In the children's ward of Moscow's Cancer Institute, the patients, many of them bald and frail, rocked happily to Saturday's musical performance by a group of American students.


Such visits to the hospital by performers of all kinds are commonplace nowadays -- to the point where the children often look for more than just entertainment.


"From the foreigners, they usually expect presents," said Marina Bialik, a psychologist for the children's ward. "It is a habit now for the children."


This wasn't the case three years ago when performers, let alone gifts, were a rarity and the children were not visited by anyone other than their parents and the occasional church group, Bialik said. But, the volunteer work of expatriates and the slowly shifting attitudes of Russians toward the concept of volunteerism are changing all that.


Saturday's festivities in the children's ward were part of the United Way charity's "Day of Caring," which included weekend events at 12 different sites around Moscow. At each place a group of volunteers -- mostly foreigners -- was paired with organizations helping sick, handicapped and orphaned children.


Aside from helping children's groups, the larger aim of the twice-yearly "Day of Caring," is to serve as an example of how a volunteer program works in a society where, until recently, volunteering was rarely voluntary.


"Our idea has always been to establish this as a model by involving Westerners in a way that sets an example for community volunteerism," said Paul Murphy, director of United Way International in the Newly Independent States. "I really believe that the old attitudes towards volunteerism are changing, particularly with the younger generation. I think it is part of the evolution into a different society -- knowing that you have to take somebody's hand and walk with them."


Crucial to that evolution is overcoming the communist legacy of forced volunteerism which still gives the very word a negative connotation.


Although the majority of participants in the third Day of Caring were expatriate westerners , organizers said a growing number of Russians are taking part in the activity. Lena Gusakova, a 22-year-old student from the Moscow Linguistic University, joined a group from the school to spend the day with the toddlers from Orphanage No. 12 in southwest Moscow.


"I'm going to tell my girlfriends about this and I think they'll come in the future," said Gusakova, as she watched over children in the orphanage's playground. "I think it'll grow. Russians are kind-natured and they take to heart other people's problems."


However, Gusakova cautioned that until Russia's economic situation improves, volunteers may be scarce. "The situation is so difficult and people are so tired with their own lives that they may despair and forget about others ... But kind people will always exist."


At a recent conference for dozens of nonprofit groups, the consensus at workshops and in discussion was that there is much progress to be made in educating the public about western-style volunteerism.


"The attitudes haven't changed a lot. It's a pity," said Katya Greshnova, a program coordinator with World Learning Inc., an American group which sponsored a recent conference for dozens of nonprofit groups. "The main problem is that the traditions that existed before 1917 were lost during the Soviet period."


World Learning, which dispenses and now monitors the use of some $15.8 million in United States government aid to non-government organizations in Russia, uses the same philosophy as United Way. American nonprofit groups are given grants from the United States Agency for International Development to work with Russian counterparts with the aim of eventually boosting volunteerism and making the Russian groups self-sufficient.


With over 100 participants, the three-day conference was the largest of its kind in Russia, said Ruth Pojman, a project officer with World Learning.


While the programs of both the United Way and USAID use Western traditions of charity as models, Pojman said legal and cultural differences often make things difficult. Fundraising, for example, is a problem.


"There are some success stories, but not big success stories because there is very little incentive for businesses to give money," she said. "There are no tax breaks."


Russian volunteers, too, tend to be different from their Western counterparts. They typically do not think of themselves as volunteers but as merely working in an area in which they have a direct interest, Pojman said. She described Western volunteers as "more casual" and less likely to have a direct interest in the cause.


Greshnova said the first encouraging signs emerged from the conference. The number of volunteers "has really impressed me because very few people can afford to work for no money," she said. She cited an impressive ratio of volunteers to staff members of up to 20 to 1 at some of the women's organizations which attended the conference.


In some situations, however, volunteers have received peculiar reactions from those whom they wish to help. Tony Dutcher, an American college student who was working Saturday with the children at the cancer hospital, said he recently offered to teach English to Russian students.


"It was difficult. I went to a nearby high school in mid-September to volunteer. They had a hard time understanding what I wanted to do," said Dutcher, 18. "Even after I explained, they still thought it was all for money."