Institutions cannot improve

Alphia Abdikeeva, CIDH Pro Igual

A piece of news caught my attention recently: conditions in Bulgarian institutions for children with disabilities have improved following a damning report on human rights abuses there. Well, it´s good to know. But I cannot shake off a nagging feeling: is it good news or bad news that the institutions have “improved”, if they still exist?

The institution, by its nature, creates two classes of beings: one in the position of power, and the other powerless. And we all know that power corrupts, especially such absolute and unchecked power that the staff of the residential institution usually have over vulnerable people in their “care.”

Last year, the report by the Bulgarian Helsinki Committee revealed that hundreds of deaths of children with mental and physical disabilities took place due to appalling lack of care, staff negligence and even physical abuse in the state-run “care homes”. Now, we are told, somebody is actually giving these children food and checks their medications. Deaths in the care homes will now be more thoroughly investigated and surprise official inspections are supposed to prevent abusive practices. So we are told.

But we have also been told by the Bulgarian government that all residential institutions for people with mental and other disabilities would be closed down by 2014 and replaced by community-based supports. So, why hasn´t the government closed the “care homes” as soon as their horrendous practices came to light? Why (and how) exactly have their conditions improved? Have the authorities put material resources – surely not unlimited – into the institutions to “improve” them? If so, what of the pledge to close down the institutions?

And just before someone brings up the “our country is poor” argument for not switching to community-based services, it is utterly disingenuous to claim that the level of economic development of a country has anything to do with the treatment in the institution. (Not to mention that community-based services may actually be less costly than institutions.) The most recent undercover media investigation in a UK care home has convincingly demonstrated that even in that prosperous country, with centuries of humanist values, the situation of institutionalized people is not that different from a situation in an impoverished or “transition” country. It is the very nature of the institution that makes abuse not only possible but almost inevitable.

So, rejoice not that the conditions in the Bulgarian institutions have “improved”, because just about anything would qualify as an “improvement” in a place where children were starved, abused and neglected to death. Rather, keep asking — when will the last institution be closed down, in Bulgaria and elsewhere? Institutions simply cannot “improve”!