06/06/2011 06:27 pm ET | Updated Aug 06, 2011

Visit to WWO Programs in Varna, Bulgaria on International Children's Day

Journal from the field #2, June 1, 2011
Dr. Aronson in Bulgaria, May 28-June 2, 2011

While in Bulgaria, we met with the head of UNICEF in the Bulgaria office, where I outlined our work goals for orphans and vulnerable children in Bulgaria by sharing information about our Granny Programs and toy libraries. I was able to successfully convey our passion and care for the children of Bulgaria. Discussion after we left the meeting was positive; we made a good impression and my eagerness to "lend a hand" and be part of the team of professionals in Bulgaria was received open-heartedly.

Then we set out to visit WWO programs in Varna, a seaside city in the northern region of the country. How sweet that we should be flying to Varna to see the newest of the WWO Granny Programs and toy libraries on June 1, International Children's Day.

I was accompanied by my director of programs, WWO's program manager in Bulgaria and our partner who is the psychologist from Milossardie. Milossardie is the charity in Bulgaria that we have worked with for a decade. It is a five-hour drive from Sofia to the Black Sea and I have done it a few times, but the one-hour flight is so much easier. There's just one scheduled flight a day out of Sofia, so we were up early and able to accomplish a lot leisurely, because the end of day flight was at 6 p.m... still time to get back to Sofia to do more business meetings. My first trip to Bulgaria was September 26, 1998, as a pediatrician specializing in orphan medical issues. I was asked to consult with an adoption agency in New York to help train Bulgarian psychologists and grannies for the first ever Granny program in a Bulgarian orphanage.

I slept during the hour flight to Varna and we went directly by taxi to the orphanage. Varna Orphanage Director Dr. Djankova was at the UNICEF meetings so we would be working with the psychologists, Elena and Daniella, along with our grannies and toy librarians, who are the pedagogues at Varna. "Igrachki biblioteka" is the Bulgarian phrase for toy library. All day long, I listen to the Bulgarian language, catching words that seem to be repeated over and over again, and I am comforted by my recognition. I usually ask what a word is here and there, because it is a cute word and is used so much. I love the phrase "igrachki" which means toys and "biblioteka" sounds like the French word for library, "bibliotheque." The word for children is "detsa", which is very sweet and mentioned often while we are in meetings. You can also find this word on the gates of all children's homes, i.e. dom detsa.

Once we arrive, I am reminded about how beautiful this orphanage is, with freshly painted stucco and colorful window awnings. The grounds are landscaped with flowers and trees that are lovingly cared for by gardeners. The primary-colored playground equipment is old and metal, but there are some new plastic pieces that are mixed in as well. I remember the first time I was in Varna in September 1998, 13 years ago. I was looking at a photo album from that trip just a few weeks ago and now I have it out on my desk. The orphanage, in fact, looks nicer now than then.

I met Dr. Djankova, the director of the orphanage, and that was a great moment for me -- she was so warm and gave me a strong handshake. She was eager to start the training of the "Ba Bas" (the Bulgarian word for grandmothers) and open the first Granny Program in Bulgaria. I trained two Bulgarian psychologists, and one of them, who was part of the orientation and training of the first grannies, is still working with us after all these years in other programs.

As we walked into the orphanage on Wednesday, June 1, I immediately saw the unlit atrium set up with chairs where the caretakers had been seated, 13 years ago. I saw the podium where Dr. Djankova stood and informed the staff that she would be working with Ba Bas and that there would be a Granny Program. As I stood outside the atrium as an onlooker, I witnessed this courageous pediatrician explain the program and the staff grumbled loudly and showed their displeasure. They were threatened by outsiders who would perhaps take their jobs and their potential opportunities for raises in wages. Still, Dr. Djankova stuck to her plan in spite of their disapproval and the program has lasted all these years. The program was sponsored by a U.S.-based organization until January 2011, when WWO took it over after the prior organization left Bulgaria. I have the photos of that historical moment in my album.

I met with Dr. Djankova in Sofia on Wednesday night, after we returned to the capital. She looked the same. Her hair is dyed, but she was dressed beautifully in linen, and her smile was young and authentic. We hugged and we kissed European-style on both cheeks. We sat and chatted with translation through WWO's program manager. It was as though we had seen each other a week ago. We both had that same mutual respect for one another. I told her about the wonderful visit we had at her orphanage and congratulated her on her superb and courageous work all these years. She agreed that we should do more work together and thanked WWO for making sure the Ba Bas and children were able to continue their work together when the organization left six months ago... not a missed beat for the kids in need.

Then I talked about growth and new ideas. She was excited, but let me know that there was less authority given to her regarding new programs. She promised to help WWO approach the regional authorities for permission to grow the programs outside of the orphanage so that they can become more community-based. The toy library is quite transferable to impoverished children in the community. This could mean that the community could enter the orphanage and the toy library would be in local community centers and book libraries. And I described preschool education for children starting at 18 months of age as a major innovation that WWO would like to begin at Varna. I also asked her about getting involved with the Roma community.

I was especially clear that programming for kids had to start from the minute the kids were placed in care at Varna -- way before the six-month age which has been the traditional start of the Granny Program. The Bulgarian psychologists at Varna had revealed how wonderful and improved the development of the children had been due to services provided starting at six months of age. What I noticed about the children was that they already had many of the manifestations of depression and attachment disorder, such as poor eye contact, rocking and obsession with watching their hands and fingers even in early infancy.