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The homes for the mentally ill –

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					The homes for the mentally ill –
poverty, cages and chains

Antoaneta Nenkova, Slavka Kukova, Bulgarian Helsinki Committee monitors

  On 28 January 2002, the European Committee for the Prevention of Torture
  (CPT) of the Council of Europe published a report on Bulgaria where it alleges
  that torture and ill-treatment practices occur in pre-trial detention, in prisons
  and psychiatric institutions in the country. The organization warns that mentally
  ill men are sentenced to a slow death in the home in the village of Terter.

  The report was published after the Bulgarian government sent its comments
  and gave the green light for publication, and it reveals the findings of the CPT
  visit to Bulgaria carried out from 25 April to 7 May 1999. The Bulgarian
  authorities sent two commentaries to the report. The commentaries from the
  year 2000 were returned for lack of comprehensive and specific information.
  The second commentaries were sent the following year. In their second report
  the Bulgarian authorities acknowledge that fist blows, kicks and truncheons,
  electroshock and blows to the soles of the feet are used in pre-trial detention
  facilities and prisons across the country. Furthermore, the authorities confirm
  the conclusion about the home in Terter.

  “The home for mentally ill men has been closed down and the men have been
  transferred to an institution which offers better hygiene and better living
  conditions,” says the report of the Kostov government. The truth however is
  different. Today, the men from the Terter home are living in three different
  homes for mentally ill persons – in the villages of Samuil, Radovets and
  Chuchurkata. These homes are no less appalling than the one they left in
  Terter.




S
       ome 30 homes for children with mental retardation exist in Bulgaria, alongside
       85 closed institutions for adults – 52 for mentally disabled individuals, 22
       psychiatric dispensaries and 11 psychiatric hospitals. Two thirds of these
institutions have been set up in desolate villages and obscure towns, far away from the
cities with a developed infrastructure.

As human rights monitors from the Bulgarian Helsinki Committee (BHC), we have
been to most of these places - Gorno Varshilo, Cherni Vrh, Radovets, Samuil,
Sanadinovo, Dragash Vojvoda, Chuchurkata, Pastra, Razdol… Several times in some
of them.

Sanadinovo – the Bulgarian Island of Leros
The first time we came to Sanadinovo in September last year, we found 96 ill women
who were wrapped in rags, lying on remnants of mental beds and bare springs, amidst
faeces and swarms of flies. Cages rather than drugs were used to control them…
Years ago people used to live up here in the mountain, 35 km from the town of
Nikopol. Landslides sunk the entire village of Osum. The houses disappeared. Only
the home for mentally ill women remained. Some of the women here hear voices,
others are epileptics, yet others are euphemistically called „mentally retarded‟.

The only way to get to this social care home is by a shallow broken metal bridge. The
only way out of this forgotten place is death.

A high white fence divides the yard in two. During our first visit the staff told us that
the small two-room building behind the fence houses the “idiots”… We still
remember the bodies crumpled in bizarre postures, two or three to e metal bed, lying
right on top the metal springs, swarms of flies covering the women‟s bodies. Filthy,
half-naked… this scene feels like a Felini film. The stench is overwhelming even on
the outside. The toilet is at the back of the room – two clogged holes in the middle of
a cement floor, and single cold-water tap. Faeces are everywhere – on the floor, on the
tattered clothes, the beds, the walls…

And then – a cage under the open sky. The “cooler”, as the staff explains, is where the
most aggressive residents are punished. “They‟re idiots, that‟s why keep them in the
cage,” the orderlies tell us.

During our first visit the cage was empty, but the second time six women are locked
inside – half-naked, squatting in the corner or sitting straight the ground. One of them
is not wearing any underwear… We meet with Christina Christova, deputy minister of
social policy, after every visit to a social home.

The cage is no longer there.

A week ago, we paid a third visit to Sanadinovo together with representatives from
Amnesty International and the US-based NGO Mental Disability Rights International
(MDRI). The picture is somewhat changed. The walls, doors and floors in the rooms
have been washed. The ward for the bedridden women has been closed down by the
epidemiology authorities for refurbishment. The beds have mattresses and bed linen.
The money from the social ministry went toward buying 13 tons of naphtha. Donor
aid helped buy 20 beds and 50 night tables. Only now the staff has to walk 10 km in
one direction to the home because the home cannot afford to cover their transport
expenses.

An investigation carried out by the Regional Prosecutor‟s Office in Pleven
recommended that the home is closed down. The Ministry of Labour and Social
Policy promised to move the institution and to give out a financial aid of 30,000 BGN
[15,000 Euro] for repair, food and drugs. To this day the money has still not reached
the social home, which is still standing in the mountain on the spot on the sunken
village of Osum.

Years ago, the scandalous psychiatric prison on the Greek island of Leros was closed
down thanks to international pressure. Today, Amnesty International insists that the
same happens with the home for mentally retarded women by Sanadinovo.
The home for mentally ill men in Dragash Vojvoda
registered 12 deaths in January and February 2002 alone. The death certificates give
heart and respiratory deficiency as the cause of death. Pavlina Ivanova, former home
director, however, believes that cold and hunger were the real cause of death in the
majority of cases. In three cases only was a post mortem carried out; the pathologist‟s
conclusion was bronchopneumonia.

This is the second time we have come to the home. The yard in Dragash Vojvoda
swarms with “officers and sergeants” – the men in this home wear greatcoats and
army jackets, most have put on a soldier beret, with flimsy sandals and rubber
galoshes on bare feet. We see them lying on the benches listening to the local radio
station. It is on air until 10 pm every evening and is their one and only source of
entertainment. 147 men with mental disabilities have been living here for years. Aged
between 18 and 60, they are diagnosed with mental retardation, epilepsy, and
schizophrenia.

Long one-floor buildings that were once premises of the local state agricultural
cooperative…

In one of the rooms, we come across a man sleeping in his greatcoat and galoshes on
the mattress. There are faeces on the floor, and urine at the far end of the room. The
beds have been made with clean white sheets. We are told however that there is only
one bed sheet per bed. The floor in the dormitories has rotted everywhere, one of the
rooms even has a hole on the floor. The ceiling looks like its about to collapse.
Windows without glass, torn our woodwork around the doors, dirty and sooty walls in
the dormitories, day rooms, washing premises…

Last January the Hygiene and Epidemiology Institute in Pleven insisted that major
repair works are carried out in the home. To this day the money for this purpose is
still unavailable.

The water cuts here are frequent – the water pump is so old that it breaks down every
week. There is no central heating system to speak of. A few hours of heat from the
heaters working on wood and coal every day is all the warm that the men here can
hope for. This home too has a “cooler” – an alcove surrounded with wire – used for
punishing those who run away or become violent.

The municipal social care department in Nikopol estimates that one half a million leva
will be necessary to renovate the home, build a central heating system and repair the
water system and pump. Amnesty International recommends that this home too is
moved.

Dolls on chains
This is how in 1997 the BHC described 48 women diagnosed with schizophrenia and
mental retardation from the home for mentally disabled women in Gorno Varshilo, a
small village near the southern town of Septemvri. Dog chains - and not drugs - were
used to control them.

Four years later, there are no chains in Gorno Varshilo any longer, but isolation and
immobilization of patients is still a matter of practice across the country‟s psychiatric
institutions and social homes for disabled people. A motley arsenal of leather belts
and canvas straps is used to tie the body and wrists to the bars or springs of the beds.
Chains are used in several psychiatric hospitals (Tzarev Brod, Tzerova Koria, Vratza)
or metal handcuffs (Patalenitza). The home for mentally ill women in the village of
Cherni Vrh, near Smyadovo, the residents were tempered with straight jackets or tied
with chains. We found three women locked in three cages, build especially for the
purpose only a year ago. We saw them a week ago. We were told that they had been
there for over a month.

Treatment in Bulgaria is most often carried out with the cheapest drugs and risky
electroshock without the use of anaesthetic. When this therapy fails to produce the
desired results, chains come into use.

The European Committee against Torture prohibits the use of straps and
straightjackets. Bulgarian legislation however lacks any standards on seclusion or
restraint.

Where are the mentally ill men from Terter today?
About a dozen men from the Terter home live in the North Bulgarian village of
Samuil today. A half-derelict building. Unbearable stench. For nearly a year, this
home has gone without running water; it is brought in with a cistern. Padlocks on the
doors, residents with shaven heads wearing filthy clothes, a day room with some 40
women – wailing, banging, moaning to the sound of chalga folk-music. Our meeting
with the home director is muffled by shouts coming from behind the closed door “Our
pensions are stolen,” “They beat us up in here.” “Terter was better,” the residents tell
us and explain that the orderlies and guards in Samuil wallop them with sticks and
clubs. A psychiatrist has not set foot in the home for over a year.

Located near the country‟s border with Greece, the home in the village of Radovets is
the second home which accommodated men transferred from Terter. The barbed wire
surrounding the buildings is visible from the road. This home has not one, but seven
cages for isolation and punishment. The first one is a cage for aggressive residents –
some 5 sq. m. from the yard surrounded by a wire fence. A little to the right we see a
similar cage, only slightly bigger – with four men locked behind a metal padlocked
door. One of them waits for the orderly to pass away and ventures: “When am I going
to leave? Why don‟t you take me?” Another one shows us a tiny „room‟ under the
stairs – a coal stockroom, where he had been locked for days. The room is locked with
a metal door, through which a piece of metal is cut off for supervision. The ceiling is
so low you cannot even stand up inside, and it is too shallow to lay or sit.

We ask the men if they want to have their pictures taken. They agree. Their photos are
not mere provocations to the senses. The photos can help. That is why we decide to
take them. We take photos also of the common graves where the deceased were
buried. As well as the coal stoves, and the only water fountain in the yard, and the
falling plaster, and the dirty blankets, and the miserable remnants of bed sheets, if
any, and the bare springs, and the army greatcoats donated by the army of the former
GDR which the men wear with the letters “HAMD” (home for adults with mental
disorders) painted over them to stop anybody from stealing them.

When they came to Radovets, the men from Terter were visibly undernourished and
showed signs of frostbite. Some did not make it through and died, while others “got
off” with an amputation – they could not escape from the hunger and the cold either.

And finally we reach Orsoya – the third social home where some 20 men from Terter
were sent. You can find this village amidst the fields on the way from Lom to Vidin,
in the vicinity which the locals call Chuchurkata. The first thing that strikes the first-
time visitor is the room with 50 men and women – this is their day room and their
refectory. The residents live in rooms without doors, with sooty and abating walls,
peeling plaster and rotting woodwork. Four clogged toilets can be seen in the yard. A
bathroom – of 10 sq. m. – without showers or taps. And only running cold water –
which is heated in a cauldron with an immersion heater, the residents wash
themselves by pouring the hot water with a cannikin.

After the Council of Europe visit in 1999 another one is scheduled to take place in
Bulgaria this year. If the CPT delegation visits the homes where the men from Terter
have been sent, it will certainly be shocked by the “change”.

The country spends some 100,000-150,000 BGN [50,000-75,000 Euro] for a social
home with 80-100 mentally ill residents. In the year 2000, 240 Bulgarian MPs cost the
Bulgarian taxpayers 19 million BGN. Parliament‟s budget for 2001 is 24 million
BGN. And the budgets for the social homes have either remained the same, or have
been cut.

				
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