Russian Federation

Real lives

Russia: Anna, four years old and HIV-positive

A few years ago, when she was still a delicate little baby, Anna went travelling. It was probably not a pleasant trip that took her from her home in the Black Sea city of Novorossisk, across the hills of Samara and Tver and onwards to the suburban town of Ust-Izhora on the outskirts of St Petersburg. Especially as her mother wasn't with her. At the end of that particular road was Anna's new home, a large imposing building with numerous windows. Inside, she joined her new brothers and sisters, and a different sort of life began. Anna was only 14 weeks old that day, and less than 10 months later, she was confirmed as HIV-positive.

The Russian Republican Hospital for Communicable Diseases is the country's central medical institution for tackling HIV/AIDS and caring for its victims. It is also home to dozens of abandoned children, many of whom share Anna's fate of being left behind by their infected mothers. The ward that Anna has learnt to think of as home also shelters another 35 abandoned children, most victims of the HIV/AIDS epidemic. Rising prostitution, itself an indication of Russia's decline into poverty and unemployment, is fuel for the problem.

Little Anna, now nearly five, lives a life of medical treatments whose success in alleviating pain is not always guaranteed: the suffering will at times deprive her even of the ability to eat. Anguish of a different nature will sometimes take over and have her wondering about her mother whom she expects to come for her and take her home. But hospital remains Anna's life and the ward her home.

Nurses' little helper

Within those confines Anna unwittingly does as many other children do elsewhere. Being older than the others on the ward, Anna has cast herself in the role of the nurses' little helper, giving them a caring hand with the youngest ones, helping them change their clothes, nappies and the like. This caring nature is again visible in Anna's readiness to share toys with the other children. When well herself and not "on duty", her little hands can be seen constructing various paper objects or clutching crayons and drawing attentively, applying layers of colour… "I've been to the theatre once," she tells us. "I liked the food there very much... I like pickled cucumbers very much, and I hate milk."

Confined to the hospital where no visitors come calling, and far removed from the outside world, it is little wonder than Anna shares the other children's fear of strangers. Even Santa Claus's annual visit is a source of terror, so much so she even refused to accept her present. Regrettably, this could well be the last present she receives in her sad short life, for although she is provided for in care and treatment, Anna's health hasn't improved. While they are perhaps too young and innocent to fully grasp the nature of their condition, Anna and the other suffering children at the hospital are a daily reminder of the battle against HIV/AIDS. Their suffering is an impetus for chief doctor Evgeny Voronin and his staff to work harder still to improve things and ensure that at least Anna's sufferings do not befall another innocent child.

UNICEF and the Russian Republican Hospital for Communicable Diseases collaborate in a number of ways to tackle the problem, starting with the medical profession itself. UNICEF provides the hospital with the latest literature and research data on HIV/AIDS, and organizes workshops and conferences for paediatricians from all over the Russian Federation, to encourage the sharing of experiences and knowledge. These exchanges are also promoted at a regional level: UNICEF voluntary workers from Finland visited the Russian hospital to obtain a first-hand account of the problems. Medical institutions in the country are not exempt from economic problems and over the course of UNICEF's two-year involvement with the hospital, it has also provided much-needed technical and financial support. During the winter school break, children from other parts of the Federation arrive at the hospital for check-ups and follow-up treatment. UNICEF organizes a "winter camp" during that period, providing the resident children and the newcomers alike with entertainment and gifts. Ignorance about the disease and preventive measures is a major enemy of progress.

Information dissemination about HIV/AIDS and its prevention is consequently a key priority for UNICEF, especially among women at high risk of infection. The latest figures show 651 children have been born to HIV-infected mothers, while the total number of children with HIV/AIDS is just under 1,150. A recent survey, undertaken as part of the Say Yes for Children campaign, showed that good results have been achieved with Russian teenagers: the majority cited HIV/AIDS as a major concern (more so than the lack of educational and employment opportunities), and said they were receiving good information about the virus and how to safeguard against it. Regrettably, Anna may not make it to an age where she can move beyond the little helper into a nurse's uniform, helping other unfortunate children ward off the virus. The battle for prevention will continue, however, to ensure that some other Anna can be born into a happier and healthier life.

UNICEF does not consider institutionalized care as the best option for the welfare and development of orphans or other vulnerable children. Resources are better devoted to strengthening the ability of families and communities to care for such children. The search for, and support of, family and extended family is thus a priority of UNICEF programmes and projects responding to this situation. At the present time, however, homes and institutions still remain a necessary last resort for many children.