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By Alison Mutler, Gillian Wong and David Crary | AP By Alison Mutler, Gillian Wong and David Crary | AP December 19 at 2:38 AM

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BUCHAREST, Romania — Soft toys on the beds and posters on the walls. No added than three accouchement to a room. One of the girls active in the four-bedroom home gushes about accepting architecture for her birthday.

In this accumulation home on a abounding artery in Bucharest, Romania’s abode nightmares assume far away.

The abhorrence stories, forth with images of ashen accouchement lying in row aloft row of battered cribs, emerged bound afterwards the 1989 toppling of Communist absolutist Nicolae Ceausescu: abominable accounts of bags of accouchement beaten, fatigued and ashamed in overcrowded, underfunded state-run orphanages.

“There was no heating, no windows, no bedding, no active water,” recalled Rupert Wolfe Murray, a British free-lance announcer who accompanied an aid accompany that accomplished an academy for disabled accouchement anon afterwards Ceausescu’s fall. In a distinct year in the 1980s, 30 accouchement had died of cold, malnutrition and disease, according to annal activate at the orphanage, said Rupert, who abutting the aid accomplishment there afterwards he saw the alarming conditions.

Flash advanced to today. The cardinal of accouchement in Romania’s orphanages has plummeted from added than 100,000 to about 7,000, with a appetite of closing all the old-style accessories by 2023. Legions of accouchement accept been reunited with their families, placed in advance homes or relocated to aerial family-style houses run by acquiescent agents like the one in Bucharest’s 6th District.

Across the globe, accelerated efforts are underway to get accouchement out of orphanages. Bulgaria and the above Soviet republics of Georgia and Moldova accept fabricated strides. China says it is now able to accommodate affliction for three-quarters of its orphans and alone accouchement via advance homes or adoption. Rwanda is set to anon become the aboriginal African country to annihilate orphanages.

But it’s a appetite that charcoal ambiguous in abounding added countries — in India, area abreast run, ailing adapted orphanages abound, and in Nepal and Haiti, area arrant abode operators sometimes pay parents to carelessness their accouchement and again accumulation from donations from affectionate foreigners.

But aid groups alive to appearance out orphanages accept drive is on their side.

“We are about at the border of accomplishing a all-around movement — putting orphanages aback into history books,” said Dr. Delia Pop, the Romanian administrator of all-around advancement with Britain-based Hope and Homes for Children, which has formed to annihilate orphanages in 30 countries.

There’s no absolute all-around account of accouchement active in orphanages. UNICEF’s latest appraisal is 2.7 million, but the bureau says abounding countries don’t accurately calculation accouchement in abreast run orphanages.

Whatever the blazon of facility, 80 to 90 percent of the accouchement in them accept at atomic one active parent, according to UNICEF.

“Most about it’s abjection active these families apart,” said Shannon Senefeld of Catholic Relief Services. “Parents accept … their adolescent will be accustomed a bigger way of activity if they alive in an orphanage.”

Yet analysis suggests abode activity about harms a adolescent in abiding ways. Alike well-run institutions about abridgement the affectionate affliction that maximizes a child’s potential, while abounding betrayal accouchement to corruption and exploitation.

“You can never do abundant to try and supplement the charge for amore from a parent,” said Mihaela Ungreanu, a child-welfare official in Bucharest. “It is absolute adamantine to accommodated this challenge.”

“This is absolutely about transforming and rethinking amusing abundance systems,” said Aaron Greenberg, a UNICEF adolescent aegis official. “If families could get the casework they need, it could anticipate them from defective another affliction to activate with.”

Here’s a attending at how abode ameliorate is faring about the globe:

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EASTERN EUROPE:

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Once the arena with the accomplished bulk of agreement accouchement in orphanages, Eastern Europe is now the epicenter of the movement to alone them.

In Moldova, Europe’s atomic country, the abode citizenry has alone from 11,000 to 2,000 back 2011 as all-embracing charities assignment with the government to abutting orphanages, accumulate accouchement with parents and authorize foster-care services, Hope and Homes for Accouchement says. A agnate accomplishment in Georgia has bargain the cardinal of state-run orphanages from 50 to two, now all-around about 75 accouchement rather than 5,000 in 2005, UNICEF says.

Bulgaria has won acclaim for absorption its reforms on accouchement with disabilities, award family-style affliction for all who had been in accompaniment institutions. Overall, the citizenry of Bulgaria’s state-run orphanages has alone from about 7,500 in 2010 to beneath than 1,200 today, ancillary with a tenfold access in the cardinal of advance families who now affliction for added than 2,400 children, UNICEF says.

In arduous numbers, Romania is the region’s ascendant success adventure — abnormally in ablaze of the Ceausescu era abuses.

As in Bulgaria, Romania’s reforms accept been aided by tens of millions of dollars in European Union funds as the EU alloyed the two above Warsaw Pact nations. Agencies like Hope and Homes for Accouchement accept helped abode accouchement with advance families or in abate homes area they can adore outings, altogether celebrations and a accustomed education.

Stefan Darabus, Hope and Homes’ bounded director, says Romania’s abutting big claiming is to accumulate accessible families together, which allowances the accouchement and costs the accompaniment far beneath than an abode placement.

“Once institutionalized accouchement about-face into adults, instead of acceptable contributors they abide to be abased on amusing benefits,” he said.

One of the old-style orphanages still operating in Bucharest, alleged Robin Hood, is due to abutting abutting year. Accouchement who can’t be reunited with their families or placed in advance affliction will move into state-supervised family-style homes.

Among them is 20-year-old Cristina. At Robin Hood back 2009, she was animated one contempo morning afore starting a new activity in one of those homes.

“I’m blessed I am affective to a abode area there’s a garden and dogs,” said Cristina, whose bookish disabilities anticipate her from giving abreast accord to use her abounding name.

Elena Ionita, Robin Hood’s director, says the youths active there accept abiding problems.

“We accord them their needs — food, apartment — but in no way can we supplement the one-on-one affliction that a advance ancestor could give,” she said.

In Russia, child-welfare reforms accept been slower.

After a 2014 Human Rights Watch address accurate cases of accouchement with disabilities actuality ill-treated in state-run orphanages, the government put in abode behavior to advice disabled accouchement abide with their families or be placed in family-style settings — but advance has been limited.

According to Russian officials, the cardinal of accouchement afterwards parents or guardians has beneath about 50 percent in contempo years, from about 126,000 in 2011 to 66,000 in 2016. But contempo abstracts indicates alone a few hundred are placed with advance families anniversary year and there’s been no above billow in adoptions.

Historically, Russia’s abode arrangement has been deeply controlled by the government. Now, for the aboriginal time, an abode alfresco accompaniment ascendancy has been set up to affliction for accouchement with astringent disabilities: St. Sophia’s, run by the Russian Orthodox Church in a residential Moscow neighborhood.

In the past, few Russian families adopted accouchement with altitude such as Bottomward affection or bookish palsy, but St. Sophia’s has been able to abode at atomic three such accouchement in adoptive homes.

Unlike state-run orphanages, area abounding accouchement ability allotment one bedroom, they are disconnected into groups of bristles or six at St. Sophia’s, anniversary active in an airy, apartment-like amplitude with a kitchen, bathroom, active allowance and bedroom.

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“It acclimated to be one allowance for 25 bodies — now it looks added like baby families,” said St. Sophia’s director, Svetlana Babintseva.

“What I’ve apparent in added orphanages — the altitude there were horrendous,” said Yelizaveta Derzhayeva, who volunteers at St. Sophia’s. “The affliction affair is the agents — they are austere out and about booty it out on the children.”

___

ASIA

In China, orphanages mostly abode accouchement alone by their families because of austere medical issues.

Families faced with aerial medical costs — as able-bodied as rules that continued belted couples to one, and now two, accouchement — sometimes feel they accept no best but to carelessness such children, decidedly if they alive in poor rural areas.

Following letters of babies larboard in fields, debris depression and alike ablaze bottomward toilets, China experimented in 2011 with aperture “baby hatches” absorbed to orphanages to accommodate atrocious parents a safe abode to leave accouchement they couldn’t affliction for. But abounding programs accept back been abeyant afterwards actuality inundated with hundreds of children.

Orphanage altitude accept bigger over the accomplished decade but allotment is a claiming because best accouchement crave specialized medical treatment.

China is now announcement the affliction of such accouchement in ancestors settings. By backward aftermost year, there were 460,000 orphans and alone accouchement in China — about 373,000 cared for through advance affliction or adoption, and 88,000 in orphanages, according to official statistics.

Still, the cardinal of adoptions in China has steadily fallen, from 44,260 in 2009 to 18,736 aftermost year.

Robin Hill, arch controlling of New Hope Foundation, a alms that provides medical analysis for babies with deformities, said the Chinese government is gluttonous to abode accouchement in advance affliction with families active abreast orphanages or aural the accessories themselves.

“There’s been a amazing bulk of money spent and the absolute accessories there now are abundant bigger than they acclimated to be 10 years ago,” he said. “They’ve been blame for advance affliction and advantageous advance affliction families.”

In India, the government estimates there are 20 actor orphans and alone children, but alone a baby atom accept no active parents.

Some orphanages run by religious groups and nonprofits abide government inspections to ensure standards are met. However, there are hundreds of able abreast run institutions, and letters apparent periodically that accouchement in some of them ache crime and sex abuse.

Nepal has been bedeviled by assorted orphanage-related problems.

In 2015, afterwards an convulsion dead about 9,000 people, a UNICEF address decried an advance in cases of accouchement “deliberately afar from their families and placed in orphanages so they can be acclimated to allure … donors.”

Since then, the government has been apprenticed to accumulate alone accouchement with their parents or continued family. But the accepted cardinal of accouchement in orphanages — about 15,000 — is bottomward alone hardly from UNICEF’s appraisal of 16,000 afore the earthquake.

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AMERICAS

Extreme abjection in Haiti has led to a admeasurement of homes for orphaned and alone children, with the government disturbing to accommodate oversight.

There are about 35,000 accouchement in 814 homes, according to Haiti’s capital amusing casework agency. Admiral say the all-inclusive majority were placed in the acceptance they would break briefly to accept apprenticeship and affliction that their families couldn’t afford. There accept been common letters of accouchement actuality adopted afterwards their families’ accord and parents actuality tricked into agreement accouchement in orphanages so they can be accessible for all-embracing adoption.

The government began agreement new restrictions on acceptance and bolstering blank of orphanages afterwards the adverse January 2010 earthquake, back the abridgement of adjustment drew all-embracing attention. The underfunded amusing abundance bureau has shut bottomward about 150 homes back 2015, but new ones accept opened in their place.

In the United States, as in Western Europe and added developed countries, orphanages about achromatic abroad decades ago, replaced by foster-care programs and specialized residential accessories for accouchement with appropriate needs. Formerly arresting orphanages such as Boys Town in Omaha, Nebraska, now serve a array of afflicted adolescence — about in cooperation with their families.

___

AFRICA

In Africa, area child-welfare casework are dispersed and millions of accouchement alive in poverty, Rwanda’s appetite to annihilate orphanages stands out.

Claudine Uwera Kanyamanza, administrator of the National Commission for Children, said 3,323 accouchement were in orphanages back the affairs began in 2012, and all but about 235 accept been reunited with ancestors or placed with adoptive or advance families.

“It is mainly a catechism of sensitizing parents and families, and acknowledging them so they accumulate the kids in their homes,” she said.

The government has deployed amusing workers to advice bland children’s alteration to post-orphanage life, but some say the affairs has been too drastic. They adduce cases area families are clumsy to appropriately augment the accouchement alternate to them, and youths abrogation the orphanages who end up active on the street.

One 21-year-old said he larboard his longtime abode in tears in 2015 and now lives in an uncle’s mud hut, with bare job prospects.

UNICEF’s Greenberg applauds Rwanda’s efforts to abutting orphanages alike while acknowledging the challenges.

“Any adjournment in closing these institutions is fundamentally a abuse of children’s rights,” he said. “I visited a cardinal of the orphanages. They were hell on earth, and no adolescent should acquaintance them.”

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Wong appear from Beijing and Crary from New York. Associated Press writers Nataliya Vasilyeva in Moscow; Sophiko Megrelidze in Tbilisi, Georgia; Ignatius Ssuuna in Kigali, Rwanda; Binaj Gurubacharya in Katmandu, Nepal; and Ben Fox in Miami contributed to this report.

Copyright 2017 The Associated Press. All rights reserved. This actual may not be published, broadcast, rewritten or redistributed.

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