Report on the State of Human Rights in Institutions for Persons with Disabilities for example, an alarm button) and the remaining two care-givers leave their floors and go to help the third care-giver. At this moment, beneficiaries who remain on the floors left without supervision become victims of violence. The care-givers create a so-called “safety corridor” to hand food to beneficiaries who cannot come out of their rooms independently and to protect them from beneficiaries with behavioral disorders who try to grab their food and inflict physical damage on them. Despite the fact that the institution employs a psychiatrist, the situation described above makes it clear that s/he is unable to ensure the physical integrity and safety of beneficiaries. According to the staff, several days ago “at night, M. had a fit; the doctor gave him/her an injection of a sedative, but it didn’t help and s/he hit us all. [The ambulance] does not transfer him/her until s/he gets too agitated…” According to the psychologist (for whom this position is the first job and who has never had contact with persons with disabilities or taken an internship in any type of boarding house or mental institution), she cannot work with “aggressive beneficiaries” at all. Consequently, there remain three care-givers, who point out in their explanatory note that if the existing situation remains unchanged, the care-givers and/or beneficiaries may sustain serious bodily injuries and be exposed to the danger of loss of life. Upon receiving this information, on June 27, 2012, the Office of Public Defender of Georgia started studying the case135 on its initiative. In response to Public Defender’s letter136 which dealt with the proportion between the number of beneficiaries and the staff, as well as with issues of safety, we received the following information with a letter137 of the State Care Agency: “…We would like to inform you that the issue raised in your letter is not regulated by the legislation… As of today, one care-giver is assigned per nine beneficiaries. It should also be taken into account that in the institutions for persons with disabilities under LEPL State Care Agency, disabled beneficiaries are served by a physician-psychiatrist, a physiciantherapist, an instructor of labor therapy, a psychologist, and a senior nurse in addition to care-givers.” A simple logical analysis shows that the letter of the Agency contains an inaccuracy: during night hours, when, according to the staff, the risk of damage to beneficiaries’ health and violation of safety rules is the highest, none of the aforementioned members of the staff is in the institution (expect three care-givers and one nurse). Accordingly, the number of beneficiaries per one care-giver is 21, not nine. It should be noted that the same care-givers wash and iron the beneficiaries’ clothes, feed them by hand, dress them, and tidy their wardrobes. The aforementioned facts clearly refer to risks for the health and life of care-givers and beneficiaries in the Martkopi Boarding House; they also make it evident that the staff is under the risk of professional burnout and they cannot be expected to provide quality care, especially under conditions when their salary amounts to GEL 400 (net) and they have to work a night shift on every third day. According to the staff, unlike beneficiaries, they do not have job-based medical insurance to get treatment for traumas they sustain. The problem of lack of medical insurance by the staff also exists in institutions where staff often sustain physical traumas due to the imperfect system of care for beneficiaries. The majority of the care-givers of the Dusheti Boarding House note that they find it most difficult to take care for heavy-weight beneficiaries (weighing more than 100 kilograms) and to ensure their mobility. According to them, three female care-givers often have totake (transfer) a beneficiary from a bed to a wheelchair or from a wheelchair to a bath, at which time the majority of them sustain traumas of the spine. They note: “In fact, all we do from shift to shift is to get treatment for the spine.” The issue becomes even more serious if we take into account that in many countries of Europe, it is prohibited to lift and transfer beneficiaries manually in such institutions due to the increased risk of violation of the safety of beneficiaries themselves, since 135 Case No. 1249-12, June 16, 2012 136 Letter No. 2941/08-2/1249-12, June 24, 2012 137 Letter No. 08/812, August 3, 2012 ANNUAL REPORT OF THE PUBLIC DEFENDER OF GEORGIA NPM Report 2012 LACK OF MEDICAL INSURANCE BY THE STAFF