Tsimbalina Hospital       Orphanage "Vera"

Action "Bolnitsa Tsimbalina"
St.Petersburg - Russia


     Russia seems to be a "paradoxical" country. It's one of the greatest powers, there is all technology possible and conceivable ... but it seems that only one small part of the population has the profits! The money does not always seem to go where the people need it most. For example, the wages of people employed in medical and educational professions are very low.
The general impression is of misery subsisting since centuries. It is the history of people which had to fight for survival, counter invaders, counter extreme ideologies, counter bad weather. There's a certain fatalism too. The center of St.Petersburg is very pretty, with beautiful buildings, parks, roomy avenues and streets. But as soon as one goes towards the outskirts, there's misery: badly maintained streets and gardens, dirty buildings and cities ... Misery can be read on the faces, in clothing, in the absence of dental care, on damaged hands. Many people look 'sick', pale by anaemia, coughing, spitting... The lack of money doesn't make it possible for them to be nourished correctly, to take good care of themselves.
The usual wages are around 500, - Rubles per month (about 20 €), with relatively high life expenses. The basic commodities are accessible, but the least "variation" - quality food, rich in proteins and vitamins, for example - is expensive. Many families live on only one salary, some accumulate several jobs to have enough money.
In a nutshell: Under the outside image of a great power part of the Russian people live in a social and human misery, which in addition leaves a large door open to much abuse and exploitation.


The buildings are old and badly maintained. The outside is rather pretty; but the interior is "glaucous". The walls are damaged, with some pieces of plaster falling off. The paint is old, dull, and scaled. The neon lighting is insufficient.
It's clear that the individual does not have a place of his own (remains of the communist ideology?), in the sense that the rooms and almost all the parts are glazed, including the bathrooms/toilets for children.
The beds are old, rusty; the mattresses are stained and nauseous. Cloths are not changed regularly and smell of urine. In the rooms there are four or five beds, with children of all ages mixed, boys and girls from a few months of age to 13-14 years.

The personnel:
The Tsimbalina hospital is the only medical establishment to accommodate the children of the streets, for a town of 5 million inhabitants! The children - from babies to teenagers - are mainly brought here by the Police.
The hospital is composed of two teams which work together: the medical team & the social team. The medical personnel is managed and financed by the State, whereas the social personnel is supported by a non-government organization, "INNOVATIONS", Russian but subsidized by foreign organizations. It should be specified that the wage differences are between once to twice between the State and Innovations ... if the wages of the State arrive in the hands of the employees at all (it happens that the money "gets lost")!

The doctors we met appeared moved by their work (in spite of wages that are  only twice as high as the nurses', approximately 30,-US$). On the other hand, the male nurse personnel which is in direct and continuous contact with the children doesn't seem to take share humanly with their task. The nurses come to work, pay little attention to the children, neglecting the fact that some small children are wet (and, without diapers, also wet the floor), that children hit themself or bruised, etc. ... They did not choose to work in this type of hospital, with children who are often difficult; and they express it openly. As these children are actually difficult, they would need more personnel, but the "care-takers" are often young, without experience and real qualification, and dissatisfied to have to do this work.
That leads to a situation which is not pleasant for the children, who would - considering their situation - need so much attention and affection!

The social team of Innovations, selected according to other criteria, really seems to take interest in these children, their problems, and gives much more attention to the daily situation. There are a psychologist, three teachers. This team works daily (from 10:00 till 16:30, except Sunday) at the hospital. The teachers give lessons to the older children and to those who wish it, and in the remaining time they suggest activities or simply are present with the children in the playrooms.
The psychologist (together with the teacher who is responsible for the project, and the rest of the team) seeks the best solutions for each child. The choice being generally summarized with either arranging a return to the family or to find a place in a children's home (in which the conditions are... this will be the subject of another page!).
The social project really transformed the face of this hospital, creating provided playrooms, bringing televisions and video tape recorders, teaching equipment, etc... But there still remains so much to do!!

The beneficiaries :
The majority of these children faced problems of violence at home. Violence mainly being a fruit of alcohol abuse or the use of drugs. As an answer to this children are escaping to the streets. The street is a place of 'no-right', where various situations clash and where money reigns. Little compassion. Much abuse. The rate of prostitution and infantile pornography is important. Then, not rarely children arrive with syphilis or AIDS. There is also the problem of drugs, and children know drug dependence since the age of 7-8 years. To get drugs (generally glue), they are engaging in prostitution, or else.

At their arrival at the hospital they are placed in rooms closed by a latch for observation, for about two weeks. After that, either they go directly to an institution (orphanage, children's home), or they return to their family ... or they return to the street. Indeed, it is the choice of the personnel not to use force to keep them locked up; then, in the event of rebellion and of aggressiveness, it is decided to let them set out again (!). The emphasis is thus related to the conditions of reception, so the children themselves have the wish to remain and benefit from the assistance which they can find at the hospital. There are also cases of parents who are declared incompetent to deal with their children, often for problems with alcoholism or drugs. The children then are recovered by the Police and brought to the hospital. During our presence a child of 1 year was brought, with the inscription on his birth-certificate: "Birthplace: garbage"!


Help on the level of care in collaboration with the medical team
Initially there are requirements in material for everyday usage and for single use. We thus brought a small amount of what was required (stethoscope, tensiometer for children, etc ... and also blouses and clothes for the hospital). We also gave 3.000,-FF (457 €) which were divided between the purchase of clothing, medicines and food for babies.
Then, it was a surprise to see that the Russian doctors include massage in their therapies. Not only " technical " massage of the kinesitherapy (Chinese) type, but also sensitive and energy massage (acupuncture is recognized by its right value in Russia).
So, the mornings were devoted to the massage of children for whom the doctors had prescribed massage. Especially babies - 3 months to 1 year 6 months - outgoing of disease, or simply for their well being (need for contacts, to feel touched, of human warmth, for their good psychological development).

Help on the level of activities for children in collaboration with the social team
The children sometimes quite simply need attention of benevolence, to feel that people are there for them, to help them instead of exploiting them. Not speaking Russian, we could only organize manual activities of origami type, macramé, etc... Intrigued initially a little by the presence of somebody who does not speak their language, children then expressed much joy for the attention we gave them.
We tried to remain with them as long as possible, even at except activities, simply to watch television, to witness their games, etc. ...

Our last visit in Russia, although very short, had enabled us to establish many contacts in St.Petersburg. We also have established the bases of various projects which are now starting to see the light. This third visit of approximately two months and a half (from December 20, 2001 to March 4, 2002), was the starting point of a specific project with an orphanage, accommodating about thirty children.

Action with orphanage "VERA"
St.Petersburg - Russia


A structure of average size by the number of children whom it receives, "Vera" at the same time is an orphanage and also receives children in temporarily difficult social situation. It is because of the devotion and the will of the adults who work there that the material and emotional minimum can be assured. Indeed the granted budgets of the state would enable this establishment to function only three months in the year.
The complement is coming from various foreign organizations, collaborations, projects, etc ... However the minimum is assured it still misses much to really offer pleasant living conditions to these children, enabling them to build themself differently than under continuous stress and under the influence of the law spy on cell phone of the strongest.
The interior was renovated by the teachers and various people working in the orphanage, but the buildings remain in a bad state, narrow and decayed. Few showers and toilets for so many people, few rooms for activities, few places to escape from the group. The behaviour of the children to one another passes much by a form of physical violence as a discharge of the tensions and energy which they cannot evacuate. In this place space is very restricted; in the rooms there are four beds and very reduced furniture, in a space barely sufficient for two beds; there's omnipresent promiscuity (with everything what lack of intimacy brings), and too few adults to offer a sufficient presence; in such an environment it is difficult to consider the future with serenity, to establish a stable emotional development, to acquire the references necessary for a balanced adult life.


Help on the level of activities for children
During our stay we organized various activities with the children. With the assistance of a translator we ran origami activities and French lessons. These activities soon became a moment of appreciated calmness for the children. Being in small groups, they could have a closer feeling of being listened to, that we were there for them.
We also went out in small groups, to walk outside, to have a meal in a pizzeria. These were occasions for these children to find more attention, with adults being able to take time for them.

Help on the level of care
The budgets of the orphanage being very reduced, it is possible for the director only to send two children per month to the dentist. The state dentists are often famous for their lack of softness and the often radical solutions they use. The children are then not very inclined to return or to go see the dentist. However these needs are important.
Coming from families with problems, abandoned by their parents, the children from the orphanage suffered from defects of attention, malnutrition, deficiencies, etc... Their teeth are very often in a bad state. They also get much sugar and candies - adults thinking that it is a good means of offering as compensation to their problems.
Thus, we started bringing the children to a private dentist ourselves ... This was very urgent! A 13 year old girl had 8 teeth damaged! A State dentist would have uprooted at least two final teeth; the woman whom we visited passed much time and much patience and engaged a technique which made it possible to preserve them. The dentist also pointed out the important calcium deficit.