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Left Behind the Exclusion of Children and Adults with Disabilities from Reform and Rights Protection in the Republic of Georgia

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Left Behind the Exclusion of Children and Adults with Disabilities from Reform and Rights Protection in the Republic of Georgia Left Behind The Exclusion of Children and Adults with Disabilities from Reform and Rights Protection in the Republic of Georgia A report by DISABILITY RIGHTS INTERNATIONAL Primary Author: Eric Mathews, Advocacy Associate, Disability Rights International (DRI) Co-Authors: Laurie Ahern, President, DRI Eric Rosenthal, JD, Executive Director, DRI James Conroy, Ph.D., Center for Outcome Analysis Lawrence C. Kaplan, MD, ScM, Division Chief of Developmental and Behavioral Pediatrics, Baystate Children's Hospital Robert M. Levy, JD, Adjunct Professor of Law, Columbia University Law School Karen Green McGowan, RN, President-Elect of the Developmental Disabilities Nurses Association Funded by: The Open Society Foundations, The Jacob and Hilda Blaustein Foundation, The Morton and Jane Blaustein Foundation, and other generous foundation and individual supporters of DRI Copyright 2013 By Disability Rights International Copies of this report are available from: Disability Rights International 1666 Connecticut Ave. NW Suite 325 Washington, DC 20009 Telephone: 202.296.0800 E-mail: [email protected] On the web at: www.DRIadvocacy.org Disability Rights International www.DRIadvocacy.org Disability Rights International (DRI) is an international advocacy organization dedicated to the human rights and full participation in society of people with disabilities. DRI documents abuses and promotes international awareness and oversight of the rights of children and adults with disabilities. DRI trains and supports disability rights and human rights activists worldwide to promote rights enforcement and service-system reform. DRI is based in Washington, DC with regional offices in Mexico, Serbia and Ukraine. DRI has investigated human rights conditions and collaborated with activists in more than two dozen countries of the Americas, Asia, Europe and the Middle East. DRI has authored reports on Mexico (2010 and 2000), the United States (2010), Vietnam (2009, published by UNICEF), Serbia (2007), Argentina (2007), Romania (2006), Turkey (2005), Peru (2004), US Foreign Policy (2003, published by the US National Council on Disability), Kosovo (2002), Russia (1999, published by UNICEF), Hungary (1997), and Uruguay (1995). These reports have brought unprecedented international attention to the human rights of people with disabilities. Disability Rights International and staff are the recipients of the Charles Bronfman Prize (2013), the Disability Rights Legal Center’s Charles D. Siegel President’s Award (2013), the Henry Viscardi Achievement Award (2013), On Our Own of Maryland’s Distinguished Service Award (2013), the University of Chicago Public Service Award (2012), the American Psychiatric Association Human Rights Award (2009), the Washington Psychiatric Society’s Senator Paul and Mrs. Sheila Wellstone Mental Health Visionary Award (2009), the American Association of People with Disabilities Henry B. Betts Award (2008), and the Thomas J. Dodd Prize in International Justice and Human Rights (2007). Board of Directors John Heffernan, Board President—Robert F. Kennedy Center for Justice & Human Rights John Bradshaw—National Security Network Holly Burkhalter—International Justice Mission Ilene F. Cook—The Washington Post Renée Kortum Gardner—Gardner/Mills Group, LLC Şehnaz Layikel—Human Rights in Mental Health Initiative of Turkey Stephanie Ortoleva—Women Enabled Kathy Ryan—Chernobyl Children’s Project International Global Ambassador: Holly Valance I. Contents Preface: Goals and Methods of this Report ................................................................................................... i Acknowledgements ..................................................................................................................................... iv Executive Summary ...................................................................................................................................... v A. Children and Adults with Disabilities are Left Behind ...................................................................... vi B. Inadequate and Discriminatory Community Services ....................................................................... x C. Abuses in Georgia’s Institutions ....................................................................................................... xi D. New Investments in Segregated Institutions by International Donors .......................................... xiii Summary of Recommendations ................................................................................................................. xv A. Ensure Persons with Disabilities’ Right to Live in the Community .................................................. xv B. Ensure Access to Healthcare ......................................................................................................... xvii C. Protect Children from Trafficking ................................................................................................. xviii I. Introduction: Political and Social Context of Reforms .......................................................................... 1 II. Observations ........................................................................................................................................ 3 A. Denial of Medical Care for Children with Disabilities ....................................................................... 3 v The Tbilisi Infant Home ................................................................................................................ 3 v The Senaki Orphanage for Children with Disabilities ................................................................... 9 B. Segregation and Abuse of Children and Adults with Disabilities ................................................... 11 v Community Services Discriminate Against Children with Disabilities in Institutions ................. 11 v Abandonment of Adults with Disabilities .................................................................................. 13 v Denial of Legal Personhood and Access to Justice ..................................................................... 19 v Insufficient Oversight and Monitoring ....................................................................................... 21 III. Human Rights Obligations and Strategic Recommendations ........................................................... 23 A. Right to Health ............................................................................................................................... 24 B. Right to Community Integration .................................................................................................... 25 C. Right to Legal Personhood ............................................................................................................. 28 D. Human Rights Oversight ................................................................................................................ 30 IV. Recommendations to International Donors ..................................................................................... 32 A. Global Implications ........................................................................................................................ 34 V. Appendix A: Clinical Evaluation by Dr. Lawrence Kaplan ................................................................... 37 VI. Endnotes ........................................................................................................................................... 61 Preface: Goals and Methods of this Report One billion people with disabilities around the world are disproportionally represented among the world’s poor, and are widely subject to stigma and discrimination.1 Over twenty years, Disability Rights International (DRI) has documented the most extreme abuses against people with disabilities that take place where people are segregated from society: in orphanages, psychiatric facilities, nursing homes, and “social care” facilities (see our reports at www.DRIadvocacy.org). The recent adoption and widespread ratification of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) brings needed attention to important human rights protections of a population long overlooked by the human rights community. Article 19 of the CRPD establishes that all persons with disabilities have a right to live in the community. Although 138 countries have ratified the CRPD2, most countries still segregate children and adults with disabilities. According to UNICEF, there are at least 8 million children in institutions around the world.3 The actual number may be much larger, as DRI has found children detained off the public record in many countries. There is no accounting for the vast number of children who die in institutions without ever being counted or noticed – or for children who grow up and languish in adult institutions for a lifetime. This report documents policies and practices of the Republic of Georgia to examine the protection of rights of the country’s most vulnerable population: children with disabilities who are detained in institutions. While we examine rights abuses within institutions, such as life-threatening practices, inhuman and degrading treatment, and torture, our experience has shown that the protection of rights ultimately depends on the enforcement of CRPD article 19. Until all children have the opportunity to live in the community with the love and protection of a family, their rights cannot be fully enforced. DRI’s broader strategic
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