‘People die here’

“This place is not fit for human beings. You should close it down. People die here.” These are the words of a resident of a care home for adults with learning difficulties in Dragesh Voyvoda. At least 22 male residents in this home died in the coldest months of 2001. Although most cases were recorded as “acute heart and respiratory insufficiency”, post-mortem examinations in five cases in February and March 2002 revealed that the deaths were caused by pneumonia and malnutrition. In April 2002, 16 residents with bronchial conditions were not receiving prescribed antibiotics because of lack of resources. Understaffing was alarming. On one night, only three orderlies were on duty – for 140 residents.

These standards are reflected across other care homes in Bulgaria visited by Amnesty International. Living conditions are mostly impoverished and overcrowded. For example, one dormitory in a home in Podgumer had only seven beds for 12 men. Homes are characterised by negligence, inadequate health care, physical restraint and seclusion. The staff are insufficient in number and unskilled.

A care home in Radzol was derelict, filthy and dangerous. There was no central heating. One dormitory measuring 10 metres by 10 metres contained 33 beds (the minimum standard in England for a single room is 10 square metres). The orderly explained that only two beds had sheets because “the women are ill and they would only soil the sheets”. Some mattresses were heavily soiled and torn. A small stove was unlit for most of the day, and residents – some barefoot – were walking on icy paths between the buildings.

In this home, the women ate standing up. The staff said chairs had been removed because the residents threw them at each other. The food was taken in buckets to the women confined to their beds.

Although it accommodated 110 women, the home’s only bathroom was part of the laundry room. One resident complained that it was difficult to have a bath in the winter as they had to walk through the snow back to the dormitories.

Male residents in a Samuil care home, which lacked running water between May 2001 and January 2002, were living in a two-room house in the yard. In one dingy room for six men, the windows lacked glass and were almost entirely boarded up. In an adjoining, unlit room, four men shared three beds. A seclusion cell containing a cage was reportedly not used.

The main building, housing more than 100 women, had only one toilet, which was filthy. An outhouse, 150 metres away, had six holes in the ground, and excrement extended to the path outside. The staff said they could hose it down only once a day.

Bulgaria’s national service for social assistance, within the ministry of labour and social policy, approves the opening and closing of social care homes and issues guidelines and minimum standards for their operation. There was no record that its inspectorate officials had omitted to visit any of the homes visited by Amnesty International.

Ivan Fiser is central Europe researcher for Amnesty International.

Background

• The Republic of Bulgaria is 110,910 sq km (less than half the UK) with a population of 7.6 million
• Ethnic groups (per cent): Bulgarian 83.6, Turk 9.5, Roma 4.6, other 2.3 (including Macedonian, Armenian, Tatar, Circassian)
• The ministry of labour and social policy, under recent amendments to the Bulgarian Act on Social Assistance, is obliged to develop national standards for the quality of social services, which will apply to all social service providers. Failure to comply with these standards could lead to removal from the register of the social assistance agency