Psychiatric patients sterilised and mistreated
01 April, 2009

Fourteen women with mental disabilities have been sterilised in the Perm region of Russia against their will and without an appropriate court ruling.

This was the striking discovery made by the region’s human rights committee over the course of a two-year investigation, revealing numerous grave offences.

After receiving more than 50 complaints from patients of the 15 psychiatric asylums in the Perm region, an investigation was launched to analyse living conditions in these institutions. After two years of detailed study, a series of shocking discoveries was made.

Fourteen young women, born in the 1970s and 1980s were sterilised against their will, without the signed permission of their families or any appropriate court ruling. As the report states, the most poignant justification of these actions came from an unnamed asylum staff member. They did it so that the women “would not give birth to lunatics”.

"These women were proven legally incompetent by the court. So what, we have to wait for the court to give us a separate document that approves the sterilization?" a doctor told RT.

In the Russian legislation, sterilisation of legally capable women is only permissible with their accord and when they’re aged over 35, or already have two children. When the woman is not legally capable, the signed permission of two gynaecologists and a court ruling are required.

There exists, however, an appendix to the law, which states that sterilisation can be carried out based purely on medical reasons if there exists “a threat to the woman’s life or health”. Staff have tended to interpret this appendix at will, using it to cover many sterilisations.

According to the human rights commission, the staff at the institutions were not even aware that a court decision was required to conduct the procedure. They based their decision simply on the advice of the institution’s administration.


Other infringements
It was discovered that the shocking cases of unlawful sterilisation were not the only cases of severe breaches of human rights in these psychiatric institutions. The official report drafted by Tatyana Margolina outlined three main areas of severe infringements of human rights in these institutions: medical care, the right to housing and the right to fair employment.

Perhaps the most fundamental malpractice in the institutions is the lack of adequate healthcare provision. According to the report some psychiatric institutions do not even have an appropriate medical licence.

Despite being state organisations, the institutions need to renew their medical licence every few years. Of those whose license had expired, the most recent renewal was in 2001. Since then, no new medical or diagnostic supplies were provided and no new medical personnel had been taken on.

“In several institutions medical attention was not provided and people simply died,” Margolina pointed out in the report. “Their death was a result of appropriate measures not being taken in due course.”

The lack of a medical licence resulted in the absence of basic medicines and diagnostic equipment. This has resulted in several deaths due to negligence in the last two years alone. The report refers to a number of unnamed cases. The causes of death named by coronary analysis include untreated and misdiagnosed pneumonia, a stomach ulcer and meningitis.

The last case is given specific attention. The patient was admitted to an institution and passed away only days later. The orderly simply gave the patient medicines against flu-like symptoms and proceeded to ignore the case for the next two days, during which the patient’s condition steadily worsened. Renewed medical attention was only given when the patient was on his deathbed, but it was too late. Even then, an appropriate diagnosis was not made.

Staff members point out that they don’t even call ambulances for the patients since the medics simply refuse to drive out to the institutions. In most places, no individual rehabilitation programmes were developed for patients. Some do not even have a stock of the required anti-psychotic drugs.

As a result, the patients’ abilities are not developed to their fullest potential. According to the report, some of the patients would have had the chance to do basic manual work and provide for themselves if given the appropriate training. Nevertheless, such fundamentals as sports equipment, professional and educational training and development programmes simply do not exist in Perm region institutions.

The living space provided for the patient is often far less than the basic minimum required by the Russian state. Some patients live in as few as three square metres of individual space with no access to privacy – nurses often break through locked doors and into restrooms as well as shower facilities.

The report points out that the conditions in the institutions breach several clauses of the UN charter and the human rights declaration: the patients do not have access to medical care, individual space, basic dignity, employment and personal development. Nevertheless, the report only goes as far as “advising” the local administration and the relevant institution to take these facts into account.


Regional problem?
Despite the gravity of the problem and its deep-rooted nature, the local administration appears to be inert in dealing with it. RT tried to get information of what the regional government is planning to do in order to resolve this shocking breach of basic human rights.

“Tatiana Margolina is refusing to give any comments on the situation, referring to the fact that it is a regional problem and the report was released regionally,” the human rights commissioner’s press office told RT.

When the local administration’s press office was contacted directly, RT was told that the general office does not have the competence to comment on such issues, and the human rights commission should be contacted.

As a result, no official comment was given on how the living conditions of the psychiatric patients will be ameliorated. So, despite the severe cases of human rights breaches and even abuse from state care providers being brought to public light, it remains unclear what will be done.

"Unfortunately, even we only get to know about problems by seeing them. if we go to care homes, and talk to the people there – thats how we find out. And judging by what we see – nothing changes. What we say has very little effect," Sergey Isaev from thePerm Human Rights Centre.

Anna Bogdanova, RT