These babies are comparatively lucky. UNICEF estimates that 24 of every 1,000 Georgian children died before age five in 2001, compared with 8 in the United States and 6 in France. Other estimates put Georgia's infant mortality rate close to 60 per 1,000. Nearly 20 percent of hospital deaths involve children, most of whom die of respiratory problems, diarrhea and infections that would be easy to treat if resources were available. They are not, and most parents can only find poor prenatal care. This leads to many premature births, which leave babies more vulnerable to disease.
Georgia's relatively encouraging survival rates mask more depressing social realities. Though the international desire for adoption is immense, few Georgian children are eligible. Most at Orphan House have parents. The parents are often desperately poor or addicted to drugs. Like the mother on the couch in photo 10, they institutionalize their children but retain their rights as lawful parents. Few national laws guarantee minimum standards for care of abandoned children a lack that especially hurts babies born with severe mental or physical conditions.
Nationalism is another obstacle to adoption for many children. President Eduard Shevardnadze's wife Nanuli and other public leaders have insisted that Georgian children should grow up on Georgian soil, even if this means relegating many of them to institutions throughout their youth. "Few children in Georgian orphanages meet the requirements of Georgian law," advises a State Department web site for would-be adoptive parents. "Those who can be legally adopted are usually special-needs children at least several years old."
At Orphan House, Georgia's premier home for orphaned children, there are reportedly five doctors on call every day and one nurse for every six or seven infants. In provincial regions, facilities and staff are not nearly as plentiful. Georgia runs about 72 such orphans, serving about 8,000 orphans. This network of orphan facilities offers more hope than those of other post-Soviet societies, such as Romania, where infant institutionalization emerged as a crisis in the mid- 1990s. But the situation remains dire.
Officially, care for orphans is administered through the Ministry of Health, though in reality the government provides little support to operations like Orphan House. Such institutions survive on donations, a piecemeal network of support from nongovernmental organizations and the evident abundance of affection from nurses. Volunteers, like Tina Tsitsirishvili, spend their days scrambling to solicit blankets, antibiotics, food and medical attention from hospitals and a variety of foreign NGOs and government offices. In these photos, Tsitsirishvili tends to a baby and deals with a head nurse. Her case load is not likely to abate in the current climate.
John Smock is a freelance photographer and journalist based in Tbilisi and New York.
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