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An orphanage in Craiova, Romania in 1994. Photo by Michael Carroll

How can scientists act ethically when they are studying the victims of a human tragedy, such as the Romanian orphans?

Virginia Hughes is a science journalist based in Brooklyn, New York. Her blog, Only Human, is published by National Geographic.

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We drove to the orphanage on a pleasant December morning, under a sky that seemed too blue. It was a short ride through a residential neighbourhood of Bucharest, littered with posters of politicians’ heads for the upcoming elections. Nervous, I mentally recited the two rules the American professor had given me the night before: no picking up the kids, and no crying in front of them.

We pulled up to a dingy pink building, lined on all sides by tall wire fencing, and parked at the curb. After passing through the checkpoint of a stoic security guard, we stepped into an empty hallway. It was cleaner than I had expected; old plaster walls and chipped steps, yes, but no obvious filth. There was an overpowering smell of institutional food, like burned meatloaf.

Over the next hour or so, the manager of the place — a short and affable 24-year-old guy — gave us a tour. He didn’t speak much English, but Florin Ţibu, a Romanian who works with the professor, translated for us. About 50 children and teenagers lived there, boys and girls ranging in age from about six to 18, and I saw just six adults: our tour guide, three female caregivers, and two cleaning ladies in white coats. The children weren’t in school because of the big holiday: Romania’s National Day, a celebration of the country’s unification in 1918. Perhaps a typical day wouldn’t have been so chaotic. Then again, Ţibu said, the kids always flock to new visitors.

And flock they did. A boy in a red T-shirt and sweats skipped up to me, grabbed my hand, and wouldn’t let go. His head didn’t reach my shoulders, so I figured he was eight or nine years old. He was 13, Ţibu said. The boy kept looking up at me with an open, sweet face, but I found it difficult to return his gaze. Like most of the other kids, he had crossed eyes — strabismus, the professor would explain later, a common symptom of children raised in institutions, possibly because as infants they had nothing to focus their eyes on. A couple of dozen kids gathered around us in a tight circle, chirping and giggling loudly as children do. At one point they broke into a laughing fit, and I asked Ţibu what happened. They were gawking at the whiteness of my teeth, he said. Two of the girls, somewhere in that gaggle, were pregnant.

We saw the kids’ bedrooms. Each had half a dozen mattresses lying on the floor and one television set. All the TVs were blaring old cartoons, some of the same ones I remember watching in my own childhood 25 years ago. Kid after kid dragged me proudly to see their room. Once, we walked in on a cleaning lady frantically sweeping, embarrassed by the cigarette butts, grey dirt, and insect carcasses all over the floor. One of the rooms held three or four older boys, still sleeping. They were heroin addicts, I would learn, and sometimes shot up in front of the younger children.

After about half an hour of holding the sweet boy’s hand, I suddenly, urgently, needed to let go. I wriggled my fingers free, only to have him clutch them again.

St Catherine’s, a sprawling complex of late 19th-century stone buildings and desolate courtyards that was once the largest orphanage in Bucharest. Photo courtesy Dr Charles Nelson St Catherine’s was once the largest orphanage in Bucharest. Photo courtesy Dr Charles Nelson

We Americans drove back to St Catherine’s, a sprawling complex of late 19th-century stone buildings and desolate courtyards that was once the largest orphanage in Bucharest. Today, it’s mostly office space, with rooms along one long hallway occupied by the professor’s team. We sat in one of them to talk about the morning visit.

The professor is Charles Nelson, a neuroscientist from Harvard University who studies early brain development. In 1999, he and several other American scientists launched the Bucharest Early Intervention Project, a now-famous study of Romanian children who were mostly ‘social orphans’, meaning that their biological parents had given them over to the state’s care. At the time, despite an international outcry over Romania’s orphan problem, many Romanian officials staunchly believed that the behavioural problems of institutionalised children were innate — the reason their parents had left them there, rather than the result of institutional life. And because of these inherent deficiencies, the children would fare better in orphanages than families.

The scientists pitched their study as a way to find out for sure. They enrolled 136 institutionalised children, placed half of them in foster care, and tracked the physical, psychological, and neurological development of both groups for many years. They found, predictably, that kids are much better off in foster care than in orphanages.

Nelson has visited Bucharest 30 to 40 times since his first trip in 1999. Some things have changed: in 2007, Romania joined the European Union (EU). It has greatly expanded its state-funded foster-care system. The number of children in institutions — or ‘placement centres’, to use the preferred bureaucratic euphemism — has dropped dramatically. But other things haven’t changed. Romania is still a post-communist country suffering from high levels of poverty and corruption. It still has a weak medical and scientific infrastructure. It still has some 9,000 children — more than half of all the children in its child protection system — living in orphanages, like the boy who took my hand.

Nelson had warned me several times about the emotional toll of meeting these children. So I was surprised, during our debrief, to hear him say that our visit had upset him. Turns out it was the first time that he had been to an orphanage with older teenagers, not all that much younger than his own son. ‘I’m used to being really distressed when I see all the little babies, or the three- and four-year-olds,’ he said. ‘But here, I almost had to leave at one point, to get myself some air. Just the thought of these kids living like this, it was really depressing.’

How does he do this? I wondered.

Nelson never expected to be an advocate for orphans, or for anybody really: he’s a neuroscientist. In 1986, he launched his first laboratory at the University of Minnesota, which specialised in using electroencephalography (EEG) — a harmless technique for measuring brain waves via a soft skullcap of electrodes — on babies and toddlers.

His field of developmental neuroscience got a surge of attention in April 1997, when Bill and Hillary Clinton put on a one-day meeting of researchers called ‘The White House Conference on Early Childhood Development and Learning: What New Research on the Brain Tells Us About Our Youngest Children’. The First Lady gave the gist of the meeting in her opening remarks: the first three years of life, she said, ‘can determine whether children will grow up to be peaceful or violent citizens, focused or undisciplined workers, attentive or detached parents themselves’.

The conference was covered widely in the media. In the wake of all the hoopla, the Chicago-based John D and Catherine T MacArthur Foundation asked Nelson to lead a small group of scientists to dive more deeply into these topics. The resulting Research Network on Early Experience and Brain Development, fully launched in 1998, included 12 researchers who shared a plush budget of about $1.3 million a year. Nelson held the purse strings.

The Network’s first studies used animals: baby mice that were either frequently or infrequently handled by their human caretakers; baby barn owls whose brain wiring changed dramatically after wearing prisms over their eyes; and most striking, baby rhesus macaque monkeys that had been separated from their mothers.

Researchers had isolated monkeys before. In the 1960s, the American psychologist Harry Harlow famously reared baby monkeys in complete isolation for up to two years. The animals showed severe and permanent social deficits, bolstering the then-controversial idea that the maternal-child bond is crucial to healthy development. The Network scientists wanted to know whether the timing of the maternal separation made any difference.

Monkeys typically become independent around six months old. The Network studies found that when monkeys are separated very early, at just a week old, they develop severe symptoms of social withdrawal, just as Harlow had observed: rocking back and forth, hitting and biting themselves, and running away from any approaching monkey. In contrast, when the babies are separated at one month old, they show inappropriate attachment, grabbing hold of any nearby monkey. ‘We concluded from this that the four-week animal had an attachment with mom and then had that attachment ripped away,’ Nelson says ‘The one-week animal never formed an attachment, so it didn’t know how to relate socially.’

Children were getting adequate food, hygiene and medical care, but had woefully few interactions with adults, leading to severe behavioural and emotional problems

As the monkey data rolled in, Nelson was hearing about human social deprivation from his Minnesota colleague Dana Johnson, a neonatologist who had long worked on international adoptions. Johnson treated orphans from all over the world, but was most disturbed by those from Romania.

Nelson invited Johnson to talk at a Network meeting in January of 1998. In a conference room of the Claremont Hotel in Oakland, California, Johnson switched off the lights and played the Network scientists a few disturbing movies of children in Romanian orphanages. Some kids were rocking and flailing and socially withdrawn; others were clingy. ‘We were all very teary-eyed,’ Nelson recalls.

Dr Charles ‘Chuck’ Nelson photographed outside the St Catherine’s orphanage in Romania. Photo by Ginny Hughes Dr Charles ‘Chuck’ Nelson photographed outside the St Catherine’s orphanage in Romania. Photo courtesy Dr Charles Nelson

Immediately following Johnson’s presentation, Judy Cameron, leader of the monkey project, gave the group an update of her findings. ‘She starts showing videos of these monkeys, and they look just like the videos of Dana’s kids,’ Nelson told me. ‘It really freaked us all out.’

Romania has had orphanages for centuries. But its orphan crisis began in 1965, when the communist Nicolae Ceaușescu took over as the country’s leader. Over the course of his 24-year rule, Ceaușescu deliberately cultivated the orphan population in hopes of creating loyalty to — and dependency on — the state. In 1966, he made abortion illegal for the vast majority of women. He later imposed taxes on families with fewer than five children and even sent out medically trained government agents — ‘The Menstrual Police’ — to examine women who weren’t producing their quota. But Ceaușescu’s draconian economic policies meant that most families were too poor to support multiple children. So, without other options, thousands of parents left their babies in government-run orphanages.

By Christmas day in 1989, when revolutionaries executed Ceaușescu and his wife by firing squad, an estimated 170,000 children were living in more than 700 state orphanages. As the regime crumbled, journalists and humanitarians swept in. In most institutions, children were getting adequate food, hygiene and medical care, but had woefully few interactions with adults, leading to severe behavioural and emotional problems. A handful of orphanages were utterly abhorrent, depriving children of their basic needs. Soon photos of dirty, handicapped orphans lying in their own excrement were showing up in newspapers across the world. ‘I was very taken with the kids in orphanages,’ Johnson says. Their condition ‘was a stunning contrast to most of the kids we were seeing come for international adoption who had been raised in foster homes’.

In his presentation, Johnson had mentioned that the head of Romania’s newly formed Department for Child Protection, Cristian Tabacaru, was keen on closing down his country’s institutions. After seeing the movies, Network scientist Charles Zeanah, a child psychiatrist from Tulane University who specialised in infant-parent relationships, was gung-ho about meeting Tabacaru and setting up a humanitarian project.

Nelson was touched by the videos, too. And he couldn’t help but think of the scientific possibilities of studying these children. ‘The animal model could allow us to dig into brain biology and all of that but, at the same time, we’d be running a parallel human study.’

Eleven months after that emotional hotel meeting, Zeanah and his wife, a nurse and clinical psychologist, travelled to Romania and saw the orphans for themselves. During their first orphanage visit, the couple couldn’t help but start bawling in front of the kids. One child reached out to comfort them, saying: ‘It’s OK, it’s OK’.

The Zeanahs also met with Tabacaru. He was eager to work with the MacArthur group because he thought that a rigorous scientific study could help his cause. ‘If there was scientific evidence to support the idea that foster care was better for kids, he thought he’d have more leverage with his political colleagues,’ Nelson told me. The data, in other words, could speak for the children.

Two days before our visit to the orphanage, I accompanied Nelson to a homely green building that houses the psychology department of the University of Bucharest, where he holds an honorary doctorate. He had been invited by the Dean to give a talk on the ethics of human research.

All reputable scientific institutions follow a few ethical principles to guide their human experiments: participants must give informed and unambiguous consent; researchers must thoroughly consider possible risks and benefits; the gains and burdens of research must be equally distributed to participants and society at large. These rules are largely unheard of in Romania, let alone enforced.

In a packed auditorium, Nelson began his lecture by describing the fundamental moral dilemma facing all clinical studies. ‘The real goal of research is to generate useful knowledge about health and illness, not necessarily to benefit those who participate in the research,’ he said. That means, he added, that participants are at risk of being exploited.

Nelson outlined the sad history of human rights violations done in the name of science. There was Josef Mengele, the Nazi physician who performed medical experiments — radiating, sterilising, infecting, and freezing identical twins, among other atrocities — on Auschwitz prisoners. Mengele escaped capture after the war, but 20 other Nazi doctors were tried in a US military tribunal in Nuremberg, Germany. The judges at these trials created a list of 10 ethical tenets for human research, known as the Nuremberg Code. These included voluntary consent, avoidance of suffering, and the right of the subject to end the experiment at any time.

The Nuremberg Code provided the intellectual basis for the 1964 Declaration of Helsinki, the first ethics text created by the medical community and one that’s still updated frequently. It’s not legally binding, but thousands of research institutions use the declaration to guide their formal regulations and ethical review committees.

Could there be a more vulnerable study population, after all, than orphans with physical and psychological disabilities living in an economically feeble and politically unstable country

Today the importance of these rules is obvious, but it was decades before they were systematically enforced — and many ethically dubious experiments happened in the interim. In the 1950s and ‘60s, for example, researchers from New York University fed mixtures of fecal matter infected with hepatitis to mentally retarded children living at the Willowbrook State School in Staten Island. The researchers’ intent, as they would publish in the prestigious New England Journal of Medicine in 1958 and ‘59, was to track the course of the disease and the effect of new antibody treatments. (The researchers argued that since hepatitis was rampant in the institution anyway, they weren’t exposing the children to any additional harm.)

Meanwhile, 1,000 miles south, other researchers were testing the natural history of untreated syphilis on hundreds of poor black men in Tuskegee, Alabama. The men were not only denied treatment for the disease, but had no idea they were sick. In 1972, the study’s 40th year, a whistle-blower scientist finally told the press about the effort, which had been sanctioned by the US Centers for Disease Control and Prevention.

The Tuskegee syphilis experiment triggered a public uproar and a US Congressional investigation that ultimately shut down the research. ‘It became the standard bearer of unethical research,’ Nelson told the room of Romanian students.

These were the ugly precedents confronting Nelson and his colleagues in 1999, when they began discussions of how to set up the early intervention project in Bucharest. They knew from the outset that the project would be ethically precarious: could there be a more vulnerable study population, after all, than orphans with physical and psychological disabilities living in an economically feeble and politically unstable country? As the bioethicist Stuart Rennie later wrote of the Romanian orphans: ‘Researchers who choose them as study participants — in this age of intensified ethical scrutiny — would seem to have a career death-wish.’

The MacArthur Network scientists spent the better part of a year hammering out the ethical parameters and experimental design of the project. They wanted to use the gold standard of clinical research design: a randomised controlled trial. This would allow them to objectively compare children given one intervention (foster care) with those given another (institutional care). For most randomised controlled trials, if one intervention proves to be better toward the beginning of the trial, researchers will call off the study and put all participants on that treatment.

But that wouldn’t be an option for this study. The problem was that, with a few exceptions, foster care didn’t exist in Romania. That meant the scientists would have to create their own system, leading to a slew of sticky complications. How would they choose families and adequately train them? What was appropriate payment? What if a particular foster-care family was abusive, or otherwise didn’t work out? Was it fair to leave half of the children languishing in orphanages? What would happen to the children if the study (and its funding) ended?

The team answered these questions with the help of non-governmental organisations (NGOs) in Romania that specialised in orphan care. They would recruit foster families through newspaper advertisements and put them through a rigorous training programme for parenting skills. They would pay the families well — 250 Romanian Lei per month (about $96 at the time), which was almost twice the minimum wage in Romania. And after that initial placement, the Department for Child Protection would be in charge of the children’s whereabouts, just as they were before. So, for example, if a biological mother came forward and wanted her child back, the department could opt to ‘reintegrate’ the child. Or if more foster homes were to become available, then the department could move children from the institutions into families. And if the project were to stop for any reason, the Romanian government had agreed to take over the payment of the foster-care families.

Three of the MacArthur scientists — Nelson, Zeanah, and the psychologist Nathan Fox of the University of Maryland — stepped up as leaders of the project. After getting approval from ethics committees at each of their universities, the study launched a feasibility phase in November of 2000, and officially began collecting data in April 2001. The plan was to end the study after 42 months.

The researchers set up a satellite lab in St Catherine’s, which at the time was still operating as a placement centre for about 500 children. The researchers hired half a dozen Romanians to follow the participants’ personal cases and collect data — on physical growth, IQ, psychological development, and later, EEG and brain scans — every few months.

These Romanian researchers, many of whom are still part of the project, were intimately familiar with their country’s orphan problem. Take Anca Radulescu, who is now the project’s manager in Bucharest and the team’s mother hen. Radulescu was born in 1968, two years after Ceaușescu’s abortion ban, Decree 770. People born around this time are known as Decreţei: children of the decree. As a young girl, Radulescu remembers, her mother told her that despite her birth year, she was not one of the Decreţei — she was wanted.

In 1997 Radulescu had begun working at St Catherine’s as a psychologist. She was hired thanks to new legislation — passed because Romania was trying to get into the EU — that moved the administration of orphans from the Ministry of Health to the newly created Department for Child Protection. The law marked the beginning of a philosophical change in the government’s treatment of orphans, with a new focus on nurture over nature.

The transition was ‘a nightmare’, Radulescu says, because of the doctors who managed the institutions. They were dismissive of psychology and social work, both of which had been banned during Ceaușescu’s reign, and believed that the orphans’ problems were medical. They gave the children a physical exam nearly every day, and prescribed them sedatives at night. Meanwhile, the children weren’t getting the social interaction they desperately needed. They lived in units of 40 or 50 kids, each with about six adult caretakers who were kept busy preparing food and doing laundry. The kids were left in big rooms to play by themselves.

In late 2000, Radulescu started working for the brand-new Bucharest Early Intervention Project, in offices just a few corridors away from those residential units. She and the rest of the team, working closely with Romanian NGOs, used newspaper advertisements to find foster-care families and never-institutionalised children (who would serve as community controls). The team screened 187 orphans from six Bucharest institutions, eventually choosing 136 who did not have major medical problems. The children ranged from six to 31 months old. They were randomly assigned to either foster care or the orphanage, with siblings kept together. In the end, 69 children went into foster care and 67 stayed in institutions.

For its first couple of years, the Bucharest project rolled along smoothly and quietly. This was remarkable given the constant political turnovers (including one in which Tabacaru, the researchers’ government ally, was booted out).

Then, in June of 2002, a crisis. The Bucharest lab had an unannounced, and unwelcome, visitor: Baroness Emma Nicholson.

The children who grew up in institutions have less white matter, the tissue that links up different brain regions, compared with those in foster care

Nicholson, hailing from the village of Winterbourne in England, was a member of the European Parliament and had been appointed to represent Romania’s application into the EU. This made her a powerful figure in Romania, which had been trying to join the EU since 1993. She also happened to be an outspoken opponent of international adoptions, which she felt were avenues for child trafficking. Thanks to her influence, in 2001 Romania placed a moratorium on international adoptions.

After Nicholson’s visit to the lab, she was quoted in several Romanian newspapers making damning accusations against the Bucharest project. ‘She goes to the press and says that we’re doing a study, using high-tech American measures, to identify the smartest orphans so we can sell them on the black market,’ Nelson told me one night, practically sputtering.

Nicholson would deny that she ever accused the scientists of trafficking, but she continued to describe the MacArthur project as illegal and unethical. Although the claims were patently false, and no formal charges were ever made, the story was quickly picked up by international newspapers, including Le Monde and The New York Times.

The scandal died down quickly after Nelson called Michael Guest, then US ambassador to Romania, who ran interference with the Romanian government. But the team learnt an important lesson about their public profile. ‘We never, ever took a position on international adoptions — it would have been suicide,’ Nelson said. ‘We took the model of, look, we’re scientists. Our job is to collect the data and give it to others who know how to do policy, not to take sides on an issue.’

The BEIP project stayed under the radar until 8 June 2004, when Nelson’s team held a press conference to announce some exciting data. In the Hilton Hotel in Bucharest, with representatives from several Romanian ministries and the US ambassador in attendance, the researchers reported that, as expected, the 136 children who started in institutions tended to have diminished growth and intellectual ability compared with controls who had never lived outside of a family. But there was a surprising silver lining. Children who had been placed in foster care before the age of two years showed significant gains in IQ, motor skills, and psychological development compared with those who stayed in the orphanages.

The scientists published these findings in 2007, in the prestigious journal Science. That paper is the most famous to come out of project, but it’s just one of nearly 60. Others have shown, for example, that toddlers who never left institutions have more repetitive behaviours than those who went into foster care. Long-institutionalised toddlers also show different EEG brainwave patterns when looking at emotional faces.

As the children got older, the researchers gave them brain scans (renting out time with a private clinic’s MRI machine, one of only a handful in the country). These scans showed that, at around the age of eight, the children who grew up in institutions have less white matter, the tissue that links up different brain regions, compared with those in foster care. The researchers looked at the children’s genomes, too, and found that those who lived the longest in orphanages tend to have the shortest telomeres, the caps on the end of chromosomes that are related to lifespan.

The project is now funded not only by the MacArthur Foundation, but by grants from the US National Institutes of Health (NIH) and the Binder Family Foundation. After 14 years, the Bucharest project is well-known and well-respected in the scientific community. At first, though, many scientists had concerns about its ethical design.

For example, when the researchers first submitted their data to Science, the journal’s editor didn’t know what to make of its ethics. So she sent it to bioethicists at the NIH for a thorough review. ‘Even if you study ethics all the time, it turns out this is a very interesting ethical case,’ said Joseph Millum, one of the NIH bioethicists who reviewed it. As Millum and his colleague Ezekiel Emanuel would explain in a commentary published in the same issue of Science, they did not find the work to be exploitative or unethical.

The Bucharest project study differs from most randomised control trials done in disadvantaged countries, Millum explained. Those tend to be studies of a new treatment — an antiretroviral drug to treat HIV in Africans, say. It’s ethical to put people through those trials because the researchers don’t know from the outset whether the drug will work. ‘The hope is that the new knowledge you get out of the study is then going to be useful in informing practice,’ Millum said.

However, in the Bucharest project’s case, the researchers already knew from a multitude of studies in Western countries that foster care is better for children than institutionalised care — that’s why Western countries have so few institutions. So although the study could potentially answer lots of new, open questions, the one that justified its existence had already been answered.

Still, that older research had not influenced Romanian social policy; many government officials did not trust the idea of foster parents, and believed that institutions provided adequate care. That, plus the fact that the project had close connections with the government, lent credence to the argument that the study could change policy, Millum explained. ‘The answers to the question the study asked could have changed practice.’

But realistically, how likely was it that the study would change anything? And once the study was over, were the scientists supposed to then become advocates for those policy changes?

It’s complicated, Millum said. ‘People have different views about whether there is an obligation to provide successful interventions after a study is complete.’ If a medical study is taking place in Western Europe, for example, where there is a relatively robust health care system, then those health institutions will probably be the ones integrating the new data into policy, he says. But in an African country, for example, with no health care to speak of, the researchers might share more of the burden.

These are not easy waters to navigate. And there are limits, of course, to what even the most motivated scientists can do. ‘The idea that there is a single experiment that leads to a breakthrough, and then we solve the problem is, sadly, naive,’ Millum said. ‘They can’t control what happens in Romania.’

In late May this year, exactly six months after my Bucharest trip, I had lunch with Nelson in Boston to catch up. I asked him whether he thought Romania’s orphan situation had changed much since he first learnt about it 14 years ago. After all, I pointed out, some of Romania’s most destructive policies regarding orphans are still in place. The international adoption moratorium was made permanent in 2005. Domestic adoption exists, but comes with onerous regulations. A taxi driver in Bucharest told me a story about friends of his, native Romanians, who have been trying to adopt a Romanian orphan for years. The regulations seem ridiculous; for example, children can’t be adopted until the state has attempted to make contact with all of their fourth-degree relatives.

‘There are two things that have changed,’ Nelson said: one good and one bad.

The good: Romania has seen a significant drop in the rate of child abandonment and institutionalisation. On 23 June 2004, 15 days after the Bucharest project’s first big press conference, Romania passed Law 272/2004, stating that children younger than two are not allowed to be placed into residential facilities. The law has loopholes — children with severe handicaps can still be institutionalised, and young babies can still be left in maternity hospitals for their first few years — but it signifies a major change in attitude, and seems to have reduced the overall number of institutionalised children.

It’s impossible to know how much credit the Bucharest project deserves for that law. The project was by then well known among Romanian officials. But there was another powerful force at work: Romania badly wanted to get into the EU, and the EU (thanks in large part to Baroness Nicholson) had demanded that Romania deal with its orphan problem. The Bucharest project data and the EU pressure were ‘like a perfect storm’, Nelson said.

The more depressing change that Nelson has noticed since 1999 is the global recession, which hit eastern Europe hard. A study last year by the European Commission found that Romania still has the continent’s highest rate of babies abandoned in maternity hospitals per year, at 8.6 per 1,000 live births. ‘Since the recession hit, Romania has cut back on foster care,’ Nelson said, ‘and parents with kids in foster care are putting the kids back in institutions.’

For all that they hope to change in Romania’s social policy, the researchers are more immediately concerned with the children in their study. These kids have known some of these researchers for as long as they can remember. Relationships have formed.

Of the original 136 children the researchers recruited from institutions, 62 are now living with foster or adopted families, 31 were reintegrated with their biological parents, and just 17 are still living in institutions (of the rest, 10 live in ‘social apartments’, which are similar to group homes, and 16 dropped out of the study). All evidence suggests that these kids are no worse off today than they would have been had the study never existed. But that doesn’t mean they’re doing well.

In the Bucharest lab, I met a 12-year-old project participant named Simona and her biological mother. Simona was the youngest of four children; when she was eight months old, her mother could no longer afford to keep her. So she dropped her off at St Catherine’s, where her older sister, an epileptic, had already been living for several years. Simona’s mother told me how difficult it was to give up her babies. She visited them every week, and was sad to see that they were often sick with a cold or a rash. When Simona was five years old, her mother was receiving enough financial assistance from the government to bring her back home. But those years in the institution took a toll: Simona has a sweet disposition, like her mother, but she’s very thin, and her IQ is 70.

I next met 13-year-old Raluca, a strikingly pretty girl who went into foster care at 21 months old and has lived with the same family ever since. Raluca is stylish and intellectually sharp; her big eyes, unlike Simona’s, made frequent contact with mine. At first, I thought of Raluca as one of the lucky ones; she escaped the hell of the orphanage. But she has different problems. She’s defiant to her teachers and parents, and has started smoking and seeing older boys. Her foster mother has threatened to give her up.

These two girls are doing relatively well. The Bucharest project’s staff is dealing with a handful of participants in more dire situations. While sitting in on a lab meeting, I heard a few examples: a girl who at age 10 was sexually attacked by her neighbour; a Roma girl who, at age 12, was returned to an orphanage because her foster-care mother said she was stealing, lying, and ‘had a gipsy smell’; another 12-year-old girl who was reintegrated with her grandparents and then, with their blessing, married a 12-year-old boy. The scientists worry that these sorts of horror stories will become more common as the children ride the rollercoaster of adolescence.

And then there are the 17 participants who still live in orphanages. They’re slightly better off than the average institutionalised child, in that they get regular medical assessments and constant check-ins from the researchers. After doing a brain scan of one boy, for example, the researchers discovered a nasty infection hidden in the space behind his ear. These mastoid infections can be fatal, but the boy was fine after a round of antibiotics.

‘Well, you couldn’t do what I do if you got upset all the time.’

Still, institutional life is undeniably miserable. During my visit to the orphanage, I chatted with a 14-year-old Bucharest project participant named Maria. Maria was abandoned at birth and spent her first four months in two different maternity hospitals. She’s been in orphanages ever since, moving every few years. She has a normal IQ, which means she’s far more resilient than others with her history. She was shy when we talked, and didn’t make much eye contact, but otherwise seemed like a normal girl.

I asked Maria what she thought was the worst thing about living in the placement centre. She said it was the older boys who take drugs.

And what about the best thing? I asked. She paused for about half a minute, looking down at her purple Crocs. The times we get to leave for a little while, when we can take the bus to the park, she said.

When Nelson’s team first set up the Bucharest Early Intervention Project, the MacArthur Foundation gave them a separate pot of money to create a humanitarian institute in Bucharest. The goal of the so-called Institute of Child Development was to work with local officials and non-profits on orphan issues, as well as to train a new generation of Romanian researchers. The institute has put on several scientific and policy workshops, inviting hundreds of researchers from across the world. The last of these will probably take place in November. Then in December 2013, the MacArthur funding runs out, and it’s unclear whether the institute will continue under local direction.

‘We’re limited in our resources,’ says Elizabeth Furtado, who has been the Bucharest project’s manager since 2006 and visits the Bucharest lab about twice a year. Furtado has a four-year-old son. She copes with the job by compartmentalising; for example, she has very intentionally not read the full life histories of any of the participants. But sometimes the pain is unavoidable. She was with Nelson and me the day we visited the orphanage — her first time in an institution since becoming a mother. ‘It took me almost a month after coming back to get to a [point] where I could kind of let it go and focus on my relationship with my son,’ she told me.

The last two years on the project have been somewhat defeating, Furtado says, because the adolescents’ behaviours are becoming more difficult to manage, and the foster-care parents are getting less and less support — financial, educational, emotional — from the government. ‘On the one hand, I know that we are doing a lot of good for a lot of these kids,’ she says. ‘But it makes me sad that legislation isn’t keeping up with enough of what we’re finding.’

Nelson, too, has felt his share of emotional tension over this project, though he tends to downplay it (he often refers to being sad, for example, as having an ‘activated amygdala’). Like the Zeanahs, he wept on his first visit to St Catherine’s, in 1999, where he saw a room full of babies lying in cribs and staring at white ceilings while their adult caretakers chatted and smoked cigarettes in the corner. He remembers staring out the plane window for most of the long flight back. When he arrived at his house, he rushed to hug his bewildered teenage son. ‘You just feel grateful,’ he told me at our recent lunch.

Over time, though, Nelson has become desensitised, holding on to the idea that scientific data will eventually pave the road for better social policy.

This June, the researchers learnt that a grant they received from the NIH was renewed for another five years (a coup given recent cuts to the US federal budget). With that money, the team can track the children’s brain structures, cognitive skills, and emotional maturity from age 12 to 16 — a period that, despite major brain reorganisation, doesn’t get much attention in policy circles. And Nelson is in the process of setting up similar child intervention projects in other parts of the world, including Brazil and Chile.

Nelson’s last trip to Bucharest was in April. Soon after he got home to Boston, his mother came to visit. She asked him how he could go over there all the time without being constantly upset. He told her, ‘Well, you couldn’t do what I do if you got upset all the time.’

But how do you avoid it? I pressed. ‘You just sort of learn to deal with it,’ he said. ‘You put on your scientist hat and detach.’

Some names have been changed to protect the identities of those mentioned in the article.

Read more essays on childhood & adolescence and ethics


  • smok

    These children, their suffering, and the future suffering of neglected and abandoned children, will never be solved by studies like this one. This kind of neglect will end when we awaken to the intelligence of the heart, and learn to abide by it. It is as my partner said when he read this article: "This is BS. We already know that children need love, affection, encouragement, presence, etc. It is like asking if a flower needs sun to grow!"

    What is so absolutely exhausting, and heart breaking, is to read, yet again, about a scientist "becom(ing) desensitised" because he believes that his means justify his ends.

    How is it possible we still cannot see that the terrible experiments listed in this article, (not the least of which is the separation and isolation of the infant monkeys, though this is something so many of us still think is somehow acceptable), were all possible because scientists and others repressed and otherwise denied their emotions, instincts, bodily-intelligences,etc. and justified cruelty and violence?

    While Nelson is clearly not performing anything as sick as feeding children feces, or what the Nazis did, by participating in this ongoing delusion that one must cut themselves off from their feelings to find truth, he is watering the seeds that perpetuate the justification of torture and cruelty.

    Contrary to what we are taught, Emotions ARE Evidence. When the body and the heart react it is not simply "feeling to be ignored", it is an intelligence seeking to guide and inform us. What "experiments" would Nelson dream up if he really listened completely to his feelings with respect, and followed the direction they indicated? Perhaps he might actually create something that would truly help solve this terrible problem?

    i suggest the author and the scientists read a little more Albert Schweitzer and the like. I also suggest they read this story of Carl Jung in conversation with the Hopi elder, Mountain Lake:

    "At the Taos pueblo, Jung spoke for the first time with a non-white, a Hopi elder named Antonio Mirabal (also known as Ochwiay Biano and Mountain Lake), who said that whites were always uneasy and restless: "We do not understand them. We think that they are mad" (Jung, 1973, p. 248). Jung asked him why he thought the whites were mad, and the reply was " 'They say that they think with their heads . . . . We think here,' he said, indicating his heart" (p. 248). Impressed, Jung said he realized that Mountain Lake had unveiled a significant truth about whites."

    • space

      The study done by these people has improved the life of thousands of children. You can preach and say that this is BS, but this my dear friend is not bullshit. You on the other hand acting all high and mighty about the heart is bullshit.

      These people are fueled by their hearts and channeling that energy through their minds and affecting thousands of lives. Next time look past your own small conception of how the world should be and try to broaden your views and recognize the work that is done. The hardship they've had to endure to make the world a little better one small step at a time.

      In this case the means are justified for the cause. Social improvement wrapped up a layer of scientific research. Doing nothing solves nothing. So go back to your BS.

      /end rant.

      • smok

        Dear Space,

        As I replied to the fellow below, I was responding to the subtitle of the article about ethics in experiments. It is an important topic.

        And, I should have acknowledged the goodness in Nelson's work as well. However, I stand with my man who says that the question of whether or not children need love and nurturing is ridiculous. Yet, as Virginia pointed out, the trouble is there are people who do not see this, and therefore such studies are needed. This is a valid point.

        I too acknowledge your point that small steps are all we can take, and the mess with these poor children is heartbreakingly difficult. I do stand firm in my conviction, however, that compartmentalization is dangerous, dangerous territory, and we find it behind much of the darkness in the world. I too work in a heartbreaking field, where destruction and human violence are a daily occurrence. So, I acknowledge the need to nurture oneself. I do not agree, however, that my conception of the world is small–the heart is as vast and mysterious as the universe itself, and I do believe the solutions to our inhumanity and cruelty do lie in its wisdom. It also lies in peaceful, respectful exchange so we may open and learn from one another.

      • Dacus

        These studies improved nothing, it is the development of Romanian economy that made the lives of these children better.

    • Peter_Dickinson

      You seem to have completely missed the point of Nelson's statement. He desensitized himself because it was the only way he could continue to try to help these children without destroying himself in the process. To claim he did it so that his end could justify the means is way off. Purposeful desensitization is common among health care workers who must daily deal with suffering and death. The only way to continue day in and day out is to compartmentalize. Finally, you suggest that if Nelson were to engage his heart he might find a way to better help these children and solve this problem. Considering all that he's already done to help, your comment is just asinine. Why don't you do something to help if you have all the answers?

      • smok

        Hello Peter,

        Thank you for your comments. I certainly should not acknowledged that Nelson is also doing the best he can with a terrible topic and situation. I was trying to address the question of ethics in the experiments we justify, which was the subtitle of the article. I, in fact, work in a field where exploitation, rape, and destruction of individuals and communities is almost a daily occurrence. Nevertheless, my Buddhist background and training have helped me experience that the heart does speak truths which we in the West have trained ourselves to ignore and suppress. I am totally committed to being fully awake to my suffering as it guides me and helps me make the best decisions I can. I am not saying his work is not good, though and I should have clarified that. I am trying to point out that we need to be very cautious about compartmentalizing–it is dangerous, dangerous territory and has caused, and continues to cause, horrific suffering. And, lastly, there are other ways of knowing and that these may in fact, hold lasting solutions.

        • smok

          Oh Dear ! I meant to write - I should HAVE acknowledged...

          • Peter_Dickinson

            Smok, I really appreciated your comments. As a scientist myself, the subject of ethics is always on the forefront of my mind. I am very interested in hearing more of your thoughts on the dangers of compartmentalization. Would you be willing to speak more on this, and maybe provide some stories or examples that you've seen? I'd also love to hear more about being "awake to one's own suffering" as you put it. Anything you would be willing to share, as well as literature you have found useful, would be greatly appreciated. Thanks.

  • Virginia Hughes

    Hi smok,

    Thanks for reading. Your comment gets into what I hoped to be the crux of the story. I wanted to clarify one part of your comment:

    "We already know that children need love, affection, encouragement, presence, etc. It is like asking if a flower needs sun to grow!"

    Yes, that's very true. As I mention in the piece, many studies over the decades have shown this very thing. Trouble is, though, Romanian officials did not buy into that research, and so they kept the children in institutions. It was only after this study came out (and after the EU put pressure on them) that they began to put more resources into foster care and move more children out of institutions. In 1990, when Ceaucescu was killed, there were 170,000 Romanian children in orphanages. Now there are 9,000. I think it's fair to say that this study -- and the awareness it brought to these children -- deserves some part of the credit for that drop.

    • smok

      Hello Virginia,

      Thank you for this point. As I said to the people below, I should have acknowledged the good and difficult work being done by Nelson and others! I was responding to the questions of ethics in our scientific experiments and how I feel we can go very wrong as a result of compartmentalization even with the very best intentions. However, I did not mean to imply that Nelson was one of those people, rather I wanted to point out that there may be another level to reach that does not rely on repression and compartmentalization.

  • Rockys_Dad

    I clearly remember when baroness Nicholson was criticizing the Bucharest Early Intervention Project, labeling it as "very harmful experiences on children".

    Back in June 2002, the baroness had accused the University of Minnesota, the
    Tulane University, the University of Maryland and the MacArthur Foundation of
    "testing the Romanian orphans with electrodes", questioning these prestigious organizations on both legal and moral grounds. At that time, the reporters from "Adevarul" national daily investigated the case and published an article revealing the baroness' lies. Interesting to note that her own countrymen (representatives of two U.K. universities and scholars from the Royal College of Pediatrics and Child Health) were defying “Her Highness” by participating in this study.

    I think that was one of the most preposterous allegations her vivid imagination ever
    conceived (equaled, maybe, only by the time when she said that "in many cases adoptions had given oxygen and life blood to gangs linked to terrorist organizations"!!!).

    Excellent article, Ms. Hughes!

  • Randy

    Ms. Hughes,

    A very thorough article. I wonder though if Nelson's research is more about enrichment/nurture versus neglect than about foster care versus institutions. Obviously, a child growing up in his or her healthy, nurturing family is ideal, but one can imagine a neglectful foster family with poor childhood outcomes and an enriching, nurturing children's home (orphanage) with more positive childhood outcomes. Just a thought.

  • V

    I'm sorry but this article (or, more precisely the article in the
    Aeon magazine, contains things that are not true. Just bombastic. It
    happen that I was living in Romania between 1961 and 1997. I was a
    married person between 1983 and 1989 (and after that) and although there
    was a total lack or contraceptives and abortion was prohibited, there
    was not Menstrual Police and nobody was forcing anybody to have more
    cildren. Nobody was even asking about this. Whether in university, at
    work or in society. And there was no tax punishment for not having
    enough children. All these are lies written probably for making an
    article more extravagant. But they are not true. I also want to specify
    that nobody in my family was ever a communist party member and I
    cultivated all my life a profound hate for communism. So, I cannot be
    blamed that I defend anything. It is just I see no point in spreading
    lies in order to promote an article. Scientific and historical truth are
    more valuable. So, please, do your journalistic due diligence and
    verify your sources.

    • Dacus

      I truly confirm the above. I was married between 1981 and 1992 (when I left Romania) so all stories about the Menstrual Police (hear, hear) and mandatory five children are abject lies. The author is deliberately blackening Romania to make more "ethical" the study and justify the "international adoptions.

      • Dan

        Same as above. It did exist. Not everywhere though.

    • Dan

      I don't know about tax, but the "Menstrual Police" did exist. Maybe not in your workplace, maybe not in your university but in lot of factories such as APACA you had it.

  • Thormohlen

    It would have been interesting if two other groups had been included. My son spent his first 21 months in the orphanage in Suceava. The conditions were much better and several of the children coming from Suceava turned out "normal". Also, I wish the study would have tracked the progress of the children who were adopted and came to the the US or Canada. I think it would have proved that adoption was and remains the best option for many of the orphans in Romania.

    • Mridula Koshy

      The neglect of children in orphanages, their inability to attach well and in some cases to attach at all is a problem that needs to be addressed, but inter-country adoption is not the answer. Inter-country-adoption acts as an economic incentive for the creation of orphans were none exist. We tend to view child trafficking as an egregious example of the harm done by inter-country adoption. But in fact many of the children offered through legitimate channels for inter-country adoption need never have entered these channels if governments and families were working together to promote the integrity of the family. Children once in the adoption stream must live with the life long repercussion of loss of identity and belonging. An identity built around abandonment can never fully be answered with an identity of being 'chosen.' Grevious harm is done to the first parents of these children who also must live with loss for the rest of their lives. While many who are formed by adoption are able to find some measure of happiness and security, many more suffer excruciatingly. Its time to stop looking at adoption as an answer.

  • Dacus

    The study on Romanian children was unethical to the core.
    Where was the consent of the children's parents or guardians? The children were treated like lab animals for which no consent is needed. Rats and monkeys in a lab had probably more rights than the Romanians children used in that study. Those "scientists" took advantage of the chaos following the collapse of communism to do this study without any concern of the children's rights or privacy. No surprise that Baroness Nicholson was outraged. She came from a country where human rights are respected.
    Any study in these circumstances would be considered illegal and unethical in every country with a decent legal system. And to justify the lack of ethics, not to mention the illegal status of the study, the authors take the path of blackening Romania as if poverty would justify treating children like lab animals.

    • Virginia Hughes

      Hi Dacus,

      On the contrary, the researchers obtained consent from all of the children's biological parents before enrolling them in the study. The biological parents willingly left them in the orphanages and willingly allowed them in the study.

      Thanks for reading.

      • Dacus

        The fact that the parents put them willingly in an orphanage doesn't mean that they automatically consented to be treated like a monkey in a lab. If Baroness Nicholson said the study was illegal and unethical, I strongly believe her, not you. She would not made such serious allegations without irrefutable evidence.

        • space

          What are the grounds for your objections against international adoptions? I myself know quite a lot of people who were subjected to 'international adoption' and from my observations their lives are the better for it. It's all about giving these children a better change. And from the article it seems that anything is better than staying at the orphanage.

          • Mridula Koshy

            You cannot compare a life never lived with one thrust upon a person, who in all likelihood was an infant and unable to consent to this new life. Nor would you or I agree to allow our children to b taken to "better lives" very easily. Inter-country adoption as it exists today is a strictly one-way journey for the baby. If the poverty that forces most first parents to look outside the family for means of supporting their children gives way to a better situation a year later they cannot come back for their children. The fact that it is irrevocable is what is most attractive about inter-country adoption to adoptive parents in first world. It is not equally attractive to that infant shorn of citizenship, culture, religion, language, roots and family. A transplant can be affected but at great risk and great loss. These children and their first parents are human beings,fragile and complex and before we decide to stop at a solution - intercountry adoption - that is so traumatizing, we must keep searching for a better one.

    • Viorica Culea

      I am a Romanian Adoptee. I have a blog that I started, its about my adoption story. Check it out here:

    • randtke

      Dacus, why hate on Africa? Yes, Romania is in Europe, but that's a geographical thing, not a moral thing. Being in Europe is an arbitrary reason to blindly support a country's policies.

  • Dacus

    The study on Romanian children was unethical to the core.
    Where was the consent of the children's parents or guardians? The children were treated like lab animals for which no consent is needed. Rats and monkeys in a lab had probably more rights than the Romanians children used in that study. Those "scientists" took advantage of the chaos following the collapse of communism to do this study without any concern of the children's rights or privacy. No surprise that Baroness Nicholson was outraged. She came from a country where human rights are respected.
    Any study in these circumstances would be considered illegal and unethical in every country with a decent legal system. And to justify the lack of ethics, not to mention the illegal status of the study, the authors take the path of blackening Romania as if poverty would justify treating children like lab animals.

    • Wondering

      Dacus, could you give us a little more information on your decision to move to the UK? Did your sons move with you? Do you think they enjoy a better standard of living than they did in Romania, and if so, why do you think other children adopted out of their home country would not be benefitted also?

      In my experience, international adoptive parents seek to imbue their child's life with a full understanding and appreciation of their birth culture. Of course they cannot do so in the same way as biological parents if they are not Romanian (etc) themselves, but what's to say they are not emigrees. And the "experiment" you are so ethically opposed to, instead of leaving 100% of children in institutions, helped over half find foster homes. Which is it – should all children be left in institutions (you agree we know this is not optimal); should all children be placed in foster care (seemingly impossible, in light of the country's economic and political situation); should no children ever be given the chance to be loved by a family merely because that family does not live within a politically-designated border?

      • Mridula Koshy

        If children truly belong to those who can give them "a better standard of living" then allof us who are parents need to look around and make certain there isn't someone else to whom our children truly belong. I daresay those who advocate for inter-country adoption as Wondering does would not easily consent to their own children being taken from them and sent to 'a better standard of living.' As for the comparison of Dacus' children to the internationally adopted children Wondering knows as enjoying 'a better standard of living," it highlights the fundamental failure of intercountry adoption to see that life lived without the rupture and loss of ties to one's family of origin cannot be compared to the life that is painfully constructed within adoption.

        Dacus' children are blessed not only because they have 'a good standard of living' but because they did not have to first tear themselves from Dacus to achieve it. Let us not make this the choice for the word's poor infants and their parents -- to choose a good standard of living over emotionally intact lives. Why not work toward a world where children and their parents have both?

    • usethebrainsgodgiveyou

      Somehow, I believe this to be true. Madeline Albright, the US Secretary of State under Clinton, condoned
      the punitive sanctions against Iraq that resulted in an estimated
      500,000 deaths of children by remarking that such sanctions were "worth
      it." She said as much in an interview by Leslie Stahl, but backtracked and blamed Hussein.

  • Dacus

    Before Romanians orphans studied were they were studies about the effect on affection deprivation on s. The evidence was already there so such a study was neither necessary and nor justified. To treat children as lab monkeys just because they were born in destitute families is outrageous.
    Nelson's desentisation is a further evidence that the children were subject to unethical experiments.
    And I personally take offense on the comparison of Romania with Africa regarding the health regulations and policy making.

  • Robert Jensen

    One of the most important contributions for understanding the role of early emotional
    and sensory deprivation has come from the Romanian orphans who were adopted
    into well-functioning UK families. In the early 1990's a team of scientists began a project to follow the longitudinal outcomes of the orphans led by Sir Michael Rutter.
    The team followed the developmental outcomes of 160 Romanian orphans adopted
    into UK families. They originally thought that the severe emotional and sensory
    deprivation of these children had such a hugely massive environmental effect
    that they would all look the same. Not at all.

    At intake about 9-10% of the orphans met diagnostic criteria for autism. Similar autism prevalence rates have been found in other conditions featuring severe early environmental insults such as congenital rubella syndrome (7.4%) and cerebral palsy (8%).

    The study team found that in adolescents who possess the short S/S allele in the
    serotonin transporter gene were at greater risk for emotional problems. Other
    important findings were that many of the children were remarkably resilient and
    on follow-up after a period of ‘catch-up’ about 2/3rds of the orphans looked
    more like typically developing children. Another finding was found on brain
    imaging studies that implicated smaller amygdala in the children as a group. Structural abnormalities in the amygdala have been found to be common in autism.

    The BBC has a 30 minute presentation on the Romanian orphans adopted into UK
    families featuring Sir Michael Rutter:

  • William Gould

    In this case and in many others it is possible to have both at the same time, and when you do an ethical review for research you always have to demonstrate how your work will not in any way hinder existing work/care being provided and that you have taken all possible precautions in the light of working with vulnerable participants. In this case too though, research should always be secondary and any possibility of overstepping ethical boundaries (which should in any case be repeatedly reviewed) should result in termination of the project. This is why such research should always take place via a bona fide research organisation like a University, since these checks are automatically in place. By contrast, there are some 'care' organisations, particularly NGOs (which will remain nameless) that don't even do proper checks on personnel they are sending out. This is potentially much more damaging. I think it is very unfortunate that the writers of the article did not check and verify their statements about social policies in the communist period. These have, it seems, been exaggerated here, which really doesn't help the cause of the research - always better to have a social scientist on board for these things!

  • Courtyard Virginia Beach

    nice article.......

  • Jeng Kel

    This article elucidates a common ethical debate that can be traced back to the Enlightment ideals linking scientific inquiry with human progress. Science for the good of mankind (or nowadays for the sake of science itself, perhaps) can trump action for the good of individuals. It seems clear that researchers in this case were aware at some point that no matter how conclusive their data was, it was unlikely to convince the Romanian government to overhaul the system towards a better situation for these children. Yet the study was continued despite, as quoted in the article, an awareness that "they can't control what happens in Romania." So the scientific discoveries made over the course of this study may benefit others, but not the children who were studied, it seems.

    I'm curious about how the researchers who spent a year crafting the ethical parameters of this study dealt with the issue of informed consent, which looks very different when dealing with children. Who gave consent on behalf of the children involved? And are they now aware of the details of the study they were involved in?

    The excuse that compartmentalization is just what good scientists do seems a weak one to me, as all of the other ethical failures of science recounted in Nelson's lecture were undertaken with the same sort of ideal - that doing good science requires ignoring the social realities of where you are and who you are working with for the sake of proving something that might, in the future, do some good.

  • Ophelia

    To me it seems like a good idea, at least that's what it was at first. I don't find it unethical, because half of those children had a chance to get a better life. The problem starts from here, because those children had reached a difficult age and their support is being withdrawn.

    I suspect many of the so-called foster parents only did it for the money and with the money gone they will end up getting rid of these children. These children don't really have a future, and you know the saying, the higher you are, the harder you fall. That is to say, they had a decent life up to now and now they'll have nothing.
    If they were expecting the government to do something, they still haven't learnt how Romania works, and after so many years that seems just stupid to me, sorry. I think it's their responsibility to deal with those children, cause they "started it". You can't just expect others to take care of your leftovers, considering this was an experiment, not a humanitarian mission. Those have the right to say "we did our best, now you pick it up from here". These guys, on the other side, don't.

    • Adrian

      Few months ago, at Antena 3, there where some recent investigations regarding the state of the orphans in Romania past and present. Also, some of those who left Romania in 1990 and their friends (who remained here) were found and given the opportunity to tell their story.

      You might find more here (see some of those those uploaded on may 2013):

      The truth is that in the past they had life conditions resembling Dickensian novel or worse. Now conditions are much improved (but probably some of them still experience some form of abuse, according to few testimonies available). The problem is that nothing can be really changed about the past. In key moments of their lives (first years) they were deprived of the required human and material resources and that cause severe damage to their development.

  • Legend79

    I'm late to this story. I have more questions then I think there are clear answers.

    A follow up study...comparing similar study data for children who live and grow up on the streets around the world with those in this study.