We did a lot of art in the dom rebyonka (baby house). The children were begging us to hang their paintings over their bed. The staff took the paintings and we never saw them again. They said that these children are being raised in state institutions and would always be in groups the rest of their life. No reason to pamper them with personalized things now, because they wouldn’t be allowed such things later in life. And that would only make problems. This mentality is so entrenched.2
Background3
Russian institutions are bursting with abandoned children, who now total more than 600,000 children who are defined by the state as being "without parental care.”4 During each of the last two years, more than 113,000 children have been abandoned, reflecting a breathtaking rise from 67,286 in 1992. Another 30,000 arereported to run away from troubled homes each year, clogging the urban railway stations and metros, sometimes ending up in shelters and orphanages.5
Since the collapse of Soviet rule in 1991, these children have become the jetsam in Russia’s stormy economic transition. Their families are often poor, jobless, ill, and in trouble with the law; this burgeoning class of abandoned children has come to be called "social orphans"—indicating that ninety-five percent of abandoned children have a living parent.6
Official statistics on abandoned children abound, and the figures gathered from various official sources often do not correspond. The institutions that care for children span three government ministries, and the categories listed in statistical tables either overlap or are so vaguely defined as to make a fine breakdown of numbers extremely difficult. 7
According to compilations published by UNICEF in 1997, some 611, 034 Russian children are "without parental care." Of these, 337,527 are housed in baby houses, children's homes, and homes for children with disabilities.8 According toa Russian expert in their field, the latter figure includes children living part-time at home, and the full-time orphan population in institutions is closer to 200,000. Of these, at least 30,000 are committed to locked psychoneurological internaty for “ineducable” children, run by the Ministry of Labor and Social Development.9
The remaining number, according to government tables, are placed in alternative custody, including group homes and other guardianship perhaps with members of a child’s extended family. Although some tables list foster care as one of the alternative forms of custody, an international child development specialist told Human Rights Watch that there are only several hundred children living in family-sized settings, and that the standard “foster care” involves larger groups.10 Human Rights Watch commends the few pilot programs in foster care that have begun in Russia and urges speedy development of further projects that provide humane alternatives to large institutions.
It was beyond the scope of this report to conduct a full investigation of the many categories of institutions. But based on reliable sources most familiar with custodial care for abandoned children, Human Rights Watch has focused on three classes of institutions for this report: dom rebyonka, dyetskii dom, and psychoneurological internat.
Archipelago of closed institutions
Orphans in Russia are herded through a maze of state structures operated by three government ministries, which compete for limited state funds and overlap in their mandates for certain categories of orphans and children with disabilities. The Ministry of Health is charged with the care of abandoned infants from birth toroughly four years of age, and houses them in 252 baby houses which are called "dom rebyonka," housing from 18-20,000 children.11
All abandoned infants spend their first three to four years in a baby house, and are then distributed to institutions under the control of either the Ministry of Education or the Ministry of Labor and Social Development.12 Among those under the Ministry of Education, one group of children is deemed to have no disabilities, and the second group contains children diagnosed as lightly disabled, and officially termed "debil."
The most common institution for the "educable” children is called a dyetskii dom (children's home), which generally houses boys and girls. They generally attend regular Russian public schools for the compulsory nine years, where they can earn a secondary school diploma, or they can leave school at the age of fifteen.13
Abandoned children may also live in school-internaty, where they receive their education inside the institution where they live. Following secondary school, these children in the care of the Ministry of Education may receive two to three years of further training in a trade, which they pursue at another boarding institution under the Pedagogical Technical Directorate (PTU). While studying skills such as carpentry, electricity, masonry, and stuffed-animal making, among others, the children are housed in dormitories staffed by the Ministry of Education.14
At the age of five, the second group of orphans under the Education Ministry's purview—the debily—is channeled to spets internaty (or "auxiliary internaty"), where they reside while taking a significantly abbreviated course of education totaling six years, far short of a high school diploma. They are also offeredvocational training, but their program and residence are generally segregated from the non-debil orphans.15
Under Russian law, the state must provide all orphans leaving the care of the Education Ministry with an initial stipend, housing and employment. But the economic crisis since the introduction of market reforms and privatization of apartments makes this increasingly difficult. Indeed, the prospect of life in the outside world is a source of great worry to the orphans and child welfare experts alike.16
The Ministry of Labor and Social Development takes charge of orphans who are diagnosed by a board of state medical and educational reviewers as having heavy physical and mental disabilities at the age of four. Officially labeled "imbetsil" or "idiot," they are committed to closed institutions which often resemble Dickensian asylums of the nineteenth century. There they remain until the age of eighteen. Those who survive to that age are transferred to adult psychoneurological internaty, or asylums, for the duration of their lives. 17
Fragmentary statistics on the mortality rates in the institutions under the Ministry of Labor and Social Development indicate that these orphans are at significant risk of premature death. One leading child welfare advocate in Moscow told Human Rights Watch that estimates from government figures indicate the death rate in these internaty is twice the rate in the general population. He also knows one internat where he said that the death rate rose to as high as three and a half times the rate in the society outside its walls.18
While we were not able to obtain government statistics to corroborate these estimates in Russia, we noted that UNICEF researchers found higher death rates in these psychoneurological internaty across most of the former Soviet bloc.19 A1996 national statistic from Ukraine indicated that "approximately thirty percent of all severely disabled children in special homes—a staggering figure—die before they reach eighteen." 20
While UNICEF acknowledges that many of these children are at increased risk from their underlying conditions, it attributes part of the high mortality figures to crowding, poor hygiene, and low standards of care.21
Soviet-era policies and practices persist in Russian institutions. Renowned for its centralized control, the sprawling system of internaty for abandoned children was inspired by the Soviet philosophy favoring collective organization over individual care, and the ideal that the state could replace the family.22 Regimentation and discipline were integral to this philosophy, and restricted access to the institutions apparently permitted the director and staff to operate with impunity.
While most Russians who left their children in state care during the late Soviet period did so for such reasons as poverty, illness, and family problems, a certain proportion of children came from working parents and students who used the orphanages as weekly boarding institutions and retrieved their children during the weekend.
This was considered normal practice, according to the long-time director of a Moscow baby house, who told Human Rights Watch how university students would house their infants with her sometimes for two to three years:
We had families who had three kids who stayed here, then the parents finished studies and picked up the kids and left to go back home with them. We actually considered it to be fine. They were normal parents. They came and breast-fed them. In only one case the mother threw away (gave up) her child after six months.23
The contrast between the doctor's attitude toward children who had parents to visit them and those who were fully abandoned, illustrated the deep bias against orphans and their parents that endures today.
Orphan care varies broadly across Russia, making it very difficult to draw conclusions about cities, regions, or even classes of institutions. For much of this century, for example, Moscow has been a world apart from anywhere else in the sprawling country, and this gulf has widened dramatically with the lifting of market controls in recent years. In matters of public funding, children's institutions in the capital and several other main cities enjoy higher levels than those in the regions of Mordovia, Tver' and Smolensk.24
But even the USSR, in its idiosyncratic way, was a land of exceptions. Orphanage directors, like the bosses of factories and vast collective farms, enjoyed considerable discretion over their domains. The director's personal commitment to children's welfare worked to the favor or to the detriment of the orphans. Human Rights Watch learned of compassionate, energetic directors with imagination and pluck who sought out child welfare information from the West, and took the initiative to improve their institutions by raising money locally and training their staff.
The result today is a hybrid of the former centralized system and low-grade anarchy, which also applies to the uneven enforcement of laws and standards protecting children introduced by the Russian Federation since 1991. This is complicated by the process of decentralization generally unfolding in the government ministries that oversee the institutional care and the diagnosis of children.
Among the positive consequences of the transitional period of the 1990s has been the initial access to institutions by charities and professionals, bringing assistance and information. The most marked improvement in the physical conditions is seen in the baby houses, which have received substantial assistance from international adoption agencies.
But one of the negative effects of this low-grade anarchy is that while abuses in the institutions may be exposed, children's rights advocates report that many more go unreported and there is an absence of accountability between central and local jurisdictions.
For all these reasons the findings from our mission do not apply to every orphanage in Russia. Variations and exceptions abound in every respect, from the circumstances leading to the abandonment of an infant, to the education, health and course of development enjoyed by or denied a child.
There are general contours to this landscape, however, and the following section is offered to help navigate through the tunneled world of Russian orphans. It presents their odyssey in terms of the best and worst prospects that the state offers an abandoned child. It is followed by a discussion of variations, and the prevailing prejudices and attitudes that foster the violation of these children's rights.
Type 1: Best prospects for a child abandoned at birth and healthy
In this case, a child is born at a state-run hospital or maternity ward and is left there in the hands of the Ministry of Health. The staff of the maternity ward will observe the child, giving him or her various medical and developmental diagnoses based on what it known of the family history and birth.
According to Russian medical practice, all risk factors are listed on any infant's chart under the initial diagnosis, and the high risks of many orphans win them a diagnosis of at least “delayed.” Within a few weeks, all infants, except those who require immediate hospital care, are transferred to state-run baby houses where they reside for roughly four years.
Even in the best case, children who are closest to normal health at birth become retarded to some degree after these four years of collective living, deprived of individual nurture. An alarming number of less resilient infants seem to succumb to a self-fulfilling diagnosis of retarded.25 This puts them at a distinct disadvantage at the age of four, when all institutionalized children are evaluated by the state Psychological-Medical-Pedagogical Commission of the Ministry of Education for distribution to institutions for children five years old and up.26 The evaluation, which becomes an official "diagnosis" entered into an orphan's record, is often based on the visiting commission's one-time session with the child.27
It is impossible to overstate the crucial importance of this test to an orphan's future. It is a crossroads which routes the child either to a life of limitedopportunities, or to a life of doom. Many Russian experts interviewed by Human Rights Watch sharply criticized this process, and could readily identify children who were certainly misdiagnosed. Although Russian law provides for the child to appeal through his legal guardian, it is almost impossible for a four-year-old in the custody of the orphanage director to lodge a complaint.
In the best case—if the toddlers clear this hurdle—they will be channeled into an orphanage in the Education Ministry system. There they will receive nine years of public education, learn a vocation, and get a job and place to live after the age of eighteen.
In general these children will enter the tunneled domain of state institutions, where they will inhabit a stultifying world apart from society at large. Orphans in Moscow told Human Rights Watch that their public school classmates teased them as "dyet-domovskii” kids. 28 Upon returning to their dyetskii dom after a school day, the orphans are once again in their separate world, where they find a dubious haven. Teenaged orphans in Moscow and St. Petersburg interviewed by Human Rights Watch reported several categories of abuse they had suffered or witnessed. They said that children with no parents are treated more harshly than those whose parents are in touch with them. Punishment by the director and staff may involve physical assault, verbal abuse, public humiliation (for example forcing children to strip in front of peers), isolation in unheated rooms in winter, or standing naked in front of an open window in winter. Runaways from the orphanage are often regarded as abnormal and sent to psychiatric hospitals.29
Brutal treatment is not confined to direct confrontations with adults, however, for they encourage older children to beat up, bully, intimidate and coerce the younger ones.30 Orphans interviewed by Human Rights Watch had abundant episodes to recount, including punishment by proxy. Not only are they brutalized by this, they are socially stunted, and poorly prepared for a decent life as adults in the outside world.
When the orphans graduate from their world of the dyetskii dom, they face a "new Russia" in such social upheaval and economic disarray that it is distressful for those who have grown up in it. Gone is the social safety net of the Soviet era which at least guaranteed orphans housing, employment and a place in the army. Now, as a diplomat in Moscow told Human Rights Watch, "Their passport is marked with "dyetskii dom" so that people always know they were from orphanages. They have no one to turn to when they're unleashed at eighteen. Some have never ridden a metro before or been to a store or anything. A lot of them end up on the streets."31
Type 2: Worst prospects for a child abandoned at birth and disabled
A baby born with physical or mental disabilities in Russia faces the worst prospects if he or she is abandoned at birth. Some of them have only physical disabilities, or minor mental retardation and could learn to walk and talk, read and write. Among these are children with mild Down syndrome, cerebral palsy, and correctable conditions such as club foot and cleft palate.
Numerous parents are routinely pressured at the maternity ward to give up such infants.32 After initial observation they are transferred to baby houses where the children classified with severe physical and mental disabilities are segregated into lying-down rooms. Confined to cribs, staring at the ceiling, these babies are fed and changed, but they are deprived of one-to-one attention and sensory stimulation and are not encouraged to walk or talk. However tentative their diagnosis of retardation was at birth, particularly for those who have only physical disabilities, it becomes self-fulfilling by the age of four.33
In the worst case, these babies fail the diagnostic evaluation of the Psychological-Medical-Pedagogical Commission at the age of four and are handed over to the Labor and Social Development Ministry. There they are interned in closed internaty for imbetsily and idioty, where there is little more than a perfunctory classroom to keep some of the children busy for a few hours a week.
The bedridden children from the baby houses are again confined to cots in lying-down rooms, often laid out on bare rubber mattress covers, unclothed fromthe waist down and incontinent, as we witnessed in one internat and heard in credible reports from volunteers working in many state institutions.34
Human Rights Watch saw children who were considered “too active” or “too difficult” being confined to dark or barren rooms with barely a place to sit. The staff tethered them by a limb if they believed they might try to escape, and restrained others in makeshift straitjackets made of dingy cotton sacks pulled over the torso and drawn at the waist and neck.35
Children with Down syndrome and other hereditary conditions are regularly passed over for corrective-heart surgery that is routine in the West, based on a long-held bias against spending medical resources on children judged as "socially useless."36
The orphans who survive to the age of eighteen move on to an adult internat, again removed from public view. Some, however, are housed in huge centers with hundreds of handicapped people across the age spectrum and where older inmates feed and care for younger or more disabled ones.
There are scores of variations on the two types of journeys followed by Russian orphans. For instance, some children are abandoned after living several years at home. As one baby house director told Human Rights Watch, this can occur in the case of severe disability, when a family struggles for a while to raise their child themselves:
If the mother decides to keep the child, after three years, maybe, she loses her job. The state subsdidies are minimal. The man might leave her. While the child weighs under twenty-two pounds, she can carry him. But then the baby grows, more care is needed and she has less money, and her physical and moral strength is getting weaker. We know instances where those cases will be found locked in a dark room in an apartment, because the mother had to goto work to feed her children, because the monthly pension for having a disabled child is really miserable—200,000 rubles (U.S. $30).37
Not all variations are so bleak. Volunteers and child development specialists in Russia told us about an increasing number of children who are being kept an extra year or two in the baby houses in order to improve their chances of passing the commission evaluation and avoid banishment to a psychoneurological internat. In addition, not all the children in baby houses are neglected equally, as certain children have winning personalities or attractive characteristics that encourage the staff to devote more attention to them.38
Finally, all children have their individual constitutions, which miraculously navigate some of them through the harshest circumstances, and help them not only to survive, but thrive.
Prejudice against orphans: a legacy of ignorance and fear
At the heart of the systematic abuse and neglect suffered by orphans in Russia lies a deep tradition of ignorance and fear. Time and again people told us, repeating like a mantra, how the Soviet ideology promoted the quest for the perfect Soviet man. As Dr. Severny explained, "All children and everyone had to meet the standard, and if they did not meet the standard, they had to be kept apart and hidden from the rest."39 Children with disabilities were not seen in public, and the myths associated with them flourished.
The effort to hide such children from the rest of society reflects a "deep, deep prejudice and fear of handicapped people in general," according to a journalist who has worked extensively on the issue of disabilities and orphans in Moscow.40 The process begins in the maternity ward, only hours after the infant is delivered: "That's where the doctors tell the parents, who are already in shock from the birth of a child with difficulties, that the child will never walk, will never talk, will droolall his life. They encourage them to give the child up. They terrorize them. And they also associate disabilities with moral shortcomings of the parents, and make the parents feel guilty for something they must have done."41
One of the most pernicious consequences of this prejudice is that it taints all abandoned children in Russia, despite the fact that the issue has been discussed and debated abundantly in the Russian press for several years. A clear summary of this point appeared in an article exploring local biases against adopting a baby abandoned by a stranger.
The fear that the child will in some way be “damaged goods” stems from the knowledge that mothers of mentally and physically handicapped children are routinely advised by doctors to put their baby in an orphanage and “try again.” Consequently, healthy babies who are given up for financial or domestic reasons are unfairly branded “defective.”42
That Russians often regard orphans as "not really human" corroborates numerous interviews we had with the sanitarki in Internat X and with press articles we reviewed for this report, in underscoring the notion of genetic determinism that informs both lay people and orphanage staff.43
We found an alarming number of references in the Russian press to disabled orphans as "not really human." A sympathetic explanation was offered to us by a Russian journalist who has followed the problem closely:
I'm sorry to say, you will hear terrible things about orphanages and they are probably true. It is a really large scale problem. The staff sees them as animals. We saw it. Even the nannies who "love" them, treat them mostly—really like pets. They do not really see that there is a person inside who could think, or learn something.
Recently there was an article in a Russian paper about a baby house where kids with defects live. A few days later the readers wrote a reply, that these kidsshould be killed. “We don't want to see them,” they said. People are not ready to share any money with those that are disabled. They believe they're not really human beings. It's terrible, I know.44
Such views are hardly the most shocking to be expressed in the Russian press since the appalling conditions of psychoneurological internaty were revealed several years ago. In 1993, an article in a Moscow daily quoted a letter that had appeared in a leading Russian weekly from the mother of a child with Down syndrome. The letter was entitled, "Why Coddle Such Freaks?," and it read, "I am asking the doctor to put my child to sleep. I have been told that we have humaneness in our country," she wrote. "We have humaneness—so we let them live?"45
Reinforcing the legacy of ignorance and fear of orphans is the pervasive fear of exposing abuses of children's rights, all the way from the time that parents are terrorized into leaving their child in that ward, to the years when the children are beaten up and bullied in the dyetskii dom. One former charity worker who helped distribute private donations to many baby houses summed up what others told Human Rights Watch:
If you expose everything, they will shut down the institution to outsiders. No one says to open it up to scrutiny, because there's no faith in the justice system. No top heads will roll. So keep quiet.
They have a saying in Russian, “Tishe yedesh, dal’sho budesh,” which means, “The more quietly you go, the farther you go.” The nail that sticks up highest gets hit first. The kids can't talk either; keep them far enough away that nobody knows. These are all stewing grounds for enormous amounts of pathology.46
In another interview, the Russian journalist Marina Stepanova further illustrated the power of an orphanage director to punish staff who share information with outsiders:
We were told last time that the nurses who talked with us were fired, but the director stayed on. When we were there in the winter of 1997, the nurse told me that people came with stuffed animals, and the next day they were for sale in the market. It's quite clear that the kids are being deprived of food. We brought five cartons of yogurt, and the best they will get is two. This orphanage system has to be changed at the top.47
3 In this report, the word “children” refers to anyone under the age of eighteen. The U.N. Convention on the Rights of the Child defines a child as “every human being below the age of eighteen years unless, under the law applicable to the child, majority is attained earlier” (Article 1). Convention on the Rights of the Child, G.A. res. 44/25, annex 44 U.N. GAOR Supp.(No.49) 167, U.N. Doc. A/4/49 (1989). The full text of the Convention on the Rights of the Child is set forth in the Appendix.
4 Ministerstvo truda y sotsal’novo razvitia Rosyskoi Federatsii. O polozhenii detei v Rosyskoi Federatsii. 1996 god. (Ministry of labor and social development of the Russian Federation.) On the Situation of Children in the Russian Federation. Annual report for 1996 (Moscow: Ministry of Labor and Social Development, 1997), p. 107. Also supplementary statistics from Human Rights Watch interview with Dr. Anatoly Severny, child development expert and president of the Independent Association of Psychiatrists and Psychologists, February 12, 1998.
5 On the Situation of Children in the Russian Federation, p. 107.
6 UNICEF, Children at Risk in Central and Eastern Europe: Perils and Promises, Regional Monitoring Report No. 4 (Florence: International Child Development Centre, 1997). Hereafter cited as UNICEF, Children at Risk.
7 Government reports on children's welfare services include a variety of institutions called “internat” in Russian. This means “boarding” institution, but must not be construed to be equivalent to educational institutions with the same title in other countries. Russian internaty may bear specialized prefixes, such as "auxiliary" and "spets," which cater to children with various levels of disability and educational need. Some internaty combine boarding and education facilities for children; some contain both abandoned children and children whose parents take them home on the weekends. In daily parlance, however, people in Russia often use terms loosely and interchangeably. The Ministry of Education operates a variety of internaty, or boarding institutions, for two major categories of orphans from five to eighteen years of age who have been classified as educable.
8 UNICEF, Children at Risk, p. 67. UNICEF underscores the difficulty in obtaining reliable statistics on children in public care, writing that, “Rather than reflecting a problem-oriented approach to meeting children’s needs, data are simply collected and published according to administrative categories, even through there are considerable overlaps and variations among the functions of different institutions. For example, children with slight disabilities may be placed in orphanages, while homes for the disabled may host some basically healthy children. In most cases, however, there are no comprehensive data providing an overview of the needs of all children with disabilities in substitutecare....Indeed, poor data availability and inadequate statistical reporting are major constraints for effectively tackling, at the national level, the many issues surrounding children in public care. There is an acute need for internationally coordinated action to improve administrative reporting systems and develop specific problem-oriented surveys. Without these, children will continue to be ‘lost in state care.’” Ibid, p. 68.
9 Human Rights Watch interview, Dr. Anatoly Severny, February 12, 1998 and November 14, 1998; UNICEF, Children at Risk, p. 70.
10 Human Rights Watch interview, international child welfare specialist, October 15, 1998.
11 Ministerstvo truda y sotsal’novo razvitia Rosyskoi Federatsii. O polozhenii detei v Rosyskoi Federatsii. 1996 god. (Ministry of labor and social development of the Russian Federation.) On the Situation of Children in the Russian Federation. Annual report for 1996 (Moscow: Ministry of Labor and Social Development, 1997).
12 Until a few years ago, children went to a pre-school institution after the baby house until being transferred a second time to the dyetskii dom for their school years. This practice is being phased out in order to minimize the number of institutions where children spend their lives.
13 Though not officially blocked for higher education, it is rare for orphans to achieve a sufficient academic level to qualify for university entry.
14 Human Rights Watch interview, orphans, St. Petersburg, February 27, 1998.
15 Human Rights Watch interview, Russian orphanage teacher (vospitatel’), March 5, 1998.
16 Human Rights Watch interviews, orphans in Moscow, St. Petersburg and region north of Moscow, February-March 1998; Dr. Anatoly Severny, Moscow, February 12, 1998.
17 Human Rights Watch interview, Dr. Anatoly Severny, February 12, 1998.
18 Ibid. It is not clear if these death rates refer to the total Russian population, to children in general, or to children with disabilities.
19 UNICEF, Children at Risk, p. 89.
21 UNICEF also reports that health standards have fallen in baby houses: "The incidence of malnutrition disorders, rickets and anaemia increased in Russian infants homes by 20, 13 and 75 percent respectively between 1989-1994." UNICEF, Children at Risk, p. 83.
23 Human Rights Watch interview, Dr. Elena Petrenko (not her real name), March 2, 1998.
24 UNICEF, Children at Risk, p. 87.
25 Human Rights Watch interviews, Dr. Vsevolod Rybchonok, March 6, 1998; Dr. Anatoly Severny, February 12, 1998.
27 According to experts interviewed by Human Rights Watch, Russian children living with their families undergo a general developmental evaluation as they approach school age, but this is conducted by a different department of the Ministry of Education. Human Rights Watch interview, Ministry of Education official, October 19, 1998.
28 Human Rights Watch interview, Irina V., Masha K. (not their real names), Moscow orphans, February 20, 1998.
29 Human Rights Watch interviews, orphans, Moscow, February 20, 1998; St. Petersburg, February 27, 28, 29, March 1, 1998. See Chapter VII for a detailed discussion of the children’s treatment.
30 Human Rights Watch interviews orphans in St. Petersburg, February 28, 29 and March 1, 1998.
31 Human Rights Watch interview, March 3, 1998.
32 Human Rights Watch interview, two child welfare experts, Moscow, February 20 & 23, 1998.
34 Human Rights Watch visit to Internat X and interviews with staff, February 15, 1998; interviews, volunteers working in state institutions, February 1998; interviews, two Health Ministry officials who periodically visit Internat Y for disabled orphans, March 5, 1998.
35 Human Rights Watch visit to Internat X, February 15, 1998; interviews, volunteers in orphanages, February 1998.
36 Human Rights Watch interview, Dr. Anatoly Severny, February 12, 1998.
37 Human Rights Watch interview, Dr. Mikhail Airumyan, March 5, 1998. Exchange rate as of March 1998. As of November 1998 all dollar values in this report are now halved due to August 1998 ruble devaluation.
38 Human Rights Watch interview, volunteer, February 23, 1998; journalist, February 11, 1998.
39 Human Rights Watch interview, Dr. Anatoly Severny, February 21, 1998.
40 Human Rights Watch interview, Natasha Fairweather, February 20, 1998.
42 Juliet Butler, "Someone Else's Baby," Moscow Times, November 2, 1996, p. 14.
43 Human Rights Watch site visit to internat, February 15, 1998; interview, Marina Stepanova (not her real name), February 10, 1998, among others.
44 Human Rights Watch interview, Marina Stepanova, journalist, January 22, 1998.
45 Andrea Smith, "Don't Give Up: She May be Talking with Angels," Moscow Tribune, April 29, 1995, p. 8.
46 Human Rights Watch interview, Sandy Marinelli (not her real name) Moscow, February 25, 1998.
47 Human Rights Watch interview, Marina Stepanova, February 11, 1998. Based on her earlier visit to Internat X.