In Georgia, many children with disabilities end up in state institutions, hidden away from the rest of society. Lack of funding means that care is often poor. But a new project launched by the United Nations children's charity, Unicef, may be about to change this.
Driving west from Georgia's capital Tbilisi, the road drops into a beautiful, green valley.
Hidden from view, few Georgians know about Kaspi
Turn left and a bumpy lane takes you past attractive cottages, surrounded by orchards, heavy with fruit.
Crunching along the gravel you pass a ruined factory.
It is a hulking shell. Concrete walls crumbling, steel girders, like an exposed skeleton, rusting slowly.
There are factories like it all over Georgia, evidence of an economy that collapsed following the Soviet Union's demise.
Cross a stream and you reach a set of gates. Beyond them is a long, double-storey building hidden behind some trees.
In the grounds, nurses in white coats watch over children. This is the Kaspi Children's Hospital, one of two institutions in this former Soviet republic where children with severe mental and physical disabilities are sent.
As you walk down a long, dingy corridor you can hear crying and moaning.
Occasionally there is a piercing scream.
Push open any door and, in each grimy room, you will find a small group of children, a single electric bulb, a few battered, old pieces of furniture, and a wood stove for heating.
Some of the children are in wheelchairs, listless, their heads lolling to one side.
In Georgia disability carries a serious social stigma. The state's only way of dealing with abandoned children has been to shut them away, out of sight
On a bench sit three young boys, none is more than four years old.
They are hunched, rocking back and forth, one sobbing gently. Another boy, perhaps seven years old, bangs his head rhythmically against the window frame.
The wood is splintered and broken from the blows.
Kaspi is home to 100 children. Most have been rejected by their families and dumped here.
In Georgia disability carries a serious social stigma. The state's only way of dealing with abandoned children has been to shut them away, out of sight.
Such attitudes towards disability are common in Eastern Europe and Central Asia, a legacy from Soviet times.
Georgia's situation is exacerbated by the economic collapse.
The country used to enjoy the highest standard of living in the Soviet Union. Now, half of all families live below the poverty line.
Georgia's government, to its credit, has acknowledged that institutions meant to care for children can harm them. But few families want the disabled children back
State institutions simply cannot afford to give the children proper care.
Each nurse at Kaspi earns $25 (£14) a month. That is less than half of official poverty wages.
The children get little love and no special therapy. Deprived of stimulation and treatment their disabilities grow more severe.
Nowhere else to go
In the music room we found 12-year-old Rosa, a slim girl with cropped dark hair and deep, dark eyes.
Rosa has schizophrenia and is Kaspi's newest arrival.
Even when she reaches 18, Rosa may end up staying in the hospital
She is intelligent and well aware of where she is.
Crying, she told us her parents had both died.
Her aunt, it seems, did not want to care for a child with a mental illness. So the aunt told Rosa she was taking her to school, and brought her to Kaspi.
"I don't like it here," said Rosa through her tears. "I'm angry with my aunt, she lied to me. I want to go home."
Officially the children are meant to leave at 18 years old. But most have nowhere else to go so they stay put.
A few committed organisations like the UN Children's Fund, Unicef, and the charity World Vision are trying to change this.
Georgia's government, to its credit, has acknowledged that institutions meant to care for children can harm them.
But few families want their disabled children back. Just two children have moved out of Kaspi in two years.
So the emphasis now, is on trying to prevent the children from being abandoned.
In Tbilisi I was shown a pilot project, a Unicef sponsored kindergarten, where children with disabilities are taught in a regular school.
Changing the way disabled children are treated in Georgia will take time
The effect is astonishing. They are stimulated and engaged, completely different to the sad, introverted children in Kaspi.
At the kindergarten, parents get classes in how to care for disabled children at home.
I met Maya, a mother in her late twenties. Her son, Dimitri, has cerebral palsy and is in a wheelchair.
When her husband realised the boy was disabled he left Maya and Dimitri.
She was, she says, too ashamed to take her son out in public. But she has now changed her thinking. She brings Dimitri to the kindergarten every day and wants him to go to a normal school.
The difficulty is that it will take money and time to reform the system and change attitudes to disability
Dimitri is a chubby, happy boy. A perfect advert for the benefits of keeping children in a loving, family environment and out of cold, hidden institutions like Kaspi.
The difficulty is that it will take money and time to reform the system and change attitudes to disability.
Meanwhile, Rosa and others will stay stuck where they are, isolated, unhappy and alone.
From Our Own Correspondent was broadcast on Saturday, 6 August, 2005 at 1130 BST on BBC Radio 4. Please check the programme schedules for World Service transmission times.