Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
in 11 out of 17 countries in the region. The overall rate of children living in formal care has
risen from 1,503 per 100,000 in 2000 to 1,738 in 2007. 14
The unremitting inflow of children into institutionalized care is encouraged by a pervasive
belief, shared by state workers, residential staff and parents alike, that children will receive
a better upbringing in an institution than within a ‘troubled’, ‘asocial’ or dysfunctional
family. 15
At the same time, this relinquishment of children reflects both an absence of services
that would enable problems to be identified early on, and a failure to implement effective
preventative measures to strengthen family capacity to care and provide for children. 2,11
Weak linkages between health and child protection services in supporting mothers and
families with infant disabilities or HIV infection are also recognized as factors leading to
relinquishment. Without counselling and support, parents may feel they do not have the
capacity or means to provide appropriate care. Professionals in both the health and child
protection sectors express concerns that the other sector is insufficiently informed about
the services they offer and the problems they encounter. This also leads to inaccurate
information being provided to those wishing to access the services, resulting in missed
opportunities for early identification and timely referral of cases.
HIV and abandonment
For children infected or affected by HIV the likelihood of being abandoned is higher than
for other children (see Figure 1). Although HIV per se may not be the main reason for
abandonment, HIV tends to be a marker for a number of other factors of exclusion and
vulnerability. In the Russian Federation and Ukraine, about 6 to 10 per cent of children born to
HIV-positive mothers are abandoned in maternity wards, paediatric hospitals and residential
institutions, with little opportunity for foster care, adoption or family reunification. 16,18
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.
11