A child in a Russian state orphanage for children with disabilities.

(Moscow) – Nearly 30 percent of all children with disabilities in Russia live in state orphanages where they may face violence and neglect. Russia should stop abuse of children with disabilities in state care, and make it a priority to provide support for children with disabilities to live with their families or in other family settings, rather than in institutions.

What Russia Should Do

Establish a zero-tolerance policy toward violence and neglect of children with disabilities.
Support family care for children with disabilities, including with accurate information on children’s developmental potential and accessible community-based services.
Make a clear, time-bound plan to end institutionalization of children and move children into birth, foster, and adoptive families.

The 93-page report, “Abandoned by the State: Violence, Neglect, and Isolation for Children with Disabilities in Russian Orphanages,” found that many children and young people with disabilities who have lived in state orphanages suffered serious abuse and neglect on the part of institution staff that impedes their development. Some children interviewed by Human Rights Watch said that orphanage staff beat them, injected them with sedatives, and sent them to psychiatric hospitals for days or weeks at a time to control or punish them.

“Violence and neglect of children with disabilities in orphanages is heartbreaking and completely deplorable,” said Andrea Mazzarino, a Europe and Central Asia researcher at Human Rights Watch and author of the report. “The Russian government should establish a zero-tolerance policy for violence against children in institutions and immediately strengthen programs to keep children in their families.”

The report is based on over 200 interviews with children, family members, advocates, and orphanage staff, and visits to 10 state orphanages across Russia where children with disabilities live. Most of the children in these institutions have families. But staff in institutions Human Rights Watch visited sometimes discouraged visits with families or other contact with family members, claiming that such contact “spoiled” children by getting them accustomed to too much attention.

Children and children’s rights activists reported that in orphanages children often lack access to needed health care, adequate nutrition, attention, and opportunities for play, and that many children receive little to no formal education. Lack of adequate support and training for orphanage staff, as well as understaffing, is a central factor in staff treatment of children. Children had few if any meaningful opportunities to seek help or report abuse.

At least 95 percent of children living in Russian orphanages and foster care have at least one living parent. The Russian government has made a public commitment to move away from the overuse of institutionalization of children, including children with disabilities. But government officials have not focused sufficient attention on the particular circumstances of institutionalized children with disabilities.

In cases Human Rights Watch documented, many children with disabilities ended up in orphanages because healthcare workers pressured their parents to give them up, claiming that children lacked developmental potential or that parents would be unable to care for them. The lack of adequate and appropriate education, access to rehabilitation and health care, and financial and other state support in many communities in Russia also affected parents’ decisions to place or keep their children in institutions.

Within orphanages, Human Rights Watch documented the segregation of children whom staff deemed to have the most “severe” disabilities into so-called “lying-down” rooms, where they are confined to cribs and often tied to furniture with rags. Many of these children received little attention except for feeding and diaper changing. Many children in these settings are rarely if ever given the chance to leave their cribs, interact with other children, or go outside. The practice of placing children with certain types of disabilities in “lying down” rooms is discriminatory and should be ended, Human Rights Watch said.

“Many children with disabilities confined to ‘lying down’ rooms suffer stunning delays in their physical, emotional, and intellectual development,” Mazzarino said. “This is an avoidable tragedy if only all children with disabilities are given the proper nutrition, health care, and education that they have a right to.”

Human Rights Watch spoke with many orphanage staff who expressed a desire to help children develop their potential. However, staff often treat children in unacceptable ways because they lack adequate support, including training in nonviolent disciplinary methods or in the nutritional and physical needs of children with various types of disabilities.

Under international law, Russia has a commitment to protect children from all forms of violence and neglect in order to ensure that children with disabilities are not separated from their parents against their will and to protect children with disabilities from all forms of discrimination.

Among the steps the Russian government has taken to address high rates of institutionalization of children is development of the National Action Strategy on the Rights of Children for 2012-2017. The document includes a commitment to prevent abandonment of children to institutions and decrease institutional care. However, this and other policies devote insufficient attention to the particular needs of children with disabilities and lack concrete plans for implementation and monitoring, Human Rights Watch found.

Now that the government has recognized the need to reduce institutionalization of children, it needs clear, achievable plans to achieve this goal, Human Rights Watch said. The government should provide support to children living with their birth families or, where this is not possible, expand foster care and adoption programs.

Russia lacks a federal system to place children with disabilities in foster or adoptive families. And parents in these families reported obstacles to raising children with disabilities in their communities, including lack of support and opportunities for education and other services. They also described negative attitudes by government officials.

The Russian government should create a time-bound plan to end institutionalization of children, Human Rights Watch said. Placing children in state care should be only for the short-term and in very limited circumstances that serve the best interest of the child and comply with international human rights law. The government should also provide social support and services to families to help them raise children with disabilities at home.

International and domestic donors should earmark funds for programs that help move children out of orphanages into family-based care as well as programs that support children’s inclusion in the community, such as accessible schools and healthcare services.

“Until the Russian government and donors act, tens of thousands of Russian children may spend their lives between four walls, isolated from their families, communities, and peers, and denied the range of opportunities available to other children,” Mazzarino said. “The Russian government can be doing much more to support parents raising a child with a disability, rather than pushing children into institutions.”