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Serbia's horrific institutions a relic of the past
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A culture of shame surrounds people with mental disabilities here in Serbia. It's an unchanged remnant of the country's troubled past. The government offers little help to families with disabled children. So mothers like Dusica, who gave birth to a son with cerebral palsy, face an unimaginable choice: keep their children at home and risk financial ruin, or send them away to a remote state institution – for life.
Dusica: Every fate, every story is different. Every one of those parents carries their own pain.
Hers would be an agonizing decision.
Srdjan, a hard-working truck driver, trusted the advice of his doctors 11 years ago and gave his first son to an institution. Still, he lives with a haunting love for a child he has never met.
Srdjan: As for the scars that are left in me and my wife, we'll always have them.
He wonders about the fate of his boy. So do we. Where is he and where are the thousands of others like him? In a wary country like this, it is not easy to get answers. But NBC news gained unprecedented access to some of serbia's most remote mental institutions.
This is the Kovin Institution in central Serbia. Behind the walls of the compound, a patient lies motionless on the ground ... A disturbing glimpse of what is to come.
Dr. Milan Milic is the director of this institution.
Ann Curry: So you have about 600 patients now?
Dr. Milan Milic: Right now about 600.
Ann Curry: Men and women?
Dr. Milan Milic: Men and women.
Across the grounds, we see women lined up for sedatives and other medication. The doctor says higher doses compensate for treatment they're unable to provide. Up dark staircases, we enter closed wards few outsiders have seen.
Ann Curry: So this is the room where the most severe cases are kept?
Residents here are locked inside from morning to night. Men sleep in crowded rooms on cots lined up one after another. The walls are crumbling. The windows' bars rusting.
We're struck by how open the director is as he shows us around. The reason he's willing to do it, he says, is his strong belief that conditions here must be exposed. But he asks us to protect the privacy of his patients.
Dr. Milan Milic: I don't want to continue this way.
Ann Curry: What do you wish – what do you wish you could give these patients that you cannot give them?
Dr. Milan Milic: Most - human living condition. This is a - this is not the condition for humans to live in.
Ann Curry: You just said, "This is not conditions that human beings should live in."
Dr. Milan Milic: Yes, yes.
The conditions take their toll on the patients. A commotion soon breaks out in a hallway. And we see for ourselves what happens when stressed residents become aggressive.
Attendants surround a woman. She is quickly moved to a room and strapped to a bed with leather restraints.
Ann Curry: She wasn't harming anyone, so why restrain her?
Agitation, he says, is often the start of physical agression.
Dr. Milan Milic: This is the first step.
Ann Curry: How long will she be like this?
Dr. Milan Milic: Let's say about two to six hours - not - not more.
Ann Curry: Do you think - do you think that the conditions here increase the aggression?
Dr. Milan Milic: Yes.
Ann Curry: So you have to restrain them more?
Dr. Milan Milic: Yes.
Ann Curry: Why are you willing to speak about this?
Dr. Milan Milic: Because I'm stupid.
Ann Curry: You think that you might get in trouble for speaking to us this way?
Dr. Milan Milic: It will not be the first time.
Ann Curry: You can't be silent.
Dr. Milan Milic: No, no, I can't be silent.
At another institution, in this locked ward, gaunt men and women wander through dim halls like ghosts. Walls are rotting. Flies are everywhere. Feet stick to filthy floors.
This is a shower room where groups of adults are hosed down. Many spend their entire adult lives here.
Laurie Ahern: Those people are virtual prisoners there until they die. They'll never get out.
Laurie Ahern is Associate Director of Mental Disability Rights International, a Washington-based group that has been investigating Serbia's mental institutions for four years. She accompanies us to another institution in a rural part of Serbia, Stamnica.
Adults and children are put here. Some might say warehoused.
This is Ward Two. Adult women here crowd on benches in the same small room, day after day.
When Ahern visited nine months before in the dead of winter, her team took this videotape showing the same people huddled together. Some appeared frightened and vulnerable. An overwhelmed and underpaid ¶attendant tries to manage amid the chaos. When we visited the children's ward across the street, we got a sense of what life might be like for Srdjan's son, and others like him.
The freshly painted walls belie the reality of what we see. Children languishing in crib after crib. And we discover something startling about some of these boys and girls: They have stopped growing.
Laurie Ahern: This child is so starved for attention and love.
Katarina is nine. She has Down Syndrome.
Ann Curry: You don't want to let go of my finger, do you?
The staff told us that tiny Jasmina is actually a teenager.
Ann Curry: This is a 15-year old girl?
Dr. Charles Nelson: This is called growth retardation, or failure to thrive.
We showed some of our findings to Dr. Charles Nelson, a professor of pediatrics at Harvard Medical School who specializes in the effects of institutional life on children.
Dr. Charles Nelson: For every two months they spend in a bad institution, they lose one month of linear growth. So, you can imagine over the course of a year that a child who should be growing like this might be growing like this.
Ann Curry: Explain that to me.
Dr. Charles Nelson: The brain produces a hormone that allows you to grow. And the brain doesn't produce that hormone when you're under such severe conditions of deprivation. A classic sign of child neglect is kids who don't grow.
We found child after child suffering from growth retardation. But one patient stood out.
Ann Curry: This is a 21-year-old boy who's never been let out of the crib.
His body seems frozen. The staff tells us that after infrequent visits from his mother, Nico sheds tears.
Ann Curry: And when I touch him, I can tell he knows I'm touching him.
Laurie Ahern: Uh-huh. Uh-huh.
Ann Curry: I blinked at him, and he blinked back at me. Repeatedly, whenever I blinked at him.
Ann Curry: The horror is that there is someone in there--
Laurie Ahern: Inside. They're abs--
Ann Curry: Who knows--
Laurie Ahern: Yes. Yes, yes.
Ann Curry: - and who can't speak.
Laurie Ahern: Right, right.
Many parents like Srdjan have little idea about these conditions when they're urged to give up their disabled children.
Srdjan: Even the medical workers who worked in those institutions told me it is better to have those children where they're all the same.
And given the circumstances, Srdjan still trusts that an institution he has never seen is the best place for a son he has never met.
He tries not to question his decision. Still, we wanted to see if we could find out what kind of life his son – and so many others – lead.
Our investigation takes us many miles from Belgrade, past villages and farms, to one of the most notorious institutions in Serbia. This is the Kulina institution. The few human rights advocates who have been inside tell grim stories. We soon understand why.
Nearly 600 hundred children and adults live here. We find full-grown men crammed into cribs. A half-naked woman left alone in a tiny room. And stick-thin children alone, some with bodies contorted and atrophied from years of neglect.
There is one part-time physical therapist and no staff psychiatrist for all 600 patients. Meager pay and dismal conditions make it difficult to hire workers here – let alone well-trained workers. That may explain why early one morning, without an official escort, we find this: A little boy tied to his crib, and still tied later that afternoon.
Laurie Ahern found the same thing here and in other institutions, time and again, both children and adults.
Laurie Ahern: We found people being tied up not for ten minutes, but hours. Four, five, six hours and day after day, after day.
Laurie Ahern: It's torture.
Laurie Ahern: Once you get into an institution, unless you're lucky enough to have someone come and take you out, you're there for life.
Ann Curry: ' Til death?
Laurie Ahern: 'Til death, exactly.
Day turns to night at Kulina ... Still, there is never really any peace.
A skeleton staff tends to a child struggling to breathe, and a boy who repeatedly punches his ears so hard they bleed. The same scenes play out week after week, year after year.
Is this what life is like for Uros, the son Srdjan gave up with the hope that he would be well cared for?
Srdjan: I want him to live life normally as much as he can.
And how does the government explain the treatment of thousands of its most vulnerable people?
Ann Curry: Are these conditions, in your mind, humane?
We're about to find out.
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