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People with psychosocial impairments are chained

(London) - Hundreds of thousands of people with psychosocial impairments are chained around the world, Human Rights Watch said in a report released today. Men, women and children, some of them just 10 years old, are chained or cramped for weeks, months and even years in around 60 countries in Asia, Africa, Europe, the Middle East and North, Central and South America Locked up rooms.

The 56-page report "Living in Chains: Shackling of People with Psychosocial Disabilities Worldwide" shows that people with psychosocial disabilities are often chained by their own families at home or in overcrowded facilities in unsanitary conditions, mostly against their will. The reasons for this are widespread stigmatization and a lack of psychiatric health care. Many are forced to eat and sleep in a confined space and also to relieve themselves there. In state or privately operated facilities as well as in traditional or religious healing centers, they are often forced to fast and to take medication or herbal preparations. Furthermore, they are exposed to physical and sexual violence. The report includes data from on-site investigations and interviews from Afghanistan, Burkina Faso, Cambodia, China, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Sierra Leone, Palestine, the unilaterally independent Republic of Somaliland, the South -Sudan and Yemen.

"Chaining people with psychosocial impairments is a widespread, brutal practice that is an open secret in many communities," said Kriti Sharma, an expert on the rights of people with disabilities at Human Rights Watch and author of the report. “People spend years chained to a tree, in cages or goat stalls, simply because their families don't know what else to do with them. And the government is not offering them a decent, humane alternative. "

While many countries are now taking psychosocial impairment more seriously, the practice of chaining has largely gone unnoticed. No figures are available and there are no international or regional efforts to free people from the chains with coordinated campaigns. That is why Human Rights Watch, together with people who stand up for the rights of people with psychosocial impairments and have witnessed their situation first hand, as well as human rights and anti-torture organizations around the world, in the run-up to the International Day of Intellectual Health launched the global #BreakTheChains campaign on October 10th, aiming to end the chaining of people with psychosocial impairments.

Human Rights Watch spoke to more than 350 people with mental health impairments, including children, as well as 430 family members, agency employees, professionals, miracle healers, government officials, and campaigners for the rights of people with disabilities. When Human Rights Watch researched the situation in 110 countries, Human Rights Watch found evidence that people with psychosocial impairments are chained in approximately 60 countries, regardless of age, ethnicity, religion, socioeconomic class, or whether they live in the country or not live in cities.

An estimated 792 million people worldwide suffer from psychosocial impairments, and thus around one in ten people or one in five children. Yet governments spend less than two percent of their health budgets on mental health care. In more than two-thirds of countries, national health insurance systems do not provide for reimbursement of expenses for mental health services. In countries where such services are free or subsidized, long journeys or travel expenses are often a significant obstacle.

Given the lack of awareness and insufficient support services, many families feel that they have no alternative to chaining their loved ones. Often there is a fear that the person could run away or hurt himself or others.

The practice of chaining is common in families who attribute psychosocial impairment to evil spirits or sins. Therefore, traditional healers or faith healers are the first port of call; The families only access psychiatric facilities in an emergency. Mura, a 56-year-old man in Bali, Indonesia, was taken to 103 different miracle healers and, when that had no effect, was locked in a room for years.

In many countries, families take loved ones, including children as young as 10, to traditional healing centers or miracle healers, where they are chained to punish or restrict their freedom of movement. Chained people live in extremely unworthy conditions. They are also often forced to take medication or undergo alternative "treatments". These include, for example, taking “magical” herbal preparations, fasting, brutal massages by traditional healers, reciting verses of the Koran directly into the person's ear, Christian chants or special baths.

Chaining is detrimental to both mental and physical health. Chained people unfortunately suffer from post-traumatic stress, malnutrition, infectious diseases, nerve damage, muscle atrophy and cardiovascular problems. Chained people cannot move because the chains often prevent them from walking or standing up. Some are even chained to another person, which means that they have to relieve themselves together and sleep next to each other.

A man from Kenya who currently lives chained said, “This is not how people should live. People have to be free. "

"In many of these facilities, the hygienic conditions are horrific, as those affected are not allowed to bathe or change their clothes and their lives take place within a two-meter radius," said Sharma. "They are being robbed of their dignity."

Without access to sanitation, soap, or basic medical care, people chained are at greater risk of developing Covid-19. And in countries where the Covid-19 pandemic is hindering access to mental health facilities, people with psychosocial impairments can increasingly run the risk of being chained.

National governments should immediately ban chaining, tackle stigma, and develop community-based health services that are widely accessible, high quality, and affordable. Human Rights Watch recommends that governments take immediate action to record and review conditions in state and privately owned facilities. In addition, measures should be taken if there is abuse in facilities.

"It is horrific that hundreds of thousands of people around the world have to live chained, isolated, abused and alone," said Sharma. "Governments must no longer sweep this problem under the carpet, but must take concrete action now."

More quotes:

“I've lived chained for five years. The chain is so heavy. It doesn't feel right; it makes me sad. I'm in a small room with seven men. I am not allowed to wear any clothes, only underwear. In the morning I eat porridge and if I'm lucky I can find bread in the evening, but that doesn't happen every evening. "

—Paul, a man with psychosocial impairment in Kisumu, Kenya, February 2020

"The chaining of people with psychosocial impairments has to come to an end - it has to come to an end."
—Tina Mensah, Ghana Deputy Minister of Health, Accra, Ghana, November 8, 2019

“I'm locked in this cell and that makes me sad. I want to go out, go to work, grow rice in the rice fields. Please open the door. Please open the door. Don't lock me in. "
—Made, a man with psychosocial impairment who has been detained in a purpose-built cell on his father's land for two years, Bali, Indonesia, November 2019

"I was afraid that someone would attack me at night and that I would not be able to defend myself because of my chains."
—Felipe, a mentally ill man who was chained naked with a padlock in a mental hospital, Puebla, Mexico, 2018

“I relieve myself in plastic bags that you take with you at night. It has been days since I last bathed. I get food once a day. I can't walk around freely. I sleep in the house at night. In a different place from the men. I hate the chains. "
—Mudinat, a psychosocial impaired woman chained to a church, Abeokuta, Nigeria, September 2019

“Throughout my childhood my aunt was locked in a wooden shed and I wasn't allowed to have any contact with her. My family believed that their psychosocial impairment would stigmatize the entire family. I really wanted to help my aunt, but couldn't. It broke my heart. "
—Ying (name changed), a young woman who grew up in Goungdong Province, China, November 2019

"Neighborhood people say I'm crazy [maluca or n’lhanyi]. I was taken to a traditional healing center where they cut my wrists open to give me medication and another where a faith healer forced me to take baths of chicken blood. "
—Fiera, 42, a woman with psychosocial impairment, Maputo, Mozambique, November 2019

“It breaks my heart that two of my cousins ​​with psychosocial impairments have been locked up together in the same room for many years. My aunt tried her best to help them, but she is struggling with stigma and the lack of effective mental health care in Oman. It is time for governments to act and stop leaving families alone. "
—Ridha, family member with chained loved ones in Oman, September 2020

“I was chained, beaten, and smoked to drive the devil away. They are convinced that you are obsessed and soak liquids through your nose to drive the devil out. "
—Benjamin, 40, campaigner for the rights of people with psychosocial disabilities and chained to a church in Monteserrado, Liberia, February 2020

“The families handcuff them [people with psychosocial impairment] on a regular basis. We can see that in the marks on their bodies. They have scars. "
- Mexican public prosecutor's office protecting people with disabilities