U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Printing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001

43–969 PDF 2008

CARE FOR THE DISABLED IN ROMANIA 

HEARING 

BEFORE THE

COMMISSION ON SECURITY AND 

COOPERATION IN EUROPE 

ONE HUNDRED NINTH CONGRESS 

SECOND SESSION 

SEPTEMBER 13, 2006 

Printed for the use of the 

Commission on Security and Cooperation in Europe 

[CSCE 109–2–9] 

( 

Available via http://www.csce.gov 
COMMISSION ON SECURITY AND COOPERATION IN EUROPE 

LEGISLATIVE BRANCH COMMISSIONERS 

HOUSE SENATE 

CHRISTOPHER H. SMITH, New Jersey, 

Co-Chairman 

FRANK R. WOLF, Virginia 

JOSEPH R. PITTS, Pennsylvania 

ROBERT B. ADERHOLT, Alabama 

MIKE PENCE, Indiana 

BENJAMIN L. CARDIN, Maryland 

LOUISE McINTOSH SLAUGHTER, 

New York 

ALCEE L. HASTINGS, Florida 

MIKE McINTYRE, North Carolina 

SAM BROWNBACK, Kansas, 

Chairman 

GORDON SMITH, Oregon 

SAXBY CHAMBLISS, Georgia 

RICHARD BURR, North Carolina 

DAVID VITTER, Louisiana 

CHRISTOPHER J. DODD, Connecticut 

RUSSELL D. FEINGOLD, Wisconsin 

HILLARY RODHAM CLINTON, New York 

VACANT 

EXECUTIVE BRANCH COMMISSIONERS 

VACANT, Department of State 

VACANT, Department of Defense 

VACANT, Department of Commerce 

(II) 
CARE FOR THE DISABLED IN ROMANIA 

SEPTEMBER 13, 2006 

COMMISSIONERS 

Page 

Hon. Sam Brownback, Chairman, Commission on Security 

and Cooperation in Europe ..................................................... 9 

Hon. Christopher H. Smith, Co-Chairman, Commission on 

Security and Cooperation in Europe ...................................... 1 

WITNESSES 

Adrian Mindroiu, Director of the Directorate for European 

Integration, Head of PIU, SPO, Romanian National Authority for Persons with Disabilities ...................................... 4 

Cristian Ispas, Founder and Director, Motivation Romania 

Foundation, National Director, Special Olympics Romania 10 

Eric Rosenthal, Executive Director, Mental Disabilities 

Rights International ................................................................ 12 

APPENDICES 

Hon. Sam Brownback: 

Prepared statement of ............................................................. 37 

Material submitted for the record by ..................................... 56 

Prepared statement of Hon. Christopher H. Smith ................. 38 

Prepared statement of Adrian Mindroiu ................................... 40 

Prepared statement of Cristian Ispas ....................................... 45 

Prepared statement of Eric Rosenthal ...................................... 52 

(III) 

(1) 

CARE FOR THE DISABLED IN ROMANIA 

September 13, 2006 

COMMISSION ON SECURITY AND COOPERATION IN EUROPE

WASHINGTON, DC 

The hearing was held at 2:06 p.m. in room 226 Dirksen Senate 

Office Building, Washington, DC, Hon. Christopher H. Smith, CoChairman, Commission on Security and Cooperation in Europe, 

presiding. 

Commissioners present: Hon. Sam Brownback, Chairman, Commission on Security and Cooperation in Europe; and Hon. Christopher H. Smith, Co-Chairman, Commission on Security and Cooperation in Europe. 

Witnesses present: Adrian Mindroiu, Director of the Directorate 

for European Integration, Head of PIU, SPO, Romanian National 

Authority for Persons with Disabilities; Cristian Ispas, Founder 

and Director, Motivation Romania Foundation, National Director, 

Special Olympics Romania; and Eric Rosenthal, Executive Director, 

Mental Disabilities Rights International. 

HON. CHRISTOPHER H. SMITH, CO-CHAIRMAN, 

COMMISSION ON SECURITY AND COOPERATION IN EUROPE 

Mr. SMITH. The Commission will come to order. And I want to 

wish everyone a good afternoon. 

I want to thank my friend and colleague, Senator Brownback, 

who will be joining us shortly, and other members of the Commission. 

This is a very, very important hearing. As you know, Romanians 

have made enormous strides in many, many areas. And as a longtime friend of that country, I certainly welcome these changes. 

It has been heartening to see democratic reforms that allow all 

citizens in Romania greater participation in the political decisionmaking process and economic reforms, genuinely to improve the 

quality of life of the people living in Romania. 

Ladies and gentlemen, however, ‘‘Hidden Suffering,’’ the May 

2006 report by Mental Disability Rights International, has shed 

light on a segment of Romanian society whose lives remain woefully unchanged. For adults and children with disabilities, too 

many endure an existence shrouded in darkness, shut out of the 

mainstream of society, and in conditions that are all too reminiscent of the images we saw of orphanages exposed to the public eye 

in the early 1990s. 

I would note parenthetically that having made several trips to 

Romania, I remember so well when Dorothy Taft and I were there 
2 

just a few weeks after the December 1989 revolution. At the time 

we went to some of the orphanages and were struck by 60 and 70 

children lined up, many of whom could not even be turned or handled in a proper way by well meaning, but certainly understaffed 

orphanages in Bucharest. 

And we wondered then, as we now are concerned, about their 

plight as individuals. They were hurting. Some of them were laying 

in their own excrement, because, again, there was nobody even 

there to change them. 

As I think many people in this room know, last year this commission held a hearing on Romania’s ban on inter-country adoption. 

The testimony at that hearing was riveting and very moving. 

As witness Dr. Dana Johnson from the University of Minnesota 

testified, and I quote, ‘‘contemporary child development research 

has unequivocally shown that in infancy, hospital or orphanage 

care for longer than four to six months can cause permanent alterations in cognitive, emotional and behavioral development. A reasonable estimate is that an infant loses about one to two I.Q. points 

per month and sustains predictable losses in growth, as well as 

motor and language development between 4 and 24 months of age 

while living in an institutional care environment.’’ 

I would note that the report that we will be spending much of 

our time discussing today comes to many of those same conclusions. One of those conclusions, and I’ll just read it very briefly, 

was where one of the nurses said—just let me find it—that, how 

these children were close to death, an MDRI investigator found. 

But one of the others said that these kids were actually—let me 

find it before we move on—that there is deterioration—the bottom 

line is, to paraphrase it—in the lives of these children when they 

sit in these places of warehousing. 

Of course, it has been proven—here it is. In Timisoara, one of the 

nurses said, ‘‘they become disabled in here.’’ In other words, that’s 

not how they started out. But because of the factors that they face, 

they become disabled. 

Of course, it has been proven, also, that placement in a permanent, nurturing home, by contrast can immeasurably improve their 

development. We also know that many of the inter-country adoption cases, which were abruptly halted, involved children with critical physical and developmental disabilities. 

The children involved have to-date been denied the opportunity 

for a permanent family, critical medical care and a loving home, in 

which they have the best chance to develop as they are able. 

One of the cases that I worked on personally—and I was joined 

by some of my colleagues—which thankfully was resolved, at least 

so far, positively, was in the case of a child with spina bifida who 

had actually come to the United States, was living with a doctor 

who specializes in spina bifida. 

I chaired the Spina Bifida Caucus in the House, and we worked 

very hard on those issues and care for spina bifida-afflicted children. 

Amazingly, the Government of Romania was in a position where 

they wanted that child—who was already placed, already here—to 

go back to Romania, probably to a warehousing situation, to leave 
3 

a place where very aggressive care and love was being provided to 

that child. To me that was absurd. 

Sadly, Romania’s policies do not take into consideration the best 

interests of the child. And I say that with respect to my friends in 

Romania, because I have an enormous respect for the government 

and for many of the parliamentarians, who I know very well. But 

it doesn’t change the facts on the ground. Facts are stubborn 

things. 

I would also emphasize that is especially true when we talk best 

interests of the child, a child who has special needs, who could otherwise be a candidate for adoption. 

I am particularly troubled by reports that some institutionalized 

children may lack even basic identity documents, and, therefore, 

have no chance of being adopted into permanent homes in Romania. 

We have received other reports that some children who have no 

disabilities are nevertheless housed in institutions, because of lack 

of an adoptive family. Again, the research has shown that institutionalized care can actually cause permanent disability. 

Let me just finally say, in reading this report—as I, and I know 

my colleagues on the Commission have done—this is a serious indictment and cries out, begs remediation, and to do so immediately. 

One of the statements made by a nurse in Timisoara—and I 

quoted it in part, and now I will quote it a little bit more—‘‘we do 

our best, but it’s impossible for us to stop the spread of lice and 

contagious diseases. I give it an injection, and a baby cries, and I 

have to keep going. There are too many. They become disabled 

from being here.’’ 

One of these statements that really grabbed me was when a staff 

member agreed to unwrap several of the children. One girl, who 

looked to be about 4 to 5 years old, was actually 17, and weighed 

no more than 25 pounds. As the staff removed the restraint, her 

skin came off with the sheet, leaving a raw, open wound beneath 

it. 

Another boy looked to be the size of a baby, and he was 7 years 

old. He, too, when unwrapped, was wasting away, his legs covered 

with sores and his fingers chewed and swollen. 

So, there’s—this is a serious report that needs to be taken very 

seriously, and aggressively approached with an idea to remediate 

it and fixing the situation. 

I would note parenthetically that no country is beyond reproach 

when it comes to how they treat their disabled. I remember so well 

years ago—and it was while I was still in high school—a report 

that came to light right near my home—it was in Staten Island— 

when Geraldo Rivera went in with a camera and took pictures of 

people, many of whom were naked and were being mistreated, as 

a result of very poor and inadequate—and I would say cruel, in 

some cases—care. 

That was in proximity to my home, in another State, in New 

York, but right near the State of New Jersey. 

That led, and other kinds of exposes, to a very aggressive disability rights movement in this country. It also helped to create 

ombudsmen and other kinds of permanent oversight bodies—and 

we have them in New Jersey, we have them in other States—peo-
4 

ple who work on disability issues and do nothing but try to mitigate abuse when they see it. 

It also later on had some bearing, the whole disability rights 

movement, on the enactment of the ADA, the Americans with Disabilities Act, which was landmark, historic, human rights, civil 

rights legislation for the disabled—which is still in the process of 

being implemented. 

So, again I say to my friends in Romania, all of us have been 

there, but it’s what you do once these kinds of exposes occur. And 

I would hope that it would be all about reform and making it right 

for those who have been afflicted with disability, mental or physical. 

We are very fortunate today to be joined by Adrian Mindroiu, Director of European Integration in the National Authority for Persons With Disabilities. He has flown in from Bucharest to participate at this hearing. And we are grateful that you were able to 

come to Washington to share with us your expertise. 

I yield the floor to my friend. 

ADRIAN MINDROIU, DIRECTOR OF THE DIRECTORATE FOR 

EUROPEAN INTEGRATION, HEAD OF PIU, SPO, ROMANIAN 

NATIONAL AUTHORITY FOR THE PERSONS WITH DISABILITIES 

Mr. MINDROIU. Honorable Members of the U.S. Congress, distinguished representatives of the NGO community, ladies and gentlemen. I am sincerely honored with the invitation presented by the 

Helsinki Commission to testify before the U.S. Congress. 

I took the decision to respond to this invitation, and have come 

a long way from Bucharest, sharing the belief this event will be a 

unique opportunity to inform you first hand on a relevant set of 

measures that the current Government of Romania, which I proudly represent today, has been undertaking on an issue of unique 

sensitivity, both to our public responsibility and personal awareness: improving the life of people with disabilities, who are equal 

in civil rights to us all. 

It is also my belief that today’s event will be a constructive exchange of perspectives on lessons learned and good practices, to the 

benefit of our concerned citizens. 

I am familiar with the process followed by dedicated defenders 

of the rights for people with disabilities for over a period of more 

than 20 years in the United States, which ultimately leads to the 

Americans with Disabilities Act, a groundbreaking piece of legislation, that admirably transformed the entire American society into 

a more inclusive and equal opportunity community. 

Likewise and parallel progressive development has taken place 

in the EU countries and, of course, in Romania, too. The very history of the European ‘‘aquis communautaire’’ proves that gradual 

maturation of the questions in the member states, both in terms 

of political awareness and Result-oriented policies. 

Speaking about political awareness, I feel indebted to refer to the 

1990 OSCE Moscow Document in which participating States acknowledge the importance of binding political commitments to ensure the protection of the human rights of persons with disabilities 
5 

in the OSCE area, as a consensual political platform to further action and shared accountability on this matter. 

My testimony here will be focused on what happened during the 

last 2 years in Romania. It’s the period in which the new government is involved in the reform of the persons with disabilities system. 

As a governmental body, we were charged—the National Authority for Persons with Disabilities—to initiate action-oriented policies 

to elaborate, monitor and control the implementing of the quality 

standards in the field, to innovate interagency procedures and 

other chains of cooperation with NGO partners and all the society, 

in order to effectively and immediately implement policies. 

To make a long story short, we had to produce concrete results 

and unarguable progress, so as to rise up to the standards—worldrecognized standards—and compulsory requirements of the EU integration process. 

We started from a low level, and we reach today the moment 

when we have a national strategy—the national strategy was 

elaborated last year—and the plan of action system, and these two 

are sustainable by unprecedented financial resources. 

For my government, filling the gap of previous years with concern to assistance for persons with disabilities is a key component 

of developing a comprehensive care system with a long-term vision. 

The main motivation is to comprehensively integrate the principle 

of mainstreaming—mainstreaming defined as systemic consideration of the specific needs of disabled people in a broad sense, 

which have to be respected when designing policies and measures. 

Its main objective is to protect, offer equal opportunity and combat discrimination on grounds of disability, against those persons 

that, due to their social, physical, psychical or economic impediments, cannot provide for their social needs, and develop their own 

capacities and capabilities to function and participate in society. 

I’d like to briefly speak about the quite new legislative framework in Romania, because it is very important what has happened 

in the last year and a half in the field. 

Last year, in 2006, together with our partners, NGOs, the Romanian Government approved the national strategy, which is called 

the National Strategy on the Protection, Integration and Social Inclusion of Disabled Persons. And the period covered by this national strategy is 2006–2013. 

And the name of the strategy is ‘‘Equal Opportunity for the Disabled: Towards a Society Without Discrimination.’’ 

Its ultimate goal is to ensure—and the most important goal—is 

to ensure the right to exercise fundamental civil liberties of persons 

with disabilities, and ensure a meaningful increase of their life 

quality. 

The core concept of the strategy is the liberty of choice: a person 

with disabilities has been assured the opportunity to make choices 

concerning its own life. 

Therefore, the National Strategy is the basic platform to ensure 

a broad and consistent mainstreaming throughout all governmental 

policies. 

Subsequently, in the same year—that means, somewhere in October 2006—the Romanian Government has approved and sub-
6 

mitted to the parliament, a draft law concerning the protection of 

persons with disabilities. This law was approved by the Romanian 

Senate at the end of March this year and currently is under debate 

in the low chamber of the parliament. 

We are expecting the law to be approved by the parliament this 

autumn. So, until December, we have a new and very courageous 

law concerning the rights of and the protection of the persons with 

disabilities. 

I would like to tell you a little about the national system of social 

assistance, because the social protection of the persons with disabilities is a part of the national system of social assistance in Romania. 

In this respect, in March of this year, the Romanian Parliament 

approved the Framework Law on the National System of Social Assistance. And this law replaced an outdated legislation of 2001, and 

all other previous regulations and special provisions concerning the 

protection of disabled, child protection, elder protection and all 

other members of the Romanian society who need social protection. 

The Framework Law granted the Romanian Ministry of Labor, 

Social Solidarity and Family the main role in issuing and coordination of social policy at large, and social assistance in particular. 

As a result, the Ministry of Labor, Social Solidarity and Family, 

and the National Authority for Persons with Disabilities, which is 

an authority under the supervision of the Ministry of Labor, alongside other concerned institutions, participate in policymaking, manage and coordinate the national system for persons with disabilities—national system of care for persons with disabilities—promote their rights and grant methodological and financial support 

to the social care programs for the disabled person. 

An outline on the National System of Protection for Persons with 

Disabilities follows. The services provided under this system enclose all types of financial aid addressed to disabled persons or 

their family and their caregivers, as well as social assistance. That 

means, social services. 

And the social services are targeted to maintain, habilitate respective—rehabilitate and develop individual skills, and are provided either at home or in specialized institutions. 

The increasing participation of non-governmental organization 

and other social partners is a specific trait of the care system for 

persons with disabilities. 

If we are talking about the current state of the residential system care for persons with disabilities, I have to inform you that the 

situation of the disabled persons in the residential system represents the most difficult and sensitive issue we are doing our utmost to cope with on a priority basis. 

Statistically speaking, on March 31 this year, in Romania there 

were registered almost 461,000 persons with disabilities. And this 

includes 405,000 adults and almost 55,000 children. 

Out of this total, almost 18,000 adults and 354 children received 

specialized care in residential institutions. The rest received care 

within their family or in a family like environment. At the same 

date, Romania had 149 residential institutions for disabled adults. 
7 

I want to make it—to specify that the National Authority for the 

persons who are handicapped are dealing with adults with disabilities. That means people over 18. 

For the children with disability, their rights are protected, and 

all the services are provided under the supervision of the National 

Authority for Child Protection and Adoption, our partners in the 

Ministry of Labor and Social Solidarity and Family. 

The main challenges facing the institutions that provide care for 

persons with disabilities in Romania are: 

First, the majority of our residential institutions are overcrowded, and the living standards in these institutions are very 

low. 

By the way, this summer we had an action, and we evaluated the 

implementation, the degree of the standards implementation in our 

system. And the result of this assessment will be published on our 

Web site by the end of this month. Very, very important for us is 

how our institutions are implementing the standards that are compulsory. 

Second, and the second big problem of the residential institutions 

is that, in these institutions are a mix of types and degrees of disability. And in each institution we can find people with different 

types of disability, different degrees of disability. And that makes 

it impossible to provide tailored-to-fit services for the individual 

needs identified for each beneficiary. 

Other information I want to—that’s not presented in my testimony is that I want to inform you that the needs—we create services based on the identified needs for each person. And we have, 

since 2003, together with some specialists from Holland, we created 

a scale of support. That means, a scale of assessment to identify 

the needs of the person. 

At the beginning of this year, we realized that this scale does not 

cover all the needs we need, and the most important one, this scale 

does not give us information about the needs of persons with mental disabilities and their needs. 

That’s why we searched, and we updated our scale of supports 

with a part identified in Wisconsin. The scale of assessment for the 

persons with disabilities in Wisconsin is very, very close to our 

needs. And that’s because the problems are almost the same as 

identified there. That means, these big institutions and a mix of 

types and degrees of disability. So, we started last week to assess 

again the persons using our new scale. 

Third, is the problem—a very, very important problem with—in 

our staffing of the national institutions for adults with disabilities. 

The staff employed in these institutions lacks specialized professional training. 

And if we are talking about prevention of institutionalization, if 

we are talking about support to families who have persons with 

disabilities, a fourth problem is that of day centers, ambulatory 

centers for rehabilitation of persons—rehabilitation of disabled persons, and all the community services are not enough, are still 

scarce. 

For example, this year we started to create centers for homecare 

services. But it is the first time. Then we tried to create in five 

pilot counties this type of services. 
8 

What have we done until today? 

The National Authority for Persons with Disabilities has closely 

oriented its actions on identifying solutions for these challenges. 

Though much remains to be done, I will briefly go through what 

we have succeeded to achieve so far. 

If we are talking about the capacity of national institutions, at 

the beginning of 2005, each county presented a plan for the restructuring of the old type residential institutions and, of course, 

those with large sizes and overcrowded. 

According to them, these county plans, the number of residents 

located in these institutions will be reduced, and at the same time, 

will create alternative community services. 

For this, we have now financial support provided by a grant 

scheme from PHARE 2003. It means around 16 million euros. And 

national program financed from the national budget of around 3.9 

million euros, and a loan granted by the World Bank in May this 

year of around 18 million euros. 

As we speak, this financial assistance is oriented to reorganize 

and transform almost 48 residential institutions in the very near 

future. 

Why ‘‘almost’’ 45? Because it’s a grant. Everything is on the 

grant scheme. And based on the project, we can transform 48 or 

49 or 47. But the financial means it’s around 48 institutions. 

If we are talking about improving the quality of life, in February 

2006, the Government of Romania has granted 3.5 million euros to 

ensure the modernization and indoor remodeling, including the 

purchase of new furniture and other needs for 45 centers. 

Another 14 centers have been benefiting from a financial assistance to ensure the designing for the complete restoration of the 

buildings. Last month, the government approved the financing of 

a round 2.9 million euros to complete the repairs for five of the 

above centers, which already restoration projects have been passed. 

And these days, when I left Romania, we have another government decision, which will provide financing for another four centers. This government decision is in the endorsement phase. Probably it will be approved by the government at the beginning of October. 

Another problem—a problem very, very important—is the cross 

handicap problem. And this problem, a sensitive issue, is represented by the people with mental and neuro-psychical disabilities. 

Due to the fact that beneficiaries of the assistance and care offered by our Centers for Rehabilitation and Recovery of Neuro-psychical disabled persons, most of them are people with psychical impairments, who mostly require specialized medical care. 

And that’s why the Ministry of Health is currently unfolding a 

comprehensive assessment mission of all residents in the center— 

not of the residents of the psychiatric hospitals, but for our centers, 

which I would like to underline again. We provide social services 

in most of the—in the majority. Of course, are medical care. But 

most of our services are social type services. 

As a member of the Interagency Committee of Mental Health, coordinated by the Ministry of Health, the National Authority for 
9 

Persons with Disabilities closely follows the developments on this 

particular issue. 

Moreover, in January of this year, the government has approved 

a memorandum, jointly initiated by the Ministry of Labor, Social 

Solidarity and Family and our authority, on the measures meant 

to solve problems of the institutionalized persons with mental disabilities. Among the most important measures is the approval of 

building of 10 new residential centers with a capacity up to 50 

places each, in which we will want to ensure an adequate assistance for persons who currently reside in overcrowded centers. 

Another direction of our reform is to improve the qualifications 

of specialized personnel. To this end, the national authority has 

issued nationwide plan to upgrade the professional skills of the 

personnel enrolled in the care protection system for persons with 

disabilities. 

We are much focused on the program, this year training for 

trainers. 

Mr. BROWNBACK [presiding]. I wonder if we could get this—if you 

don’t mind, if we could get this to a point of closure, and then I’d 

like to bring up a couple of other witnesses to testify, and invite 

you to stay at the table. 

And I think something that would be most helpful to me, if it 

would work for you, is to have an interaction then as we question 

the panelists, and you responding to their questions and assertions, 

as well. 

Does that—would that work for you? Is that acceptable? 

Mr. MINDROIU. It’s perfect for me. 

Mr. BROWNBACK. OK. So, if you wouldn’t mind wrapping your 

testimony up, and then I’ll bring these other two witnesses forward. 

Mr. MINDROIU. Thank you very much. 

HON. SAM BROWNBACK, CHAIRMAN, COMMISSION ON 

SECURITY AND COOPERATION IN EUROPE 

Mr. BROWNBACK. Thank you for that, and thank you for your testimony. I apologize for being late. We had a vote on the floor. I do 

have an opening statement that I’ll submit for the record. 

You’re welcome to stay there, if you would like, Mr. Mindroiu. 

I’m sorry. My enunciation was not good. 

We’ll call up the other two witnesses at this time to make a presentation. 

It’s Cristian Ispas. He’s Executive Director of Motivation Romania. Mr. Ispas has worked for 13 years in the Romanian non-governmental sector, founding and building sustainability and capacity 

in the Motivation Romania Foundation. That’s a non-governmental 

organization providing programs and support to wheelchair users. 

I’m delighted to have him present. 

And then also, we’ll have Eric Rosenthal, Executive Director of 

Mental Disability Rights International, an advocacy group dedicated to international recognition and enforcement of the rights of 

people with mental disabilities. 

He’s quoted, as well, in the ‘‘New York Times’’ article May 10, 

regarding a report done, I believe, by your organization on the situation in Romania. 
10 

I want to invite both of you to put testimony forward. We have 

your written testimony. The most appreciated thing is if you would 

summarize your statements. And then I personally, and I think 

Congressman Smith, as well, would like to ask questions that several of you would respond to, and we can get more of a dialogue 

going at that point. 

Mr. Ispas, if you would. Your testimony will be placed in the 

record as if presented, and if you would like to summarize that, 

that would be most helpful. 

CRISTIAN ISPAS, FOUNDER AND DIRECTOR, MOTIVATION 

ROMANIA FOUNDATION, NATIONAL DIRECTOR, SPECIAL 

OLYMPICS ROMANIA 

Mr. ISPAS. Senator Brownback, Congressman Smith, I would like 

to thank you very much for inviting me to testify here in front of 

the Commission and share with you my opinion as representative 

of the NGO community in Romania regarding the situation of people with disabilities. 

We are, at Motivation, we are an organization that was created 

in 1995, to serve people with motor disabilities. We started with 

production of adapted wheelchairs and with programs aimed at 

training wheelchair users in independent living skills. 

In 2001, we met with a group from the United States called Mosaic, who came to Romania aiming at starting a program to support children with severe disabilities from institutions. 

We partnered with Mosaic and with some seed money from them 

that they raised from American individuals. And then with support 

from the USAID mission in Romania, we were able to create three 

group homes, to refurbish a building and transform it into an educational and rehabilitation center. 

We built the first wheelchair accessible camp in Romania. We 

created different type alternative services for children from one institution north of Bucharest in a small community called 

Tancabesti. 

The photo that you received, that you have, show—the first two 

photos show the situation of the children as we found them in 

Tancabesti in the summer of 2002. You can see then two photos 

with our children, who live in the group homes. We have two group 

homes, one with eight children and another with six children. 

You can see the changes in their life as soon as they got the appropriate care. 

The initial objective was to transfer 22 children. The fact that we 

managed to put in place foster care placements and even reunification with natural families, allowed us to transfer 40 more children 

out of the institution in Tancabesti. 

Probably one of the best examples of our work, the best outcome 

of our work, is Cristina’s story—the little girl you will find in the 

fifth photo, together with our production manager from the workshop. When we went to Tancabesti, she was laying in bed at the 

age of eight, diagnosed with cerebral palsy, considered being unable to do anything. 

At the beginning we provided her with a specialized, adapted 

wheelchair. And you can see the girl, how she starts to develop. 

Then we transferred her to our transition center, and in the next 
11 

photo you could see her after only 2 months of work with our physical therapy. 

Next photo shows Cristina on the day of her baptism. We did 

that with our children. Most of our staff who are in wheelchairs 

kind of adopted these children. 

Cristina lives now with her foster mom. And you can see the difference between July 2002 and August 2006. 

We provided these children not only with residential and educational services. Our children benefit from the Special Olympics 

program that we have in Romania. 

They are now part of the huge family, global family of Special 

Olympics. And they are recognized and congratulated by the community as real winners in the competitions that we have in Romania—regular competitions in different sports according to their 

abilities. 

Programs like ours, like Special Olympics, like other NGOs offer 

in Romania, not only identify creative alternative solutions for the 

children from the institutions, but also influence public policy. 

This is why we consider that the legal framework in Romania is 

quite developed at this moment. 

However, we still have a lot of work to do with the central and 

local governments, with the NGO community, in order to close all 

those institutions shown in MDRI report. 

And what we would need to do that? I mean, if you look at the 

girl on the front page of MDRI report, and then look on the photo 

which is next one after Cristina, it’s the same girl. When we found 

her—when MDRI researchers found Ioana in the center in Braila, 

I think she was 12 years old and she weighed about 24 pounds. 

After she was transferred from that psychiatric unit to the new 

center where she lives, and physical therapists worked with her, 

she improved a lot. And you see on the next page, provided with 

an appropriate seating system, a wheelchair, she developed a lot. 

So, how much will it cost to have a child like Ioana in this status? We, based on our experience, we think it’s around $500 a 

month or $6,000 a year. In the American standards, I don’t think 

that’s a lot. For Romania, it is a lot. 

The biggest challenges that we think we have in Romania, and 

how to solve these problems, are the weak cooperation between 

central and local governments, especially in enforcing the existing 

laws, and, of course, the financial sustainability. 

As you could see from the graph on the left page of this package, 

we started this program with the seed money from Mosaic and 

USAID, $64,000. And then the total amount of money that we received from USAID was $325,000. 

Our partners from Mosaic raised from American individuals. We 

raised from European donors another $700,000 to put in place all 

these programs and to run them up to the end of 2006. 

The problem now is that—which shouldn’t be a problem—Romania will access European Union, hopefully January 1. But until we 

will be able to access the structural funds that will come from the 

European Union, we think that will take time until the government 

will put in place all the procedures. 

So, we think, we estimate that in 2009—and the figures that you 

see there are 2007, 2008, and 2009—are estimates. So there is a 
12 

gap between this moment of 2006 and 2009. Our problem is how 

to bridge this gap. 

So, for us it is essential to find for 2007, for us as an organiza- tion. But, of course, for other organizations. But for us, $200,000 

for 2007 to support—to sustain this program. We would like also 

to replicate it, to see it in other communities implemented by local 

government and also by other NGOs. 

Please let me finish this by making a few recommendations. 

First of all, we think that the Government of Romania should perform a comprehensive assessment of all institutions and situations 

of people from institutions. So we don’t need an international organization to come and show us what are the problems there. 

To make this information transparent for the local community, 

local and international NGOs, so we can come with plans to solve 

these problems. 

We would like the central government to enforce the existing 

laws at local level, to convince local governments to allocate budgets to solve these problems. 

We would like, as well, the central and local governments to 

identify funding to sustain the existing programs of NGOs, and 

also to replicate the model of good practices at the country level. 

And finally, we would like to see a program, a model program 

like the USAID program in Romania, ChildNet, a program of costsharing between local and international sources of funding to be 

replicated, to be copied, to be continued in Romania for the benefit 

of our children. 

And in the end, I would like to read something which I think it’s 

important for this testimony. 

We cannot afford to lose momentum in the establishment of community-based services in Romania. I am confident that, with continued international support, the Romanian Government, working 

with the NGO community, can make continued progress for the 

benefit of children and adults with disabilities. 

Thank you very much. 

Mr. BROWNBACK. Thank you, and God bless you for your work. 

I had a chance to meet yesterday with Mr. Ispas and to see some 

of the work and the smiling faces of some of the kids that you’re 

working with. And it’s a delight to see that and see the progress 

being made. 

Mr. Rosenthal, thank you very much for joining us, and I look 

forward to your presentation regarding your report on what’s taking place in Romania. 

ERIC ROSENTHAL, EXECUTIVE DIRECTOR, MENTAL 

DISABILITIES RIGHTS INTERNATIONAL 

Mr. ROSENTHAL. Thank you very much, Senator Brownback and 

Congressman Smith, for convening this important hearing. 

The human rights of people with disabilities around the world is 

a subject that has received too little attention. They are among the 

most vulnerable people in any country. And your willingness to 

bring the attention of the Commission and the U.S. Congress to 

this issue is extremely valuable and extremely important. 

Before I plunge into our findings on Romania and respond to the 

important statements of the other speakers today, my organization, 
13 

Mental Disability Rights International, has investigated human 

rights abuses in 23 different countries. 

We have published reports on the situation in Turkey, Russia, 

Mexico, Uruguay, Hungary. It’s important to recognize that we are 

applying the same human rights standards to Romania that we 

have applied to every other country of the world. 

Many of the people who are on our board have dedicated their 

lives to doing similar work in the United States. And as Congressman Smith properly pointed out, the disability rights movement is 

a direct outgrowth of finding similar civil rights problems in the 

United States in our own institutions. 

And because we found those terrible problems in our own institutions, we created civil rights laws and oversight mechanisms that 

require conditions in institutions to be monitored, that require institutions to be closed down, particularly if that allows children to 

grow up with a family and not in an institution, and to have some 

form of oversight to make sure. Even a good foster care program 

needs oversight in the community. 

What we have found in Romania, I’m sorry to say, in the 13 

years that I have done this, are some of the most serious human 

rights abuses we have observed anywhere on a grand scale. 

We started out investigating conditions in adult psychiatric facilities. And while our report is focused on children—because 

they’re the most vulnerable, and the most immediate action can be 

taken to save their lives—it is but the tip of an iceberg of a vast, 

vast problem facing thousands of people whose lives have essentially been thrown away. 

There are at least 30,000 children in institutions and well more 

than that in terms of the adult facilities. 

The conditions that we have seen are life-threatening abuses, 

with inhuman and degrading treatment, and segregation from society. These are basic, fundamental violations of international 

human rights law. They should not be tolerated in Romania, and 

they should not be tolerated in any country. 

In putting this in a human rights framework, we do it for a very 

specific reason—not just to generate outrage and public support for 

reform. But when human rights violations take place, this becomes 

the currency of international affairs. 

It’s not just a question of social policy, and who are we as Americans to tell any other country what their social policy should be. 

But when children are left to die, when people with disabilities are 

segregated from society for a lifetime, that’s where we need to take 

a strong stand. 

It’s a critical time, as Romania is being considered for accession 

into the European Union. And the European Union has identified 

as one of the ongoing issues that has not yet been resolved the care 

of people with disabilities in institutions. And we have called on 

the European Union, certainly, even if it accepts Romania for admission, to continue to monitor these issues, because they have not 

been resolved, and to ensure that the structural adjustment funding that’s used for Romania be used as an incentive and be linked 

to real reforms. 
14 

* [http://www.mdri.org/projects/romania/romania-May%209%20finallwith%20photos.pdf] 

I have every confidence that reform in Romania is possible. The 

wonderful work of Motivation demonstrates that children can be integrated into the community. 

Mr. Mindroiu himself has a wonderful reputation within Romania for having done some excellent work to provide some models of 

community care for people with disabilities. Reform can happen in 

Romania, but there are 300,000 people with intellectual disabilities, and probably close to three million people with disabilities, 

who are extremely vulnerable. 

Our findings in one small institution are representative of a 

much wider problem. Since the release of our report * in May, our 

findings have been corroborated. ABC News went in, and a week 

before the release of our report, just after a couple of days spending 

some time in Romania, they found abuses every bit as serious as 

what we found in the Braila psychiatric hospital. 

The Romanian newspaper, ‘‘Jurnalul National,’’ conducted a series of investigations. And in many different institutions, they 

found horrendous abuses going on. They called the conditions in 

the institutions ‘‘a refined Auschwitz.’’ That was their term, not 

ours. 

Just last week, ITV News, independent news in Britain, aired 

findings in institutions. These are institutions where children are 

kept, and the facilities are so horrendous, the staffing is so low, 

they generate disability. They are life-threatening. They should not 

be tolerated in Romania. 

We strongly encourage the United States in its foreign assistance, in its political relations and its economic relations to raise 

this issue at every point. We believe that if we create the incentives for reform, reform can take place. 

The Government of Romania cannot solve these problems until 

they recognize that they exist. 

I have to say, the response of the Romanian Government has 

been shameful up to now. They have denied the allegations of our 

report. They have said they’re outdated. They’ve said that the problems have been solved, when our findings are both recent and they 

have been widely corroborated. 

Until they recognize that there are life-threatening abuses, how 

can they possibly solve them? 

We in the United States have an oversight mechanism for our institutions and our community services. There is no equivalent oversight mechanism. There is no transparency. There is no accountability. 

The Center for Legal Resources found that 100 adults in the 

Poiana Mare psychiatric facility froze to death. And the response 

by the government was that it was an administrative problem, by 

not having enough food and not enough heating. 

There needs to be—— 

Mr. BROWNBACK. When did this happen? 

Mr. ROSENTHAL. It’s cited in our report. Two years ago, in 2004, 

the Center for Legal Resources and Amnesty International published reports of 100 people in the Poiana Mare psychiatric facility 

freezing to death. 
15 

And despite international pressure, no individual has been held 

accountable for that. 

Mr. BROWNBACK. Thank you. 

Mr. ROSENTHAL. The Government of Romania must recognize the 

problems in order to reform them. 

In addition to creating oversight and rights protection, we are 

concerned about the direction of reform. While many positive 

changes have taken place, and some children and adults have been 

integrated into the community, in the reform process the government continues to build new institutions. 

In the testimony of the government today, we learned that in the 

mental health system the reform process includes building 10 new 

psychiatric facilities. Their stated goal of the policy reform is community integration. Why are they building 10 new psychiatric facilities? 

I confess. In the United States, after abuses were identified, we 

made many of the same mistakes. We thought, close down the big, 

horrendous facilities and in the interim, let’s create smaller, cleaner, nicer institutions. 

Ten years later, we found out that those smaller, cleaner, nicer 

institutions were just as dirty, were just as abusive, and kept people segregated from society. That is not the direction of reform. 

We are watching Romania in slow motion making the same mistakes that were made in many other countries. 

They may be intending to do well. They are trying to close down 

these big facilities. But the direction of big facilities to small facilities is a terrible, terrible mistake. 

Congressman Smith, you properly identify when you cited the research literature that shows that every child needs to grow up in 

a family. It is the loving care of a parent that is necessary for any 

child to grow up with psychological well-being. Children are permanently damaged by growing up in institutions. 

So, according to UNICEF, Romania has built 200 new institutions for children in the last three years alone. They may be moving from big, dirty facilities to small, clean ones, but a new generation of children is being lost. 

There needs to be some accountability—not just plans, not just 

new strategic plans for reform, but accountability for abuses and 

specific outcomes of seeing children integrated in families. 

Thank you very much. 

Mr. BROWNBACK. Thank you. That was powerful of a statement. 

Let’s run the time clock at 10 minutes here, Chris, if you’re all 

right with that. 

Do you have—are you being called for a vote or anything? Do you 

need to—— 

Mr. SMITH. [Inaudible]. 

Mr. BROWNBACK. OK. Good, good. 

Gentlemen, thank you all for being here and testifying. I’ve got 

some questions and some interaction that I’d like to see. 

First, Mr. Mindroiu, I want to enter into the record the ‘‘New 

York Times’’ piece from May 10 of this year, and it’s citing MDRI’s 

report. I’m sure you’ve reviewed this ‘‘New York Times’’ article on 

the abuses that were found. 
16 

Mr. Rosenthal is quoted in this paper as saying, ‘‘it was the most 

horrible thing I’ve seen in 13 years of doing this work.’’ 

How do you respond to that? Do you—is this the situation in Romania? 

Mr. MINDROIU. We cannot deny the importance of the work did 

by Mental Rights Disability International. 

And we consider that these problems and these facts MDRI discovered in Romania. It is better to be presented to the authority, 

to the national authority, the responsible authorities in the time 

they are identified, and not after a year, or something like that. 

Because, for sure, the facts they saw in Romania happened in 

2002, 2003, 2004. But, for sure, most and many of these problems 

were solved by the Romanian authorities. 

For example, in Braila, in the hospital they saw and they picture 

of the girl on the cover of the report, this hospital is closed at the 

end of last year. There’s no hospital there now. 

And Mr. Rosenthal told about the ITV News, their broadcast of 

two weeks ago, and they are talking about one center in Romania. 

I was the manager of the closing down of the project. I know exactly that this center is closed down since the beginning of this 

year, and nobody is there now. 

This is—I can tell you. Of course, these things were happening 

in Romania. Probably there are—we can find in one or two places 

we can find—I don’t know what to say. These are mostly things 

about children, and we are not dealing with children. 

But it’s not usual to find these things in Romania. And we are 

working hard not to find these issues, these things now. 

Mr. BROWNBACK. If I could comment on our own history in the 

United States. 

You came here and you can go back, and not that far back in the 

United States history, and find these sorts of problems existing in 

this country. You could probably find some situations today that 

you wouldn’t be very pleased with, that I wouldn’t be very pleased 

with. 

And yet—I mean, I do believe one of the key ways of moving forward is to identify where system problems have occurred. When 

you’re sitting in national government, community government levels, where system problems have occurred, and then try to put in 

place systems to see that that doesn’t occur, or that you just, you 

break the old models up and try to go at a different model. 

But first you have to identify the problem and you have to own 

it. And we’ve had plenty of problems here, and there were a number of people, too, for a long period time that advocated that it’s 

too expensive. This is difficult to do, because this takes very individualized care. 

My own other experience in this has been that the earlier the 

problem—particularly a mental health problem—is identified, the 

more options you have for successfully working with the individual. 

I mean, it really is key for early treatment and help. 

I don’t bring you here to beat on you, or to beat on the Romanian 

Government. I ask you, just in looking at these things—we get 

these reports and you see these studies, more than anything to 

identify the problem. And then, what is it that we can assist with? 
17 

I have seen your testimony about here’s where you’re going at 

this. And if there are specific ways that we or others can help in 

working with this, we’re happy to try to do it. 

But it does require—yes, the problem does exist and we’re willing 

to move forward with it. 

Mr. MINDROIU. What can I tell you is, after we saw the report, 

teams from the Ministry of Health, the Ministry and National Authority for Child Protection and from our authority, visited all the 

locations the report told about and evaluated the real situation. 

That’s why we know what is there now. 

And these days, a very large assessment process started and will 

evaluate all the institutions for children and the persons with disabilities until the end of the year. 

And the evaluators are completely independent persons, completely independent, from neither the Romanian Government nor 

from the local authorities. 

It’s exactly in the same way you said about—first of all it has 

to identify what are the problems. And we have to assess again. 

And we are doing this these days. 

Mr. BROWNBACK. Are you—Mr. Ispas suggested a comprehensive 

review by the Federal Government, by the national government in 

Romania. Are you—is that what you’re saying you’re doing, is a 

comprehensive review by the central government of conditions for 

mental disabilities? 

Mr. MINDROIU. It’s our response of Mr. Ispas’ testimony. And not 

testimony, but his ideas. And he is not the only person from civil 

society who had the same ideas. So, we took—we had the opportunity now to assess everything. 

It’ll be all the institutions and psychiatric institutions. Everything will be assessed until the end of this year. 

Mr. BROWNBACK. And then a report issued by the central government of what you found? 

Mr. MINDROIU. Of course. Of course. 

And we’ll see the needs and the reality. 

Mr. BROWNBACK. Mr. Rosenthal, you’ve heard the testimony 

about how the problem is being dealt with by the Romanian Government and the view that a number of these institutions have 

been closed. 

Is that—that is a factual statement? It’s either—this is verifiable 

one way or the other. 

Mr. ROSENTHAL. What we have seen is a shell game, where people are moved from one institution to another institution. So one 

institution is closed and they’re moved to perhaps a smaller and 

perhaps a cleaner institution, but to another institution. 

In Braila, the psychiatric facility was closed, and they moved 

them to two smaller institutions. When we visited in December of 

this year—we first identified the problem in June 2005. 

And let me say, the Center for Legal Resources, a Romanian organization, found the problem first in June 2004. They went public. 

They identified the problem. 

We got there a year later and the problem had not been solved 

after—between 2004 and 2005. 
18 

The videotape of that abusive facility, described by Congressman 

Smith from our report, was taken by me in June of 2005—the most 

horrendous abuses against these children. 

We came back in December, and they had closed down the psychiatric facility, but they moved them to two other facilities. And 

when we were there we said, well, why haven’t you integrated 

these children in the community? These children need families. 

Why another institution? 

We were told that there were no services available anywhere in 

the country for children with this kind of disability—no services— 

and that these children would spend the rest of their lives in institutions. 

Before the release of our report, I spoke to one service provider 

who visited Braila in April of this year, and funding was not available to get those kids out of those institutions into the promised 

group homes. After the release of the report, the funding miraculously became available. 

So, yes, after the spotlight of international attention has been on 

these particular children in Braila, finally there is some action. 

But the children of Braila—those 46 souls whose lives have already been so terribly hurt—what about the thousands and thousands of other children? It has been documented time and time 

again by other independent investigators that these abuses exist. 

To say that the government is now doing an assessment, after all 

this time—certainly, they need to do an assessment. But there is 

no independent mechanism to do that assessment. And indeed, the 

governmental structures are so fragmented, the Ministry of Health 

doesn’t know what’s going on in the institutions under the authority of the local governments. 

When we asked the Ministry of Health how many people were 

in institutions, they had no idea. As part of their reform, they’re 

transferring authority over their psychiatric facilities to the local 

authorities, for which there is no budget. 

Their reform plan is simply to take an institution and take it out 

of Ministry of Health authority and put it into the local government authority, and then they can say there are fewer institutions. 

The worst abuses are going on in the mental health system, and 

no one is taking responsibility for it. The numbers that were given 

in the official testimony of the number of people with disabilities 

in institutions here only represent the individuals under his authority at the National Authority for Persons with Handicaps. 

There is such a bureaucratic maze of different authorities, there 

can be no national policy on these matters. 

So, there has to be, as Senator Brownback—you identified some 

recognition of the problem and a way to step back and say, if there 

is a problem, we have to find some new way of dealing with this 

that includes the creation of an independent monitoring authority 

and a mechanism for dealing with this in which a national policy 

can actually be implemented. 

Mr. BROWNBACK. If my colleague would let me just let Mr. 

Mindroiu respond to this, because I do appreciate your attendance, 

your being here and your willingness to engage with us on this. 
19 

And specifically, do you intend to move people from one institution to another? Or is it—are you moving to an effort to get them 

from an institution into a family, a group home type situation? 

Mr. MINDROIU. This is—there are two different things, for children and for adults. This is for children, the best way is to move 

it into families. This is for sure. 

What we are talking about—— 

Mr. BROWNBACK. It’s your policy that you are doing on a national 

basis. 

Mr. MINDROIU. I distributed a brochure with what has happened, 

and it’s produced by the National Authority for Child Protection. 

And these are—in that brochure are a lot of figures, real figures, 

and what has happened now. 

So, for children, the best way to integrate them is from institutions into families—natural families or shelter families, if we cannot find the natural family, or because of traditions and mentality, 

and so on, they refuse to take a child with disability inside the 

family. 

But when we are talking about adults institutionalized since, I 

don’t know, 1990, with 15 or 20 years of institutionalization, is 

very, very difficult to take from a residential institution and to sent 

it to a shelter family, or a natural family. 

So, another type of institution like a shelter home is the first 

step when we are talking about their social integration, because 

the main idea is, we have persons now in big, overcrowded institutions. They have to—for them we have to do everything, to identify 

perfectly their needs, and to create the services in the way to include them back into society, even for the employment of them. 

And these are making by steps, step-by-step. There are different 

types of institutions, and each institution has its own mission. So, 

that’s why from a big residential institution it’s very difficult to 

send it back on the first step to the family. And we are talking 

about an adult over 30 years old, which are staying in an institution since he was 18. 

This is what—this is how our policies in this field are going on. 

Mr. BROWNBACK. It’s been my experience that people that have 

particularly mental disabilities—certainly physical disabilities, 

too—really enrich a country. They make us richer, and they make 

us better. 

A lady in my office is blind. And she gives the best Capitol Hill 

tours of anybody in my office, and I’d put her up against anybody 

on Capitol Hill. 

But she had a very aggressive treatment as a child. And she inspires the rest of my office. Everybody else is just—she actually 

went skydiving two weeks ago. And so, a lot of other people went 

out saying, well, if she can do it, I can, too. 

And they enrich us. 

And I can look back on our history when we didn’t really treat 

people with disabilities as an asset. They were a liability. They 

were a cost in the system. 

And, OK, what are we going to do now? 

And we were the poorer for it as a nation. They really do make 

us better. It’s tough. It can be hard and expensive, but they make 

us better. 
20 

My colleague, Congressman Smith? 

Mr. SMITH. Thank you very much, Mr. Chairman. 

Let me just begin, Mr. Mindroiu. In the MDRI report, a statement is made that the National Authority for Children’s Rights 

told MDRI in 2006 that doctors still encourage parents to give up 

a child when a baby with a disability is born. 

UNICEF concludes from a recent study of recent child abandonment, that the ‘‘acceptance and perpetuation of such situations constitutes not only a violation of the law, but also an acute lack of 

understanding of the child’s developmental needs.’’ 

My question first is, is that the case? 

Mr. MINDROIU. It’s very difficult for me to give an answer to this 

question, because we are not really involved in the child protection 

system. So, I’m not very sure if—I don’t know what to say. 

But I do not believe that the doctors recommend to a family to 

abandon a child with a disability. I cannot believe that. 

Mr. SMITH. Is that something that you could get back to us on 

for the record, so we have, you know—— 

Mr. MINDROIU. It’s easier for me to—— 

Mr. SMITH. Because it’s very important—— 

Mr. MINDROIU [continuing]. To give you an official—— 

Mr. SMITH. That’s the beginning of—— 

Mr. MINDROIU [continuing]. An official, right answer from our 

colleagues from the National Authority for Child Protection, because I do not know exactly what is happening in the system of the 

child protection. 

Mr. SMITH. I would ask that you at least make an inquiry and 

please get back to us if you get an answer. 

I would just note parenthetically that the whole idea of abandonment—you know, neglect and abuse is an extension of a mindset 

that I believe is employed even before birth, when things or techniques like amniocentesis and other means are used to determine 

whether or not the child is disabled. And then another abandonment, an abortion occurs. 

That mindset then carries forth at time of birth, if these doctors 

indeed are suggesting an abandonment of such a child. 

Mr. MINDROIU. Well, I’m not so sure that the facilities of the hospitals permit to have this information before the child’s birth. 

Mr. SMITH. OK. Well, let’s—— 

Mr. MINDROIU. There are just a few in this end. 

I really do not believe that doctors would do this kind of thing. 

It’s completely against the law. 

Mr. SMITH. OK. Mr. Rosenthal? 

Mr. ROSENTHAL. Yes, Congressman Smith, if I could add one detail. 

In addition to the problem that we identified, of active encouragement of abandonment, there is a problem that the system is entirely overwhelmed. There simply are no community services for 

newborn children with disabilities. There’s no place to go. 

The government admits that when a child with a disability is 

born, there are officially hundreds and probably thousands of children who never leave the maternity ward of the hospital, because 

there is no support. 
21 

A poor mother comes in. She has a child with a disability. She 

can’t get the support she needs. 

I have met heartbroken mothers and fathers of children with disabilities who desperately wanted to keep their child with a disability at home. But they lack the support from the government, 

and felt, well, there are institutions out there where they’re assured of getting three meals a day. 

And I’ve spoken to these heartbroken parents who have given up 

their children to those institutions. It is a very sad thing. 

The law of Romania, law 272—the same one that banned the 

international adoptions—also said that no child under age two may 

be placed in an institution. So, that’s had two perverse results. 

One, children are placed outside the official system. 

When we were in Timisoara, we asked the child protection authorities, are there any children, infants zero to two, in institutions? They said no. 

When we went to the hospital and asked the staff at the maternity ward, they said, well, if you go down this street two blocks to 

the left, there’s this institution that they said was for, you know, 

recuperation of children who are undernourished. 

And in that facility there were 62 infants in beds with three 

staff. They never got out of their cribs. The staff was extremely 

well-meaning, trying to keep these children alive and clean. And 

those children had no life except growing up in a crib. It was a very 

sad thing. 

So, there is simply no mechanism set up to help those children 

and to help families keep those children. Or, to the extent that 

there is a system, it’s overwhelmed. 

Mr. SMITH. Thank you. 

Let me just ask Mr. Mindroiu a question. You mentioned visits 

before. And I’m wondering if those visits are done in an unannounced way, whether or not there are protections for whistleblowers, as Mr. Rosenthal just said. 

And I was struck by this when Dorothy Taft and I visited the orphanages, right as Ceausescu left and Iliescu came in. They were 

well-meaning. They were just absolutely, totally overwhelmed by 

the number of children per helper, per nurse or whatever. 

So my question is, when someone might come forward with that 

information, to whom does she or he address it? Do they make unannounced visits with some real clout? 

Because it seems to me that, just like we found with our own institutions where abuse is rampant, it wasn’t until you did those unannounced, coming in the door, documenting what is going on, that 

you get to the bottom of what abuse may be occurring. 

Mr. MINDROIU. The responsibility for these institutions, or for 

the general direction for social assistance and child protection— 

that means the level, each county level—or in the hospital, to the 

manager of the hospital. 

Normally is, when you go to see something, to have the approval 

of the responsible for that. But you do not have to take permission 

one week before. OK, let’s go to see. Nothing is—everything is 

transparent. 

Mr. SMITH. But is that regularized? Does it happen—is there like 

a strike force mentality? 
22 

And I would just say before you answer, you know, we have in 

this country a very, I think well-developed sense that we trust and 

we verify. Whether it be VA hospitals—I served as Chairman of the 

Veterans’ Affairs Committee for four years. And very often, it was 

the eyes and ears of those who went unannounced, whether it be 

the General Accounting Office or some other, or even the veterans 

service organizations—we assume the best. 

But we’re always looking out for the vulnerable. And that means 

that you have to not worry about whether or not it’s an affront if 

you walk in the door. 

So, it’s a strike force mentality to find—and if somebody does 

blow the whistle, a nurse, are there protections for her or him to, 

you know, against retaliation and dismissal and other kinds of retaliatory—— 

Mr. MINDROIU. Nobody fires an employee who says everything 

is—in an institution. 

But in Romania, there is a law—— 

Mr. SMITH. Are there protections in law for that person to assert 

their—you know, the retaliation in law, and say this is a direct—— 

Mr. MINDROIU. There is no contract which—a labor contract, 

every labor contract protects the persons, the employees in this respect. 

But there is a committee, an anti-discrimination committee, forcing by the law, by the anti-discrimination law, they can control everything and without any permission. 

But I do not think it is normal to go to see an institution, to say, 

OK, I come here to assess, to make a health assessment, to put the 

closedown, to picture them and after that to publish the pictures. 

It’s not a very good way for working. 

Mr. SMITH. With all due respect, I would disagree that you help 

both those who administer, and especially those who are at risk. 

And again, it’s not with the intent to embarrass. It’s the intent to 

ensure that their full rights as individuals, notwithstanding their 

disability, are fully guaranteed. 

An adversarial relationship is benign and good when it is done 

with that as the intent. And that’s what my understanding is, what 

MDRI has tried to do. And to reject it, it seems to me—I mean, everything in here, shouldn’t we say, is that true? What are we doing 

to make sure that it’s rectified, if it is true, and to give a full and 

thorough explanation if it is not? 

And I wonder, Mr. Rosenthal, did you get a point-by-point, rebuttal to this? How did that play out? 

Mr. ROSENTHAL. We did not. We got broad denials. We were told 

that there was a parliamentary inquiry when our report came out. 

We were told that journalists were brought into the institutions 

and they were found to be clean. 

I mean, of course, it’s easy to bring journalists into an institution, and of course they’re going to be clean on an official visit of 

this kind. 

And yet, ironically, the very government response is an admission. Why are these children in institutions? Why are they in clean 

institutions at all? After the release of our report and we identified 

these abuses, there should be efforts to get them out of institutions 

and into families. 
23 

And so, the very government rebuttal was an admission, in a 

sense, a part of the problem. And that was pointed out to me by 

a Romanian journalist who was covering this. 

We responded to the Romanian Government by saying, look, if 

you want to conduct an inquiry—we outlined a program for on-site 

inspections without notice, in which photo and video documentation 

would be taken. We got no response to the government. 

We’ve called on Europe to continue monitoring. An independent 

monitoring mechanism needs to take place, whether by us or by 

Europe, by the United States, by some independent United Nations 

authority. 

These are fundamental human rights at stake. And there is certainly precedent in international law for on-site inspections where 

very serious human rights abuses are at stake. 

Mr. SMITH. Yes, please, Mr. Mindroiu? 

Mr. MINDROIU. For sure, the Romanian Government is not 

against any monitoring, as long as we do not break the law. 

Mr. SMITH. But again, we’d be talking about people with the authority to not just visit, singular, but to do visits, plural—hopefully 

unannounced and in a way that you would have experts looking 

and knowing what they’re looking for. 

And there needs to be a division, you know, a pretty bright line 

of demarcation, so they’re not coming from the same ministry, writing up a report that could be a whitewash. 

Mr. MINDROIU. From the beginning of next year in the national 

Framework Law on the Social Assistance, is creating something 

that is called the ‘‘social observer.’’ And the main duty of this social 

observer as a kind of independent observer is exactly to monitor 

and to inspect the human rights and all the social services, and so 

on. 

Because, Mr. Rosenthal is right. Yes, you cannot control yourself. 

This is completely, completely correct. You cannot control yourself. 

That’s why, for example, we have an inspector in each town, in 

each county. And this inspector is under our supervision, is our employee. And our inspector is a monitor, the fulfilment of the standards, of the quality standards in the institutions. 

But the institutions are not ours. You understand? It belongs to 

the county council, the local government. 

So, it’s a kind of independence. But for sure, in this respect, Mr. 

Rosenthal is right. You cannot control yourself. 

Mr. SMITH. Let me ask with regards to from larger to smaller. 

It seems to me that it has a surface appeal ring to it. We tried 

it here to some extent, and it didn’t work. And we have found, 

again, that the placement, particularly with an adoption setting, 

with people who are ready to adopt a disabled child, or a group 

home setting where you’ve got in many cases the disabled running—we have running the setting themselves. 

We had a project called Project Hope—independent living for disabled persons—in my district. It is the model of people who are robust. Many of them are afflicted with Down syndrome and other 

disabilities. 

And yet, they work, they use public transportation to get to 

work, and they live out very, very productive and very happy lives, 
24 

and are really, I think, as Sam Brownback said a moment ago, you 

know, that we value them. 

We learn from the fact they have not only coped, they overcome 

their disabilities. And those of us are put to shame who don’t suffer 

some disabilities when we complain and we see how they overcome 

their adversity. But they need to be given the setting and the opportunity to do so. 

My concern about going to smaller institutions is that it misses 

by a mile that the people are not well served. It could lead to more 

abuse, because of a lack of accountability. And that would be a 

question I would ask. 

Doesn’t it make it harder when you have scattered sites, to do 

the kind of oversight and accountability in these smaller home settings? And frankly, where did that come from? 

You know, we had a hearing 1 year ago—almost to the day, one 

day off, last year—on what we believe to be a very cruel provision 

in law 272 that deals with ending, essentially, inter-country adoption. 

The European Commission talks about how Romania has fulfilled its obligations pursuant to the Convention on the Rights of 

the Child and the European convention. How about the Hague 

Convention on Inter-country Adoption, designed exclusively, after 

10 years of very rigorous and robust debate among the nations of 

the world, to develop a protocol so that there is transparency in 

adoption? 

Romania turns around—and frankly, I was appalled at this and 

said it very clearly on many occasions. The House of Representatives did so by way of aresolution, that the idea of Romania’s intercountry adoptions has ended, under largely undue pressure from 

Lady Nicholson, who was the rapporteur for Romania’s EU accession. 

We find that appalling. And especially now, not just kids who 

don’t suffer handicaps, but it impacts these handicapped children. 

So, where did this transfer from larger to smaller approach really 

come from? And what about the accountability issue, when you 

have scattered sites and fewer people? And you might tell us, how 

many people are actually in the oversight business when it comes 

to the disabled in Romania? 

Mr. MINDROIU. Why smaller institutions? I’ll first refer to the 

adult field, and after that I’ll speak just a little about the international adoptions, because it’s very difficult for me. I was not involved at all in this issue. So, but I can—I have some information, 

some ideas I hold, something. 

First of all, the institutions, actually, institutions for adults are 

very, very isolated. The small ones are only created in the community. 

And this is the main idea, to take them from isolated institutions, to send them to a community, because the tradition in Romania is to hide the disabled—unfortunately. This is a verity. We cannot fight it. 

But we can try—and we are doing this—to modify this behavior 

of most of the citizens. And first of all it is to take disability inside 

the community, to be seen—persons with disabilities to be seen. 

That’s why our smaller institutions. 
25 

But because the first idea is they are highly isolated, far on the 

hills. And you saw, Mr. Rosenthal, and you cannot say that it is 

not the truth here. 

We are talking about children’s disabilities. There are only 350, 

something like that, in institutions. And this is a true fact. And 

until 500 children, they are in different type of hospitals, and so 

on. Just a few are in institutions. 

But the main idea is, disabled people to be inside the society, inside the community. Before—this is before they grow and they can 

live in the community for themselves. 

What about adoptions? I don’t know. It’s a law. It started in last 

year. We have to try to fulfil the provisions of the law. We’ll see. 

It’s very difficult for me to speak about adoptions. Please believe 

me. 

Mr. SMITH. Let me just—— 

Mr. BROWNBACK. Yes, I’ve just got one question. And then I’d 

just turn the hearing over to you, if you’d like to, Congressman 

Smith. 

Mr. Ispas, I’d just, if I could, ask you to comment on any of the 

discussion you’ve had here. You’re a practitioner on the ground 

with some model facilities. 

Do you see the trend moving towards more of your facilities? And 

what’s it going to take in the way of resources to see that happen? 

Mr. ISPAS. Senator Brownback, I would say that we all know that 

there is no white nor black. There is a gray in between. 

Through my work, I had the opportunity to visit institutions 

since 1995, with the distribution of wheelchairs. More recently, 

since I became the National Director of Special Olympics, I have 

also visited institutions with our programs of Special Olympics. 

I would say that we should take into consideration the actual 

economic situation of Romania. And the alternative that our organization, and other organizations in Romania, propose—community-based services in family-like settings—is an alternative at this 

moment for Romania. 

I don’t speak here about institutions which will accommodate 50 

people, children or others. One child with disability, 300, 1,000 children with disabilities or adults with disabilities—we have to take 

care of them. 

We, at Motivation and Special Olympics, have 26 people with disabilities employed among 80 staff. We are blessed to have the ability to take care of these children. 

I think—and this is why, what I think the Romanian Government should admit—we should unify our forces, admit the problem, 

recognize it, and then cooperate with international supporters of 

our efforts, but only after the problem will be admitted, to sustain 

the actual programs and to replicate them. 

This is the alternative. Again, I want to say it again, that we 

propose. We verified it, and we think that the group home as a 

transition towards the natural family or the foster family is the 

most appropriate solution now. 

What we hope will happen by 2009, is that we will receive support from European Union, from the structural funds. Forty percent we hope to get from the total cost of the services. 
26 

We hope the Romanian Government will understand that it has 

to allocate more resources and provide another 40 percent of these 

costs. And then we, the civil society, we have to make available another 20 percent from the individual donors or companies. 

Mr. BROWNBACK. And it sounds like, too, there’s also some need 

to really have the discussion with the public, from what Mr. 

Mindroiu was saying. It has been an objective in the past to hide 

those with disabilities, and you need a discussion with the public 

that this is not a liability, this is an asset. 

And this is something that we can really celebrate, like you do 

with Special Olympics. It’s a celebration to me, of sorts, of people 

really overcoming. And that discussion needs to take place, as well. 

Mr. ISPAS. Senator, Romania used, before 1989, to be—I mean, 

seen from inside—seen as a perfect society without disabled. This 

is why they were hidden in huge institutions in the forests. 

The United States has a history of over 200 years of social services. You mentioned earlier that, not a long time ago, only in the 

1970s, as far as I know, problems like this existed in the United 

States. 

Romania is a very young democracy of 16 years. We cannot 

transform all these or solve all these problems overnight. We know 

it will take time. But everybody from the Romanian society should 

contribute to this. 

We—again, and Motivation will help with equipment. We’ve 

adapted wheelchairs. We help with care and also training for staff 

from other places. 

Both at Special Olympics and Motivation, we bring people with 

disabilities forward. We organize the wheelchair sports on the 

streets, just for the community to become used to seeing the abilities of people with disabilities, to see what these people can do and 

how valuable they could be for our society. 

Again, that idea that the disabled are probably the most difficult 

problem of Romania, that we have to hide them because they are 

ugly—that’s started to change. Otherwise, you won’t see all these 

programs that we have now. 

The problem is to convince the whole Romanian community—I 

mean, the government, the civil society—that we have to really involve in providing alternatives for these people. 

Mr. BROWNBACK. I want to turn this back over to Congressman 

Smith. I’m going to have to leave. But God bless you for your work, 

and I look forward to working with you, Mr. Mindroiu. 

This is a tough issue. It’s an expensive transition. My experience 

has been that, once transitioned, everybody is a lot happier, and 

the cost structure of it declines substantially, as well. It not only 

declines, you actually have some income that comes in from people 

being productive in the society. 

But it is a tough transition, and I look forward to working with 

you and others in the Romanian Government to see this on 

through. 

Mr. Rosenthal, I appreciate you and your group and your work 

bringing this forward. This can’t be pretty things to do, but they’re 

important things to do. And I’m delighted that you’ve done that. 

Congressman? 

Mr. SMITH. Thanks very much, Chairman Brownback. 
27 

Let me just ask a few follow-up questions. 

The issue of the National Strategy—and I wonder if you might 

all want to comment on it—it contains specific dates, who the responsible, principal responsible party is, deadlines, measures. It 

seems like a very, very comprehensive effort to transition—to use 

the words of Chairman Brownback just a moment ago—in assisting 

the handicapped. 

It even has a whole section, 2.2, of assuring family support services, something, Mr. Rosenthal, you’ve mentioned a number of 

times as being severely lacking. 

And I’m just wondering what your assessment is. This was put 

out in 2005. It’s pretty much a 2006 onward looking document, to 

2013. 

How well is it coming out of the blocks? Is it moving forward? 

Mr. Rosenthal? 

Mr. ROSENTHAL. We are very concerned, frankly, about these 

plans. There is no shortage of plans. There have been national 

strategies. Year after year after year, the Government of Romania 

has come up with national strategies. 

It has brought in EU experts to develop these strategies. And 

we’ve seen deadline after deadline come and go. 

To have a new national strategy, 2006 to 2008, the specific timetables that are in there—there are no outcomes that they actually 

have to produce until after the EU accession process is essentially 

over. 

We have been terribly disappointed by many previous reform 

strategies that simply have not been implemented. 

I sat in, in February of this year, at a meeting of the Inter-Ministerial Committee on Mental Health, where all the different ministries that were supposed to be dealing with the mental disability 

issues got together. 

The sub-secretary in the Ministry of Health was there. And he 

was asked questions by the very senior level advisor to the prime 

minister. 

And she said—and there was a plan in mental health—she said, 

where in your plan are costs? Where does it say how much you 

need to do this? How many—she literally said—how much money 

do you need for toilet seats, to make sure these institutions have 

the basic hygiene facilities? 

He said, I can’t tell you. I can’t tell you, because we don’t know 

how many people are in institutions. We don’t know what their 

needs are. We don’t know what their disabilities are. 

There is such absolute chaos at the policy level, it’s a very—you 

know, it’s an inch-and-a-half-thick plan, and yet there is such basic 

lack of information that they can’t cost out any specific change. 

There was utter exasperation on the part of the advisor to the 

prime minister who said, I can’t say. I cannot turn to the European 

Union and say that reform is a national priority, unless you give 

me specifics about how much it’s going to cost, when you’re going 

to produce it and what outcomes we’re going to see. So, I am very, 

very skeptical. 

There is one national pilot project at Techirghiol. And I’m sure 

I’m not pronouncing that correctly. 
28 

And what I have been told by advocates in Romania, is that the 

national pilot project that’s supposed to be used to help cost this 

out, is already under-funded, that the staff—the budget for staff— 

is only at 50 percent of what was in the pilot project, and that the 

budget that’s down on paper is going to run out after another 

month or so. 

So, the pilot projects that they’ve already set up are under-funded and can’t possibly be used as a model for reform. 

So, again, we’ve called on the European Union, and we certainly 

call on the U.S. Government, to look for outcomes. What are they 

producing? Another plan that starts in 2006 and ends in 2013 is 

not an assurance. We want to see human beings moved out of institutions, not into new facilities. 

The viewpoint that the official government presented today, that 

it’s an improvement to move people from big institutions into small 

institutions in the center of the city, is totally at odds with all 

thinking in the social science field, with evidence in the psychiatric 

field, with evidence in the developmental disability field. 

A person segregated from society will continue to be segregated 

from society, will become more disabled. Just because their institution has moved from the countryside into the center of the city does 

not mean that that segregation is not damaging to that person’s 

mental disabilities. 

This testimony on page six says, they are now investing in new 

psychiatric facilities. That is the opposite direction that they are 

going. 

Romania is not a rich country. This is a one-in-a-lifetime opportunity for the infusion of foreign funds, and they are blowing it. 

They are blowing it on a major scale, and it is a tragedy—a tragedy—to see them using this one-shot infusion of funding to build 

new institutions. 

Senator Brownback talked about how the process of reform is 

costly. Rarely does a country have an opportunity for an infusion 

of foreign money to help them with the transition process. 

But instead of using it—the problem is that transition requires, 

essentially, funding two systems at once. You have to keep the old 

institutions open until you create the community facilities. And 

therefore, there is a very brief period of a couple years where you 

have to fund essentially two systems. 

But they’re not funding two systems. They’re reforming the old 

system by moving them from one institution to the other. They’re 

blowing their one chance. 

The views that are expressed by the government are simply not 

consistent with basic human rights principles that have been opted 

by the European Union, by the world community. 

Just last month, the United Nations finished work on a new 

draft convention on the rights of people with disabilities. It’s an 

historic document that will help bring the rights of people with disabilities into the mainstream of the international human rights 

field—a subject that has been overlooked as a human rights issue. 

There is one concept, one idea that pervades that convention, 

that there was world consensus on. And that is, the right to participation in the community, full participation in society, being part of 

families, making decisions for themselves. 
29 

This policy of building new psychiatric facilities, of moving people 

into new facilities in the center of town, is contrary to basic human 

rights principles accepted by the international community. 

Mr. Mindroiu? 

Mr. MINDROIU. First of all, I’d like to inform you that the National Strategy was elaborated only by Romanians together, the national authority together with the NGOs, and Mr. Ispas was there 

and participated. And he knows exactly how we created the strategy. 

The second part is that Mr. Rosenthal knows exactly, to move a 

person from a residential center. In the family, you need at least 

six months to work with that person, just for a movement. It’s not 

an object to be moved. 

That’s why the strategy, because we are talking about people— 

we are talking about lives—it is between 2006 and 2013. 

Why? Because 2013, because it’s about the national development 

plan, and it’s about financing the scale. We are talking about seven 

years of financing. That’s why our strategy runs through 2013. It’s 

exactly like in all the European countries, about the financing. 

Mr. Rosenthal told us about his participation to a meeting in the 

Ministry of Health. Yes, it was. But it was the first. And he is 

right. At that moment, nobody from the Ministry of Health knew 

how much costs would be involved. That’s why in my testimony I 

told you the Ministry of Health now assesses every person with disability from the psychiatric hospitals and from our centers. 

And we do not want to create 10 psychiatric units. We are talking about persons with mental disabilities, which are now residents 

of very big, overcrowded institutions since, I don’t know, maybe the 

1980s. 

That’s why we want to create something special, or to create special services for them and their special needs. And the special and 

the services we want to create will be based on the Ministry of 

Health assessment, which is produced in this period. 

I don’t know. Maybe we won’t create 10 centers. But we have 

the—we propose to the government the financing, to have the financing. After the assessment we’ll see what kind of services they 

want, and we’ll create those services. 

But as you say, we need financing for that. And we need to have 

a budget. And the beginning of this year, with a budget, some 

money for services dedicated only for persons with mental disabilities. 

Because there is a thing nobody would like to speak about: the 

problem with mental health problems—the persons with mental 

health problems need the same type of community services like 

persons with mental disabilities. 

That’s why there is a misunderstanding, the difference between 

mental disability and psychiatric illness. 

And this is—there are no specialists, there are not so many specialists in the world who can say, you are sick or you are disabled, 

when we are talking about mental disability. It’s very, very difficult, because they need medical care and community care. It’s not 

very easy to assess this kind of need. 

Mr. SMITH. Is there a sense, even if it’s a general assessment, as 

to how much it would cost to fully implement the... 
30 

Mr. MINDROIU. I can tell you, the institutional reform—that 

means restructuring or closing down the old type of institutions 

and creating alternative residential services, including group 

homes and shelter homes and everything—costs around 150 million 

euros. This is my project, that’s why I know. 

Establishing the home care services means that sustainability 

costs are around 100 million euros, too. 

And after that, we have to speak about the training of the staff, 

because the main challenge of the system is the staff. The staff provides services, not a building. 

So, this is my main concern, the training of the staff. And this 

is—I’d like angels to help us. 

Mr. SMITH. Let me ask Mr. Ispas. Mr. Ispas, you might have an 

answer to this. 

Do you agree that the goal should be to move children out of institutional care into family settings? And what barriers exist to do 

that? 

Obviously, all over the world, including the U.S., because of better health care and better interventions, more and more of our disabled are living longer lives and more productive lives. And many 

of their families, even if they are still living at home, worry about 

what happens when they die. And that’s a problem we’re facing 

here in the United States big time. 

But, what is your answer to that question? 

And secondly—and perhaps others would want to touch on this— 

when I got elected 26 years ago, the prevalence of autism was one 

out of every 10,000 in the United States. That was the generally 

accepted number. 

A few years ago, I became aware of what I thought was a spike 

in one of my townships, Brick Township. So we brought in some 

experts and we found that the number was significantly higher. 

But as the work was being done, the Centers for Disease Control 

and others, including many of the advocates in the autism area, became aware that we probably have a prevalence much higher. 

So I drafted some legislation that created centers of excellence 

within CDC to look and to being to chronicle and to react, as well— 

mostly on the NIH side. 

We now believe that the prevalence of autism is one out of every 

166 children. 

Now, unlike a baby born, autism often isn’t detected until several 

months later into that child’s life. And sometimes it’s after an 

MMR shot, sometimes it’s through some other trigger, perhaps affecting a two-year-old. And so, we have what we think is an epidemic of autistic children. 

And I’m wondering if you might speak to what the experience is 

in Romania. Is it being captured as to how many kids are suffering 

from it? What are you doing about it? 

Because that presents a whole set of independent issues—you 

know, those kids are warehoused. If early intervention is not undertaken, the prognosis for their life is greatly diminished. The earlier the intervention, the better. And so, I would ask you that. 

And finally, the Chamber of Deputies has a proposed law on the 

protection and fostering of disabled people’s rights. I’m wondering 
31 

what the status is of that law, whether or not the NGOs and interested parties have commented on it. 

Is it a good proposal? Does it have deficiencies? And all three of 

you might want to respond on that draft law. 

Mr. ISPAS. Congressman, thanks. Could you please repeat the 

first question? 

Mr. SMITH. The first one had to do with those individuals who 

are now growing into adulthood, over 18, 19, 20. What are the barriers for them? What is Romania doing? 

And I would ask you one other question. You mentioned earlier 

about USAID. In your testimony you said, USAID’s ChildNet program provided a model of cost-sharing between local, national and 

international funding sources. 

Well, USAID, as we all know—you know, their funding spigot is 

coming to a close in Romania. 

What’s going to happen? I mean, since it’s worked pretty well for 

you, what would be your recommendations to us to maybe—you 

know, what’s the bridge that’s out there to continue that kind of 

funding? 

Mr. ISPAS. OK. If I may answer? 

The problem of children arriving at the age of 18, and having to 

leave the institutions for children, to me, it is, again, one of the biggest challenges in Romania. 

If you ask me about the children that live in our group homes, 

I would say that the day we took them out from the institution, we 

committed ourselves. Since that moment, we have a moral commitment to those children. 

We will either find a community alternative for them, independent or semi-independent living, living with their family, or 

they will stay with us. Because at this moment, if, let’s say, one 

of them is 18 years old, he will be placed in an institution for 

adults, which is a place we don’t want to visit. 

I have been in places like this—it’s true, not in the latest years. 

But again, my goal would be to close these institutions as soon as 

possible. 

So, again, that is a real problem for the children who will be 18 

years old, who are in other places than group homes managed by 

NGOs. 

Then the question regarding statistics about autism, we have a 

few children with autism. And just recently, we had a team from 

Germany who trained our staff in working with these children. 

But at the national level, I believe there is no—but I might be 

wrong—but I think there are no statistics about how many cases 

of children with autism we have. But I agree, it is a serious problem and we have to approach that problem. 

Talking about USAID leaving Romania at the end of this year, 

as I pointed out in my testimony, this is one of the financial sustainability challenges. We should identify something to put in place 

of the funding that the American Government, through USAID, 

provided and helped Romania. 

All what we can hope is that we will identify other sources of income that will contribute and will create the incentives for the Romanian Government to come and match this funding, because it 

should be a common approach for the problem. 
32 

Mr. SMITH. Any comment, putting on the draft legislation? 

Mr. ROSENTHAL. With regard to draft legislation, again, we have 

a lot of problems with a lot of the legislation that’s on the books. 

Again, law 272, which I mentioned, explicitly permits children with 

disabilities, infants with disabilities, to be institutionalized, though 

it bans other children. 

There have been many times when the Romanian Government 

has specifically asked for the European Union to give it technical 

assistance on the drafting of legislation, and in particular, in the 

area of mental health and psychiatric disabilities. 

There was a law adopted about four years ago on the rights of 

people with mental disabilities. It contained many positive rights 

that said specifically, every person has a right to individualized 

treatment, to participation in the community. 

What the law says on paper is so far different from what happens on the ground. I mean, we go to institutions where there are 

100 people in a common ward and they’re spending their day sitting in bed. So, the law does not have an impact on the actual 

treatment of the individuals. 

In terms of basic civil liberties, one of the key points in the mental health law was, how do you guide—when can a person be involuntarily detained? 

Many people are locked up in institutions for the rest of their 

lives. And one of the core provisions of international human rights 

law is that, before a person is detained, they at least have a right 

to a hearing before an independent authority. 

After four years of failing to create norms—what they call norms, 

what we would call regulations—to implement the mental health 

law, the Government of Romania, just before the EU accession 

process closed in April, adopted these norms. They did not respond 

to the biggest gap in the law. 

This was a gap that was identified by the EU experts, failing to 

create a right to a hearing before a person is institutionalized. And 

the norms didn’t solve that problem. 

So, in the area that I am most an expert of, the rights of people 

with psychiatric disabilities, there are major gaps where the law is 

not meeting the basic core minimum requirements of international 

human rights law. 

Mr. SMITH. I’d just ask a question with regards to—from time to 

time—and you see these reports in America—some doctor or 

nurse—most recently it was a nurse—takes it upon themselves to 

euthanize people that they consider to have a life that’s not worth 

living. 

It has always been a problem with handicapped individuals or 

disabled persons, that somebody in their misguided view feels that 

they are better off dead than alive. 

Are there any instances in Romania, reported or suspected, 

where particularly severely disabled persons have been subjected to 

euthanasia? 

Yes, Mr. Rosenthal? 

Mr. ROSENTHAL. This is an extremely hard thing to document in 

terms of the intent to actually kill a person or let a person die. 
33 

Conditions that we have seen in institutions—in Braila, for example, when we saw them—were so bad that the natural implication is that many of these children are going to die. 

When Center for Legal Resources identified the problem in 2004, 

they found 51 children. When we got there, there were 46. What 

happened to those other five children? 

In the conditions that I observed in June 2005, there were emaciated children with their bones sticking out from their skin, 

wrapped from head to toe. Obviously, since we exposed that, conditions have gotten much better, but they have been documented by 

other people. 

We believe that children with disabilities, and particularly who 

are outside the child protection system, in the psychiatric system, 

are in such horrendous conditions, that in many situations they are 

essentially left to die. 

So, there are not—there’s not a policy, necessarily, that we could 

identify, or an individual who is choosing to kill them off. But if 

you let children grow up in those circumstances, they will die. 

And the psychiatric literature also identifies—you know, you 

don’t have to deprive a child of food for that child to have what 

they call failure to thrive, or to die. 

The very fact of leaving a child in a crib—they can have all the 

food available, but without the loving touch of a caring parent, 

those children will just stop crying. Then they’ll stop eating, and 

they’ll start to waste away. 

So, the institutions where we saw, that were clean facilities, 

where there was food, those children are going to die from failure 

to thrive. So essentially, the impact is the same. 

Mr. SMITH. Mr. Mindroiu? 

Mr. MINDROIU. So, all we have to do—and I spoke about this, 

and it is very important—the training of the staff. 

Of course, we cannot say it, in our institutions people are starving. It’s unbelievable to say that. 

But, if the staff are not very well trained, of course, they cannot 

do anything for a child with a severe disability to eat on his own. 

So, we have to work a lot with the staff. And we have to train 

them, and you have to employ them on a vocational basis, and so 

on. This is my opinion, and it’s my personal opinion. The biggest 

challenge we have in our field is not to build houses, but to prepare 

people to work with and to help the disabled to live independently. 

But I have only one—if it is possible—only one question I do not 

understand. Why are children after 18 years old to go into an institution, if they leave you? Why to go into an institution and not a 

social house, or something like that, to live independently? This is 

what I did not understand, Cristian. 

You said that one child, one of your children, will go for sure 

after 18 years in an institution. Why in an institution, and not in 

a social house? 

Mr. ISPAS. I think this is a misunderstanding. I didn’t say that 

one of our children will go to an institution. I said that none of our 

children will go to an institution. 

Mr. MINDROIU. Thank you very much. 

Mr. ISPAS. I was talking about the situation of children in other 

places, for example in institutions for children, at the age of 18 or 
34 

maybe later, 21, he will be transferred from there to an institution 

for adults. 

Sorry for the misunderstanding. 

Mr. ROSENTHAL. But if I may observe, there is a problem of children aging out of the orphanages, who are so disabled as a result 

of growing up for 18 years in an orphanage, that they need supportive care. And if there is no supportive care in the community, 

they will go into adult facilities. 

We visited many, many adult facilities where children, without 

necessarily having been born with a disability, just from the very 

fact of having grown up in orphanages, had been transferred from 

the orphanage to the adult facility. 

And in our report you’ll see, we found many young adults in 

those long-term facilities. So you saw people who had been there 

30, 40, 50 years, sitting around. And then you saw a 19-year-old, 

a 20-year-old. 

I remember seeing a young woman who had been—she had been 

sexually abused as a child, put into an orphanage, never got counseling or care. The staff, you know—it was just a very sad situation, because this child had really, ever since being placed in the 

institution to get her out of that abusive family situation, had 

spent her life in the orphanage, knew nothing else and was transferred, then, from the orphanage to the adult facility. 

So, it’s a very vulnerable age. And many, many children will 

grow up to live a lifetime in an institution. 

Without supportive services, without care in the community, you 

can’t solve the child problem. You’re just going to grow them up 

and leave them to a lifetime in long-term asylum. 

Mr. SMITH. Let me just ask Mr. Mindroiu. 

There’re two ways of dealing with criticism. We find this in the 

United States all the time, as it’s human nature. 

You can either deal with a report or with a group that apparently, or seems to be adversarial with an arms length approach, or 

you can bring them in and say, show us. You’re a mirror. We may 

not accept everything you say, but we do want to hear what you’ve 

got to say. 

And again, the fact that you are here, I think is very—we very 

much appreciate that. 

But with MDRI, do you have any kind of working relationship 

with MDRI or other organizations that routinely are critical, to 

meet with them on a regular basis and take that as a point of, OK, 

how are we doing? And then engaging in the disagreement or 

agreement. 

But I find it’s totally valuable. I do this—we do this as a Congress all the time with groups that have very strong opinions 

against what the U.S. is doing. 

Amnesty International is as critical of the U.S. as it is of other 

countries, in many cases. And it does form a good backdrop to say, 

how are we doing, you know, to take our pulse. 

Mr. MINDROIU. With MDRI, we do not have any connection, because we didn’t know, met him until today, from National Authority. But we have a close relationship with juridical center. They are 

partners in Romania. And the other partner they had in Romania 

for the Timisoara visit, the Pentru Voi, for your foundation. 
35 

And we are working very close with, for your foundation. And 

there is a juridical resource center. We finance them projects. 

For example, last year we financed a project for their partner in 

Romania, Juridical Resource Center. And they produced four movies, let’s say four movies, with problems in our institutions. 

We financed that project. They told us, OK, we’ll be tough. OK. 

We pay to be tough for that, and you will do what you’ll have to 

do and what you intend to do. 

And for Pentru Voi Foundation, for your foundation in Timisoara, 

all the time they are financed by us, because they know how to 

write projects. 

Mr. SMITH. Let me just respectfully request or suggest, some contacts would be helpful, and the higher and the more frequent, the 

better, so that some of these issues can be resolved. 

Mr. MINDROIU. You know, it’s like in a marriage. It’s better for 

a husband to say to his wife, or the wife to the husband, OK, you’re 

not right here. So, it’s the same thing. 

We need the social society to tell us, you’re wrong. You have 

problems. You have to do something, because, you know, you didn’t 

see that. But you have to do it. And it is my duty to show you what 

is the problem. 

That’s why I was a little bit—I was not very happy when they 

saw that in 2004, 2005, and didn’t tell us anything about before 

2006. 

Mr. ROSENTHAL. If I may respond, I never got to Braila before 

2005. It was the Center for Legal Resources, a Romanian organization, that identified the problem in 2004. And they went immediately to the government, and the government did nothing. 

So, we got our report out as soon as possible. The material in our 

report was fresh. 

In terms of the idea of constructive dialogue, we are very much 

in favor of constructive dialogue. We are pleased to offer technical 

assistance. In many, many countries we have done so. 

In Mexico, after we identified horrendous abuses in a Mexican facility, the government immediately hired the main psychiatrist on 

our team to come down to Mexico. They worked very closely. Within six months they had closed one of the most abusive facilities in 

Mexico. 

Just last year we identified a problem in Turkey where they 

were using electroconvulsive therapy with no anesthesia. Shortly 

after the release of our report, they abolished the practice. 

Many other countries have responded to our reports, though adversarial, in a constructive manner by responding to them. 

In the case of the Romanian Government, we’ve gotten denial, 

denial, denial and straight misinformation. You keep repeating the 

same information, that we didn’t come to you. I was never in Braila 

in 2004. 

This material is very much up-to-date. It is a national problem. 

There are children in life-threatening circumstances now. 

And we have quite a bit of expertise in how you provide oversight 

and protection, and we’ve never been asked for that expertise, because we have been told time and time again, we’ve solved this 

problem. This is an ancient problem. Two or three years ago we 

had this problem, but the problem no longer exists. 
36 

So, there has been no basis for us to help or offer our services, 

when all we’ve gotten is denial, denial, denial. And frankly, the European Union has been given tremendous misinformation by the 

Romanian Government about what’s going on here. A lot of what 

they’ve been told is essentially misleading. 

And if we’re going to have a public policy discussion on this, 

there has to be an acknowledgment of these very serious, lifethreatening abuses in institutions. And only by that acknowledgment can a problem, a system be set up to end it. 

Mr. SMITH. Let me just—did you want to comment? Please. 

Because I would hope that this could be the beginning of a new 

day of cooperation. 

Very often, this kind of connection will lead—as you pointed out, 

in Mexico and elsewhere to concrete action. We all have to be 

shown what our problems are. 

I mean, in my own state we had a problem, not just with mental 

facilities and abuse—and that’s really nationwide—we had problems with nursing homes. And it wasn’t until we established ombudsmen with the ability to go in and check, and working aggressively, where you would think there wouldn’t be a problem, with 

abuse that—the elderly were very fearful to say anything, because 

of the retaliation when somebody would leave. 

It’s an ongoing problem, but we’re working on it every day. So, 

we all have problems. And I would hope—not to sound trite, but 

transparency and working with the groups that are bringing forward these very considerable concerns. 

As governments, I think our bottom line is we have a duty to 

protect, particularly the weakest and the vulnerable. And so, I hope 

that you would work together. And I would encourage it and plead 

with you to do so. 

Mr. MINDROIU. Probably we will work together. 

Mr. SMITH. On that note—and again, I want to thank our distinguished witnesses, all three, for being here and for providing such 

candid answers. And hopefully, a new chapter will be written as we 

go forward. 

If you have anything further as we conclude? 

Mr. ROSENTHAL. We would just like to thank you very much for 

bringing attention to these issues. We know that the U.S. Government policies towards Romania are ongoing. And we just strongly 

encourage you to raise these in your future dealings with the Romanian Government. Thank you very much. 

Mr. SMITH. Thank you so much. 

Mr. MINDROIU. We are very happy that you invite us there, and 

we have the opportunity to tell you what is our vision about the 

Romanian system, what are our problems, what we want to do, and 

what are the difficulties. Thank you very much. 

Mr. SMITH. Thank you, sir. 

Mr. ISPAS. Thank you for inviting me here, and thank you for 

considering our recommendations. 

Mr. SMITH. Thank you so much. 

The hearing is adjourned. 

[Whereupon, at 4:12 p.m., the hearing was adjourned.] 
37 

A P P E N D I C E S 

PREPARED STATEMENT OF HON. SAM BROWNBACK, CHAIRMAN, COMMISSION ON SECURITY AND COOPERATION IN EUROPE 

We have convened this hearing to examine the state of care for 

the disabled in Romania. By way of introduction to that subject, I’d 

like to make a few observations. 

First, in 1991, the OSCE participating States specifically 

committedto protect the human rights of persons with disabilities. 

At the same time, Congress took steps to ensure that the annual 

country reports on human rights, prepared by the Department of 

State, would include information about the treatment of disabled 

persons. More recently, Congress allocated funds in the 2005 Appropriations Act for programs and activities to address the needs 

and protect the rights of people with disabilities in developing 

countries. 

In other words, the rights of disabled people are an important 

part of our human rights and our foreign policy dialogue with other 

nations. It is a measure of society how we treat the most disadvantaged among us. 

Earlier this year, Mental Disability Rights International issued 

a report that was saddening and, in some ways, shocking, for the 

image it portrayed of neglect and abuse of the disabled in Romania. 

Today’s hearing will allow us to hear more about that report and 

the findings of its principal author. We will also hear from Motivation Romania, a non-governmental organization working on-theground in Romania providing services to disabled adults and children. A representative of the Romanian Government will also share 

with us his government’s perspectives on the challenges of meeting 

needs and protecting the rights of its disabled citizens. 
38 

PREPARED STATEMENT OF HON. CHRISTOPHER H. SMITH, COCHAIRMAN, COMMISSION ON SECURITY AND COOPERATION 

IN EUROPE 

Mr. Chairman, thank you for convening this important hearing. 

As you know, Romania has made enormous strides in many, 

many areas, and as a long-time friend of that country, I welcome 

these changes. It has been heartening to see democratic reforms 

allow all citizens in Romania greater participation in the political 

decision-making processes and economic reforms genuinely improve 

the quality of life for many people living in Romania. 

Ladies and gentlemen, ‘‘Hidden Suffering’’, the May 2006 report 

by Mental Disabilities Rights International, has shed light on a 

segment of Romania’s society whose livesremain woefully unchanged. For adults and children with disabilities, too many endure an existence shroudedin darkness, shut out of mainstream society, and in conditions that are all too reminiscent of the images 

we saw of orphanages exposed to the public eye in the early 1990s. 

As most in this room know, last year this Commission held a 

hearing on Romania’s ban on inter-country adoption. The testimony 

was riveting. As witness Dr. Dana Johnson from the University of 

Minnesota testified: ‘‘Contemporary child development research has 

unequivocally shown that in infancy, hospital or orphanage care for 

longer than 4–6 months can cause permanent alterations in cognitive, emotional and behavioral development. A reasonable estimate is that an infant loses about 1–2 IQ points/month, and sustains predictable losses in growth as well as motor and language 

development between 4 and 24 months of age while living in an institutional care environment.’’ Of course, it has been proven also 

that placement in a permanent, nurturing home in early life can 

immeasurably improve their development. We also know that many 

of the inter-country adoption cases which were abruptly halted involved children with critical physical and developmental disabilities. They have, to date, been denied the opportunity for a permanent family, critical medical care, and a loving home in which they 

have the best chance to develop as they are able. 

Sadly, Romania’s policies do not take into consideration the best 

interests of the child, and especially not the best interest of children with special needs who could otherwise be candidates for 

adoption. I am particularly troubled by reportsthat some institutionalized children may lack even basic identity documents, and 

therefore have no chance of being adopted into permanent homes 

in Romania. We have received other reports that some children 

who have no disabilities are housed in institutions because of a 

lack of an adoptive family. Again, the research has shown that institutionalized care can actually cause permanent disability. 

I welcome our three witnesses here today, each bringing a different set of insights: Eric Rosenthal, who has written a critical report on the quality of care provided for children with disabilities in 

Romania; Cristian Ispas, who devotes his life, day-in and day-out, 

to providing services and programs for people with mobility impairments in Romania; and Adrian Mindroiu, a Romanian Government 

representative working for the National Authority for Persons with 

Disabilities and who can provide the most up-to-date information 

on the Romanian Government’s initiatives in this area. Mr. Ispas 
39 

and Mr. Mindroiu, I especially want to thank you both for coming 

across the Atlantic to be with us here today. 
40 

PREPARED STATEMENT OF ADRIAN MINDROIU, DIRECTOR OF 

THE DIRECTORATE FOR EUROPEAN INTEGRATION, HEAD OF 

PIU, SPO, ROMANIAN NATIONAL AUTHORITY FOR THE PERSONS WITH DISABILITIES 

Honourable Members of the US Congress, 

Distinguished representatives of the NGO community, 

Ladies and gentlemen, 

I am sincerely honoured with the invitation presented by the 

Helsinki Commission to testify before the US Congress. I took the 

decision to respond to this invitation and come a long way from Bucharest sharing the belief this event will be a unique opportunity 

to inform you firsthand on a relevant set of measures that current 

Government of Romania—which I proudly represent today—has 

been undertaking on an issues of unique sensitivity both to our 

public responsibility and awareness: improving the life of people 

with disabilities, who are equal in civil rights to us all. 

It is also my belief that today’s event will be a constructive exchange of perspectives on lessons learned and good practices, to the 

benefit of our concerned citizens. I am familiar with the process, resiliently followed by dedicated defenders of the rights for people 

with disabilities in the United States, for a period of more than 20 

years which ultimately lead to the Americans with Disabilities Act, 

a ground-breaking piece of legislation. It admirably transformed 

the entire American society into a more inclusive and equal opportunity community. A likewise and parallel progressive development 

has taken place in the EU countries. The very history of the European aquis communautaire proves the gradual maturation of the 

question in the Member States, both in terms of political awareness 

and result—oriented policies. Speaking about political awareness, I 

feel indebted to refer to the Moscow document of 1990, where Participating States acknowledged the importance of a binding political commitment, to ensure the protection of the human rights of 

persons with disabilities in the OSCE area, as a consensual political platform to further action and shared accountability on the 

matter. 

My testimony will be focused on what has happened during two 

last years in my country, period which I have been actively involved in the activity of the National Authority for Persons with 

Disabilities. As a governmental body we were charged to initiate 

action oriented policies, to elaborate, monitor and control the implementing of the quality standards in the field, to innovate interagency procedures and other chains of cooperation with NGO partners, in order to effectively and immediately implement policies. To 

make a long story short—we had to produce concrete results and 

unarguable progresses so as to rise up to the European standards 

and compulsory requirements of the EU integration process. 

We started from a low level of accomplishments; we reached the 

moment when we have a National Strategy and a Plan of Action, 

sustainable by perspectives of significant financial resources. 

For my Government, filling the gap of previous years with concern to assistance for persons with disabilities is a key component 

of developing a comprehensive care system with a long term vision. 

The main motivation of our strive is to comprehensively integrate 

the principle of mainstreaming, defined as systemic consideration 
41 

of the specific needs of disabled people, in a broad sense, which 

have to be respected when designing policies and measures. Its 

main objective is to protect, offer equal opportunity, and combat 

discrimination on grounds of disability against those persons that, 

due to social, physical, psychical or economic impediments, cannot 

provide for their social needs, and develop their own capacities and 

capabilities to function and participate in society. 

LEGISLATIVE FRAMEWORK IN ROMANIA

To prove by facts the concept we embrace is implemented in real 

life, may I briefly point out to the basic tools we rely on—the legal 

infrastructure. 

Under the current government, 17 legislative pieces have been 

approved or are currently under consideration by the parliamentary commissions, out of a total of 38 relevant regulations on the 

matter concerned. Among the most important, I will mention only 

the following: 

In 2005, Romanian Government approved the National Strategy 

on the Protection, Integration and Social Inclusion of Disabled Persons for 2006–2013, entitled ‘‘Equal opportunities for the disabled—towards a society without discrimination’’. Its ultimate goal 

is to ensure the right to exercise fundamental civil liberties of persons with disabilities, and ensure a meaningful increase of their 

life quality. The core concept of the strategy is the liberty of choice: 

a person with disabilities has been ensured the opportunity to 

make choices concerning its own life.Therefore, the National Strategy is the basic platform to ensure a broad and consistent 

mainstreaming throughout all governmental policies. 

Subsequently, the same year, the Romanian Government has approved and submitted to the Parliament a draft law concerning the 

protection of persons with disabilities. It was approved by the Romanian Senate and is currently under debate in the lower chamber 

of the Parliament. 

In March this year, the Parliament approved the Framework 

Law (known as Law no 47) on the National System of Social Assistance, regulating the organization and functioning of the social assistance system in Romania, including the disabled persons. It replaced on outdated legislation of 2001 and all the other previous 

regulations and special provisions concerning the protection of the 

disabled. The Framework Law grants the Romanian Ministry of 

Labour, Social Solidarity and Family the main role in issuing and 

coordination of social policy at large, and social assistance in particular. As a result, the Ministry of Labour, Social Solidarity and 

Family and the National Authority for Persons with Disabilities, 

alongside other concerned institutions, participate in policy-making, manage and coordinate the national system for persons with 

disabilities, promote their rights and grant methodological and financial support to the social care programs for the disabled. 

AN OUTLINE OF THE NATIONAL SYSTEM OF PROTECTION FOR

PERSONS WITH DISABILITIES

The services provided under this system enclose all types of financial aid addressed to disabled persons or their care-givers, as 
42 

well as social assistance. Social services are targeted to maintain, 

rehabilitate and develop individual skills and are provided either 

at home or in specialized institutions. The increasing participation 

of non-governmental organizations and other social partners is a 

specific trait of the care system for persons with disabilities. 

THE CURRENT STATE OF THE RESIDENTIAL SYSTEM CARE FOR

PERSONS WITH DISABILITIES

The situation of the disabled persons in the residential system 

represents the most difficult and sensitive issue we are doing our 

utmost to cope with, on a priority basis. On March 31, 2006, in Romania there were registered 460,698 persons with disabilities, 

among which 405,107 are adults and 55,591 children. Out of this 

total, 17,959 adults and 354 children received specialized care in 

residential institutions. The rest receive care within their families 

and in a family-like environment. At the same date, Romania had 

149 residential institutions for disabled adults. In these institutions, the provided social services do their best to fit the types and 

degrees of disability of each beneficiary. 

The main challenges facing the institutions that provide care for 

persons with disabilities in Romania are: 

1. The majority of residential institutions are over-crowded and 

the living standards in these institutions need important further 

improvement; 

2. A mix of types and degrees of disability are encountered in the 

same institution, which limits the possibility to provide tailored-to 

fit services for the individual needs identified for each beneficiary; 

3. The qualified personnel needs a quick increase in number by 

supporting specialized professional training programs; 

4. Day centres, ambulatory centres for the rehabilitation of persons with different degrees and types of disability, as well as community services designed to prevent the institutionalization of the 

disabled are still scarce. 

The National Authority for Persons with Disabilities has closely 

oriented its actions on identifying solutions for these challenges. 

Though much remains to be done, I will briefly go through what 

we have succeeded to achieve so far: 

1. Filled to capacity residential institutions—at the beginning of 

the 2005, the County Plans for restructuring residential institutions of large sizes have been approved and endorsed by the National Authority. According to them, the number of residence located in these institutions will be reduced at the same time with 

the creation of alternative community services. The financial support for this reform is provided through means of Phare grants (16 

million euro), national budgetary funding (3,9 million euro) and a 

loan granted by the World Bank (of 18 million euro). As we speak, 

this financial assistance is oriented to reorganize and transform almost 48 residential institutions in the very near future. 

2. Improving the quality of life in residential centers—in February 2006, the Government of Romania has granted 3.4 million 

euros to ensure the modernization and indoor remodeling, including the purchase of new furniture, for 45 centers. Other 14 centers 

have been benefiting from a financial assistance to ensure the designing for the complete restoration of the buildings. Just last 
43 

month the Government approved the financing of 2,9 million euros 

to complete repair of 5 centers for which already restoration 

projects have been passed. These days a new Government decision 

which will provide financing—in amount of 2.3 million euros—for 

the complete repairs of another 4 centers is in the endorsement 

phase. 

3. Cross handicap problem—a sensitive issue is represented by 

the people with mental and neuro-psychical disabilities. Due to the 

fact the beneficiaries of the assistance offered by Centers for Rehabilitation and Recovery of Neuro-psychical disabled persons are 

people with psychical impairment—who mostly require specialized 

medical care—Ministry of Health is currently unfolding a comprehensive assessment mission of all residents in the centers. As 

a member of the Interagency Committee of Mental Health, coordinated by the Ministry of Health, the National Authority for Persons with Disabilities closely follows the developments on this particular issue. Moreover, in January this year, the Government has 

approved a Memorandum jointly initiated by the Ministry of Labor, 

Social Solidarity and Family and our Authority on the measures 

meant to solve problems of the institutionalized persons with mental disabilities. Among the most important measures is the approval for construction of 10 residential centers with a capacity up 

to 50 places each, to ensure an adequate assistance for persons who 

currently reside in overcrowded centers. 

4. Improve qualifications of the specialized personnel—to this end 

National Authority has issued a nation wide plan to upgrade the 

professional skills of the personnel enrolled in the care protection 

system for people with disabilities. First stage of this plan is projected for the 2006–2008. During 2006, we are much focused on the 

program training the trainers. 

5. In 2006, another nation-wide program was created to provide 

the funds for the establishment of 47 ambulatory centres for the 

neuro-motor rehabilitation of the disabled, both institutionalized 

and living at home. These centres complement the community type 

services which are being created and advance in parallel with the 

reorganization of large capacity residential institutions. 

All these measures are only the beginning of the institutional reform of the system, which target the disappearance of large scale 

institutions and creating the community type services. Other additional measures, included in the National Strategy for 2006–2013, 

will come into effect in the following years. 

Recognizing the need and critical importance of the partnership 

with of non-governmental institutions in the field of care for the 

disabled, The Government of Romania has expanded the practice 

launched by our predecessors, in 2001, through providing financial 

aid to NGOs on a yearly basis. In 2006, governmental assistance 

was granted to projects submitted by 22 NGOs, comprising of 

835,000 euros. Moreover all the available financing provided by the 

Government of Romania in the field of social assistance is open 

both to private and public social service providers, which means 

that in Romania there is no discrimination between NGOs and 

state service providers in the field of social assistance. We deeply 

acknowledge local and international NGOs contribution, as well as 

the international donors’ support, the US included, for remaining 
44 

committed to help the Romanian Government’s endeavour to seek 

improvement for people with disability life and to implement our 

public policies in the field. To this end, their role was and will be 

very meaningful for the years to come. 

Ladies and gentlemen, 

My intervention today could not exhaust neither the inventory of 

the progresses Romania has made within the last two years with 

respect to the protection of rights for disabled people, nor the difficulties my Government is working hard to bring to a rapid and 

irreversible solution. A soon a full fledged member of the EU, Romania will take much advantage of Europe’s experiences and EU 

legislative and financial tools to foster its social policies in service 

of all its citizens, including of those with special needs. I am confident that also thanks to the joint efforts with our NGO partners, 

the realities will steadily continue to be transformed, to ensure a 

life in dignity for people with disabilities in Romania. 

The last, but not the least, may I appreciate the interest for this 

topic in relation to my country here, in the US, and I am ready to 

respond to other questions of interest. 
45 

PREPARED STATEMENT OF CRISTIAN ISPAS, FOUNDER AND 

DIRECTOR, MOTIVATION ROMANIA FOUNDATION, NATIONAL 

DIRECTOR, SPECIAL OLYMPICS ROMANIA 

Good afternoon, 

My name is Cristian Ispas and I am the Founder and Director 

of Motivation Romania Foundation and National Director of Special 

Olympics Romania. I would like to thank Senator Brownback and 

the United States Commission on Security and Cooperation in Europe (the Helsinki Commission) and their staff for inviting me to 

give testimony concerning the status of children and adults with 

disabilities in Romania. 

BACKGROUND

Motivation Romania is a non-governmental organization (NGO) 

established in 1995. Our primary mission is to create sustainable 

programs to increase the quality of life of people with disabilities 

of all ages in Romania. We are governed by a Board of Directors 

that includes two physicians, one physiotherapist, one person with 

disabilities and a company manager. We abide by the principle of 

full transparency and accountability, as documented by our most 

recent annual report. We employ 74 full-time staff and in keeping 

with our commitment to empowering people with disabilities, 17 of 

our staff are wheelchair users. Initially, Motivation Romania focused on helping young adults with mobility disabilities access 

quality mobility supports so that they could live independently. 

Among our accomplishments, we have produced and distributed 

over 1,700 wheelchairs for children and adults with motor disabilities; provided wheelchair skills and peer group training for at least 

1,000 children, adults and their families; trained a network of 

wheelchair specialists; and created programs of peer support. 

Today, our wheelchair production workshop is accredited by the Romanian Health Insurance Agency, which now pays for 20% of the 

wheelchairs that we donate in Romania. 

While support to people with mobility disabilities remains an important part of our mission, over the years, our mission broadened 

and we began to focus on building sustainable community-based 

supports for children with disabilities, many of whom had been 

abandoned in orphanages, often in very dire circumstances. 

In the summer of 2001, Motivation Romania Foundation met Mosaic, a faith-based non-profit organization based in Omaha, Nebraska. The Mosaic Foundation has a 93 year history of working 

with people with disabilities and currently provides services in 15 

states and consults with programs in six countries. Mosaic came to 

Romania to evaluate the needs of children with disabilities who 

were living in state-operated institutions and to identify a Romanian partner who was capable of creating community-based, familylike residential alternatives. Motivation Romania Foundation was 

recommended as that partner by the U.S. Agency for International 

Development (USAID) Mission in Romania. Together, we made our 

first visit to Placement Center No. 4 Tancabesti. Upon confirming 

the living conditions of children in that institution, we immediately 

began formulating a plan to address their dire needs for care, 

health, education and social integration. In 2002, with approxi-
46 

mately $64,000 in private donations raised by IMPACT, an international alliance founded by Mosaic and NGOS from Great Britain, 

Norway, Germany and the United States, we began to build housing and develop other services for the children of Tancabesti. 

At the time when we started our intervention in Tancabesti, the 

institution housed 80 children with disabilities in a derelict twostory building serving both as living quarters and special school, 

and filled with that pervasive smell that no one who has visited 

such a place can easily forget. The children that came to greet us 

during our first visits were wearing ragged clothes and barely any 

shoes; they had very short haircuts, so it was difficult to tell girls 

from boys. From the way they were pushing at each other to reach 

their new visitors, asking to be taken home, one could see that they 

were craving attention and care. 

We were impressed with the lack of any sign that the children 

had their own toys, pictures or clothes. We were even more stricken by the glass-door toy cabinet, present in only one of the dormitories, having a big lock on the door. 

The institution’s director guided us on our first tour and explained that the main reason for this situation lay in the insufficient funds available to pay for staff, clothes, medication, and food. 

She was very open and it was due to her that we were able to 

transfer the first four children into our temporary transitional center in January, 2003. 

We continued to take children out of Tancabesti throughout 

2003. Altogether, in 2003, we transferred 14 children, and 22 children followed in 2004–2006. Of the 36 children with disabilities 

transferred from Tancabesti, 22 now live in Motivation’s three 

group homes, 12 are with foster families, and 2 have been reunited 

with their natural family. Our largest group home accommodates 

8 children while the smallest one accommodates 4 children. We believe this fairly represents a family-like setting bringing with it all 

of the options of community integration in schools, social interactions such as Special Olympics, and eventually, for many of the 

children, opportunities for living in more independent settings 

paired with real vocational options and training. In our model we 

have no plans to build additional group homes in Ilfov county. We 

see these settings as opportunities for children to grow and become 

more independent and as a result move either to foster care settings or be reunited with their natural family. Our track record 

speaks for itself. Under the USAID grant we committed to supporting 22 children in group homes. As a result of an aggressive 

effort, we have been able to move 14 children out of the group 

homes to foster care or family reunification. This has allowed us to 

bring an additional 14 children from the institution to the group 

homes. This movement towards more independent and natural settings has occurred in less than 24 months. 

A major reason for our success in creating model communitybased programs for these children was Childnet—a partnership between USAID and the Romanian government. Through Childnet, 

Motivation Romania together with two other Romanian non-profits 

were awarded consecutive grants totaling 325,000 USD. Building 

upon our success in developing community-based care for the children of Tancabesti, in 2003. We initiated a Preventative Services 
47 

Program to support parents caring for children with disabilities in 

their own homes and communities. We worked in partnership with 

the Department of Social Assistance and Child Protection of Sector 

3, Bucharest, providing occupational therapy, counseling, respite 

care and in-home support to more than 50 children with disabilities 

and their families. In addition, we developed a Day Care Center in 

Cornetu, a village that hosts one of Motivation’s group homes. The 

Center provides education, physical rehabilitation and family support for over 40 children. This Center is special because it serves 

both children with disabilities and non-disabled children. It is also 

one of the very few places where Romanian families can come together to participate in programs and receive services focusing on 

the common needs of their children. 

Another important result of our work has been the inclusion of 

children with disabilities in public schools. Our efforts were successful initially but we encountered resistance from teachers, principals and families of children without disabilities. With help from 

IMPACT experts, we organized disability awareness trainings and 

provided support that contributed to increased openness on the 

part of community groups towards children with disabilities living 

in our group homes and foster families. Some of the children in our 

homes also participate in the Special Olympics and have represented Romania at national and international Special Olympics 

competitions. Other programs for children with disabilities from institutions include: • summer camps for children and direct care staff at Motivation’s wheelchair accessible camp in Varatec. • intervention supported by USAID and UNICEF for the children with severe disabilities at the Braila institution featured in 

the Mental Disability Rights International (MDRI) report including 

wheelchair provision, physiotherapy and social activities. 

In recognition of the quality of our services for children with disabilities from institutions, our staff was invited to train direct care 

staff from state-run institutions and NGOs from across Romania 

who work with children with disabilities. Our training team organized events throughout the country from October 2004 to March 

2006, training more than 64 direct care staff from institutions, 30 

educators from mainstream schools and nonprofit centers, and 36 

parents and foster parents of children with disabilities. 

An important factor in our ability to create sustainable programs 

has been our partnership with Mosaic Foundation. Mosaic staff 

have not only provided invaluable technical expertise but they 

have, through private donations, provided critical financial support. 

For example, Mosaic Foundation, working through IMPACT, raised 

the initial seed money that helped move 36 children out of 

Tancabesti. Since, then, Mosaic Foundation has helped to raised 

more than $500,000 to support our programs and develop new services. With Mosaic’s assistance, we also purchased land and build an 

accessible camp in Varatec, Moldova region. 

The camp serves children from our group homes, institutions, 

natural or foster families and their parents. 

Mosaic Foundation and IMPACT Alliance not only engage in significant fundraising efforts on our behalf, they provide invaluable, 

hands-on, staff training and assistance. The contribution of staff 
48 

from Mosaic and IMPACT was very important at crucial points 

during our project, such as at the transfer of the first four children 

from the institution, or at the time when we started to work with 

teachers for the school integration of our children. We have benefited greatly from the knowledge, experience and enthusiasm of 

Mosaic staff from Nebraska, Kansas, Iowa, Connecticut and other 

parts of the U.S., as well as staff from our German IMPACT partner, all of whom travel to Romania on a regular basis to work with 

our children and mentor our staff. 

OPENING DOORS AND CHANGING LIVES

Motivation Romania is firmly committed to improving the welfare of people with disabilities. Our experience tells us that every 

human being has the potential to live a full life. Cristina is just one 

example. Like many children in Romania who have a disability, 

Cristina was abandoned by her parents and left at Tancabesti, together with her non-disabled brothers Dani and Cristian. When we 

first met Cristina in 2002, she was 7 years old and weighed 14 

kilos. Because she had spent most of her time confined to a crib, 

she was unable to walk, and she could not eat solid food. 

Cristina and her brother Dani were among the first children that 

we took from Tancabesti. At first, she was very scared and pushed 

away our staff. However, slowly, she learned to trust and with time 

she blossomed, in spite of her severe autism. As a first step in helping her regain muscle tone and strength, our staff designed and 

built her a customized wheel chair. Today, Cristina is able to walk 

by herself, and she dresses and eats without assistance. Most importantly, she is living in a loving home, with her foster mother, 

and she sees both of her brothers as often as possible. 

THE PICTURE TODAY

Unfortunately, as ‘‘Hidden Suffering,’’ the recent report by the 

MDRI makes clear, for every Cristina in Romania, there are still 

more children living without hope, abandoned in institutions, without adequate support, stimulation or love. Too many of these children live in dire circumstances, confined, neglected and deprived of 

adequate sustenance and lacking basic medical care. We respect 

the work of MDRI and other human rights advocates who give 

voice to the voiceless and provide a powerful impetus for change. 

While MDRI has highlighted serious issues and conditions in Romanian institutions, we also believe that progress has been made. 

For example, the cover of the MDRI report shows a young girl confined to the Braila institution. At the time of the photo, she was 

12 years of age. Like many others confined to Braila, she was horribly neglected. I am able to report that Ioana, as well as 36 other 

children from Braila, are now living in a renovated and well 

equipped placement center. As the more recent photograph shows, 

Ioana has gained weight, and her health status and welfare have 

improved. Our team, Motivation Romania, built an adaptive, customized wheelchair designed for her daily use, improving her ability to eat, to ambulate, and to grow. Her circumstance today demonstrates the potential for children, once neglected in institutions, 

to thrive. 
49 

1Statement in Romanian available from ANPDC Website at: www.copii.ro/ 

ANPDClcomunicatlpresalONGl1703.doc. Date consulted: September 7, 2006. 2Serviciile Sociale vor fi Concesionate ONGurilor (Social Services will be Contracted with 

NGOs). Curentul. Available from: http://www.curentul.ro/ 

curentul.php?numar=20060823&cat=7&subcat=100&subart=41838. Date consulted: September 

6, 2006. 

It was in fact the MDRI report that identified this isolated hospital psychiatric unit housing children like Ioana. The NGO community would not have had access to this information without their 

investigation. Once made aware of the situation the NGO community in partnership with UNICEF, USAID, and local authorities 

formed a team to address the deplorable conditions and create an 

intervention plan to secure the health and safety of these children. 

However the actual situation, though improved, still does not address the long term needs of these children. 

Although mentioned only briefly in the MDRI report, Motivation 

Romania and other geographically dispersed NGOs are in fact operating centers of excellence throughout the country. Together, we 

are not only protecting children with disabilities from the abuses 

and neglect of the past; we are changing Romanian cultural norms 

and fostering changes in public policy. For example: • Until very recently, the Romanian government did not have 

authority to contract with NGOs for services. This law was changed 

to allow the government to provide base amount subsidies to NGOs 

for the provision of social services. This represents a major shift in 

public policy that will stimulate the growth of desperately needed 

services, if adequate funding is made available. • Romanian governmental representatives, including Mr. Bogdan 

Panait, President of the National Authority for Child Protection 

and Adoptions (ANPDC) recently stated that the government intends to contract to NGOs approximately 40–45% of current services by 2008.1 A subsequent newspaper article dated August 23, 

2006, stated that ANPDC has developed a policy proposal to this 

end, which is projected to be applied starting next year in five pilot 

counties.2

• The government currently is considering establishing a central 

payor for contracted services. Under the existing system, there are 

multiple and confusing funding streams that are difficult to navigate and often have conflicting requirements. • Some county governments are providing personal assistants 

and funding for services for children coming out of institutions. For 

example, the Social Assistance Department in Ilfov county currently pays for 12 foster parents and 3 of our staff who care for 

children transferred through our project from the Tancabesti Institution, and we are currently in negotiations with the county to pay 

for all of the salaries of direct care workers employed at Motivation’s group homes. However this is still not enough to cover all 

costs related to quality residential and educational services that we 

provide. 

CHALLENGES

Motivation’s work, as well as the work of other NGOs, stands as 

proof of the progress that can be made to improve the lives of children and adults with disabilities in Romania. However, more must 
50 

be done to address unmet needs. Many more children could benefit 

from services like those that we are providing to Cristina, and that 

additional preventative services are needed to avoid institutionalization in the first instance. We know, however, that legacies of 

discrimination cannot be eliminated overnight. It starts with political will, followed by hard work, sustained effort, unfailing commitment and money. 

Indeed, an overarching challenge is the need to identify and secure adequate funding to maintain existing services and to create 

new capacity. Table 1 graphically shows our challenge. When we 

began in 2002, all of our money was raised from private donor 

sources. In 2003, we nearly quadrupled our operating budget. However, roughly two-thirds of our funding was attributable to private 

donations; while the last third came from a USAID grant. For the 

past several years, private donations and USAID grant funding has 

been critical to our ability to sustain programming and create new 

services. However, with the USAID mission leaving Romania, our 

funding ended in April 2006. Although the Romanian central and 

local governments’ share of funding has increased, it still only represents 20 percent, a small portion of our budget. With accession 

into the European Union (EU), we anticipate being able to access 

EU structural funds in 2009. However, given the loss of USAID 

funding beginning this year, absent a greater commitment by the 

Romanian government to fund services for people with disabilities, 

Motivation Romanian and other similar programs will experience 

serious budget shortfalls for the next two to four years. Without 

funding, we will not only have to curtail existing programs, but we 

will be unable to address the plight of children who remain institutionalized. 

Another challenge concerns the need for better coordination between the national and local governments. While public policy has 

changed at the national level, some local authorities have little or 

no interest and no incentives to fund or provide services to people 

with disabilities that meet national minimum, quality standards. 

The national government, for its part, does not provide sufficient 

incentives, nor does it enforce its own standards. 

The Romanian government has stated in many public forums 

their desire to build the infrastructure that ensures that people 

with disabilities in Romania can live full lives in their own communities. Indeed, the presence of President Didilescu here, in these 

proceedings, indicates that the Romanian government is prepared 

to make the next step in supporting nongovernmental initiatives. 

The Romanian government is aware of the ability of nongovernmental organizations in this country to provide quality services to 

people with disabilities. In my opinion, it is time to support the 

replication of these successful models of community-based care for 

people with disabilities still living in Romanian institutions and 

those at risk of institutionalization. Through our joint efforts we 

can extend the opportunities for children like Cristina to other children and adults with disabilities from institutions. What we need 

is the support of the international community in partnership with 

the Romanian government to ensure the next steps in our journey 

to help fulfill our dreams. 
51 

Based on our years of experience, we have documented the costs 

of quality care. To take one child out of an institution such as those 

identified by MDRI and provide them with adequate nutrition, 

clothing, medical care, rehabilitation, recreation, and education 

costs about $500 per month or approximately $6,000 per year. 

Let me close by providing you with several recommendations: 

1. The Romanian national and local governments must identify 

and secure funding to sustain existing programs of NGOs and create new capacity to support people with disabilities, particularly 

people living in institutions. The government should exercise the 

political will to reinstate this as a major priority. 

2. USAID’s Childnet program provided a model of cost-sharing 

between local, national, and international funding sources that assured a high degree of accountability. We would like to see additional US and international support provided to the Romanian government in a way that creates incentives for both the central and 

local governments to fund existing community-based services and 

replicate model programs to provide new capacity. This is particularly important in light of the loss of USAID and other international funding and the anticipated gap in funding that we face 

until the European Union structural funds are operational. 

3.The Romanian government must enforce existing laws for children with disabilities to ensure the full implementation at local 

level of the United Nations Convention on the Rights of the Child 

(CRC) for individuals with disabilities. It is not sufficient for the 

national government to say that their only role is to provide guidance and oversight; they must also provide enforcement and accountability. 

4. To address the need to identify people with disabilities who 

have been placed in settings like the one discovered in Braila, the 

government should conduct a comprehensive assessment of all hospital, psychiatric, rehabilitation units, placement centers, and other 

institutions to ensure that there is a level of transparency available 

to the NGO community and international human rights groups so 

that the tragedy of Braila is not repeated. 

We cannot afford to lose momentum in the establishment of community-based services in Romania. I am confident that with continued international support, the Romanian government working with 

the NGO community can make continued progress for the benefit 

of children and adults with disabilities and achieve a quality of life 

for individuals not previously attainable. 

Thank you again for this opportunity. I am happy to answer your 

questions. 
52 

PREPARED STATEMENT OF ERIC ROSENTHAL, EXECUTIVE 

DIRECTOR, MENTAL DISABILITIES RIGHTS INTERNATIONAL 

I would like to thank Senator Brownback and all the members 

of the Commission on Security and Cooperation in Europe for this 

opportunity to speak today about the human rights of people with 

disabilities in Romania. I will describe the findings of Mental Disability Rights International’s investigative report, Hidden Suffering: Romania’s Segregation and Abuse of Infants and Children 

with Disabilities, published in May 2006. The Romanian government must be held internationally accountable for human rights 

violations against its citizens with disabilities. 

Mental Disability Rights International (MDRI) is a human rights 

organization dedicated to the recognition and enforcement of the 

rights of people with disabilities worldwide. The rights of people 

with disabilities have been long overlooked by the human rights 

community, and MDRI is dedicated to bringing attention to the 

concerns of this population that is subject to stigma, economic and 

social marginalization, legal discrimination, and segregation from 

society in much of the world. MDRI has documented human rights 

abuses in 23 countries and we have published reports on human 

rights abuses against people with disabilities in Turkey, Peru, 

Kosovo, Mexico, Russia, Hungary, and Uruguay. 

In our report, MDRI holds Romania to the same, universal 

human rights standards that we use to assess every other county. 

The life-threatening abuses, the extremely inhuman and degrading 

conditions of detention, and the large scale on which people with 

disabilities are segregated from Romanian society in stands out as 

some of the most serious and pervasive human rights violations 

MDRI has found anywhere. There are at least 30,000 children detained in institutions—and probably many more—who will be developmentally and psychologically scarred for life as a result of 

their improper and unnecessary placement in Romanian institutions. There are an even larger number of adults whose lives have 

been thrown away as they languish in almost total inactivity in 

abusive facilities. 

These hearings come at a critical time when Romania’s treatment of children and adults with disabilities is under intense international scrutiny. The European Union (EU) is now reviewing Romania’s human rights record as it considers admitting Romania as 

its newest member state. MDRI has called on the EU to require 

concrete action by the Romanian government to end the abuses we 

identified and to fully integrate children with disabilities into the 

community. Similarly, I urge the United States to take a stand on 

these issues. Foreign assistance, trade, and political cooperation 

should be linked to ending these human rights abuses in Romania. 

Romania can end these abuses—if the international community 

takes a strong stand. The world community would not tolerate such 

extreme abuses against any other population. 

The factual findings of our report are based on MDRI’s investigation in Romania from February 2005 through February 2006. Our 

findings are as follows: 

MDRI’s investigation found that children are detained in numerous adult facilities. While the rights of all people detained in these 

institutions are being violated, children are particularly at risk. 
53 

I have visited institutions in twenty countries around the world. 

What I witnessed at the adult psychiatric facility Braila was the 

most disturbing horror I have ever seen. These children were close 

to death. 

In 2004, the Center for Legal Resources, a Romanian human 

rights organization, found 51 children living in the Brailia psychiatric institution in atrocious conditions. The Center wrote to the 

government to demand change. When MDRI visited Braila in June 

2005, we found 46 children living in horrendous conditions. I personally observed children tied to cribs, wrapped head to toe in 

sheets used as full-body restraints, with open wounds and bed 

sores all over their bodies, malnourished, and near death. We 

found teenagers so emaciated that they looked like they were 3 or 

4 years old. Their spindly arms and legs were twisted into contorted positions from disuse and atrophy. Their eyes had sunken 

deeply into their skulls, and they stared blankly at the walls. Ribs 

and other bones stuck out from their skin, which seemed to sag 

from their bodies without any extra flesh. 

Staff agreed to unwrap several of the children. As the staff removed the restraints on one girl, her skin came off with the sheet, 

leaving a raw open wound beneath it. 

I ask members of the Commission to look at the cover of MDRI’s 

report, Hidden Suffering, that we have distributed today. The emaciated child in this picture is a teenager who weighed less than 30 

pounds. • At the urging of the EU, Romania has begun reforming its 

child care system. Yet children with disabilities have often been 

left behind. Romania adopted much-publicized legislation, Law 272, 

which bans placement of babies in institutions. But there is a loophole in this law that permits any child with a ‘‘severe disability’’ 

to be institutionalized. The law is commonly used to institutionalize babies with even the most minor disabilities. MDRI also 

found babies without any disabilities detained in institutions, a 

clear violation of this law. 

In February 2006, MDRI found 65 infants—with and without disabilities—in an institution for children in the city of Timisoara. 

One nurse working this facility told us: 

I have worked here for twenty years and my heart has turned 

to stone. I thought it would be better after the revolution, but it 

is not. We do our best, but it is impossible for us to stop the spread 

of lice and contagious diseases. . . . I give an injection and a baby 

cries and I have to keep going. There are too many. They become 

disabled from being here. 

There are so few staff at this facility that the children never 

leave their cribs. These children are becoming psychologically and 

developmentally disabled as a result of this lack of attention. Institution staff informed MDRI investigators that some children could 

easily be adopted, but they are stuck in the facility only because 

they lack identity papers. It is impossible to say how many more 

facilities of this kind exist in Romania. 

• As part of Romania’s reform, many children with disabilities 

have merely been moved from large to small institutions. While 

these facilities are newer and cleaner, they are still inappropriate 

for children and will contribute to increased disability. Extensive 
54 

Romanian and international funding has gone into building new institutions, draining scarce resources from the process of creating 

foster care and other services necessary for the community integration of children with disabilities. According to UNICEF, nearly 200 

new ‘‘small’’ institutions have been opened in recent years. 

The government of Romania claims that it has reduced the population of its institutions for children from 100,000 to 30,000 in the 

last few years. Our investigation calls into question those numbers. 

There is no way to tell how many children are detained in adult 

facilities and how many children have merely been transferred to 

smaller institutions now called ‘‘family-like’’ environments. We visited one facility for 25 children in the center for Timisoara, where 

children had been moved after a notoriously abusive orphanage 

had been closed. The local child protection authorities referred to 

this facility as a form of community integration. In fact, these children were entirely segregated from society. We observed children 

sitting around in rooms doing nothing. Deprived of a family and of 

loving care, the children who grow up in these facilities will become 

more and more disabled. 

As the psychiatric literature reveals, it is not just physical deprivation that can lead to loss of life. Emotional abandonment—resulting in ‘‘failure to thrive’’—causes both emotional and physical damage to children at a critical time in their development. Even children who receive adequate food in clean institutions become disabled; some children are so emotionally neglected they will not 

eat—they may become malnourished and die. 

In addition to the 30,000 children acknowledged to live in institutions, at least 9,000 babies are abandoned each year—a rate of 

abandonment that has not changed over thirty years since the 

Ceausescu era. Romania has created a ‘‘maternal assistance’’ program to provide foster care for children with disabilities, but it cannot meet the enormous needs of the large number of abandoned babies. The government admits that at least 700 abandoned children 

languish in maternity wards of hospitals—other sources put the 

number much higher. There is a particularly large gap in services 

for children and adults with disabilities. Throughout the country, 

we found children and adults with disabilities detained in institutions because of the lack of community supports. Most children 

with disabilities face the prospect of life-time institutionalization 

unless major changes take place. 

While the government of Romania has worked hard to demonstrate to the world that it is reducing the size of its orphanage 

population, what we have observed could be described as an enormous shell game—where children are being hidden as they are 

moved from one institution to another. 

The Sub-Secretary in charge of Mental Health at the Ministry of 

Health admitted to MDRI in February 2005 that he has no way to 

estimate the number of children in adults facilities. According to 

the Sub-Secretary at the Ministry of Health: 

It is not clear how many patients there are with disability in psychiatric hospitals. We do not know why or on which basis people 

are kept in different institutions. There are people with disabilities 

and without disabilities in institutions . . . patients’ rights are not 
55 

well known, even by the doctors. . . . All institutions are overcrowded. 

One of the greatest obstacles to reform—or for the implementation of any effective national policies regarding people with disabilities in Romania—is that responsibility for care of children and 

adults with disabilities is divided among numerous ministries and 

authorities at the local and national level. Nor is there any independent mechanism for monitoring human rights conditions in institutions or assuring quality of care. The Sub-Secretary told us: 

To date, I have never received any complaint about what is going 

on in the mental health system. There is no mechanism in place 

to bring complaints to me. 

Behind the closed doors of institutions for children and adults 

with disabilities, terrible human rights abuses take place. Yet 

there is no accountability for abuse, even when documented and 

publicized by human rights organizations in and outside of Romania. For example, the Center for Legal Resources and Amnesty 

International documented that more than 100 people died of exposure in the Poiane Mare psychiatric facility in 2003, and 17 people 

died in the facility in February 2004. To date, no one has been held 

accountable. The Romanian government still insists that people 

died of natural causes or ‘‘deficiencies of an administrative nature.’’ 

In papers submitted to the European Committee for the Prevention 

of Torture, the Romanian government described as ‘‘administrative 

deficiencies’’ such practices as the ‘‘lack of heating in the patients’ 

rooms, hypo-caloric food, insufficient and unqualified staff for the 

care of psychiatric patients, lack of good medicines, extremely reduced possibilities of pre-clinical investigation. . . .’’ etc 

The government of Romania cannot remedy human rights violations that it continues to deny. The government has shamefully responded to MDRI’s report by simply denying the facts we have presented and claiming that we have fraudulently used old video. In 

an echo of communist-era thinking, officials have accused MDRI of 

being part of a conspiracy for one ulterior motive or another. Since 

the release of our report, however, our findings have been extensively corroborated by independent journalists from Romania, the 

United States, and Europe. ABC News broadcast video footage 

taken in early May 2006 showing institutions for children every bit 

as abusive as those depicted in MDRI’s report. The respected Romanian newspaper, Jornalul National, conducted a series of powerful independent exposes of institutions for children, labeling them 

‘‘a refined Auschwitz.’’ A group of 33 service providers for children 

in Romania took out a full page advertisement in the Financial 

Times to protest human rights abuses against children in Romania’s child care system. Just last week, ITV news broadcast another 

two-part documentary on abandoned babies in abusive Romanian 

institutions. The Sunday Mail and the Times of London have also 

run similar stories. 

There is a humanitarian crisis facing people with disabilities in 

Romania. This crisis is taking place on a grand scale. Immediate 

attention is needed to protect children and adults with disabilities 

from these life-threatening abuses. 
56 

MATERIAL SUBMITTED FOR THE RECORD BY HON. SAM 

BROWNBACK, CHAIRMAN, COMMISSION ON SECURITY AND 

COOPERATION IN EUROPE 

[The New York Times, Wednesday, May 10, 2006] 

ROMANIA’S ORPHANS FACE WIDESPREAD ABUSE, GROUP SAYS

(By Craig S. Smith) 

Children tied to cribs and chairs often cold, underfed and 

smeared with their own feces: Romania has tried over the last decade to erase those images of its orphanages seen around the world. 

But thousands of children in government-run institutions are 

stilliving in conditions that are little changed from a decade ago, 

investigators for Mental Disability Rights International found. 

Writing in a report to be released today, just days before the European Union issues its final assessment on whether Romania has 

met human rights and other membership standards, researchers 

described an eerie silence in a ward where 65 abandoned children 

were housed, because children who do not receive attention when 

they cry learn to stop crying. 

In an adult psychiatric hospital, investigators found some children wrapped head to toe in sheets used as full-body restraints; 

When the staff agreed to remove the sheet on a 17 year-old girl, 

the report states, ‘‘her skin came off with the sheet, leaving a raw 

open wound beneath it.’’ 

‘‘It was the most horrible thing I’ve ever seen in 13 years of doing 

this work,’’ said Eric Rosenthal, executive director of Mental Disability Rights International, a Washington-based group, and the coauthor of the report. 

Mr. Rosenthal’s group is urging the European Union to insist 

that Romania take immediate action to end the abuse before next 

year, when the country hopes to join the union. 

The strategy has worked before. In September 2005, as Turkey 

began formal talks to join the European Union, Mental Disabilty 

Rights International released a report on the use of electroshock 

therapy without anesthesia in Turkish psychiatric hospitals. Turkey has since ended the practice at its main psychiatric hospital in 

Istanbul and is addressing other problems raised in the report. 

Simona Pella, an offcial at Romania’s National Authority for the 

Protection of Children’s Rights, said she had not yet seen the report, but disputed its findings. 

‘‘We are talking about a report made by a nongovernmental organization, and it’s their opinion,’’ Ms. Pella said by telephone from 

Bucharest. ‘‘They are not talking about facts in all of Romania, just 

about some cases in two counties. 

While the number of children in the country orphanages has 

dropped to about 30,000 from 170,000 in the early 1990’s, many 

children particularly those with mental or physical disabilties, have 

simply been moved into less visible, though equally appalling, institutions, including adult psychiatric hospitals, Mental Disability 

Rights International found. 

‘‘Romania was rushing to show that it had decreased its orphanage population, but it left children with disabilties behind,’’ Mr. 
57 

Rosenthal said in New York on Monday. He said there was no way 

to estimate how many children were living in the conditions described in the report. 

Romania’s orphanages are a legacy of Nicolae Ceausescu’s rule. 

He banned birth control and left under-financed state institutions 

to care for the wave of abandoned children that followed. After he 

was assassinated in 1989, as Communist rule ended the horrors of 

the system were exposed to the world. 

Much has improved since then. Foreign aid organizations rushed 

in, and European and American advisers worked with Romania’s 

new government to help put abandoned children up for adoption or 

place them in foster homes. In January 2005, intending to bring 

the country in line with European Union practices, Romania 

passed a law that prohibited placing children under 3 in institutions unless they were ‘‘severely disabled.’’ The law also blocked 

foreign adoptions in the hope of cutting down on child traffcking. 

But, according to the report, about 9,000 babies are deserted in 

Romania every year, one of the highest rates in Europe. The country’s foster care and adoption programs strain to keep up with the 

number of thildren who need their help. 

As a result, abandoned children with even mild disabilties and 

some with none at all are being kept in maternity wards or other 

hospital-associated institutions until they are old enough to be 

moved to an orphanage or other institution. In February, investigators for the group found 65 infants, some without any disabilty, 

being cared for by three people at a ‘‘nutritional recuperation center’’ in the western city of Timisoara. 

The children were confined to their cribs most of the time, the 

report states. Some of the older ones rocked back and forth, banging their heads or ‘‘making the rhythmic sounds from dislocated 

jaws common in children left lying down for extended periods,’’ the 

report said. 

Karen Green McGowan, a registered nurse who assessed many 

of the children cited in the report, said the early neglect led to 

disabilties later on, making it likely that many otherwise normal 

children woufd end up institutionalized for life. 

‘‘What they’re doing there, in my opinion, is manufacturing 

disabilty,’’ Ms. Green McGowan said. ‘‘By the time they’re in their 

teens, these kids are being moved into institutions.’’ 

Ms. Pella, the government official said that her figures showed 

that 5,000 children are abandoned each year but that half are 

eventually reunited with their familes. Foster care and adoption 

programs handle the rest, she said. Only those who require medical 

care stay in the hospital or are institutionalized, she said. 

But the report documents several cases of older children, some 

kept in permanent restraints, in adult facilties, including the St. 

Pantelimon adult psychiatric hospital in the eastern city of Braila. 

‘‘We found 46 children in Braila one near death, that looked like 

they were from Auschwitz, just skin and bones,’’ Mr. Rosenthal 

said. 

‘‘They found bed ridden teenagers so emaciated that they looked 

like they were 3 or 4 years old,’’ their limbs atrophied and contorted from disuse. 
58 

Instead of giving the children attention, the report states, the 

hospital staff tied them down. 

After Mental Disabilty Rights International and a Romanian organization notified the government of the situation, the children 

were moved to two smaller institutions for children, the report stated. But the more disabled of them remained isolated, without even 

a bathroom for toilet training. All of them, up to the age of 17, use 

diapers. 

Æ 

This is an official publication of the 

Commission on Security and 

Cooperation in Europe. 

★ ★ ★ 

This publication is intended to document 

developments and trends in participating 

States of the Organization for Security 

and Cooperation in Europe (OSCE). 

★ ★ ★ 

All Commission publications may be freely 

reproduced, in any form, with appropriate 

credit. The Commission encourages 

the widest possible dissemination 

of its publications. 

★ ★ ★ 

http://www.csce.gov 

The Commission’s Web site provides 

access to the latest press releases 

and reports, as well as hearings and 

briefings. Using the Commission’s electronic 

subscription service, readers are able 

to receive press releases, articles, 

and other materials by topic or countries 

of particular interest. 

Please subscribe today.