Troubled children bound tightly to fetid cribs. A six-year-old boy who tried to rip off his ear while tied to a chair. A teenage girl who sought 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.
On Wednesday, Serbia's Social Affairs Minister Rasim Ljajic did not dispute the allegations in the report, saying "when I visit these places I cannot sleep for three days."
He also 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 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."
The report could not be independently verified as The Associated Press was not given permission to visit the institutions.
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. MDRI has released similar reports on facilities in Romania, Hungary, Mexico, Peru, Russia, Turkey, Uruguay, Argentina and Serbia's province of Kosovo.
The report, titled "Torment not Treatment," 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.
While acknowledging MDRI's main findings, Ljajic, the social affairs minister, criticized the report as "malicious" because it does not "lead to the solution of the problem."
"The mere title of the report, Torment not Treatment, suggests that someone intentionally wants to torment the patients, and that is absolutely not true or acceptable," Ljajic said.
Eric Rosenthal, MDRI's executive director, said the intention was not to accuse anyone of wrongdoing, but to point out problems.
"Our message is a message of hope ... that the Serbian government will make immediate changes," Rosenthal said.
The group said Wednesday it would send its report to the EU, the United Nations and other international organizations.
MDRI 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 that the most extreme human rights violations "are tantamount to torture."
"They eat, they go to bathroom and die in those cribs," MDRI investigator Laurie Ahern told reporters Wednesday as the group showed a graphic video of patients and poor conditions in Serbia's mental institutions.
In the MDRI report, Ahern recounted her visit to one such hospital.
"I looked into the crib and saw a child who looked to be 7 or 8 years old," she said. "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."'
The report says that many of the children incessantly try to hurt themselves - and the commonly accepted practice of physical restraints only exacerbates the problem, "leading to continued self-abuse and even more physical restraint."
It said MDRI investigators observed many children at the institution biting and chewing their own fingers.
The MDRI recommended that some of Serbia's mental institutions be closed and their patients be allowed "access to education, employment, decent and safe housing, friends and family based on their disability."