Russia: The Children’s Hospital in Chelyabinsk

So far, three-month-old Lika’s tender experience of life has been confined to the maternity ward at the Children’s Hospital in Chelyabinsk in the southern Urals region of Russia. Born to a mother living with HIV/AIDS who arrived at the hospital to give birth, Lika was abandoned immediately afterwards. Lika’s mother did not receive care and treatment to protect her unborn baby from HIV transmission, but Lika appears to have avoided infection. Due to the difficulty of diagnosis in infants less than 18 months’ old, however, Lika’s HIV status remains uncertain.

Another of the Chelyabinsk Children’s Hospital patients is 19-month-old Valentina. Her HIV-positive, drug-using parents were impatient to learn their daughter’s HIV status: “It was too late to change our behaviour to avoid being HIV infected, but our baby shouldn’t suffer.” Happily, they have recently discovered that Valentina is HIV negative. Having spent all 19 months of her life at the hospital, she will soon be returning home to her parents.

By the end of 2004, the official number of HIV cases in the Russian Federation exceeded 300,000, although the actual figure may be closer to 1 million. In 2004, approximately 40 per cent of new cases were among women. Correspondingly, the number of children born to HIV-positive mothers has risen dramatically to a total of 15,000 in 2004.

The problem of the institutionalisation of children in the Russian Federation is considerable – with an estimated 500,000 children in institutional care (about 1.5 per cent of all Russia’s children). Increasingly, Russian children enter institutions because they have been abandoned rather than being orphans. Tragically, between 10 and 20 per cent of babies born to HIV-positive mothers are abandoned, regardless of the baby’s HIV status.

UNICEF supports the Russian government (at both the federal and regional level) to develop legislation, policy and practice for children left without parental or family care. With the aim of providing alternatives to institutional care, UNICEF works with partners to deliver community-based treatment, care, support and protection to children living with and affected by HIV/AIDS. This involves training for social workers, psychologists, health professionals and people living with HIV to provide counselling, psychological support, and prevention, treatment and care to families affected by HIV/AIDS.

The nurses that look after Lika and Valentina at the Children’s Hospital in Chelyabinsk have been trained to respond holistically to the needs of HIV-positive women and their children. One of the nurses points out, “We are dealing not only with babies but also with their mothers, who often feel hopeless after learning their children’s diagnosis. We have to provide medical care as well as address psychological needs.”