Assessment of social care homes in Ukraine
On February 24, 2017, the final report on the assessment visit sopcial care homes in Ukraine was presented at the Office of the Ombudsman for Human Rights of the Verkhovna Rada. The report is a joint publication of the Ombudsman for Human Rights and Human Rights in Mental Health-FGIP.
The English version of the report can be downloaded here
The Ukrainian version of the report can be downloaded here
The following is the short statement of FGIP Chief Executive Robert van Voren during the presentation of the report:
Ladies and Gentlemen,
There are some images that remain engraved in your eyeballs for the rest of your life.
For me one of those images dates back to 1991, more than 25 years ago, when I for the first time entered a Soviet psychiatric hospital. It was here in Kyiv, at the Pavlivka, when the then director Revenok was on holiday and staff was able to show me the geronto-psychiatric department. Some sixty or seventy elderly patients in rags were lying on rusty beds, sometimes without matrasses, sometimes three patients lying on two beds shoved together, literally rotting away in the cellar of one of the buildings on the territory. The image remains with me until this very day, and so does the indescribable stench, the result of broken down sanitation and the stale smell of unwashed bodies and filthy clothes and bed linen. Later, I saw similar situations in social care homes in the vicinity of Kyiv, but that first impression remains with me till this very day.
Yes, Ukraine has come a long way, and surely the situation now is incomparable. The social care homes that we visited in December of last year were indeed all comfortably heated; patients were adequately fed and clothed, at least for the purpose of being inside the institution. Yet when I returned home to Lithuania after the assessment visit, I was ordered to put all my clothes, vests, jacket and coat into the washing machine, because the smell from the institution had permeated all of the cloth and the only way to get rid of it was by means of a thorough cleaning.
We were maybe not more than ten hours in the four institutions, yet the specific institution-smell already stuck to us. Can you imagine if one lives there day in day out, week in week out, month after month, year after year, without the hope of ever leaving the place? Then the institution-smell enters the body through all its pores, and eventually settles in one’s brain, leaving the person not only physically but also mentally institutionalized. And mind you, that counts for clients, but likewise also for the staffing – they have also become institutionalized.
And again I have images that are engraved in my eyeballs, this time different ones but no less distressing. What I saw were people lost in a system, who had given up all hope of ever coming out, shockingly often dumped by relatives who took away their apartments or just refused to take care of them. I saw women who lost all femininity, often with teeth rotting away because of medication and the absence of adequate tooth care, dressed in worker’s clothes and with a standardized haircut. And what is worse: with eyes showing a total resignation to one’s fate, already afraid to go out and become part of society. Twenty-four years, and probably another fifty-sixty years ahead, and already buried for life.
This cannot be. No civilized country can allow this to happen, for whatever reason. This is evil, and is in complete violation of human rights and human dignity. This has to stop.
Mind you, I am not claiming that the staff working at the institutions is violating human rights on purpose. I saw many well-intentioned professionals, some of them sincerely touched by the fate of their clients yet unable to change their fate fundamentally because the system does not allow it. I saw the compassion and desperation in their eyes and understood that they would be the first to support change if it would be allowed or made possible. Of course, I also saw professionals who do not deserve that name, who should be retired immediately and banned from working with human beings, for the very reason that they forgot they are working with human beings and not prisoners, or simple objects like logs or screws.
The assessment visit was a shocking experience, maybe especially because in spite of all materials improvements over the past twenty-five years the system did not change as such and is fundamentally inhuman and against everything a civilized society based on the rule of law stands for. But the shock also has a positive effect – it has strengthened our determination to help Ukraine to end this evil, and to build an alternative system in which people are viewed as human beings with abilities, instead of objects with disabilities.
We have sufficient experience in working in this region to understand that this is not an overnight process. It will take years, many years, before the last doors of Ukrainian social care homes will close, but the process has to start today, focused on developing alternatives, closing the front door of the institutions and starting to re-assess the clients’ mental health.
We understand it is a tedious and expensive task, but in our view all diagnoses should be reassessed. They are based on a totally outdated Soviet diagnostic system, exclusively focused on disabilities instead of abilities and seeing disabilities where they actually might not exist at all. Also, reassessment will identify those who wound up in these institutions for non-medical reasons, either because of negligence or on purpose, for mercantile reasons.
There are many things I can add, but I think the report speaks for itself. We tried to be as balanced and objective as possible, avoiding assumptions and emotional accusations, but the truth cannot be hidden, and should be faced upfront, in all its naked rawness. Almost 60,000 Ukrainian citizens are deprived of equal opportunities and participation in society, and there is no justified reason to allow this to continue.
35 years of FGIP: 35 years of commitment to mental health
Anniversary project: support the work of Nest (Sri Lanka)
In December 2015 it is 35 years ago that the Foundation Human Rights in Mental Health-FGIP was founded in Paris. Originally called “The International Association against the Political Use of Psychiatry”, it was intended to be a temporary confederation of national organizations involved in the fight against the political abuse of psychiatry in the USSR. The organization successfully lobbied national and international medical associations, human rights groups and governmental agencies and by the end of the decade the political abuse of psychiatry had indeed come to an end. However, with the USSR opening up to the outside world, a new challenge appeared on the horizon: the struggle for a humane, ethical and consumer-oriented mental health care system. The subsequent 25 years the organization, now called GIP (Geneva – and later Global – Initiative on Psychiatry) worked tirelessly to improve the lives of persons with mental illness in Central & Eastern Europe, the former USSR, and later also in Africa, Sri Lanka, Indochina and the Caribbean. Hundreds of projects were implemented, ranging van small grassroots initiatives to large-scale reform projects, and the organization received international acclaim for its efficacy and commitment.
Now that the organization exists 35 years, our work is far from over. Through its central office of the Federation Global Initiative on Psychiatry (FGIP), its member organizations in Bulgaria, Georgia and Lithuania, and its many partners all over the world the organization continues its struggle for a humane and ethical mental health care system worldwide.
One of our partner organizations in based in Sri Lanka. Set up more than 25 years ago by Sally Hullugalle, the organization has developed a wide range of activities for persons with mental health problems who need support and care. Tirelessly, the volunteers of Nest work in both hospitals and the community, and through their work they have helped hundreds of people restore their lives and become active members of society again. Nest embodies all the values that FGIP stands for: commitment and dedication, determination, putting the consumers central and helping them to become or remain part of the community and have full-bodied lives.
One of the projects focuses at the Mulleriyawa mental hospital for women, where originally more than seven hundred women were locked up for the rest of their lives and lived under horrific conditions. Thanks to Nest, more than half of the women have been reintegrated into society and the remainder is living under far better circumstances both on the hospital grounds and in houses nearby. In order to continue their work, Nest needs financial support to meet the basic needs of the women, as well as to purchase a trishaw to transport women to the market for shopping or for outings into the community. Having a trishaw would greatly enhance the efficacy of Nest and give the women of Mulleriyawa a much greater sense of mobility and independence. The total cost for a trishaw is 4,000 euro, while the annual budget for Nest operations at Mulleriyawa is approximately 6,000 euro.
Instead of presents: support to Nest
When people have a birthday, they often receive presents. And so in the case of GIP's 35th anniversary, people have asked us whether we have special wishes. GIP was founded to help people in difficult circumstances. Then our target groups were people who were incarcerated in psychiatric hospitals for non-medical reasons because of their political or religious beliefs, now they are persons with mental illness who do not get adequate treatment or are stigmatised within their society. We feel it is not GIP that deserves a present, but rather our target population. For that reason we would like to ask your financial contribution to this special anniversary project.
Help us to continue our work in the coming years – and help Nest to continue their invaluable work.
ING Bank, Amsterdam, The Netherlands
BIC code: INGBNL2A
Bank account number: NL46 INGB 0006 0707 13
att.: Human Rights in Mental Health-FGIP, Postbus 1956, 1200 BZ Hilversum (NL)
Donations from the US that are made by check should be made out to “GIP-USA” and send to our address in The Netherlands, as they will be cashed in the United States by one of our members to avoid excessive bank costs.
Call for applications: 2017 Jim Birley Scholarship
Jim Birley Scholarship 2017
For young mental health professionals and other stakeholders who have shown exemplary commitment to issues of human rights in mental health
In November 2013, the Board of the Federation Global Initiative on Psychiatry decided to honor its late Past Chairman Dr. Jim Birley by instituting a scholarship focusing on issues that Dr. Birley was especially committed to: issues of human rights in mental health, and stimulating young mental health professionals and other stakeholders to pay special attention to the rights of persons with mental illness.
The Jim Birley Scholarship will be provided once a year during a high visibility event to a young mental health professional or another stakeholder (user, family-member or carer) who has shown exemplary commitment to the issue of human rights in mental health.
In 2017 one scholarships of 5,000 euro will be awarded (in case of equal points the scholarship might be divided between two winners). The scholarship is to be used for a cause to be proposed by the winner and should contribute to the strengthening of human rights in the field of mental health.
A committee consisting of four members, including a member of the Birley family, will select the winners from the submitted applications.
How to apply?
Candidates for the Jim Birley Scholarship should write to Human Rights in Mental Health-FGIP and in a letter explain:
- Why they should be eligible,
- Provide details about their background and what they have done to further human rights in mental health, and
- What they intend to do with the scholarship.
Two letters of recommendation should be added.
Applications should be submitted before June 11, 2017.
The Selection Committee will then select the winners of that year.
The winners of the award will be announced in late June 2017.