Photographs [not available] by Richard Phibbs

Romania, a smallish country and a desperately poor one, leads Europe in only one arena: the number of children with AIDS. More than 9,000 cases of childhood HIV have been reported, and nearly three--quarters of the nation’s PWAs are under the age of 15. According to official U.S. statistics, more than 2,000 children with HIV have died, but experts agree that the number is much higher.

The roots of Romania’s epidemic go back to the rule of ruthless Stalinist dictator Nicolae Ceausescu. In the years before his 1989 overthrow and execution, Ceausescu warehoused thousands of children, the products of a national ban on birth control and abortion, in orphanages under appalling conditions. Children who were anemic or simply run-down were given blood transfusions as a sort of “pick-me-up,” bad medicine made lethal because Romania did not then screen its blood supply. Many more children were vaccinated with contaminated needles. By 1991, Romania had half the pediatric AIDS cases in Europe.

The world was riveted by horrifying TV images of “Romania’s AIDS babies,” and in the first heat of media coverage, well-wishers in Europe and the U.S. established nonprofits to care for some of these children. Antiretroviral combination therapy arrived in 1997 and death rates plummeted. But government support and international aid have been sporadic, and the cost of the lifesaving treatments—at least $1,200 a year—prices them well out of the range of most Romanians. Last year the Romanian government and U.S. pharmaceutical giant Merck announced a partnership to supply Romanians with HIV meds on demand. But health-care providers complain that the supply has been intermittent and there aren’t enough drugs to go around.

Only two-thirds of the 70 children at Victor Babes Hospital in Bucharest get the HIV treatment they need, according to Mary Veal, an American social worker. What’s equally bad, Veal says: “We’re always short of top-of-the-line medications to treat opportunistic infections. Specific forms of lethal meningitis require Diflucan every day for life, but we can only give it in emergencies because it’s so expensive.” Almost all the children have or have had TB; hepatitis is rampant. Veal supplies even basic needs, from ibuprofen and vitamins to good food and warm clothes.

Veal, who came to Bucharest from Georgia in 1993, runs a small nonprofit caring for children with HIV at Victor Babes Hospital; other children are able to live with their families because nurses from Veal’s program visit them at home. Veal recalls “hellish” early days when kids slept two to a crib, and she often stayed overnight at the hospital so no child would be left to die alone. Things are better now. The place is bright and airy, with cartoon characters painted on the wall. Outside is a playground built by Irish volunteers.

“Today our hospital has the best care in the country,” Veal says, “but when I met a 10 year old with HIV from the States, I was bowled over. With instant meds at the first signs of trouble, she hadn’t become symptomatic in her entire life.” Veal confesses to being “overwhelmed by the unfairness” of the contrast. “My kids here have as much right to live as a child in America or Britain. They deserve a future.”

After the brief media fixation on “Romania’s AIDS babies,” the AIDS spotlight moved on, to other countries, other victims. Meanwhile, many of the Romanian children with HIV have grown to be teenagers, though often frail and small for their years. Their needs have grown with them, leaving caregivers such as Mary Veal still begging for aid. “I used to buy Pampers for these kids,” she says. “Now I’m buying tampons. I don’t know whether to laugh or cry.”

Carol has lived in Victor Babes Hospital nearly all of his 14 years. As with many of the children here, nothing is known about his background. Orphans abandoned to institutions can be anti-social, even wild, but Carol is different. Sweet, at home in the hospital, he is a sort of trustee for the staff and has the run of the place—for example, conscientiously herding the restless younger kids back into the TV room. He took us on a tour of the grounds, the only world he has ever known: the sun room, the parking lot and the security gate, and the kitchen dumpster, where he found this kitten. The kids named it Mimi, after the Romanian word for cat. As he was photographed, Carol’s huge dark eyes, wary at first, became more confident. He even smiled. It wasn’t until the photos were processed that we saw the single tear on his cheek.

The little boy in front of Palatul Parlamentului, one of the late dictator’s grandiose monuments to himself that helped impoverish his people, does not have HIV. But as a Roma (gypsy), long a despised minority, he faces a future nearly as harsh. He wore no shoes; half of one foot was sliced away. A well-dressed Bucharesti asked me, “Why does your friend photograph this person?We are a proud country.” We gave the boy a few lei for posing, and he bought a bag of chips. As we left, a gang of older boys was circling, waiting to take the rest of his money. We looked back and saw him holding the bag with its colorful logo: Lucky Boy.

Marian, a poised and handsome nine-year-old, lives with his father in a village outside Bucharest. Both have HIV. So do his uncle, his aunt and several cousins. His mother died in January 2002, six months before this photo was taken. All in all, though, Marian is lucky—he has antiretroviral meds, and a nurse delivers high-protein food to his home. Marian works hard and does well in third grade, despite frequent absences due to illness. As we were photographing the two, his father, an often-unemployed fisherman, brought a worn envelope of family photos and set them on a tree stump in the yard (at right): Many are of Marian’s mother; in one, she is in her wedding dress; in another, she lies in her coffin, surrounded by candles. 

Cristy, 14, is quiet, but with a gentle appeal and a winning smile. When the photos were taken, he hung back shyly at first, while bolder children rushed to the camera. A favorite of the hospital staff, he is fortunate to have a family. His mother brought him to the hospital for this 2001 stay, but now he is back home.

Geta, 13, is bright and fun-loving; she adores wearing makeup and outings to the Bucharest McDonalds or the movies. Like tens of thousands of abandoned children, Geta’s past is a mystery. Her future is murky, too. Now teenagers, the kids worry about losing their beds to sicker children, about having to leave their friends and the schooling they get at the hospital. AIDS is a terrible stigma in Romania. There are few jobs, and Bucharest’s streets and subways are already full of homeless children. Some of the kids, especially those who live at home, nurse hopes for the future. Girls speak about falling in love and having babies; one boy is determined to become a veterinarian. But children who have lived in the hospital know death.They have lost friends to it. Sometimes they refuse their medicine or snap at a caregiver. More often, though, they are brave and uncomplaining.

Florrie, age 7 in this May 2001 shot, is a tiny girl with tiny gold earrings and tiny painted nails. Her mother, who also has HIV, was seriously ill in the hospital. Both have since returned to the family’s isolated village, 60 miles away. They live with Florrie’s grandparents and an aunt, who supports the family on her $30-a-month bakery wages. Victor Babes Hospital caregivers mail the family food and clothes; Florrie and her mom can now keep to their drug regimens. At their last caregiver visit, Florrie and her mother were doing well.

Daniel, 14, is one of the brightest kids at Victor Babes Hospital, but a rascal, too, pushing the limits, antagonizing the caregivers. He is streetwise and animated, clever at pantomime. He shams comic tears, then watches to see if he gets a laugh. Given a balloon, he blows it up, holds it and rocks it as if it were a baby, then puts it under his shirt mocking pregnancy. Recently, Daniel and his mother appeared on an Oprah-style Romanian TV show about parents who place their children in institutions. It’s the only way many can get their kids health care.

Marian, 13, was photographed at the monthly party held for birthday celebrants. From the moment the kids ran onto the playground, the May 2001 bash was a blur of movement and a swell of chatter in Romanian, English and a pidgin Italian that proved the best way of communicating. Between high-fives and hugs, kids tossed balls, blew up balloons and ate pizza and ice cream. Occasionally, something would happen to remind us of their frailty—a boy speeding on a makeshift skateboard suddenly fell, then lay on the asphalt coughing, momentarily too weak to move—but most of the time the kids were just kids, laughing, playing, having fun. The boys were fascinated by the photo equipment. Marian was entrusted to hold the unused lenses.

Like the other boys, Marian has a man’s deep voice, gruff and penetrating, and a distinctly macho swagger. But once back in the hospital’s intensive-care unit, he lovingly submits to his mother’s embrace.

Posing for a photo in May 2001, Daniel, then 13, falls into Ameri-can-accented body language. Boys become muscle-men, puffing out chests and flexing biceps; girls strut like supermodels on the catwalk. Some of the children we met during our first visit were still at the hospital when we re-turned a year later. Others, who lived in orphanages or with their families, had returned home when their conditions—for now—stabilized. Last year, out of 60 children in Victor Babes Hospital, five died.

Photographer Richard Phibbs and writer Richard Jonas have traveled twice to Romania. They are working on a book about their experiences, the proceeds of which will benefit Nobody’s Child, a nonprofit group supporting children with AIDS in Romania and elsewhere. To help with the project, contact phibbsny@aol.com.