The shelter has an "isolation unit" where patients are put if they become violent and dangerous. It is, in fact, a small courtyard with an iron fence. There is no place to sit and only a small separate room where the patients can sleep. "Some may say that the 'isolation unit' is not up to international standards, but this is the best we can do under these conditions and with the funding available to us," says Lulcev.

Bulgarian facilities for mentally disturbed and deranged people have come under growing fire after Amnesty International last year published shocking reports on inhuman conditions in which the patients are kept. The "isolation unit" in Podgumer is like a four-star hotelcompared with what can be seen in a similar institution in Sanadinovo. "About 20 women are kept in a metal cage with a concrete floor. Some are lying on the floor and shouting. A girl in fatigues is pulling at the chicken wire, not even noticing the blood dripping from her shredded fingers. The dirty walls are peeling and colorless, and covered with feces," wrote last year a reporter of the most widely-read Bulgarian newspaper Trud.

AI activists found the facility in Radovec in a similar state. "We saw two men in one bedroom. One of them was blind, and his bed was dirty. There was a basin under his bed which he used without anybody's help, filled with urine and dirt," said the report.

"The conditions in certain facilities we visited were indeed horrifying. Mentally ill people are indeed subject to discrimination. They are sheltered in small places away from the public eye and government institutions," says Irene Khan, AI secretary general. She claims that mentally ill people in Bulgaria have fewer rights than ordinary criminals. They are not treated, but their conduct is controlled," says Khan.

In one of its latest reports, AI says that about 20 percent of people suffering from mental diseases are dying in shelters in Bulgaria because of undernourishment, pneumonia and exposure. These were the causes of death of 27 patients in a facility located in the village of
Dragas Vojvoda, in northern Bulgaria, at the end of 2001 and the first few months of 2002.

After AI went public with its report for the first half of 2002, Bulgarian authorities launched an investigation, but no charges have been pressed yet against people suspected of criminal negligence in relation to what the reports revealed. Meanwhile, the facility in Dragas Vojvoda has been closed and 150 patients cared for by 42 medical workers were transferred to other facilities. Last year the institution in the village of Sanadinovo was also closed. AI reported that female patients unwilling to behave as required were held in "metal cages."

Workers from the closed facilities are unwilling to talk for fear of losing their jobs. On condition of anonymity some of them have denied reports of abuse and criminal negligence. Instead, they blame everything on lack of money.

Bulgarian authorities were not pleased with AI's report. "The conditions in some of the institutions are indeed grave, but AI was not fully objective either," said Hristina Hristova, assistant minister of social affairs.

According to her, nothing has been done in 50 years to normalize the conditions in such institutions, whereas only last year the government remodeled 14 and built nine new shelters, worth two million leva. In 2002, four shelters were closed, among which were the two located in
Dragas Vojvoda and Sanadinovo.

However, the deplorable conditions in the mental institutions caused public outcry, forcing Labor and Social Affairs Minister Lidija Suleva to explain to Parliament why this was so. "Out of 108 shelters 29 must be shut down immediately because of inadequate conditions and because they cannot be remodeled," she admitted, and announced that in the next three years the government will spend 20 million leva on remodeling old institutions and building new ones.

Suleva appealed to the public to take into account the difficulties faced by the government in dealing with this issue. She also criticized what she called a lack of compassion in society in general and on the part of relatives, saying that almost all the families of about 100 women sheltered in the Sanadinovo facility had refused to temporarily take them while a new facility is built.

Doctor Lulcev says that "much like during the socialist era, the facilities are still run by incompetent people," and employees are not motivated to do their job properly. "Women hired for cleaning jobs cannot be expected to take care of people who faint or calm violent and disturbed patients, and all that for a salary of 100 leva (EUR50)," Lulcev said.

At Lulcev's institution the patients sleep in separate rooms, four beds to each room. The rooms are clean but the floor is concrete. The building has central heating, but the temperature depends on whether there is enough money to pay the heating bills. This year, says Lulcev, it will not be cold.

The patients do not complain about the food. "It is edible," says Ilijan Petrov. Like other patients he has a 40 lev pension of which 35 goes to pay for his accommodation. This is the case with other patients as well; they use the remaining money to buy cigarettes or food, but this is insufficient.

Lulcev adds that despite efforts by his staff to make the Podgumer facility decent, "I wouldn't be surprised if an international organization were horrified by the living conditions here. The state has to understand that it is obliged to care for all its citizens and their rights, especially if they are unable to do that themselves," says Dr Lulcev.

Right before winter started the Bulgarian government announced that money for heating the shelters had been secured. New regulations were also announced and staff members in institutions sheltering mental patients will be required to meet strict professional and moral
standards. The conditions in these facilities and violations of the patients' human rights could prove a setback for Bulgaria, which hopes to join the European Union as soon as possible.

(BETA)