As the Russian economy continues to deteriorate, there are no more riveting images emerging than those of the hungry and neglected children housed within Russia's vast orphanage system. Ten years ago, similar images appeared of wretched Romanian babies and children in appallingly squalid orphanages. The West was quick to respond with generous assistance to those institutions. But as Romania's minimal economic social net evaporated, that aid encouraged families unable to care for their kids at home -- particularly kids with mental and physical disabilities -- to give them up. The result was a 37 percent increase in Romania's orphanage population in just 10 years.
Today humanitarians in the U.S. Congress are poised to make the same mistake in Russia by funneling millions of dollars to Soviet-era custodial institutions. There is a humane, effective and economical alternative that should be implemented immediately to head off a tragedy of immense proportion.
According to the Russian government, there are 500,000 children in institutions, and an additional 100,000 kids lose their families every year, living on the streets or the orphanages. The vast majority of these children are so-called "social orphans" -- children with living parents who are left at institutions because poor families cannot feed them. Many have mental or physical disabilities for which there are no social services at the community level.
Until recently there has been almost no alternative for parents to placing their children in a state institution, and there are strong pressures to do that. But the children's lives are a horror once they are institutionalized: With family ties severed, little or no education and minimal emotional involvement from even the most well-meaning but overworked caregivers, their disabilities worsen.
The plight of "orphanage" kids in Russia is not all that different from that of American children with disabilities 30 years ago. We too had virtually no social services for families or education for the children. Parents of kids with disabilities were often advised to place them in institutions.
But over the past few decades, activist parents and the burgeoning disability rights movement in the United States have transformed the lives of children and adults with disabilities. Community social services and education now exist for even severely disabled youngsters, and in many states all institutional placements have ended.
Change is likely to come in Russia the same way, if the United States and other donors do not discourage it by shoring up the Russian orphanage system. A handful of parents who have bucked social convention and economic disincentives and kept their children at home have joined to form the Down's Syndrome Association and other groups. They are lobbying the government for services, demanding schooling for their children and urging a reform of government policies so that families have incentives and support to keep kids at home.
These brave efforts, are starting to bear fruit. Authorities in the city of Samara have taken the initiative to remove children from orphanages and place them in families in the communities. Elsewhere, a handful of model foster care programs have begun, and there are several small integrated schools in Moscow.
The goal of Russian disability rights activists is for every child to live in a family, and for the orphanages to eventually close their doors forever. It should be the goal of foreign donors as well. It can be achieved -- at a cost saving -- by comprehensive and generous programs to subsidize families or foster families, mainstream kids into the educational system, and offer distressed parents at risk of abandoning their children cash payments, day care or rehabilitative services. Russian social workers need to be trained and assisted in monitoring the children once they leave the orphanages. Advocacy efforts for disabled people need to be supported.
The leading disability rights activist in the United States and Europe, Gunnar Dybwad, has concluded that "four decades of work to improve the living conditions of children with disabilities has taught us one major lesson: There is no such thing as a good institution." Children, especially those with mental or physical disabilities, invariably will suffer in Russian institutions, no matter how much foreign aid pours in. Their only hope for healthy and meaningful lives is for them to be taken out and placed in families that are supported by a network of local social services.
Holly Burkhalter is advocacy director of Physicians for Human Rights. Eric Rosenthal is executive director of Mental Disability Rights International.