The report, Abandoned & Disappeared: Mexico’s Segregation and Abuse of Children and Adults with Disabilities
, comes on the heels of the investigation and was jointly released by Disability Rights International
(DRI) and the Comisión Méxicana de Defensa y Promoción de los Derechos Humanos (CMDPDH).
Among the atrocities revealed in institutions are patients with disabilities permanently bound to beds and wheelchairs; lobotomies conducted without consent; people with disabilities detained for life; and “filthy and inhumane living conditions.”
Equally depressing are the report’s findings on Mexican orphanages: children simply disappearing with no record of placement, trafficking, forced labor, exploitation and segregation of children with disabilities.
The 73-page report notes that:
“The government of Mexico has no record as to how many people are detained in its psychiatric facilities, orphanages, shelters, and other institutions for people with disabilities.”
Attorney Eric Rosenthal, Executive Director of DRI and the report’s primary author, said: “These are Mexico’s most vulnerable citizens – abandoned children disappearing into a world of exploitation and abuse and people with disabilities forced to endure a lifetime of egregious human rights abuses in institutions. We found egregious violations of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) – a Convention the Mexican government championed and helped draft. The government of Mexico has promised to uphold these rights.”
The report describes in shocking detail the conditions patients must face. A DRI investigator, returning ten years after a previous visit to CAISAME [E.P.] in Guadalujara reported:
"I walked into a room that I had visited ten years before at CAISAME [E.P.] Guadalajara. Ten years ago, children were left lying on mats in this room, rocking back and forth, some gouging their fingers in their eyes. When I came back, I found many of the same people in the same room but now they are in their teens or early twenties. They were in the exact places, still on the floor on mats. Many of them had bandaged hands from biting themselves. I saw the same boy in a wheelchair that I had met ten years before in the same chair. Staff confirmed that he was kept permanently restrained."
While some of the long-term facilities were described as “physically clean,” the report notes others are “filthy and filled with overpowering smells.” These, however, appear to be cosmetic differences; many of the conditions and human-rights issues remain strikingly familiar in the long-term facilities. While many of the larger adult facilities have large open areas of fields and trees, people are positioned together in crowded rooms:
"The vast majority of people languish in inactivity, sitting on beds, chairs, or floors doing nothing. Clothing is shared, old, and ill-fitting. At most facilities, we observed almost no interaction between patients and staff. We observed patients eating from floors covered in urine at Nieto and Samuel Ramirez Moreno, and the staff did not intervene.”
In many instances, lack of community services - including medications and support - means people are detained in institutions. The report quotes the director of Samuel Ramirez Moreno Hospital:
“They can buy tortillas, or they can take their medication. They can’t do both.”
Lack of proper medications also means some women end up in the country’s criminal justice system, in jails, or in prisons. In certain instances, the women commit minor crimes just to return to jail where they are able to receive the medical care and medications they need.
Another DRI investigator reported:
“I first visited Samuel Ramirez Moreno Hospital in 1992, and they told me that they were about to fix the water pipes because of the lack of water in the institution. I returned to the facility in 1999 and the problem had still not been fixed. In September 2010, I returned to the facility and observed people sitting in clothes covered in urine and feces. Staff told me that they had run out of water to clean the patients, and there was no clean clothing. Authorities promised that the water problems would soon be solved by a major rebuilding project at the facility.”
Other issues the investigation team uncovered were a lack of adequate clothing, lack of privacy and personal space and lack of protection from sexual abuse and violence. Extremely low staffing levels in most psychiatric facilities means it is impossible to protect patients from violence.
A blind woman with a psychosocial disability who was detained at the CAIS Villa Mujeres in Mexico City told investigators:
“I was raped here two years ago by a member of the staff. The man who raped me ran away. I asked to be transferred to this ward where the patients are older and I feel safer [...] The truth is, I felt safer when I was living on the streets.”
Many of the facilities had individuals restrained to wheelchairs, with legs and feet purple and swollen as a result of lack of circulation due to abnormal positioning and immobility. Left untreated, gangrene and amputation may be the end result.
A near-total lack of activity was discovered at long-term adult facilities in the Federal District and State of Mexico, Veracruz, Jalisco, Puebla and Oaxaca. This provides no chance for community integration, the report notes:
“Without activities to occupy them, adults with disabilities may be heavily medicated to keep them sedated.”
The report went on to state that the majority of residents in all the adult institutions visited by the investigative teams showed the residents “did not receive any sort of rehabilitative services.”
Inappropriate treatments or lack of care lead to other dangers. Aggression and self-abusive behavior patterns develop among the patients, often-times caused by their inability to communicate unmet needs and pain.
For some, the self-injuries or aggressive behavior will resort to lobotomies or other forms of psychosurgery:
“There are patients where medication does not work. For them, we have brain surgery. They remove the part of the brain that causes aggression. One woman, Pancha, was tied up in the hospital for months but was still aggressive. So we sent her for brain surgery. The doctors in the hospital decided she needed this. Her legal representative, the director of this institution, had to approve.” - Director of Fraternidad sin Fronteras
In one instance, at La Salud, DIR and CMDPDH investigators observed a man slumped over in his wheelchair after receiving brain surgery. His speech was slurred and slow. The director of La Salud noted the man had been aggressive before the surgery but was now entirely passive.
At other institutions, overmedication is the answer for disabilities treatments. Karen McGowan Green, a developmental disabilities nurse noted:
“I observed high levels of tardive dyskenesia, an irreversible degeneration of the nerves that results from neuroleptics. Many patients had uncontrollable rhythmic movements of their hands, protruding tongues, and shuffling gaits - signs of overmedication. I reviewed patient records at the Concha Vazquez psychiatric facility and found that most patients had dangerously high levels of neuroleptics that would be considered excessive anywhere in the world. I saw two or three individuals on fifteen different medications.”
For many of Mexico’s disabled, there is no hope, no life, no future. For children resigned to orphanages, the rest of their adult lives are spent in institutions. For children placed in institutions, they are simply transferred from the children’s wing to the adult area upon reaching 18 years of age.
“They arrive. They grow up here. And then they die here.” - Director of Fraternidad sin Fronteras
Among DRI’s recommendations for Mexico’s legal obligations under international law, they suggest patients’ rights to community integration (must be established under Mexican law), comprehensive plans drawn up for integrating all disabled peoples into the community, establishment of oversight mechanisms for protecting children and adults, ending new children placements in institutions, the immediate ending of life-threatening abuses and torture, the creation of new legal reforms to protect disabled people, and access to justice for disabled people.