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Andryusha suffering from malnutrition exhaustion; a patient at the children’s home at Kalinovka, 5 February 2008
What is happening at the facility for disabled children at Kalinovka (Zaporozhye Oblast) is simply intolerable in a civilized society. The death of an orphan child in a remote village where there is almost complete lack of medical care—is it really possible in the 21st century?
Unfortunately, the situation at Kalinovka (150 km. from Zaporozhye), despite some improvements, remains depressing. I will mention only several facts and let the reader draw her/his own conclusions.
One doctor comes out from the raion center town of Chernigov once a week for two hours and must serve 156 seriously disabled children and young persons, nearly all of them wards of the state and without families. At this time it is not possible to supply even basic medical care. The children’s diagnoses are serious and varied. They include congenital neurological impairments such as brain hernia (the little girl Nadya appears to have an encephalocele), hydro¬cephaly, profound cogni¬tive impairments, lack of arms and legs, Down Syndrome; other disabilities include cerebral palsy, congenital blindness, multiple fracturing of arms and legs, and HIV infection. Thirty-five residents of the facility occupy the building for bedridden children and spend virtually all of their time in bed.
But the majority of children have had practically no medical checkups from the time of their admission into the children’s home. Many, if not most, have not been thoroughly examined by specialists. Blood analysis is done no more than once a year and by no means for every child. (There is no lab technician at the internat, and a visiting technician can only take away twenty blood samples at a time. For example, there is a child at the home with what appears to be a swollen peritoneal cavity the size of half a soccer ball. Up to now there has been no defini¬tive diag¬nosis; anti-inflammatory medication is not prescribed.
Some ten to twelve children have obvious hypotrophy (emaciation and loss of muscle tone), and several have cachexia (the final stages of exhaustion and corporeal deple¬tion due to malnourishment and starvation, as may be observed, for example, in the final stages of cancer). The cause of this condition, from all appearances, seems not to be the lack of food, but inappropriate diet and type of nourishment, due to the fact that the special needs of these illnesses are over¬looked.
The bedridden children may never get outdoors—for years! And the “crawlers” only get outdoors during the warm season of the year. Many children lie the entire day gazing at the white ceiling of the room.
Rehabilitation measures are lacking: there is no massage specialist, no physical therapist, and no rehab person.
Hygiene standards are poorly observed—living quarters may not be aired out for months, ultraviolet disinfection is not generally provided, two disposable diapers per day do not suffice!
As for children dying at Kalinovka, a commission to investigate the causes of their deaths has not been created. In a single year at the internat ten to fifteen children die. Last year one child died, this year (in 1? months) already two. The particular cause of death of both children—ill with hydrocephaly—in our opinion may be attributed to the breakdown of the heating system and the frigid tem¬perature in the room.
The dead children are usually buried in trenches in the children’s cemetery a kilometer distant from the internat. Here gravesites are marked with small wooden stakes and a little nameplate. After six months one can no longer make out the inscrip¬tion on the little nameplate. Most of the old graves (altogether around 400 from the 1950s on) scarcely show even a little mound. In our view, the burial of children in such a manner is unconscionable in a civilized country.
I did not wish to write about all of this, but what happened at Kalinovka two days ago compelled me to share with the patrons of this website what I experienced.
Just by chance, before departing from the children’s home, I was passing down a corridor when I heard a child’s cry from one of the rooms. Glancing over, I saw nurses’ aides changing a small child’s pampers. This child, Andryusha, caught my attention. He is nearly five and weighs 6,900 grams (15.2 lbs.). During the one-and-a-half months of his stay at Kalinovka he lost 1500 grams. Andryusha was admitted to Kalinovka from the baby home “Solnyshko,” where medical care is somewhat better. It was painful to look at the little fellow: he was skin and bones—a fully depleted and dehydrated creature (cachexia). Each touch of the aides caused him pain. The aides explained that for about a week already, Andryusha had not succeeded in eating or drinking. After each feeding, he vomited. They were feeding him cream of wheat with a bottle. The aides had no idea what more to do with Andryusha. For some reason no one had thought to summon emergency help, a doctor, who would be able to order intravenous feeding and prescribe appropriate nourishment.
Andryusha showing severe cachexia...
Fortunately, the doctor from the raion center was expected precisely on this day. He examined Andryusha, diagnosed an extreme stage of cachexia (starvation plus dehydration), and right away it was decided to take the little fellow to the hospital. In addition to Andryusha, two to three other residents at Kalinovka were diagnosed with cachexia, but only Andryusha was taken to the hospital.
And thus, for the past two days, Andryusha has been fed intravenously at the raion hospital in Chernigov. Thanks to our sponsors, we bought an acidified milk product NAN and the formula Nestogen for him. The formula will continue to be needed. We are pleased, though it is still early, that there is a change for the better. In three days Andryusha gained 350 grams of weight, began to eat the formula, and did not spit it up.
The Zaporozhye charity, Schastlivyi Rebyonok (Happy Child) will do everything possible in the shortest possible time so that a pediatrician and neurologist might begin to work at Kalinovka. To achieve this we plan to appeal to the governor and the head pediatrician of Zaporozhye Oblast, but in the event they take no action, we intend to draw the attention of the larger community to this problem (go public). As a last resort we will raise funds to supplement the wages of a doctor who agrees to work at Kalinovka. Tentatively, the amount of the supple¬ment would be 1500 to 2000 hryvnia ($300-400) per month. At the present moment we are looking for donors.
We also appeal to all those for whom the fate of these abandoned children is a matter of conscience. There is an ongoing need for volunteers or funds to purchase:
- nutritional formulas made by Nestle or a similar product (for example, the extremely costly formula Peptamen);
- disposable diapers in sizes 3-7;
- carriages or wheelchairs and special beds with on wheels (for transporting children confined to beds around the ward);
- ultraviolet (quartz) lamps (standard wall lamps for UAH 150 per lamp, and special lamps with an extending arm);
- high-quality digital scales, digital thermometers, and blood pressure cuffs sized for a child’s arm;
- high-quality vitamins;
- furniture for the rehab specialist’s corner (two sets: a cabinet, sofa, leatherette or leather sofa, arm chair, a soft carpet, 9 by 9, warm rugs for the playroom);
- developmental toys and sports equipment (collections of wooden blocks, durable, resilient balls, dry pool;
- office supplies: albums, paper, felt-tipped pens, colored pencils or crayons, plasticine;
- cassette radios able to read MP3 disks and USB flash drives for music therapy;
- donors for a clad double-pane window and air conditioner for the play rooms (at present the children spend the entire day in the play area, and the window there is stuck; the room cannot be aired out);
- athletic or play court for the internat yard;
- persons who desire somehow to fix the children’s cemetery (placing iron crosses and nameplates on the graves, for example).
If you are interested in making a tax-deductible donation from the U.S., please contact James Shetler of Eleanore’s Kids, e-mail firstname.lastname@example.org, or David Sudermann at email@example.com. Otherwise, donations may be made through bank transfer to the Happy Child Fund or directly to Albert Pavlov, e-mail firstname.lastname@example.org (check English version also of the website www.deti.zp.ua)
For any questions you may have, you may write in English to Albert Pavlov:
Detizp [at] mail.ru