EMACIATED and listless, Elianora looks three years old but is actually 17. She spends her days in a cot barely 3ft long, staring blankly through iron bars at the mustard stone wall of a bare room that defines her entire world. She is unable to lift her withered arms.

For one hour every two days, Elianora escapes her little prison for some physiotherapy on her wasted limbs.

In a neighbouring room Erhan, 7, has one leg tied to the end of his bed with a pair of purple tights and both arms bound to stop him being “aggressive”.

He is alert and lively — and smiles a toothless grin when his free leg is tickled — but overburdened carers can only give him therapy for one hour every three days.

Elianora and Erhan’s “home” is tucked away in the village of Medven in the mountains of central Bulgaria. Medven is one of many isolated spots where Bulgaria conceals deprived and abandoned children.

For children such as these, the country’s prospective entry into the European Union has brought no respite from suffering. Unlike neighbouring Romania, Bulgaria was not forced to improve childcare as a condition of EU membership.

Written off by their families, 51 mentally disabled children exist in Medven under the care of a single qualified nurse and a few unqualified supervisors.

Their home is bleak and unwelcoming. The cold floors reek of a disinfectant that masks the smell of unappetising food. Heavy silences are broken not by laughter but by the occasional anguished wail.

For the most severely disabled children — who suffer from cerebral palsy, Down’s syndrome or heart disease — life is experienced only within the confines of a metal cot.

The cots are crammed side by side in small rooms with a paltry scattering of toys and no visual stimulation. The children are left to stare into space.

One little girl bangs her head repeatedly against the metal bars. Acen, 7, who has Down’s, jumps up excitedly, smiling and cheekily blowing raspberries as visitors enter the room.

The atmosphere is so oppressive that few outsiders venture into the Medven institution. That day’s shift nurse, Sister Kodinova, said only one or two families came regularly. “Most (of the children have parents but the conditions are so hard that they don’t visit,” she explained.

She added that the institution survived on the goodwill of donors as government funding barely covered the cost of medicine and wages. “We need everything — shoes, clothing, sheets, food, Pampers. It’s very hard,” she said. The staff, who clearly care for the children, are simply overwhelmed.