Amazed and excited by a summer in Romania, with plans to return

This summer I traveled to Romania. As an intern for the Humana Foundation I spent five weeks working as a volunteer in hospitals and conducting an independent research project. As I prepared for the trip I learned about environmental health issues like those affecting Copsa Mica, a town in the Transylvanian Alps of Romania. In Baia Mare, renowned as the most polluted city in Europe, eighty percent of children have blood lead levels higher than what we deem acceptable in the United States.

Copsa Mica is a picturesque village where the grassy hills are dotted with white sheep. Ten years ago the town was far from picturesque. Local factories, struggling to meet Communist production quotas, belched smoke laden with heavy metals into the air and onto the land. A black cloud figuratively and literally darkened the sheep, buildings, and town.

With the fall of the Iron Curtain, economic and humanitarian aid poured in, policies changed, and the pall disappeared. But one need not dig deep to see the indelible mark Communism has left on this and so many other Romanian towns.

The soil remains contaminated, the grass toxic to the sheep, and the meat from the sheep is poisonous to humans. While the factories have been upgraded, they still contaminate the village and the workers in their employ. When the sheep were black from the soot, people waited in line to help, but now that the problems are veiled by green grass and white fleece, the money and effort have dwindled.

In a seminar on biotechnology on campus, I was introduced to a new range of technologies in genetic testing, including a possible test for predisposition to lead poisoning.

I began to wonder if this technology could be applied in places like Romania as a sort of policy tool. Could individuals working in high-risk jobs or living in highly contaminated areas be tested and warned if their genes put them at an even higher risk? Could the testing be used to identify individuals who should be targeted for treatment or closely monitored so as to limit their exposure?

Admittedly, it sounds like a farfetched bandage fix. How can a nation that can't afford latex gloves afford genetic testing? Why would people who knowingly work in toxic factories want to know if they have an even higher risk?

Then, I thought about how fast and how much less expensive technology has become in such a short time. I also had a hope that Romanian parents would be interested in protecting their children from these debilitating toxins. So, this idea became my project for the Humana Foundation.

I spent the first three weeks traveling around Romania, visiting hospitals and beginning to understand the state of health care in this recovering country. Most of the buildings were literally crumbling. Every site I visited was similar. I would hike up the crowded and smoky stairwells, weaving through robed laboring mothers and anxious families, using the space as makeshift waiting rooms.

I was struck by the lack of proper sterilization. Blood is routinely drawn without gloves. Those hospitals that do use gloves often reuse them, even for gynecological examinations. Paper products are just as scarce. Paper towels, wooden tongue depressors, and other disposable goods are too expensive and deemed unnecessary. The doctors frequently go from crib to crib, without so much as washing their hands, much less sterilizing the bells of their stethoscopes.

Unconcerned with my obvious lack of expertise, the doctors and nurses put me to work, washing newborn infants, palpating hepatatic spleens, and suctioning mucous from tracheotomy tubes.

Another surprising observation I made was the under-utilization of technology. I didn't expect to see a ventilator or even an incubator in Romania, but saw them in every hospital. Sadly, the doctors often lacked the expertise or confidence necessary to use the equipment, leaving it unused and covered in plastic.

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This summer I learned more than I ever imagined I would. In addition to seeing the Romanian healthcare system first hand, I went into the factories to interview the factory doctors and encountered firsthand workers who must change clothes to avoid carrying deadly particles from the factory into their homes. I met with government officials and learned how they deal with such problems. I met with researchers and ethicists who discussed the challenges of healthcare reform and environmental protection.

However, the more important lessons had nothing to do with healthcare, hospitals, or factories. Somehow, in a country I never imagined I would ever visit, I was overwhelmed by indescribable generosity. In a country where even the most highly-paid live in what we would describe as poverty, my hosts showered me with hospitality, gifts and most importantly their time, interest and help.

I left Romania amazed and excited. Amazed, because in such a short time I developed such a strong attachment to a country and a people that I knew nothing about. Excited, because, I know this is just the beginning of my Romanian experience. Allison Arensman '04 is an independent concentrator focusing on bioethics. She is from Louisville, Ky. and can reached at arensman@princeton.edu.