease and of the multiple hardships that overwhelm many disadvantaged women.

Currently, the region has the highest rates of family separation in the world, with approximately 1.3 million children deprived of parental care and isolated from family and community, even though the vast majority still have biological parents. The relinquishment of children to institutional care is an established solution for families in distress – a practice that has historic roots and continues to the present day, despite strong evidence of its negative consequences for children’s well-being.

The infrastructure of institutional care remains as that of the Soviet era. Infants who are left in maternities are transferred to baby homes (Dom Ribyonka) where they stay until the age of three. If they are not adopted during these early years they are transferred to children’s homes (Dyetski Dom) for the next four years and then onwards to ‘internats’ for 7- to 18-year-olds. This movement through different institutional settings leaves many children poorly equipped to cope or find jobs once they leave and highly vulnerable to abuse and exploitation. Young people graduating from these institutions have much higher rates of alcoholism, drug use, criminal behavior, unemployment, imprisonment and suicide than their peers.

For children with HIV who live in institutions, the chances of being adopted are particularly slim as a result of widespread prejudice. Elena, from Ukraine, who adopted two HIV-positive girls (aged 6 and 7), shares her experience:

From the moment I saw them, I immediately knew that I would love them like my own children. Imagine my surprise when the adoption agency tried to convince me not to take these two girls! They said to me, ‘Why would you want such a headache, you should take some other children.’

Despite growing availability of alternative family-based solutions, residential care is not diminishing. In recent years, the proportion of children in residential care has increased.

In the Russian Federation and Ukraine, about 6 to 10 per cent of children born to HIV-positive mothers are abandoned in maternity wards, pediatric hospitals and residential institutions, with little opportunity for foster care, adoption or family reunification. While the relative proportion of children abandoned at birth by these mothers has been decreasing, the number of HIV-positive pregnancies has grown, creating a steady increase in the cumulative numbers of children abandoned to state care overall. The reasons for infant and child relinquishment by HIV-positive women are complex. An in-depth qualitative study of HIV-infected mothers, their families and health-care workers from four regions in the Russian Federation concluded that HIV was not the primary reason for infant abandonment. Rather, the key factors increasing the likelihood of abandonment were: unwanted pregnancy, poverty, lack of family support, drug and alcohol use, fear of the infant having birth defects or disabilities, and an inability to support the costs of caring. Of these, the strongest predictor was unwanted pregnancy.

Within the context of child-care reforms in many countries of the region, support to biological families to keep their children, prevention of abandonment, and the development of family-based care alternatives to institutionalization have increasingly been a focus. UNICEF has been a key partner in many such initiatives. In Ukraine, for example, almost 90 per cent of maternities have established linkages with social services to address child abandonment. A number of ‘Mother-Baby Centres’ have been opened by state social services to support new mothers in difficult circumstances. Many of the mothers are teenagers or single women who have been rejected by their families. Reports show that over 60 per cent of mothers who are in contact with the centres change their minds about abandoning their babies. Similarly, projects led by NGOs, such as the MAMA+ project of Health Rights International with the Ukrainian Foundation for Public Health, have provided support for HIV-positive and drug-using pregnant women and mothers to enable them to keep their children. A range of client-oriented services are provided, including day-care centres, family visits, referrals to health-care facilities and drug and alcohol addiction counseling. The All-Ukrainian Network of People Living with HIV/AIDS has also taken action to find family-based care options for abandoned HIV-positive children living in institutions. Finding adoptive parents has been particularly challenging as a result of many legal obstacles, widespread social misconceptions about HIV, and the high levels of stigma and ignorance associated with the disease. As expressed by one of the project coordinators from the Network: “We have looked for adoptive parents for over two years. It is extremely difficult to find such people. We believe we need to find such families and provide them with all the necessary support. The majority of HIV-positive kids have suffered through living in orphanages and need special care.”

Yana was just eight years old when she started living on the streets. Her father, an alcoholic, died young and she was separated from her mother who was sent to jail. Originally from Moldova, one of the poorest countries in Europe, Yana wandered through several towns and eventually ended up on the streets of Odessa, Ukraine. Her ‘home’ was a makeshift shed in a park. A group of 20 street children built the hideout themselves, the youngest only six years old. They begged, stole and prostituted themselves to survive. Drugs helped them cope with their lives. Through sharing needles they also shared HIV. Yana fell sick and died at the age of 13 on the streets of Odessa, addicted to drugs and infected with HIV…”

A recent study of 15- to 19-year-old street children in St Petersburg, involving 313 participants, found that almost 40 per cent of them were HIV-positive. High levels of HIV prevalence have also been found among street children in studies in Odessa and Donetsk, Ukraine. While there are no reliable estimates of how many children are without adult supervision, living and/or working on the streets, experts agree there are probably over one million in the region. The large majority end up on the street as a result of running away from physical and psychological abuse within families, or from state-run orphanages and shelters. Once on the streets, sex and drugs become part of these children’s daily reality and other street dwellers compose their social network. Almost all street children report being sexually active and the majority have multiple partners, both through sex among peers and through selling sex.

In 2008, antiretroviral therapy (ART) coverage among adults in the region was estimated to be only 22 per cent, the second lowest in the world. The main success of health systems in the region has been the high level of coverage of services to prevent mother-to-child transmission of HIV (PMTCT) and access to pediatric AIDS treatment. An estimated 94 per cent of pregnant women have access to ARV prophylaxis. For HIV-positive children, ART coverage is estimated to be 85 per cent.

Responding effectively to the HIV epidemic in Eastern Europe and Central Asia will require a paradigm shift from blame and exclusion to support and inclusion. A rights-based approach provides the basis for that shift. As stipulated in the Convention on the Rights of the Child, all rights apply to all children without exception, and States have an obligation to protect all children from discrimination and to take positive action to promote their rights. In building and sustaining the response to HIV, governments must take the lead in developing approaches that are firmly rooted in the needs and rights of children and young people. Developing a rights-based response to meet the needs of children and young people will also require additional funding. Combined international investments in HIV in the entire region do not come close to investments in a single country such as Ethiopia that has a similar number of new HIV infections annually as the Russian Federation or Ukraine, and which also falls amongst the top twelve most affected countries in the world.”

Adopted Brothers are Pediatric HIV/AIDS Ambassadors

This article is from Elizabeth Glaser Pediatric AIDS Foundation. Lee and Lucas are ambassadors for the foundation.

Children adopted with HIV

My name is Lucas, and I have a brother named Lee. We’re both 11 years old and are living with HIV. We didn’t know we were HIV-positive until one day last summer, when my mom told us why we had to take so much medicine and why we went to the doctor so often.

When I heard of HIV for the first time, I had no idea what it was. My mom showed us books with pictures of the virus and taught us about how it attacks our immune systems. Knowing I was HIV-positive seemed scary at first, but it soon began to make sense. My mom told Lee and me that we got HIV from our biological mothers, who passed it on to us in the womb. It is hard to live with HIV, but I know it will never go away. Now, the only choice is to take all my meds and keep the virus at bay. Some of our meds taste absolutely awful. As bad as it seems to live with HIV, I realize how lucky we are to live in a dedicated family and place where we get good care.
Hopefully someday soon, there will be a cure for HIV. Until then, the most important thing we can do is eliminate pediatric AIDS by preventing the transmission of HIV from moms to their children. We can eliminate it if we raise money, educate people who don’t understand, and help the moms and kids that need it.

I dream of a world free of HIV so no other kids have to become a victim of this virus.

You can order holiday cards designed by Lee and Lucas to benefit the Elizabeth Glaser Pediatric AIDS Foundation.

Why I Advocate for HIV-positive Orphans

I wholeheartedly believe that there won’t be any more HIV positive orphans to advocate for within my lifetime.

That’s right.

Until that time, I will advocate for parental care until the time comes when my advocacy efforts are no longer needed.

The solution, of course, is in preventing mother to child transmission of HIV/AIDS (PMTCT). Preventing a birthmother from transmitting the virus to her newborn is only a matter of having access to medication.

In 2006, about 530,000 children became newly infected.  In 2008, around 430,000 children became infected.  As time goes on, fewer babies are being born with HIV/AIDS due to PMTCT. At the rate of 100,000 fewer per year, we’re only a few years away!

In 2004, only 10% of pregnant women with HIV were receiving ARVs in low and middle income countries.  In 2008, that figure was up to 45%. Elizabeth Glaser Pediatric AIDS Foundation reports 53% of pregnant women worldwide are currently receiving ARVs (June 2010). [Kaiser reported 51% in July 2010.] This percentage is increasing every year and I feel it is feasible to get to nearly 100% PMTCT rates in the foreseeable future.

In high income countries, mother to child transmission has been virtually eliminated and I have every reason to believe that this will be true worldwide as access to treatment becomes more commonplace. As an example, less than 200 babies are born HIV positive in the United States every year because pregnant women in this country have access to the meds. Out of those children who do end up positive, the vast majority stay with their biological families and only a couple of children per year end up in need of foster or adoptive parents.

So why do I advocate for HIV positive orphans? I choose to advocate because I feel orphans with HIV are among the most underprivileged people in society.  Their need for healthcare is a life or death matter and their need for a family is paramount to become a productive member of society.  These children have few people speaking out for them and they truly do not have the means to speak out for themselves.  Being a child without parents must be an immensely difficult position to be in.  I can’t imagine how it might be for a helpless sick  child without a parent who loves them, cares for them, protects them and provides for their daily needs.  Statistics regarding the future prospects of children who emancipate from orphanages, the foster-care system, or who grow up as street children are profoundly bleak: prostitution, homelessness, substance abuse, incarceration and suicide affect the vast majority of those children who grow up as orphans and never find permanent, loving homes. In my opinion,  orphans with HIV  and other diagnoses which ostracize them, are the most disadvantaged people on the planet and I cannot think of a group in greater need of a voice.

Until there is universal access to prevention of mother to child transmission of HIV, I will continue to bring awareness, educate families and find homes for these precious children. There are TOO MANY – at least 200 children (that I know of) are eligible for international adoption RIGHT NOW. If you would like to join me in advocating, please be in touch. We need at least 200 families and I can’t find them alone – people need to see these precious faces and learn the facts about pediatric HIV. If you are not in a position to adopt, please consider sponsoring a child so they may stay in a permanent loving family, contributing to the adoption fund of family trying to bring an HIV+ child home, or advocate on behalf of a child so that a family can find them.


Christmas Gifts for HIV+ Orphans

Life2Orphans “Wishing On An Angel” Christmas project has many boxes filled with wonderful Christmas gifts for orphans in Ukraine. They are in need of people who can pay $30-$45 to ship each box overseas. The gifts have been generously donated and the boxes are already packed and waiting at Life2Orphans in Portland to be shipped to Ukraine. You can choose which box you would like to send. There are HIV positive orphans at several orphanages in Ukraine, so if you know which orphanage you would like to send it to, just choose that orphanage from the drop-down menu. Otherwise,  you can choose “M__ AIDS Orphanage” to be sure that HIV+ orphans will receive gifts. Here are the links:

Step 1: Boxes Available (choose one in the 0-4 year age range or for the caretakers and write down the box #).

Step 2: Fill out the form (so they know who is paying for the shipment and where to ship the specified box). Don’t mind the error message.

Step 3: Mail a check or pay via Paypal for shipping costs. I clicked on this link then clicked ‘Donate Online’ (lower left).

The organization is trying to get all of the boxes shipped by October 13th so they will make it to Ukraine in time for Christmas.

Community Support for Ethiopian Children with HIV

There are many ways to support HIV positive children, one of which is AHOPE For Children’s Community Support Program. I am a firm believer in programs such as this and others which enable parents and relatives to raise their children, rather than abandon them. Without community support programs such as this, there would be even more orphans in the world.

Hosting Opportunity – Twins!

New Horizons has a holiday hosting opportunity. Karina and Katya are twin girls. One of them is HIV positive and one is HIV negative. The HIV positive child is on daily medication. Both sisters are lovely, sweet, kind and simply amazing in their adorable personalities. They are friendly, very well spoken and smart in school.  They play well with each other and the kids at the orphanage adore them. They dream of “a home where they can live together and someone will take care of them”. This hosting program is for families interested in adoption, although there is no obligation that the host family adopt the hosted children.

India Adoption Grant

I have posted about waiting children with HIV in India. Thanks to RainbowKids for the link to M. Night Shyamalan Foundation’s MNSF India Adoption Grant. Here is the info from the website:

MNSF India Adoption GrantAdopting from India

The M. Night Shyamalan Foundation (MNSF) believes that a loving family is the birthright of every child. We hope to bring particular attention to the orphans of India and aim to facilitate their passage to a better life. We provide grants to U.S. citizens residing in America who seek to adopt children from India. The purpose of the grant is to alleviate financial obstacles to international adoption. Grants are provided to families who establish that they are eligible to adopt a child from India, are capable of providing a safe, loving, and nurturing environment for a child, but for whom the costs involved in the adoption process pose a demonstrable burden or barrier to an adoption. Only families with a gross annual income of less than $100,000 are asked to apply. Due to limited resources, the foundation cannot guarantee that all qualified applicants will be funded. Grant approvals as well as decisions regarding the amount of the award will be determined solely by the Board of Directors and will be based on funds available, the applicant pool, and applicant qualifications.

Helping Orphans in Haiti after Earthquake

If you would like to help the orphans in Haiti, as they try to recover from the devastating 7.0-magnitude earthquake that struck near Port-Au-Prince yesterday, Bethany Christian Services has the following message:

We are thankful that all of the children and staff at both of our in-country partners, God’s Littlest Angels orphanage and The Creche Enfants Jesus, were not harmed.

Dixie Bickel, the director of God’s Littlest Angels,

Haiti Earthquake
posted an update on her blog early this morning, describing the earthquake’s effects at the orphanage: “…The building stayed standing and John cannot find any cracks in the walls which is pretty amazing!… The nannies came in at 10 PM but we had two strong after shocks about midnight and the nannies and babies are sleeping outside on the ground on blankets!”  Read more on her blog

Dixie explains what it was like to survive the earthquake during an interview on
The Today Show on NBC.

If you can financially help the children in Haiti, Bethany Christian Services has set up a fund for earthquake recovery in Haiti. We will work with our partners on the ground in Haiti to use your donations to help ensure that children in Haiti are cared for and kept safe.

It is Bethany’s mission to both help many Haitian children stay in their families and also to help orphaned children be placed for adoption with families in the United States.

Please visit www.bethany.org/donate to donate to the Haiti-Earthquake Recovery fund.

Donate to the Haiti-Earthquake Recovery fund

We also hope to develop a special service trip to Haiti to help with the recovery. If you have any interest in learning more about this opportunity, please e-mail us athaitiearthquake@bethany.org.

AHOPE for Children Sponsorship Update

Forward this message to a friend
We have some extraordinary news to
share! Since we announced campaign
FIFTEEN on World AIDS Day just
six days ago, 11 new sponsors have
stepped forward! We are blown away
by your generosity. And humbled
beyond words. We ask for your
continued support to reach the goal
of campaign FIFTEEN – 15 days to
find 15 sponsors for 15 orphans with
HIV in Ethiopia – and help change the lives of some of the world’s most
vulnerable AIDS victims.
Why? AHOPE Ethiopia is a children’s home to orphans infected with HIV,
which has recently moved to a larger residence with room to care for 15 more
orphans. The space is available for 15 more children, but the funds are needed
to help provide them with basic necessities such as food, medications, education
and holistic care. A child sponsorship is just $35/month ($420/year), and a co-op
sponsorship is a great idea for a group of 10 friends, family members or sorority
sisters to each pitch in $42/year. We can also provide an Honor Card if you wish
to sponsor a child in someone else’s name or memory. We have hope that there
are more people out there that will feel inspired to help these children. Will you
please join us on this journey to give hope a home?
Again, thank you for your generous support. With eight days remaining, we are
well on our way to our goal!
For more information, please click the following link:
5023 N. Parkway Calabasas | Calabasas, CA 91302 US