Development of Children Infected With Human Immunodeficiency Virus (HIV) - A Comparative Study

Summary: Around the 80's, medicine was
confronted with a new disease, as dull
and slow at the beginning but
accordingly serious as far as prognosis
is concerned, being always followed by
the patient's death.

1.1. General Information

Around the 80's, medicine was confronted with a new disease, as dull
and slow at the beginning but accordingly serious as far as prognosis
is concerned, being always followed by the patient's death.

This lethal disease is caused by the infection with the HIV virus,
which causes in time the Acquired Immunodeficiency Syndrome (AIDS),
which is characterized by: major immune depression, development of
opportunistic infections (viral, bacterial, parasitical) and of
tumors, which affect the central nervous system.

According to the data presented during the Vancouver conference, at
present there are 22.6 million HIV-positive persons, out of which
21.8 million are adults (12.6 million men and 9.2 million women), and
0.83 million are children.

If until the Revolution of 1989, the Romanian authorities declared
this problem as non-existent, after that moment in time it was found
out that Romania had the sad record of being on top of the European
countries in point of the number of HIV infected children and
children sick with AIDS.

According to a statistics drawn up by the National Committee for
Statistics, there is a number of 4905 cases of AIDS registered before
the end of September 1997.

TOTAL PAEDIATRIC AIDS CASES: 4376
- deceased: 1508
- alive: 2806
- cases missing from the records: 62

TOTAL AIDS CASES IN ADULTS: 529
- deceased: 155
- alive: 353
- cases missing from the records: 21

The rate of child/adult cases alive is of 8 to 1.

Most of statistics reveal that there is an extremely high number of
paediatric cases. The main transmitting ways are: by medical
procedures -39%, bytransfiision - 22%, unknown - 39%.

By improving the quality of the medical act it is supposed a decrease
in the number of infected children. At the same time there is a
spectacular increase in number of the adult cases, most significantly
in the district of Constanta, where there were no more cases found to
have been infected by a horizontal way, but vertically in most of
cases.

By accepting WHO's estimations (1 AIDS case - 100 new HIV
infections), one can estimate that a number of more than 30,000 cases
is out of control in Romania; the estimation made by the Division of
Medicine of the Ministry of Health indicates a number of 20,000 HIV
infected persons nationwide.

When we analyze the triangle HIV infection - AIDS - the community's
reaction and response, we can notice that social anxiety, fear,
ignorance, stigma and poverty have serious effects at the personal,
family and social level.

It is necessary:

to ensure some improved living and feeding standards' for the
HIV+IAIDS children, who more often than not come from disorganized
families or from families that have serious social and economic
problems;

to educate families in view of taking steps towards protection.

Confronted with a totally new problem, the Romanian society, as well
as the health care services, gave a response that was little
organized and very differentiated.

The present day legislation does not provide protection for any of
the real needs of HIV/AIDS persons and their families.
The AIDS issue is not perceived in its real dimension by the
responsible authorities in Romania. The lack of a coherent,
centralized program for social assistance, the lack of a network of
social assistance in the community in romania, determined the several
non-governmental organizations to initiate programs for the support
of children and families affected by HIVIAIDS.

One of these NGOs is the British Organization Health Aid UK, which
has established since 1990, a long term project regarding the care of
HIV infected children, with the support of the Swedish Save the
Children Organization.

The project included the following stages:

The implementation of the new Tender Loving Care model in the
specialized section of the Colentina Hospital, Bucharest, by creating
an environment as close to the extra-hospital environment as
possible, with the help of English volunteers (more than 300 during
the development of the project).

Initiation of some courses for the staff caring for HIVIAIDS
children, courses that generated the establishment in 1991 of the
Bucharest nursing School, whose first generation graduated in 1994.

Establishment of some family-type communities for the HIV/AIDS
children.

At present, there are six family-type small houses (5 in Bucharest:
Lita, Feldioara, Garofita, Roxana, Snagov Annex, and one in Snagov:
Snagov House) intended for some small groups of HIV+ children, with a
view of creating an affectionate and safe environment, as similar to
the family environment as possible. Each child's individuality is
respected and encouraged, as we are trying to meet all his/her needs,
be they physical, emotional, or psychological, and thus addressing
all the aspects of the child's development.

From these advantages benefit 36 children, all of them coming from an
institutionalized environment and having lots of deficiencies at all
levels of development.

The first house established was Snagov house, where there are 8
children at present who benefit from a stable environment. The
positive results obtained in the activity of this house determined
the continuation of this project by opening other family modules.

Lita and Feldioara Houses were organized in a similar way, they
contain 8 children each, and Snagov Annex has 3 children.
As the number of children in the Snagov Annex is close to the number
of children in a real family, the good results obtained led to the
establishment of such houses with a smaller number of children. Thus,
Garofita House has 6 children, and Roxana House hosts 4 children.
Opposite to the other houses, Roxana House was designed for children
with special needs. Due to the cooperation among Health Aid Romania,
Radda Barnen Sweden and the staff in Roxana House, most of the
deficiencies and retardation the children came from the hospital with
were recovered to a great extent.

The family-type houses were established as an ideal alternative to
other institutionalized forms of HIV children's care, by offering
some special conditions and by adopting the "Tender Loving Care"
model.

The excellent results obtained by this program during the five years
of development, confirmed the need for its continuation and
multiplication. Appreciating the special results, the School
Inspectorate of Bucharest City has been partially financing this
alternative care model. A special support in the extension of this
program was given by Caritas International.
Salvati Cophi and Radda Barnen (Romanian and Swedish Save the
Children), in order to persuade the local and the central authorities
of the need to ensure the financial support for the multiplication of
this model in Bucharest, but in other districts of the country as
well, have decided to demonstrate the impact of the living
environment on the children's development.

Countries

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