Troubled children bound tightly to fetid cribs they have never left since birth. A 6-year-old boy who tried to rip off his ear while tied to a chair. A teenage girl who attempted to gouge out her eyes as mental hospital staff stood by and did nothing.
The scenes of horror are chronicled in a report released Wednesday by Mental Disability Rights International, a U.S.-based human rights group that alleges systematic abuse of mentally disabled patients in Serbia's psychiatric hospitals and social care institutions.
Allegations in the report could not be independently confirmed.
Serbia's Social Affairs Minister Rasim Ljajic said he "agreed with parts of the report" _ and ordered that one of the institutions cited by MDRI stop admitting children because it houses more than 500 "severely retarded" patients.
Health Minister Tomica Milosavljevic said he had not read the report but conceded that psychiatric facilities had continued to suffer as the nation struggled to recover from a series of civil wars in the 1990s.
"My reflex reaction is that during (Serbia's) transition, the most vulnerable groups, like handicapped people, suffer the most," he said.
Still, he said the report did not appear to adequately take into account the progress Serbia has made since 2000 to improve conditions in psychiatric hospitals.
"I'm not saying that everything is ideal, far from it," Milosavljevic said. "But ... I don't think that the problems (listed in the report) are illustrating the true situation."
Serbia's mistreatment of the mentally ill was exposed after autocratic President Slobodan Milosevic was overthrown in a popular revolt in 2000. During Milosevic's 11-year rule, health care standards plummeted as government funding was diverted to paying for the wars in Croatia, Bosnia and Kosovo.
Serbia is not alone in mistreating the mentally handicapped, the group said. Mental Disability Rights International has released similar reports on facilities in Romania, Hungary, Mexico, Peru, Russia, Turkey, Uruguay, Argentina and Serbia's province of Kosovo.
The report attributed abuse and neglect largely to understaffed and underfinanced hospitals. It could represent a setback for the Balkan nation as it seeks to join the European Union.
The group said it would send its report to the EU, the United Nations and other international organizations.
It said conditions in Serbia's mental hospitals have vastly improved with help from foreign donors, but much more needs to be done "to address the serious human rights problems that exist for some 18,000" patients.
Some children and adults with disabilities never leave their beds or cribs and some are tied down for "a lifetime" to keep them from harming themselves, it said. The report said the most extreme human rights violations "are tantamount to torture."
"They eat, they go to bathroom and die in those cribs," Laurie Ahern, MDRI's investigator, said as the group showed a graphic video of the patients and poor conditions in Serbia's mental institutions.
"To tie a person down and leave him in bed for life is tantamount to torture," said Eric Rosenthal, executive director of the Washington-based group.
"I looked into the crib and saw a child who looked to be 7 or 8 years old," the group quoted one of its investigators as saying. "The nurse told me he was 21 and had been in the institution for eleven years. ... I asked her how often he was taken out of the crib and she said, 'Never, he has never been out of the crib in 11 years.'"
Ahern said that the boy, who suffers from Down syndrome and can hardly communicate, is visited by his mother.
"When his mother comes, tears are in his eyes," Ahern said. "She wants to take the child back home, but she has no means to support him."
The report says that many of the children incessantly try to hurt themselves and that the commonly accepted "treatment" for self-abuse is the use of physical restrains.
"The practice actually exacerbates the underlying psychological damage to the person, resulting in continued self-abuse and even more physical restraint," it said, adding that MDRI investigators saw many children at the institution biting and chewing their own fingers.
The group recommended that some of Serbia's mental institutions should be closed and their patients allowed access to "education, employment, decent and safe housing, friends and family based on their disability."