OVER the past few months, a great deal of world scrutiny has been on Bulgaria for the poor state of its "caring" facilities for children with disabilities and so-called "orphanages" which are at worst financially self-interested industries.

But even more disturbing was the report about the state of care for the mentally disabled, revealed on October 10 at the International Forum on Discrimination of People with Mental Disabilities, hosted by Amnesty International and the Bulgarian Helsinki Committee.

A new report, entitled "Bulgaria: Far from the eyes of society. Systematic discrimination against people with mental disabilities" showed the grave lack of respect for basic human rights of people with mental health disorders or developmental disabilities in social care homes and psychiatric institutions.

"And this is happening here in the heart of Europe, at the beginning of the twenty-first century, in a country which is aspiring to join the European Union," said Secretary General of Amnesty Irene Khan.

The report was the product of five research missions over a period of a year by Amnesty International, the Bulgarian Helsinki Committee and Mental Disability Rights, which visited three state psychiatric hospitals and more than 16 social care homes, including five for children. They spoke to the residents as well as the Bulgarian authorities, administrators and professional staff of the institutions, NGOs and human rights activists, and the conclusions were shocking.

The high number of deaths in Bulgarian social care homes, it revealed, testified to medical neglect and a lack of food and warmth, with residents sometimes physically restrained with chains or straitjackets, or secluded in a small room or a cage for an indefinite period.

In her observation, "A Life Worse than Imprisonment: Meeting Bulgaria's Mentally Disabled", Amnesty International's campaigner on Bulgaria Theresa Freese-Treeck writes of the horrors she encountered - the stink, the filth, the screaming, the despair. Women in the Razdol institution eating with their hands directly from plates, with eating being the only organised activity of their endless, hopeless days.

"I was appalled and felt helpless," she observed. "As I surveyed the situation - a scene I had seen so many times in still photographs and read about in numerous reports while campaigning for Amnesty International - and as I listened to the screaming, watched women rocking idly in front of their plates, eating soup with their hands, or sitting isolated in a corner, starting in apparent fear whenever anyone approached, I began to comprehend the horror of living in such an institution."

The Razdol home for women was her first stop among many Bulgarian homes for mentally disabled children and adults, which also included Tri Kladentsi, Mogilino, Kachulka and Samuil.

"All were situated in remote locations scattered across the country, approachable only by dilapidated roads, which in winter months are often unusable or, on a good day, can take one-and-a-half hours to reach by car from the nearest highway or urban centre."

The Razdol lavatory, she continued, was unbearable.

"It required a long trek to the end of a dark and windy corridor for the bedridden. The stench was daunting. A quick peek inside was all I could manage, holding my breath just long enough to enter and make it back around the corner to the main corridor where the smell was not so sickening. Stalls were streaked with faeces - although staff had run water over the floors upon our arrival. I wondered what it might be like on a normal day."

An elderly but communicative resident explained how she had come to Razdol from a children's institution, a story Freese-Treeck was to hear time and time again, where those with perhaps even minor disabilities were abandoned by their families - usually at birth - and institutionalised for life.

Razdol, too, turned out to be typical of what she would find elsewhere.

In Tri Kladentsi, a home for disabled children, the inmates were under lock and key, stuffed in a room.

"No toys, no games nor any sign of activity were available to engage them," the campaigner said. "Children simply rocked back and forth, screamed or beat themselves and others."

In another such institution, Mogilino, "bedridden children lay in crib-lined rooms surrounded by flies and staring blankly. Staff did not know children's names or conditions and instead, like any visitor, referred to personal information cards."

She realised the likelihood that any child who began in an institution would undoubtedly remain in one, moving onto the conditions of Razdol for life - if it could be called life.

The worst abuses Freese-Treeck encountered, however, were at another home where women with severe mental disabilities could be beaten by staff and then confined to a windowless seclusion cell with iron-barred doors for "misbehaviour".

A Bulgarian Helsinki Committee representative explained that conditions in social care homes were worse than those in prisons or police custody. Prisons are placed in the centres of towns and cities as a deterrent to crime, but social care homes for the mentally disabled are hidden away in distant mountain villages or small towns without proper infrastructure or professionals trained to care for people with special needs - and away from the attention of potentially concerned citizens who could pressure for change.

What must be done, and what is being done? The forum called for better supplies, better training of staff in hygiene as well as recreational and rehabilitative activities. Bulgarian authorities have been called upon to promptly institute standards of treatment and care appropriate for those with disabilities and institute an independent monitoring mechanism for all homes.

Fortunately, Amnesty continues, Bulgarian authorities are in a good position for affecting change at this time, with the support of the World Bank, the World Health Organisation and the Geneva Initiative on Psychiatry which have begun financing programmes and sponsoring events to improve the lives of people with mental disabilities in countries dotted throughout the world. The United Nations is also currently developing a convention on the rights of persons with disabilities that may provide firm standards for governments and international institutions working to provide people with mental disabilities with their basic human rights.

But the most important thing is that educable children need never be consigned to institutions in the first place, to end up in such places as Razdol.

As The Echo has shown in previous articles, international demand for adoption is intense and minor disabilities are a small obstacle for many would-be parents.

But many children simply need socialising and schooling, and are kept in institutions due to poverty, ignorance, and lack of social support which could easily be rectified if government awareness and support was kicked into action.

According to a spokesperson for Save the Children, a leading UK charity working for children's rights, because disability has not yet been recognised as a key area for reform in Bulgaria, many children with minor learning disabilities or special physical needs are swept into institutions and left to mentally and emotionally deteriorate.

"Unfortunately, where children are concerned, these things fall to the Ministry of Education, and it's the most sluggish among all the ministries, the dinosaur, the slowest to reform.

"But there is an Education Act going through that will, hopefully, bring some improvements. If a child can get into school, there is absolutely no need why he or she should be in an institution, and very often what's needed to get that child into school is something simple and relatively inexpensive, such as a wheelchair ramp.

"I felt embarrassed not long ago when our organisation provided some money for a ramp, something that cost a few hundred leva, and we were praised for it as if it were some high-tech thing, when in fact with a little bit of thought and ministry backing schools could be providing these things, should be providing these things for themselves."