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“Chamber VI”-Patients Are Beaten in Mental Hospitals

September 19, 2007

If you hear somewhere that a nurse took off a slipper and hit a patient, don’t think that it is a rumor. It is true story and similar facts happen in Georgia in XXI Century.

The Georgian Parliament will hear similar stories at their autumn session when they will be introduced with the report prepared by Monitoring Group of Public Defender’s Office.

Monitoring in mental hospitals started in 2005 and covered the whole Georgia. Archil Talakvadze, coordinator of the project and chief specialist of the Public Defender’s Office, said regarding the difference between 2005 and 2007 that situation has improved since 2005; however, the monitoring conclusion will be too critical because human rights are still violated in the field.
The research showed details that are familiar to the relatives of patients as well as to medical personnel-almost all rights of the mentally disabled people are violated. They do not know anything about their diagnosis; when they will be discharged from the hospital. Very often patients are beaten, tied up and made fun of. Sometimes they are forced to work.

They cannot speak about these violations but questionnaire, drawn up by professionals particularly for them, exposed the real picture of mental hospitals.

Archil Talakvadze recalls that in 2005 the situation was much worse in the field. They discovered the facts of long-term treatments in hospitals, patients were out of social habits, their treatment was provided by medicines only, the nutrition was bad, there was anti-sanitary in hospital, medical personnel treated them rudely and punished them severely…

That time strict conclusion was submitted to the Ministry of Healthcare together with some recommendations. In 2006 only small part of those recommendations were foreseen by the Ministry; though not completely.

“They refreshed living conditions and changed personnel. They have not had any schedule yet. They started consultations with NGOs and hospitals got into desire to change something. Some of them installed a box for complaints in order to learn about critical ideas of mentally disabled people. For example, similar boxes appeared in Batumi and Surami hospitals. However, because of short funds it turned out impossible for them to implement the standards we had demanded.”

Talakvadze defined that alternative methods of treatment have been introduced in the field. Those methods are oriented to restore those skills of patients that will help them to reintegrate into the society.

The problem of forcibly prolonged treatment has been partially resolved. The reason for the problem was the funds that would disappear together with the patient. Consequently, if patients stayed in hospital for a long time they were allocated more money. Representatives of the Ministry of Healthcare state that similar situation must have been improved by the introduction of new methodology.

Sofio Lebanidze, the head of the Department for Healthcare and Urgent Situations, clarified that in 2006 the hospital budgets depended on the length of treatment. In 2007 State Programs’ format changed that system.

“Patients were arranged in various groups-acute, sub-acute and permanent patients. Funding also depends on those categories. While six lari was apportioned for one day of treatment, nowadays that money has increased. More precisely, acute patients receive 32 lari a day, sub-acute ones receive 15 lari and permanent patients receive 8, 6 lari. This sum includes nutrition and complete medical treatment. The program budget for 2007 is 4 960 000 lari, I mean for Mental Hospital. As for out-patients, they have apportioned additional sums.” So, in 2006 the program budget was 3 337 300 lari and in 2007 it increased by 1 622 700 lari.

To compare the current situation with the one before monitoring started, the budget of the field increased by 30 %; however, Archil Talakvadze pointed out (who worked at the Ministry of Healthcare before he moved to Public Defender’s Office) that hard situation in psychiatric hospitals cannot be improved by repair works and better food. Positive changes can be observed in Kutiri, Batumi and Surami hospitals. Harder situation is in Asatiani and Bediani hospitals.

“Forced labor is still problem in these institutions-they pretend not to use the labor of their patients but it is fact that mentally disabled people clean hospitals instead nurses. Very often patients are discriminated. Those who are close to the administration enjoy better conditions. Doctors think that it is unreasonable to discuss the health conditions of patients with them because they will not understand it,’ said Archil Talakvadze. 

Nino Andriashvili, lawyer for Human Rights Center took part in the work of Monitoring Council. She said that hospitals have neither lawyers, nor social workers or any other employee who will assist a patient in the case of necessity.

“We were also interested whether the patient was forcibly taking the treatment or not. If it was forced treatment, then in similar situation they must produce judge’s conclusion. However, as a rule, similar conclusions do not exist in hospitals. Patients do not know when they will be discharged from hospital. 70 % of them do not have information about their rights. Administration is obliged to put up their rights on the wall so that mentally disabled people could see it. Unfortunately, they do it only before monitoring.”

Andriashvili said that most patients did not tell truth because of fear of some other reasons during interrogation. However, the researches revealed several facts of beating in Kutiri and Asatiani Psychiatric hospital. It is common thing to punish patients by injections.

“Patients say that sometimes they are beaten by iron clubs or wooden sticks. One patient said that a nurse took off her slipper and hit him. They have quarrels on various things. They do not have place to put their stuff anywhere. Living conditions are terrible; particularly in Asatiani Hospital. We should remark that we warned the administration two or three days before our visit and they prepared to meet us-we learned about it from patients. Sick people said that very often they were made to work for what they received a cup of coffee. It is remarkable that coffee is prohibited for them.”

They have spy patients in hospitals. Administration learns about the current situation from them and then they will punish those about who they have discreditable grounds. 

Nino Andriashvili recalls one patient with diabetes who needed special diet; however, nobody paid attention to that. Just the opposite, when she asked for food and medicine, personnel was shouting at her. The patient told Adnriashvili that her sister was giving her pension to the deputy director of the hospital and asked to take better care of the sick woman. They had signed even a document according to which the nurse should have paid more attention to the patient-to buy fruit for her, etc. However, the mentally disabled person said that they did not spend that money on her food.

In Bediani they did not have medicines expect special ones for disabled people. The reason for the lack of medicaments is bad road, as administration claimed… Doctors complained about low salaries and short funds. Talakvadze agreed with them..

“Doctors say that they need more information, training and good salary in order to have motivation. Nobody will go to work in Bediani for 300 lari. The hospital is isolated from the surrounding area during the whole winter. But in Kutiri, where personnel have higher salaries, specialists are better there. However, psychiatrists have chosen their professions themselves and it is their duty to protect patients’ rights. At least they must not violate it,” said Talakvadze.

Maka M. (we prefer not to mention her surname) left Asatiani Hospital a month ago. She describes the situation there in a very obscure manner; she told not only her story but others’ too. When you are there you live not only your life.

“Parents brought a girl under force; they were twisting her arms and made her stay in hospital for three weeks. They were punishing her in this way; otherwise she was not ill at all. I also got in hospital because of my family members for the second time and I do not know why they kept me in hospital for six weeks. You cannot imagine how a person feels because of unbearable situation there. I could not sleep at nights. The only relief for me was to go into chamber VI. Permanent patients are placed in that room. They are moaning and screaming all the time. You cannot stay there if you are not like them.”

Maka was sent to the chamber for patients with nervous breakdown and schizophrenia. Because of resistance, six people were holding her and they were treating her very rudely. As a result of the situation she had problems in kidneys.

“I have been terribly afraid of injection since my childhood. I have never had taken any injections in my life. Each time I have running blood pressure and feel terribly bad. In hospital they do not care about it at all; besides that they do not know to make injection properly. They did it on wrong place and my one side was stiff for four days. You should have seen it. My wrists and arms were all in bruises.”

Three years ago when Maka initially got into a hospital she was bounded to the bed whole night. Afterwards she returned home with scratches on wrists and broken limb.

This year she was a bit luckier because as she said she was in the chamber of patients with “protectors”. In that room patients are taken better care. However, it cannot be considered a great relief with the overall situation. 

“Facts of bounding up and beating the patients are still very common. Living conditions are terrible. The hospital has only one toilet and bathroom. Patients can take bath only once in four days. Food is normal. There is not much variety in food but patients are given meat, chicken, bread and butter, macaroni. But patients clean the hospital and nurses do almost nothing. More over, they give patients the keys to door and order to open door for guests. They have bad linen of course but I had mine. Before I left hospital administration bought mattresses and curtains.”

Maka also confirmed the fact that patients do not have information about their treatment procedure and nobody tells them the date of discharge. The date of discharge is simply “tomorrow’ or “the day after tomorrow”. Six weeks passed in similar lies in Asatiani.

But when she called the hotline, (its number is put up on the wall) and asked for help, the announcement was removed on the next day.                                                                                                                                                  

“It makes no difference whether you know your rights and call for help or not. They will get in touch with the doctor who calms them down and tell that it was mentally disabled people who had called. And what do you think, whom do representatives of hotline believe?” asked Maka who added that nurses often steal their things in hospital.

“The nurse stole my cigarette. So I broke her case at night. I found many things there -stolen loaves of bread, pills of Sibazone, etc.”

We told these facts to Sofio Lebanidze who expressed her doubt while conversation. “If similar facts really occur, the guardian should apply to corresponding bodies such as Ministry of healthcare and then professionals will find out whether there are any violations in the treatment procedure. I am very surprised if the situation is really such. However, we should point out that the reform is being carried out and all kind of changes take while.

Gocha Bakuradze, director of Kutiri National Center for Mentally Disabled People, cannot see any reason for pessimism. He said that little time ago visitors from Holland liked their hospital very much. There are 470 places in the hospital; mentally disabled people, who can commit a crime because of their mental conditions, are treated there. The administration seems to have prepared the hospital for the meeting with monitoring group. Bakuradze said that they have electricity supply; besides the therapy with medicines they have implemented a new art and labor therapy that has very good results. However, they do not have gas and it causes various problems. Nevertheless, Bakuridze said that with eight lari for each patient the situation has greatly improved.

“In Holland 600 USD is spent on similar patients and here we spend only five lari. Thus we should not expect huge changes with that money. We are doing our best.”

Nino Makhashvili, the head of the organization “Global Initiative in Psychiatry”, is working on the problem for many years. She explains positive attitude to the situation in mental hospitals by a great will to improve the situation. She confirms that as soon as similar institutions have similar possibilities, they try to improve something. The changes are easy to notice after many-year-stagnation.

“I cannot say anything promising regarding the human rights. What can I say when both patients and doctors have no information about their rights? Facts of disrespect are still frequent and common. We do not have any record of won cases at the court. When mosquitoes attack you in hospital you must bring suit against administration, you have no more way out.”

However, Nino Khimshiashvili thinks that main problem is still lack of personnel. Besides that there are many innovations in the field throughout the world and they have not been introduced in our country yet. We do not have information either.

“Unfortunately nobody wants to study psychiatry nowadays. Particularly hard is the situation about nurses. Personnel of hospitals are old people who will not be replaced at all. Young nurses do not want to work in mental hospitals. Nowadays, I have only one hope that the reform will change the situation and separate psychiatric divisions will be opened in common hospitals. In this case, nobody will call them Mad Houses and human rights will be better protected there.”

Eka Kevanishvili, Tbilisi

 

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