Doctors heal ailing Romanian medical system

November 22, 1992|By Michael Ollove | Michael Ollove,Staff Reporter

The sights, televised the world over, were unforgettable: starving, sunken-eyed babies, two or three to a rusty crib, many lying in their own feces. For Barbara Bascom, though, it was sound -- or rather, its absence -- that remains the most enduring memory nearly three years after her first visit to Romania's notorious orphanages.

"You would walk into a room with 80 children and find utter silence," said the 56-year-old pediatrician. "No vocalization at all. Just the sound of the cribs knocking into each other as the children rocked back and forth. It was utterly tragic."

Dr. Bascom and her husband James, a general surgeon, were among the first foreign doctors invited into the country to evaluate and then help bury the peculiarly sinister legacy of Nicolae Ceausescu, the deposed and executed Romanian leader.

It was the orphanages that first seized their attention, tens of thousands of children squeezed into malodorous institutions with no hot water, decrepit laundry and kitchen facilities, and a single caregiver for every 30 to 50 children. Predictably, the vivid television reports about these conditions and the images of the forlorn children -- many of them dying -- touched off a stampede of Americans eager to adopt the youngsters.

But the Bascoms, Maryland residents when the Romanian revolution occurred, understood right away that the children were only a symptom of a whole society gone awry, one in which a 20-year siege had been waged against the medical profession. The treatment of the orphans, they realized, was merely the most heart-rending consequence of those policies.

"Medicine was not felt to be a productive industry," said James Bascom, 58, who, with his wife, was in Maryland last week during one of their periodic visits from Romania.

Beginning in 1974, Ceausescu began dismantling the health professions. Training in most specialties was suspended. Nursing was no longer taught at the university level.

Psychology, which Ceausescu regarded as a cult, was not taught at all. Social work ceased to exist as a profession. So, too, did physical therapy, except when it came to athletes competing internationally.

"There was this tremendous battering of [medical] professionals," James Bascom says. After 1974, the government ceased capital expenditures for hospitals and laboratories. Professors of medicine found their careers frozen. Virtually all research came to an end. Interaction between specialists -- such as between biologists and virologists -- was discouraged.

The Romanian Ministry of Health contacted the Bascoms within two months of the overthrow of Ceausescu in December 1989. Both doctors had specialties of particular interest to the Romanians. Barbara Bascom had long experience in creating treatment programs for developmentally disabled children. In the early 1980s she had established a model program for the dependents of U.S. Army personnel and later did the same for the the Arabian-American Oil Co. in Saudi Arabia.

Her husband, meanwhile, had put aside his surgical practice in the late 1980s to begin a business putting medical literature into compact, computerized form to make the material accessible and affordable to foreign markets.

The Bascoms committed themselves fully. They sold their Brookeville home and moved to Romania. At first they worked through World Vision, a Christian relief foundation. A year ago, though, they opened their own, Columbia-based foundation to help coordinate their Romanian efforts. Now they spend about one month out of every three in the United States to stoke interest in their work in Romania.

PD Most of the relief efforts in Romania involved flooding the coun

try with material goods -- food, books and toys. The Bascoms, though, threw themselves into rebuilding the country's medical profession.

All of their activity is aimed toward retraining professionals who have been isolated from their fields for 20 years. Through U.S. universities and professional organizations, they arrange for experts to retrain the Romanians and establish new programs to fill the void caused by Ceausescu's policies. They are putting in place permanent ties between U.S. and Romanian medical universities. They are also linking the Romanian schools to the orphanages to ensure that full medical services are available to the children.

"They are helping us span the decades," says George Ionita Jr., a Romanian dentist now studying at Harvard University's School of Public Health, who has worked with the Bascoms.

The country's needs sometimes seem overwhelming. Barbara Bascom says that virtually all the children who were in Romanian institutions for more than six months were developmentally retarded. "Three-year-olds who couldn't talk and couldn't walk," she says. "These were acquired disabilities, caused only by institutionalization."

Many of the children were so deprived of human contact, Barbara Bascom says, that she found them shrinking from her. "You can send some of these children into a frenzy simply by touching them," she says. "They have had no experience in relationships. If you try to cuddle them, which is your instinct, they will throw their hands over their face. We call it the orphan salute."

In an emotional way, the medical professionals reacted similarly at first, Jim Bascom says. "They were so unused to collegial contact," he says. The Romanians have come around, though. )) The Bascoms, says Cornel Tragomirescu, a press attache and first secretary in Romania's Washington embassy, are well-known and trusted in his country now. In fact, the Romanians marvel at their work. "They went to a dark corner of the earth filled with misery, chaos and fought to bring light and purpose," says Dr. Ionita.

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