Young children in straightjackets, groups of mentally disturbed adolescents spending their days in bleak rooms sitting in eerie silence, babies nearly starving to death.
Though there have been improvements, such conditions are still a reality in many of the Romania's orphanages 10 years after the fall of dictator Nicolae Ceausescu.
ABCNEWS 20/20 first reported on Romanian orphans in 1990 after a revolution overthrew the communist ruler and uncovered his bizarre plan to force women to have at least five children for the state.
The result was a proliferation of babies in overcrowded inhumane institutions. In one orphanage 20/20 visited in 1990, babies were stacked on the shelves of a cart like loaves of bread.
Bucharest today is a bustling, modern city — a stark contrast to the smoldering ruins of the 1989 revolution.
In the 10 years since 20/20's 1990 report, the world donated millions of dollars in aid to Romania's children and thousands of families have rushed to adopt.
Recently, 20/20 returned to Romania and discovered that the conditions of many of the orphanages had improved dramatically since the first report.
20/20 visited an orphanage in the northern town of Sighetu, accompanied by former resident of the facility named Izador Ruckels. Ruckels, 21, now lives with an American family in southern California and was returning to the institution where he lived for the first ten years of his life for the first time.
The same children whom he had lived with in squalor, without clothes or proper healthcare, were now decked out in suits and skirts. They had even prepared a musical performance for their old friend — a far different picture from the concentration camp like conditions 20/20 reported on in 1990.
Disturbing Conditions Persist
While conditions for many of the state run orphanages have clearly improved, there are still a troubling number of children living in squalid environments without adequate attention.
Many babies lie in cribs sucking on propped up bottles with very little human contact. At the "Showcase Orphanage" in Bucharest, there was a room full of toddlers with little to do and no caretaker in sight.
In order to visit the institutions, clearances had to be obtained from the government well in advance, which raises the question of whether the improvements at some institutions are superficial — a performance for visiting foreign journalists.
Indeed, a look past the cheerful exteriors revealed that many of Romania's orphans still endure disturbing and inhumane existences.
20/20 correspondent Tom Jarriel wondered off of the guided tour at one orphanage and discovered two young children covered with blankets, their arms tied behind their backs.
The orphanage director explained that the children were bound to prevent self-mutilation. It was a necessary measure, she argued, because the facility did not have staffing to provide individual caretakers for each child.
After 20/20 left the Sighetu orphanage, Ruckels returned document how conditions of the facility had changed when the television cameras were gone. Sadly, the cheerful environment that greeted 20/20 weeks earlier bore little resemblance to the grim conditions that Ruckels witnessed.
Some children were confined to straightjackets or tied to their chairs with their own shirtsleeves. There were toddlers who banged their heads against their steel cribs, sitting in their own urine.
Michelle Kelly, an American who runs a private orphanage in Romania rescued a child named Zambo from a facility in the northwestern city of Oradea who was literally starving to death. At 3 years old, the boy weighed only eight pounds. In the care of the state he had been tied up in a crib and left to die. Under Kelly's care, Zambo gained more than twenty pounds in three months.
Children who run away from the orphanages, or "graduate" from the institutions at age 18, face grim prospects and often end up living on the streets.
Illiterate, untrained and with no place to go, many of these kids earn a meager living by begging or prostituting their bodies. At night, communities of kids take refuge at night in the labyrinth of filthy tunnels that snake beneath the streets.