Brutal conditions for people with mental disabilities in Bulgaria

"This place is not for human beings. You should close it down. People die here." These are the words of R.H., who lives in a social care home for adults in Dragash Voyvoda, Bulgaria.

Most social care homes in Bulgaria are unsuitable for the care of people with mental disabilities and many are not fit for human habitation. High death rates testify to the lack of sufficient food, warmth or medical care. Medications used in psychiatry are widely and inappropriately administered to subdue behaviour and have no therapeutic value.

Women with mental disabilities in the social care home in Razdol endure dreadful living conditions, gross neglect and systematic abuse. The buildings are derelict, filthy and dangerous, with no central heating. In winter, residents - some barefoot - walk on icy paths between the buildings, one of which contains a recently constructed bathroom. One dormitory, measuring 10m x 10m, contains 33 beds. The orderly explained that only two beds had sheets because: "The women are ill and they would only soil the sheets." A small wood-burning stove was not lit for most of the day.

With no rehabilitation programs or therapy, residents wander aimlessly around the grounds or lie in bed in their rooms. One woman, who complained that orderlies beat residents, was too fearful to identify the place in which she said residents were locked up.

The home's location, 20km from the main road in a mountain area, puts lives at risk. During winter months, when snow makes the roads impassable to vehicles, it can take staff three hours to walk to work. Between January and June 2002, seven residents died. None of the deaths was examined in a post-mortem.

In Radovets, residents have been detained in a tiny enclosed space under the stairs as punishment. One resident, Petko K, said that he had been held there for two weeks and then kept for 10 days in a seclusion room.

Another home, in Samuil, which was without running water for more than seven months, has only one toilet in the building for over 100 women residents - six holes in the ground in an outhouse, some 150 metres away. It was impossible to avoid stepping deep into excrement, which extended on to the path outside.

Children who live all their lives in social welfare establishments receive practically no therapy or rehabilitation. Those with the most severe disabilities may be left all day in their beds, without any toys or organized activities.

At the home in Dzhurkovo, where six children and an 18-year-old died from hypothermia and malnutrition in February 1997, there have been some improvements in material conditions. However, lack of specialist therapeutic or educational training seriously impairs the children's development. In October 2001, the most severely disabled children lay on beds with only plastic sheeting. Flies swarmed about one boy's bed. The children had no toys. Children of five and six years old with Down's syndrome had been so neglected that they could not stand unsupported. One girl had chewed through the wooden frame of her cot.

Government plans to reform the current mental health care system need to be adjusted to take into account the situation in social care homes which are currently not considered to be part of the system. One social care home was closed down in June, because the conditions were considered inadequate, and the closure of another is imminent. In August, the Ministry of Education and Science issued instructions that "children with moderate and severe mental retardation and autism" are entitled to be educated within the system. Officially, these children will no longer be treated as uneducable.

There is a pressing need to improve the life-threatening conditions in social care homes for adults. Without immediate and continuous therapy and rehabilitation, the lives of mentally disabled children will be irreparably damaged. AI is calling on the international community to support a comprehensive program of reform for Bulgaria's mental health care services. For further information see: Bulgaria: Arbitrary detention and ill-treatment of people with mental disabilities (AI Index: EUR 15/008/2002) issued 10 October 2002.