The medical chart on the wall says the child clinging desperately to my legs is 12, but he is no bigger than a four-year-old. He's wearing odd shoes, his clothes are encrusted with dirt and he's as under-nourished emotionally as he is physically. As he holds on and I stroke his shaven head, he rocks backwards and forwards. And the sorrow in his eyes burns into your soul.
There's nothing much wrong with Bogdan that proper care, a little affection and some mental stimulation couldn't put right. But he has had none since he was abandoned here at birth, shortly before the overthrow of Romania's dictator, Nicolae Ceausescu, in 1989.
The old communist regime banned birth control and abortion as part of its strategy for expanding the workforce. The result was thousands of children that families could not afford to raise; the state-run orphanages were swamped. Abandoned by their parents and neglected by the authorities, Bogdan and his fellow inmates are the children the rest of Europe has chosen to forget.
This orphanage alone contains another 450 like him. All of them are officially classed as physically or mentally disabled, but many are perfectly able-bodied and capable. Neglect and the hopelessness of their environment are as much to blame as anything for their condition.
Immediately after the 1989 revolution that overthrew communist rule, the plight of Romania's orphans made headlines in the world's press. There were adoption schemes, a high-profile "challenge" television programme hosted by presenter Anneka Rice, and hundreds of stories written. Then the media lost interest, and public concern waned.
The Spital Neuropshici di Copii, infamous as Romania's worst orphanage, lies in the bleak and snow-bound town of Siret just two miles from the Ukraine border. It was built as an army barracks in the 19th century and later used as a prison. From the outside it is grim and foreboding. Inside it is worse, like one of Hieronymus Bosch's nightmare visions or a Hogarthian image of 18th-century Bedlam. Daniel O'Donnell, the Irish singer who, over the past two years, has raised more than pound;700,000 to try to get children out of the hospital, has a more succinct description. "It's hell on earth," he says.
As you enter through dilapidated double doors, the stench is unbearable and hygiene is obviously rudimentary. It comes as little surprise to learn that several children die of hepatitis each year. Each of the three floors is divided into a series of "salons", small rooms that house 20 children and maybe a dozen cots. Multi-occupancy beds are common.
The Romanian staff, who are paid a pittance, seem almost robotic, unaware of the value of a little humanity. Their skills as carers are almost non-existent. Nobody talks about it much, but beatings are commonplace. When the children are not in bed, they sit at long, low tables, rocking back and forth. There are few toys and even fewer books. Hardly any of them can read or write. On the wall chart in one salon the names of George Pintilei, 10, Danui Saftoiu, 12, and Bogdan Rosu, four, have "HIV+" written beside them. The room houses another five suspected cases.
The word "children" is misleading. Some of the inmates are in their 20s. In the basement is an ill-equipped and damp classroom where a group of young men between 18 and 21 sit looking at Noddy picture books, more suitable for three to four-year-olds. Outside in the corridor is Kojan, a 28-year-old who was placed in the orphanage when he was six following an epileptic fit. Nothing else is wrong with him but, after so long in this dreadful institution, rehabilitation into the outside world will be difficult.
Then there is Stefan, also in his 20s, who spends his days walking sadly up and down the hospital's long and crumbling drive. He has mastered a few phrases of English - "you OK?" and "thank you my friend" - which he tries out endlessly. He's physically disabled but with help could look after himself. He's desperate to escape but doesn't know how.
Ten years ago, a teenage Stefan, looking very much as he does today, featured in Anneka Rice's TV programme about the Siret institution. Yet he is still here and his situation remains unchanged. Ms Rice played a noble part in highlighting the plight of Romania's sick and abandoned children. But the situation was too grave and the problem too vast for any quick-fix solution. Basic facilities were briefly improved and buildings refurbished. But a decade on, conditions remain deplorable and the children continue to lack adequate medical, psychological or nutritional care.
But if the rest of the world forgot about the Romanian orphans, one woman did not. Monica McDaid first travelled to Siret in 1989 on a two-week visit. More than a decade later, the former teacher, who spent 20 years at comprehensives in Manchester and Birmingham teaching general science and theology ("I thought the balance of laboratory and religion would keep my feet on the ground"), is still there. When she saw the horrifying conditions, she knew she had to try to do something.
It was Ms McDaid who "challenged" Anneka Rice, and then set up the Romanian Challenge Appeal to build on the interest fostered by the programme. Initially she ploughed all the funds raised into attempts to improve conditions in the hospital. Eventually she concluded that the task was futile, and over the past two years, with the help of Daniel O'Donnell, has switched her strategy to creating smaller, purpose-built homes that can take the children out of the orphanage and give them a new life in a more nurturing environment with properly trained staff and qualified volunteers.
More to the point, with a string of chart records in Britain and Ireland and one of the most loyal and devoted followings anywhere in pop music, Daniel O'Donnell has persuaded his mostly middle-aged female fans to donate pound;700,000 since he became involved in early 1998.
Encouraged by Eileen Oglesby, a long-time supporter of the Romanian Challenge Appeal and a family friend from Kincasslagh, the village in Donegal where he was born and still lives, the singer visited the Siret orphanage in February 1998. Ms Oglesby had secretly shot a video in the orphanage which showed children eating off the floor. Mr O'Donnell had seen the images but only when he saw the full horror for himself, like Ms McDaid before him, did he decide to do something.
Nine months later, in December 1998, the first home built with money he'd raised opened its doors. Today the hostel is home to 12 girls who had previously spent all of their young lives in the orphanage - 10 able-bodied and two with cerebral palsy. Mr O'Donnell opened a second home, about a mile away, just before Christmas 1999. It is now a haven for 28 former inmates of the institution.
Whereas a visit to the hospital at Siret engenders only hopelessness and despair, the homes, barely a mile away, prove the possibility of making a difference. Life in the orphanage is based on the law of the jungle - given sweets, the children will steal them out of each other's mouths - but the transformation once they are taken out is dramatic. The able-bodied girls in the first home care attentively for Adriana, who has cerebral palsy. She is 17 but looks like a seven-year-old.
With every facility and a caring staff, the children in the two homes are also getting a proper education for the first time. "You have to adapt to their needs. Some of them are literate to a limited degree but many are not," says Mary Madigan, a 40-year-old language teacher from Galway who is on a two-year career break. Around her sit Adrian, 13, Dabija, 15, and Catalin,12, three unusually small but otherwise normal and happy young boys. Five days earlier they were in the institution, and the difference is already marked. There is a light in their eyes and a personality shining through. "Eager isn't the word. They want to learn so much," Ms Madigan says.
"Far from being mentally disabled, some of them would be accelerated learners if they had the chance. In the hospital they sat around all day with nothing to do. They never had books or pencils. Now they are thrilled just to have a simple pen to call their own."
The scale of her task is evident from the pictures drawn by her charges when they first moved into the home in mid-December. The stick-like figures are at the standard of the average four-year-old. And the simplest sights drive home the extent of their tragedy. In the neat and welcoming school room, with pots of new pencils and alphabet flash cards on the walls, a Romanian teaching assistant reads to a mixed age group from a translation of Oscar Wilde's The Happy Prince. Even the 20-year-olds are transfixed. "They've never had anyone read to them before," Ms Madigan explains. "Can you imagine reaching adulthood and never having been read a story?" When she isn't teaching, Ms Madigan is cooking or sorting out the laundry. "But it has to be about empowering the Romanians to take over and run the homes themselves," she says.
Later, Ms McDaid says: "When I came first there were 650 children in the institution. I was told they were all mentally disturbed. I didn't believe it. But it was horrendous. Urine was running down the steps and three or four children were sleeping in each cot. I thought 'This is Europe. This shouldn't be happening'."
She was determined to do something but found litle interest. "It was a job for the international aid agencies not one teacher from Birmingham who only went out to Romania for two weeks. I tried to enlist the big charities' help but nobody picked it up. Then we got Anneka Rice to take up the challenge".
Ms McDaid had planned to return to her school in Birmingham but she never went back. "Anneka tried to renovate the hospital as much as she could in three days and bring food to the children. Then she said on television somebody would always be here for them. I wondered who she was talking about - it turned out to be me."
"I didn't speak Romanian. I didn't understand charity work. But I felt she was saying to me maybe you can help carry on. And the children were looking at me and I couldn't walk away. So I said 'no problem. I can live here for a year'. I was out of my league. But volunteers were offering to come out and people were donating materials. I felt if I didn't stay, all the help and goodwill would be lost."
So she learned the language and found out how to run a charitable organisation, handling everything from fund-raising to hands-on care of the children. "We were trying to teach children to drink from a cup. It was as simple as that with the most disabled. Then we got some medical and educational input and a physiotherapist. People came out and told us what we had to do."
But after eight years of effort Ms McDaid began to feel she was getting nowhere. "I realised we had done all we could to improve conditions. I initially thought the aid would enthuse the Romanian carers and relieve them of the burden of clearing up the urine and the shit every day. It didn't happen.
"We were still asking people in Britain for money to replace taps or light fittings and I realised I wasn't doing what I was here to do. It hit me between the eyes that the children's condition hadn't improved. There were still the same numbers in the cots. We had to break the cycle of deprivation. We had to start a programme of socialising them, hygiene and educational programmes, taking them into the town, trying to instil self-respect and a little bit of dignity and give them a voice."
Ms McDaid concluded that the only answer was to get them into a new environment. This coincided with a government plan to de-institutionalise the children. But neither the government nor the Romanian Challenge Appeal had the resources to build the houses required.
Which is where Daniel O'Donnell came in. "Initially it was just a one-off charity thing," he says. "I had this song, Give A Little Love, and I could see the words of the song reflected in the pictures I had seen from the orphanage. I'd never made a charity record before but I realised that was what the song was for. I couldn't come out here and work in the physio ward but I could open my mouth and sing." The record raised pound;50,000.
Mr O'Donnell's visit to Siret cemented his commitment. "I came out here to make a video for the song and I was waiting for my wings to grow because I had done my bit." Instead, he says what he saw "clipped" his wings. "I wasn't prepared for it. I had to put my sleeve over my mouth because the smell was so bad. I couldn't let those children live like that. It was my chance to justify the privileged life I have."
Mr O'Donnell asked Ms McDaid what could be done. "She said we needed to bring the children out of the institution and build houses for them and it would take a million pounds. So I said 'Well, we'll have to do it'."
On his return he mentioned what he had seen at a concert in Belfast and a female fan came backstage afterwards to give him pound;100. "Now wherever I sing I talk about the children. Some fans have coffee mornings to raise money but all I've asked people to give is pound;1. If one million people do that we have pound;1 million."
Mr O'Donnell is three-quarters of the way towards his target, although he has no intention of stopping there. "You've seen the faces of the children in the houses and the joy, so you know it has been worthwhile. I get emotional not at the horror of the institution but when I visit the homes. You see the happiness and the hope, and remember the children left behind."
Ms McDaid describes the day in December when 28 children left the institution for the new home as the happiest and the saddest of her life. "Those who were leaving the orphanage were talking about a new life. And the children left behind were on their knees saying 'please don't let me die in here'."
A walk around the hospital with Mr O'Donnell reinforces the feeling of desperation. In several of the salons new toys have been laid out on the tables, straight out of the boxes. They sit there untouched, and the children seem confused about what to do with them. It's as if they don't even know how to play. "These are here for the cameras. I've never seen toys out like this before at all," Ms McDaid says. Sure enough, by the time we have visited the first half a dozen rooms, the toys have run out and the tables in the remaining rooms are bare.
Kojan, who was bitterly upset to have been left behind, asks if the singer will build another house for him. Mr O'Donnell says he will when he has more money. "Will you get the money tomorrow?" Kojan asks innocently. At 28 he knows nothing of the way of the world, but is smart enough to realise the children of Siret have been forgotten and Mr O'Donnell represents one of their few hopes.
"The memories I shall take home from this visit are of the children still in the hospital," says Mr O'Donnell. "I couldn't understand their words but I could understand their need and the intensity with which they asked me to build a home for them. Kojan has a sister in the orphanage who is handicapped. He needs to get out to better himself and help her. It's not much to ask."
Mr O'Donnell's priority is to build more homes. Ms McDaid agrees but strikes a note of caution. "We want to work with the Romanian government to de-institutionalise the children and bring them into the community. To do that we have to build houses and give them an education. But then we have to find a way of sustaining the homes."
Keeping each child in a home costs pound;2,000 a year, and Ms McDaid is promoting a scheme to encourage companies to sponsor a child for five years, allowing Mr O'Donnell to concentrate on raising money for building more homes. She also has a plan to buy the land around the second, larger home. It was once a collective farm and, she believes, could make the homes self-supporting. She seems to want nothing for herself except the satisfaction of knowing she has made a difference. But she won't rest until the other 400 tragic cases in the orphanage have also been given a new life. The emotional and organisational pressure must be intense, and you wonder how she keeps going. "It takes so little to achieve so much," she answers. "What else could I possibly do?" Donations can be sent to Daniel O'Donnell (Romanian Challenge Appeal) , co Ritz Music Group, 33-35 Wembley Hill Rd, Wembley,London HA9 8RT
* ROMANIA UNDER PRESSURE
There are an estimated 90,000 children living in under-funded, state-run institutions in Romania, a country with a total population of 22 million. The number of children in institutional care has changed little since the fall of Ceausescu 10 years ago.
Romania has applied to join the European Union but has been told that it must resolve the "leagan" (orphanage) problem before it can enter negotiations. Romania's official government policy since 1997 has been to de-institutionalise the children and give every child the oppportunity to grow up in a family. In reality, efforts have been hamstrung by a lack of resources and bureaucratic wrangling.
Last month a law was passed establishing a national agency for the protection of children's rights, which will for the first time have overall responsibility for all of Romania's institutionalised children and which will be directly accountable to the prime minister. Previously, responsibility had been shared between a range of government departments and local bodies. Aid agencies hope that the changes will lead to a more progressive attitude on the part of the authorities.
Although the problem remains most acute in Romania, the European Children's Trust reports a similarly distressing situation in state-run orphanages in Albania, Bulgaria, Moldova and the Republic of Macedonia. The trust can be contacted on 0171 248 2424.