Bulgaria has the highest percentage of institutionalized children of any country in Europe and the former Soviet Union (UNICEF, TransMonee database). Bulgaria and Romania entered the European Union in January 2007, but the accession process paid only superficial attention to the human rights violations inherent in institutionalizing children and adults diagnosing with mental disabilities (defined here as intellectual and psychiatric disabilities). When a child is abandoned to the state in Bulgaria, he or she risks spending her whole life in institutions: whether run by the Ministry of Health, the Ministry of Education or the Ministry of Labour and Social Policy.  Human rights violations in these institutions range from inhuman or degrading treatment arising from conditions of detention (Art. 3, European Convention for the Protection of Human Rights and Fundamental Freedoms, ECHR); violations of the right to the best attainable standard of physical and mental health (Art.12 International Covenant on Economic, Social and Cultural Rights, ICESCR) and the right to education (Art. 13, ICESCR), and for those under 18, a whole host of violations of the UN Convention on the Rights of the Child.

In June 2006, I accompanied a lawyer and researcher from the Bulgarian Helsinki Committee (BHC) (www.bghelsinki.org) on visits to Dzhurkovo, a home for young adults with mental disabilities near Laki in the Rodopi mountains; Petrovo, a home for children with mental disabilities near Stara Zagora; and the Sofia Home for Children with Mental Disabilities. In this blog, I describe the human rights violations I saw during the mission; discuss the international law obligations involved, and propose recommendations to the Bulgarian government, donors and European Union member states. The blog aims to be a "campaigning" platform for children's rights activists, and defenders of the rights of people with intellectual disabilities in central and eastern Europe and the former Soviet Union. It accompanies a lengthy report of the same title which will be published in 2007.

My project was conceived as a result of the planned “restructuring” of the Dzhurkovo care home from a children’s institution into a home for young adults, following a national scandal at the deaths of 13 children and one 18 year old in the winter of 1996-7 (see reports on Bulgaria for the relevant years at: www.amnesty.org - please click on Library and search by country). This “restructuring” took place from 30 November 2005, when Dzhurkovo’s under-18-year-olds were moved to the homes at Petrovo and Sofia. The goal of the research was not only to assess the conditions of detention, health and education rights available to the residents in all three homes, but also to monitor the human rights specifically of the children transferred from Dzhurkovo to Petrovo and Sofia, as a means of contrasting the differing levels of protection available to children in different social care homes. I found what I will call the "Dzhurkovo Disadvantage" to describe the contrast between the condition of children who were relocated from Dzhurkovo to Petrovo or the Sofia Home and the usually better condition of many long-term inmates at Petrovo and Sofia. The practice of mass institutionalization is a grave human rights concern, but conditions do vary between institutions. The children from Dzhurkovo often ate more, made medical progress, grew taller and some learned to walk following the greater one-to-one attention available to them after their move to Petrovo or Sofia.

All visits were unannounced, to avoid the risk that staff members might prepare specifically for a visit by a human rights monitoring team. At each institution, we met specialist staff at the institution, reviewed a selection of case files and individual care plans for inmates (where these were available), and then spent several hours with children and young adults, taking care to see each room of the institutions so that no inmates were excluded from the research. Access to parts of the homes other than the Director’s office was delayed in every case by a lengthy question and answer session, with staff members occasionally speaking at such length that Bulgarian-English interpretation was rendered difficult. The smell of disinfectant was pungent and the corridor floors wet and glossy after each such meeting.

The team talked to the children and young adults even when they could not speak, observed their appearance and interactions; and systematically asked staff members about each child or young adult’s date of placement, age, diagnosis, treatment, rehabilitation and education provision. With the aid of an interpreter, I asked about the facilities and timetables for rehabilitation in the institutions; food and specialist nutrition; and the inmates’ access to medical and psychiatric care. Photographs were taken where staff permitted it, and are published here without information that might identify an individual child or young adult, in order to comply with Bulgarian data protection laws.

With researchers from the Bulgarian Helsinki Committee, I met the Deputy Minister of Labour and Social Policy, Ivanka Hristova; the Mayor of Laki municipality, Todor Todorov; and the Directors of the social care homes at Petrovo and Sofia. The Director of the Dzhurkovo social care home spoke to us by telephone via a BHC interpreter, some days after the team's visit to Dzhurkovo.

Slavka Kukova and Milena Panayotova of BHC provided invaluable guidance and interpreting skills before and during the mission, and Aneta Mircheva of BHC and the Mental Disability Advocacy Center (MDAC) should be thanked for her insight into Bulgarian law and practice. This project was made possible by a Helton Fellowship from the American Society of International Law (www.asil.org) with MDAC (www.mdac.info ) as the sponsoring organization. I am grateful to colleagues at Amnesty International for their insight, critiques and flexibility as I worked on this independent project.