Inside Large Institutions: Forced Contraceptives and Abortions
My boyfriend and I are together for two years, we’ve moved in one room.We’d like to have a baby…’ says Milda [name is changed by – authors]. A 34-year-old-woman lives in a small room at a large long stay institutions for people with mental disabilities. The biggest dream of her is to have a family – a dream that is not meant to come true.
By Izabele Šležaite, Ugne Leonaviciute (http://zurnalistui.lt)
Milda, as well as other women at the institution, is forced to take contraceptives. When the pills do not do their job, in some large residential social care institutions, women are forced to have abortions. Human rights experts say that such practices are not official, yet very common in many closed long stay institutions in Lithuania.
These hidden practices have become obvious after the journalistic investigation when two journalists visited a couple of large residential social care institutions for people with mental disabilities in different parts of Lithuania.
‘If a woman doesn’t agree to take the pill on her own will, we will convince her’, says a social worker in one of the institutions visited by journalists.
According to the Ministry of Social Security and Laborin, the country, there are 28 large residential social care institutions for adults with mental disabilities. One fifth of its clients are persons without legal capacity, who can not exercise all their rights on their own. Everything what they do has to be approved by the legal guardian, usually the director of the institution they live in. All the rest of the population (with legal capacity) can vote, work, have families and, according to the Lithuanian laws -have children. However the ministry has no record of children being born or grown by families that live in such long stay institutions.
Women are not safe
While visiting long stay institutions journalists got to know that men and women live under one roof, also couples can share one room. ‘Sexual relationships are common thing here ,’ says the social worker. However female residents have revealed different sexual practices. ‘The doors aren’t locked at nights. Men who are working and living [in the institution]walk down the corridor and rape the women. Some of those men even do not use condoms. The most important thing for them is to get satisfaction,’ says one of the women living in the large residential social care institutions. ‘We had told the staff many times about this thing happening. It’s scary, but they don’t care. They had just washed me afterwards and that’s it.’
Seven years ago a group of experts from the fields of psychology, sociology and human rights were the first to talk about illegal abortions and forced contraceptives at the social care facilities. The group presented a research about the state of human rights at nine of such large residential social care institutions. The results were shocking. ‘The use of contraceptives is mandatory. If women get pregnant, the pregnancies are terminated. If women do not agree on termination themselves, different ways of pressure are used. Sometimes women are brought for abortions by fraud,’ says Dainius Pūras, a psychiatrist and one of the researchers.
The same women, who talked to the journalists at the long stay institutions, had told experts about abortions they had seven years ago. Eglė Šumskienė, one of the experts from the group, says that up till now she does not have any information that the situation has changed during years.
Also, two years after the first research, National Organization of Persons with Mental Disorders and their Friends “Club 13 and Co” carried out a similar research. The club visited six large residential social care institutions for people with mental disabilities. ‘At one of those institutions four women told us that they were forced to terminate their pregnancies,” says Danguolė Survilaitė, director of the “Club 13 and Co”.
Government in limbo
‘Nobody has a right to force residents of social care facilities to use contraceptives. This is prohibited by the European Human Rights Convention, as well as by the Lithuanian laws. If somebody wants to create a family, there cant be any coercion,’ says Eglė Čaplinskienė, head of the Equal Opportunities Division at the Ministry of Social Security and Labor.
The ministry which has to protect residents of large residential social care institutions admits hearing about such family “planning” methodologies for the first time. ‘We would need to investigate this information. If we would know which institutions you’re talking about exactly, we could inquire. Since you are not telling us the names, we would have to investigate all of them,’ says Mrs. Čaplinskienė. She had not made it clear whether the Ministry will initiate the investigation.
The directors of the large residential social care institutions, where residents talked about forced contraceptives and illegal abortions, deny all allegations. ‘We protect, monitor and supervise our residents,’ one of the directors reveals the ways used to avoid unwanted pregnancies at his institution. ‘Social workers monitor residents during the day and their assistants – during the night. Residents take care of contraception themselves,’ says the director. He insists that none of the women living in his institution are using such medication by force.
The director of the other long stay institution admits that specialists help residents choose the right method of contraception. ‘Gynecologist consult the residents; there are no women who would refuse to take the pills.’
Human Rights are not guaranteed
‘Large residential social care institutions, in general, are flawed institutions that violate human rights,’ says Artūras Germanavčius, Doctor of Medicine. ‘People must have the right to create families,’ agrees Mr. Pūras, ‘In spite of the fact that almost every social care facility declares that its main purpose is to help persons with mental disabilities to integrate into community, it seems that the staff is doing everything so the residents forget how the life behind the bars of the institution looks like,’ adds the psychiatrist.
Nevertheless, the ministry clerks are sure that in most cases residents of such institutions are the ones who do not want to have children. According to Mrs. Čaplinskienė there is a way for long stay institutions’ residents to have children, but children do not live in the institution with their parents . “To be honest, children are not raised in such homes; they are given away to orphanages. If a woman wants to raise a child and manage things on her own, we recommend that she would not live in the social care facility. She should be given an apartment in the community and raise her child there. Large institution is not the right place for children,’ says Mrs. Čaplinskienė.
The right practice?
However, there are some cases in Lithuania when children were born to parents with mental disabilities and parents were allowed to raise their children at large residential social care institutions. ‘A man and a woman lived in one room.We allowed them not to use any means of contraception, because they wanted to have children. Two babies were born. For some time the parents were taking care of the children, but after their illness has progressed, they got fed up with children and stopped taking care of them. We had to give them to the state orphanage,’ Juozas Stankevičius, director at the Zarasai long stay institution shares his experience.
A similar case in this institution also happened 7 years ago. When a couple got pregnant,their integration into the society started. They were given an apartment and got employed. ‘But their happiness has not lasted long. After half a year parents started drinking and the state took away their kids,’ says Mr. Stankevičius. He says that after the two cases he had learned his lesson and he is now trying to avoid pregnancies at his institution with all possible modern ways, as do the other large residential social care institutions. However, if there was a family who wants to have children, he says, he would be discussing their possibilities to raise children and seek for a compromise.
Law is binding, but no real actions
“We can’t just allow people with mental disabilities to have children and then to let them out of the institution to raise them on their own within the society. We have to make sure that such families receive help from social workers,’ says psychiatrist Pūras.
According The United Nations Convention on the Rights of Persons with Disabilities, that was signed by Lithuania in 2007, such closed institutions for people with mental disabilities should not even exist anymore. ‘Persons with mental disabilities should live in the community, where they, with the help of social workers, could do their daily business on their own, as well as to raise children,’ advices Mr. Germanavičius.
Experts of mental health notice that despite the fact that Lithuania has signed and ratified the convention, there aren’t any plans to actually close the 28 long stay institutions in Lithuania. To the contrary, these institutions are expanding; the buildings are being renovated with the money from the European Union Structural Funds.