How AIDS Came to Romania

Eight months after the cadaverous images of Romania’s babies with AIDS first shocked people throughout the world, almost every one of Romania’s orphanages and children’s hospitals provides a heartening example of the help being provided by European and American philanthropy. Yet at the same time, each of them continues to bear witness to the grisly legacy of the Ceausescu regime.

This evidence is not difficult to gather, as we found on a trip this summer sponsored by Helsinki Watch.1 After Nicolae Ceausescu’s overthrow on December 22, 1989, a country long sealed-off suddenly opened. Orphanage directors and hospital physicians now allow visitors from abroad into institutions that were once hidden away, and officials of the new National Salvation Front government readily discuss (if, at times, self-servingly) the past record. The consequences of Ceausescu’s systematically oppressive rule over a country that lacked both democratic traditions and independent associations of professionals, such as doctors, can now be seen all the more starkly. It is becoming possible to understand how a country in which families, not strangers, traditionally cared for the young and the old could produce thousands of abandoned children, and how in a country whose isolation and poverty might have insulated it from AIDS, children became afflicted by an HIV epidemic.

Currently there are 683 children between the ages of one and four with AIDS in Romania. At least another 1,000 are HIV positive. They live for the most part in Dickensian institutions built by the Ceausescu government to deal with the consequences of its policy of coercively raising the birth rate. Thousands of young people live in bleak, understaffed orphanages where a visitor seldom sees a child with a toy or a book. The egregious neglect and disease that one observes are not only the product of oversight and inattention (as is often true in developed countries), but of deliberate government policies. Ceausescu, by all accounts, was a simple-minded and doctrinaire Marxist, who made production the goal of the state, and classified citizens by their productive capacities. In October 1966, one year after he took power, he promulgated “pronatalist” laws aimed at compelling women to have children.

In the effort to raise Romania’s low birth rate (in 1965, there were only six thousand more births than deaths), Ceausescu banned all means of contraception, increased the taxes of childless couples, and, most important, prohibited abortion. In Romania, as in Eastern Europe and the Soviet Union, pills, condoms, and IUDs were scarce and expensive, and abortion was the primary means of birth control. In 1965 approximately 1,000,000 abortions are estimated to have been performed in Romania, terminating 80 percent of all pregnancies.2

The immediate impact of the policies intended to encourage childbearing was to increase population growth (which rose to a rate of 18 per 1,000 in 1967). But couples found a variety of ways to limit births (such as using the rhythm method and frequenting prostitutes), and the numbers slid (in 1975 to 10.4 per 1,000, and in 1980,…

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