Tied and locked: The patient who died in the fire at the psychiatry in Lovech, Bulgaria was in the isolation ward
This is the third such incident since the beginning of the year - are the institutions reacting?
by Maria Cherneva 20:31, 12/10/2023
The patient who died in the fire at the psychiatry in Lovech at the beginning of the month was locked in an isolator and could not escape. This is the third incident since the beginning of the year in which mentally ill patients have lost their lives in a hospital fire.
An open letter from the Global Initiative in Psychiatry to the Attorney General and the Ombudsman calls for an objective and impartial investigation not only of the tragedy in Lovech, but also of the vicious practices of tying up patients as punitive measures.
10 days after the fire, the patients and staff have not yet been interviewed, the cameras have not been removed. Only two expertises have been appointed - forensic and electrical. Despite BNT's inquiries, the Ministry of Health has not responded to the case.
His name was Georgi, he was 25 years old. Had it been taken a week before the accident, the acute phase of the disease should have passed. But still he was tied up and locked in the isolation ward. The fire started right there, behind that window. Tied up, the boy had no chance. Patients in the same ward can still hear his screams.
Patient - Because I am in a room next to him and I heard him screaming and shouting - "Burning, burning".
BNT: And he couldn't get out?
Patient - Yes, because he is locked and tied.
"I heard the alarm screeching and I saw the boy - he was shouting 'Fire, fire', he was tied up. And I tried to open the door, but it was locked."
Devastated, those from Georgi's ward are deeply dejected, now they are afraid that they too may be locked up. It happened all the time if they were not "obedient".
Confinement and tying up can cause serious damage to the psyche, and therefore there is an express regulation that defines the conditions for this extreme measure. And even without an investigation, it is clear that they are violated. Because if there was constant monitoring by a nurse, Georgi would have been taken out.
According to the head of the department, Dr. Katya Edreva, the incident happened in the short interval when the shifts overlapped, but this does not cancel their duties at all. In addition to continuous monitoring, the regulation also requires the presence of the doctor who prescribed the measure. The doctor must also have good reason to resort to shackling and seclusion.
"For me, the main problem is whether there were really medical indications for performing such a procedure. A person should really be in a state of excitement, which would put his life and the lives of others in danger, and according to our information, this is not the case." said Kalina Ivanova - Global Initiative in Psychiatry.
"That's exactly how they describe him - meek, calm, not the first time he's been lying down. He's about to be discharged," explained a psychiatric social worker.
However, according to the patients, something provoked Georgi's more aggressive behavior. That's why he was punished.
"The first reaction is the paramedic and he decides de facto. Paramedics and nurses are more than doctors," explained another social worker.
Aggressive behavior is to be expected from people with mental illness and psychiatry should know best how to respond or how not to provoke it. And in fact, the conditions in the hospital itself do not support this process.
"The whole environment is provoking conflicts and tension between the patients, and if a dispute and quarrel has arisen between two patients, this is the easiest way for the staff to bring order to a total institution," comments Kalina Ivanova.
But the ordinance, like all international standards, prohibits solitary confinement and shackling as punishment. Similar behavior has been registered more than once by the Committee for the Prevention of Torture, which, after repeated reports to the authorities, finally disclosed its terrifying observations in psychiatric hospitals in our country. Binding and isolation as systemic are constantly emerging from judicial practice.
"Cases of unjustified use of these harshest measures to limit a person's freedom by tying, immobilizing, is common and violations are frequent. I have had a case of severe injuries that were caused to a person while he was isolated, including case when the person is punished by tying up," explained Vladislava Tsarigradska - judge.
Due to the number of similar incidents, the Global Initiative in Psychiatry believes that George's death can also be covered up. That is why they are publicly demanding an objective investigation. A photo of the insulator or soft room before the fire can be found on the Internet. To secure it, money was collected from charity.
"Similar practices like the one that we suspect is practiced in this hospital lead to horrific incidents. And we think that this is absolutely unacceptable," explained Kalina Ivanova.
What does it mean to burn alive?
"For me, this case is another proof of the systemic problems that the Bulgarian state has. They have been commented on, including publicly, which is very rare and an exception. We for the cooperation mechanism, on the basis of which the communication between the committee for the prevention of torture and the member states, namely in the conditions of exception vis-à-vis the Bulgarian state. Public statements were made twice, one of which is a precedent in general in the committee's practice - to make a public statement against a state about the state of its psychiatry, and unfortunately it is the Bulgarian state," said judge Vladislava Tsarigradska.