Horrific pictures of Romanian orphans chained to their cots, listless and staring into space are now rare. But after the fall of Ceausescu, conditions actually worsened for many orphans.
Simona Miu, 24, who in 1998 was a local volunteer in an institution in Titan, Bucharest, said: "When I asked (the staff) if I could change the soiled nappy of a seven-year-old disabled boy, I was told 'Don't bother'.
No one cared.
"I was not even allowed to give the children any extra food brought from outside. The children were not washed," she said.
Family-care and EU funding have begun to transform some of these lives, however.Eva (not her real name) had been in a notorious institution in Maramures County, Romania, from age two because she was blind.
To stop her self-harming, the staff tied her arms and legs so that her body was bent almost double. She existed like this till she was 15, when the British-based charity Hope and Homes for Children (HHC) found her. Eva is now 18 and has begun to walk with support and can feed herself.
Irina (pictured above), now 13, spent most of her life confined to a metal-barred cot in the same orphanage as Eva. It housed 250 special needs children. Deprived of human contact, she was unable to walk, and beat her face with her fists.
After a year in a small family home, Irina is receiving specialist care and is thriving. She no longer displays self-harming behaviour.
"She has taken her first steps and is now able to move around independently with the aid of a frame," said Beth Maughan, of HHC, which has been involved in closing down nine institutions in Romania.
Even as matters begin to improve in Romania, Bulgaria is a cause for concern. Amnesty International has highlighted the remote mountain institution of Dzhurkovo, caring for 70 children with mental disabilities.
Conditions were so poor that at least six children died during 1995-1997.
In its latest report on the EU accession countries, Amnesty says that despite some improvement in Dzhurkovo,"little has changed in the life of most children". Until Bulgaria develops a plan for de-institutionalisation, children will remain at risk in the country, Save the Children Bulgaria says.