Disabled people in Greece are often stigmatised and can struggle to get the support they need. Some disabled children who live in a state-run home are locked up in cages – staff say they want to improve conditions but money is short.
Nine-year-old Jenny stands and rocks backwards and forwards, staring through the bars of a wooden cage.
When the door is unlocked she jumps down on to the stone floor and wraps her arms tightly around the nurse. But a few minutes later she allows herself to be locked back in again without a fuss.
She is used to her cage. It’s been her home since she was two years old.
Jenny, who has been diagnosed with autism, lives in a state-run institution for disabled children in Lechaina, a small town in the south of Greece, along with more than 60 others, many of whom are locked in cells or cages.
Fotis, who is in his twenties and has Down’s syndrome, sleeps in a small cell separated from the other residents by ceiling-high wooden bars and a locked gate. His cell is furnished only with a single bed. There are no personal possessions in sight anywhere in the centre.
“Are we going on a trip?” is this wiry young man’s hopeful refrain whenever he sees anyone new. But with barely six members of staff caring for more than 65 residents there is rarely an opportunity to leave the centre.
In the small staff room, an array of closed circuit TV screens flicker, permanently tuned into the large wooden boxes that dominate the upstairs rooms.
The poor conditions first came to the attention of the authorities five years ago when a group of European graduates spent several months at the centre as volunteers.
Catarina Neves, a Portuguese psychology graduate was among them.
“On the first day there I was completely shocked… I could never have imagined that we would have this situation in a modern European country but I was even more surprised that the staff were behaving like it was normal,” she says.
The volunteers wrote up their experiences in a document that they sent to politicians, European Union officials, and every human rights and disability rights organisation they could find. Occasionally they received replies thanking them for their email without any promise of action but mostly they were ignored.
Then in 2010 the volunteers’ testimony came to the attention of the Greek ombudsman for the rights of the child who visited the centre and published a damning report in which he highlighted, “the degrading living conditions… the deprivation of care and support provided, the use of sedating medication, children being strapped to their beds, the use of wooden cage-beds for children with learning disabilities, the electronic surveillance, as well as the fact that such practices constitute violations of human rights.”
He also referred to the fact that there had been several deaths at the centre due to a lack of supervision. A 15-year-old died in 2006 after choking on an object he had accidentally swallowed. Ten months later when a 16-year-old died, the post-mortem examination revealed his stomach was full of pieces of fabric, thread and bandages.
It was after these incidents that management of the centre decided that the staffing levels made it impossible to protect the children from harm. Their solution was to have the cages custom built for the residents.
However the ombudsman’s report concluded that the cages and any practices employing long-term restraints “are clearly illegal and are in direct contradiction with the obligation for respect and protection of the human rights of the residents,” and he urged the Greek government to take immediate steps to rectify the situation.
But after almost five years the only changes are superficial.
Some of the wooden bars have been painted and funding was found to turn the day room into a soft-play area – but there is still no-one to engage with the residents, who sit alone in the room on plastic mats rocking and staring at the walls while an assistant watches from the doorway.
There is only one nurse and one assistant per floor responsible for more than 20 residents – there is no permanent doctor at the centre.
When residents need to go to hospital, they are accompanied by one of the nurses which means more than 20 residents are left in the care of just one person.
“On a nightshift I was often left alone with three assistants, who are not even nurses, to care for more than 60 patients. If there were any medical problems with the children there was no one to ask for help except God,” says a senior nurse who recently retired from the centre and spoke to the BBC on condition of anonymity.
She says the cages were necessary. “We fought to have those caged beds built to give the children more freedom. Before that the residents were permanently tied by their arms and legs to their beds.
“Anyway, the children are used to them now. They like them.”
Local doctor George Gotis who has been volunteering his services at the centre for more than two decades also sees the cages in a positive light.
“I believe this is one of the best institutions for disabled children not only Greece but in Europe,” he says.
“Many of these profoundly disabled children have lasted far beyond their average life expectancy and these expensive caged beds, which were built to help protect them from injuring themselves, have played a big role in that.”
The new director of the centre Gina Tsoukala, who has not been paid for nearly a year, says she can’t quit because she feels she owes it to the residents to stay and fight their cause.
“Obviously we shouldn’t have cages here but it is impossible for us to manage without them when we have such low levels of staff.”
“Some of the residents have self-destructive tendencies or are quarrelsome and so on the advice of a doctor we have to use these wooden partitions. But the children are still free to communicate and to some degree to interact with each other.”
At lunchtime the children who are behind bars are fed inside their cages.
The director says only the very basic needs of the children can be covered by her staff. In one shift a nurse and assistant have to change the nappies of more than 20 residents, hose them down, spoon feed them and medicate them.
“We are doing everything we can but we do not have the resources to give anything else,” says Tsoukala.
“More than two thirds of these children have been abandoned by their families and we do not have the time to give them the emotional support we would like, nor to give them the individual care they deserve.”
But arguing that the cages are there for the safety of the children is wrong, says Steven Allen, of The Mental Disability Advocacy Center (MDAC) – an international human rights organisation for people with mental disabilities.
“The cages are there to protect the staff not the children,” he says. “They are based on a model of care that is about coercion, restriction and making people with disabilities easy to manage, not treating them as human beings with rights.
“Being kept in a cage is seriously detrimental to the psychological health of patients, has no therapeutic value and can actually be physically dangerous. There have been cases [elsewhere] where the bars of cages have fallen on to patients and killed them,” he says.
The MDAC says the only other countries which currently use similar caged beds are the Czech Republic and Romania.
The head of the Association for Families and People with Disabilities in Ilia, the local prefecture, Ioannis Papadatos, has his office in a huge state of the art centre designed to cater for people with disabilities.
Complete with swimming pool, physiotherapy and speech therapy facilities, and a large number of flats for semi-independent living, it was built with EU funds. But today it sits empty because the Greek state can’t afford to staff it.
Ioannis Papadatos used to be on the board of trustees for the children’s centre at Lechaina until last year. He says he battled to make conditions better at the centre – two girls with autism now go to a special school for a few hours a day.
But for many residents he says, “The only time they will really be released is when they die.”
This is a subject close to his heart. His first child, 24-year-old Andonis, was born with Down’s syndrome.
Andonis has visited the centre with his father and seen people with similar conditions to his own living behind bars. When asked about it he visibly shivers.
“Oh, don’t talk about it! It gives me the chills,” he says.
Sociable and confident, Andonis is unusual in that he was raised by parents who were proud of him and encouraged him to live as independent a life as possible, in a country where disability is still stigmatised.
Gina Tsoukala says the mothers of some of the residents do not even know of their existence. She believes that in some cases, when disabled children were born, the father and hospital conspired to tell the mother the baby had died.
There are about a dozen centres for disabled children and adults in Greece but getting access to them is difficult and it is unclear what conditions are like inside each of them. The BBC’s requests to visit other institutions in Athens and Sidirokastro, in the north of Greece were refused.
But there are plans to improve the institution at Lechaina and other similar homes, says Efi Bekou, the general secretary in charge of welfare at the Ministry of Labour and Social Welfare
“At the moment there are 12 centres for disabled children and adults around Greece but we are opening increasing numbers of homes in the community and hope to eventually close all big institutions.”
She says the economic crisis means that the Greek state is bound to rules set by its lenders in the EU and IMF, including a moratorium on hiring new staff – as a result, she says, it would be impossible to employ the number of staff needed at the centre.
But while she says the government is discussing the children’s situation she admits, “I can’t give you an exact time line for when those children will be transferred out of that institution.”
The names of the children in this article have been changed.
Chloe Hadjimatheou’s report can be heard on World Update on the BBC World Service from 10:00 GMT on Friday 14 November.