Problems in Tbilisi Infant House

Nino Devidze

Poor access to healthcare, non-adapted environment for the children with disabilities, lack of rehabilitation programs – it is incomplete list of problems, which were revealed in Tbilisi based Infant House during the monitoring conducted by the Public Defender’s Office. 

Public Defender addressed to the Ministry of Labor, Healthcare and Social Welfare with the recommendation to estimate special needs of the beneficiaries at Tbilisi based Infant House. 

Natia Pirashvili, head of the Center for the Rights of People with Disabilities at the Public Defender’s Office, said, they visited the Infant House during non-scheduled monitoring. “As you know, the Ministry of Healthcare monitors infant houses but it is more internal audit that aims at the increase of level. Purpose of our unintended monitoring was to detect systemic and individual shortcomings and to respond on them.”

There are 55 beneficiaries in the Tbilisi Infant House; their age ranges from 0 to 6 years; 54 of them is disabled. “The visit revealed several problems; namely, the profile and service of the institution do not satisfy the special needs of disabled children: the institution does not have necessary entertainment facilities for the development of disabled children; Physical environment (buildings, balconies, yard). There are children who require long term medical assistance. Institution does not have medical staff for palliative care implementation. In the frame of the state program for children care and social integration, beneficiaries of Tbilisi Infant House shall involve sub-programs of habilitation/rehabilitation service that is absent for in the institution. We petitioned to the Ministry of Healthcare to evaluate special needs of the beneficiaries and act in accordance to their findings.”

Chief specialist at the Department for Social Welfare of the Ministry Maka Vardosanidze said, the recommendations of the Public Defender are almost equal to the recommendations issued by the Ministry. “Monitoring group of the Healthcare Ministry evaluated service in the infant house in compliance to the standards for children care. Every beneficiary of the Infant House has serious disability problems. We checked how timely they receive medical aid or rehabilitation service. Children, who needed shunting (two beneficiaries), will be operated on. However, there are beneficiaries, whose health problems are beyond medical assistance because if neuro-surgeons operate them on, the operations might end lethally. Unfortunately, rehabilitation procedures are not enough because children are not involved in state programs.”

Public Defender released recommendation about non-qualified personnel too. Natia Pirashvili said the personnel is not qualified for the work with the children with special needs. “In the past, this institution served only disabled children. So, majority of its personnel were trained in individual approaches to children but they have not taken specialized trainings.”

“General training program that was elaborated by the Ministry is not oriented only on the children with disabilities. The training course covers different modules, which includes needs of disabled people too. The monitoring revealed that there are staff members, who have not taken the course. It is noteworthy that personnel are often changed in the Infant House,” Maka Vardosanidze said.

In the frame of the ongoing children’s welfare reform, deinstitutionalization process of infant houses was to finish by the end of 2013 though the process has not started in the houses for disabled children. “Children, who could not involve alternative services, stay in the Infant House. As you know, in the frame of the children’s welfare reform, which was launched in 2010, the state was authorized to close all large orphanages. The state shall strengthen families of disabled children,” Natia Pirashvili said.

Ministry of Healthcare intends to amend the profile of the Infant House in near future. “Generally, the specifics of the institution will be changed in near future. We aim either to change its profile, or distribute their beneficiaries in other institutions according to their individual needs. Nowadays, there are no large residential institutions in the country. Children either return to biological families, or they are reintegrated in small family-type institutions. Soon, those houses will also close down because we are oriented at family environment,” Maka Vardosanidze said. 

Monitoring unit was created in the Social Department of the Ministry. Their representatives say the monitoring unit will eventually monitor institutions, that will improve quality of services in them.