Human Rights Report 2012 about Torture and Abuse of Patients in Estonia

Posted: April 12, 2012
Overview about the abuse of patients and the violation of human rights in Estonian hospitals, Report compiled by Estonian Patients Advocacy Association (EPAA) in 2011, Contacts: www.epey.ee Translation from April 2012

The abuse of patients in Estonia has been highlighted by Estonian Human Rights Centre in its annual 2011 report, launched in April 2012 with the note that patients abuse in Estonia is a severe violation of human rights and international agreements signed by Estonia; and in some cases the patients abuse in Estonia can be called a torture. The following overview was one the main documents used for EHRC report opening chapter about the patients abuse.

Summary of abuse cases:

- The patients and their loved ones are treated without respect, with humiliation and brutally, health service providers cause knowingly and constantly severe misery to patients;
- the care for patients can be described as criminal neglect, patients are treated in a way that is humiliating and causes suffering;
- patients whose condition restricts their movement and force them to stay in bed are not fed, left without water and not assisted when they wish to visit toilet;
- patients considered by staff inconvenient are illegally chained/tied;
- the necessary health care tests are not made, medications not provided;
- instead of necessary care patients are injected/given huge doses of intoxicating drugs and/or chained to bed;
- patients and their relatives are verbally abused and humiliated, when patients or their relatives complain and ask for better care they are threatened to be kicked off from the hospital and the staff starts to persecute them;
- some health care providers try knowingly to take steps that could cause the death of the patient (giving them overdose of drugs, withdrawing necessary medications, freezing the bed-attached- patients while leaving them next to opened window during chilly Nordic weather; etc.
- Estonia lacks the objective and effective handling of patients complaints about medical service quality;
- there are no serious investigations in Estonia about suspicious death cases in hospitals and nursing hospitals;

Overview and examples of abuse cases in Estonian hospitals as revealed by patients

The cases are unedited complaints by patients and their relatives from 17 Estonian hospitals and nursing hospitals as provided to Estonian Patients Advocacy Association and to the Estonian national broadcasting company ETV program Eyewitness (Pealtnägija) that reported in 2011 patients abuse at the Keila branch of Tallinn biggest hospital PERH.

There is shortage of health care services in Estonia and what is offered is often unqualified, brutal and humiliating.

The serious complaints in nursing care have been registered from different parts of Estonia that indicates there are general shortages in the health care system;
- irrelevant financial scheme that cuts the interest of health care service providers to offer quality service and achieve the gratification of patients and destroys the chances to enable new service providers to enter the health care market (finances should move with the patient but not like in Estonia where the health care finances are allocated according to the service agreements concluded and supervised by the Estonian Sickness Fund, that looks a weird order giving favors to some service providers);
- lack of quality systems both on state and institutional level;
- lack of assistance services for families, limited supportive options in nursing for the patients loved ones;
- complete lack of objective and effective handling of patients complaints about medical service quality;
- complete lack of investigations about suspicious death cases in hospitals and nursing hospitals;

Patients have illustrated to Estonian Patients Advocacy Association the health care and nursing services in 17 Estonian hospitals and nursing hospitals with following examples and complaints.

1. Patients and their relatives are not informed about the treatment, health care services and prognosis. The request for information is ignored and both patient and the relatives are left uninformed. In some cases relatives are not informed about the death of patient or the info is given to the wrong people.

Among the complaints provided by patients following cases were described:

a) when I entered the hospital I did not find anywhere the info where exactly is my mother-in-law, so we had to walk through all the floors until we found her at the 6th floor;
b) it was impossible to meet the doctor, we were waiting hours for doctor behind the doctor´s room, our emails remained without answer;
c) at the section where my sister was we did not see any medical staff, I was looking for nurse or doctor to get info about her medical condition and test results to ask whether she has been fed and taken care, but unfortunately I did not manage to find anyone. After visiting hospital and calling hospital every day we managed to finally reach the doctor via phone a week later;
d) I wished to ask about the health condition and treatment of my mother-in-law. The staff member who was Russian and spoke bad Estonian answered arrogantly that I should not ask her but turn to doctor. Because it was Sunday, another doctor was at work. I asked to meet the doctor in person but was not allowed, instead the phone number of doctor was dialed and I was handed the phone to speak. After introducing myself and telling why I am at the hospital I was berated by the doctor who asked how can I dare to trouble the doctor and I was told the doctor is not obliged to tell me anything at all. After more and more verbal abuse by doctor I finally hang up;
e) I was told someone of doctors is dealing with my sister but until today I do not know who that was because there was no-one to ask;
f) Two weeks passed and there was no talk any more about the treatment or washing. It was also not possible to meet the doctor. It all made me to wonder later how naive we had been;
g) I had tried all the time to speak to the doctor but I managed to meet the doctor finally only when I had to go to sign the papers to receive the personal belongings after the death;
h) In the evening of the day when she was transformed I wished to go to see her but was told the visiting time is over. When we called the hospital we were told there is no point to come to see the grandmother because she is in comatose. Upon our strong request we were allowed to visit the hospital and it turned out grandmother was not at all in comatose but fully conscious. The same male doctor also later apologized that he messed up something. When we looked for the doctor of the grandmother it turned out no medical treatment was ordered for her and there was also no medical documents about her previous illness at Tallinn biggest hospital PERH branch in Mustamäe;
i) We did not see doctor even once during all that time;
j) When we talked (with doctor) on phone the doctor did not return any calls despite promising so. I will call you back... and that was it. The patient had very rare illness. Where is gone the professional attitude, professional interest?
k) We the relatives were not informed about the transfer, despite you could presume first aid staff or hospital might do that, especially when its about a severely ill patient who is not capable to do that himself. So we started to search together with mother. After several calls and searching numbers in net we finally found out where the patient had been transformed;
l) With all documents finally in hand we then had to go to morgue to take clothes to our loved one who had perished. When we reached the morgue it turned out we had been sent to wrong morgue by hospital despite we had been given even the bulletin of the funeral company and the address had been underlined for us by hospital! The bulletin was in Russian despite we had asked it in Estonian because we do not know Russian. They said only in Russian, so we live in Estonia but not even bulletins in own language.
m) On August 6 my mom and uncle found that the bed of my dad in hospital was empty. When they finally found the nurse they were told dad is in Tallinn biggest hospital morgue. When asked why the hospital did not inform family about the death the reply was that probably there were no contact data left despite I had asked so many times the doctor whether they have my number and answer was always: of course. Later it turned out finding an empty bed in that hospital like that and the practice not to inform relatives about the death is a common thing in that hospital.
n) When the staff heard I am myself from Estonian Patients Advocacy Association the man shouted categorically and impolitely: "WITH YOU I am not going to speak!" and disappeared behind the door quickly.
o) The hospital gave misleading info and the client had to drive without the need 100 km.
p) Client says his mother-in-law is in hospital and the doctor declines to speak on phone and share the info. The patient is in such a severe condition she is not able to defend her rights and handle the situation. Client is seeking to get info from a doctor regarding the health condition of the loved one and treatment.
q) Mother of the client is taken to hospital after traffic accident. Client asks to see the treatment plan for her mom. The doctor is not giving the information on phone and cuts the phone call without offering any time to meet. The attempt to arrange the meeting via nurse fails also because the nurse claims she has no idea when the doctor is in hospital and ready to meet.
r) When I asked when I can meet the doctor I was shouted: do not interrupt us, we have important work tasks!

2. Patients and their relatives in Estonian hospitals are treated in disrespectful, humiliating and brutal way. Health care service providers cause knowingly and constantly severe suffering

2.1. patient not taken care despite regulations request, bed-attached-patient not turned from one side to other as requested and as a result it causes bedsores that can be avoided only if the relatives make the nursing procedures themselves

s) the patient had been not turned in bed for several days;
t) I am still wondering how the bedsores can occur already during the first day in hospital;
u) the patient was not washed 22 days!
v) our mother got bedsores;
w) our mother had got bedsores and she was left "resting" on rot sheets. When we cleaned her the nurse came and screamed why we interfere with her job, adding that what we do is not prolonging the life of our mother, and nurse also asked us to give her money;
x) My spouse had got big bedsores during the weekend in hospital that was the result of bad nursing - how to impact the medical staff to do their job better? Asking for help;
y) patient got bedsores in hospital and there were even little worms inside the wounds by the time the patient was taken to another hospital. Because the patient had no close relatives the acquaintances who had informed Estonian Patient Advocacy Association did not wish to make official complain. Patient itself was in such a severe condition it made it impossible to stand for her rights herself;
z) The patient was kept only in bed and without any movement three weeks and we were told lies by staff. Patient roommates told us the patient had been kept in bed all that time.

2.2. Bed-attached patients are not fed, not given drink and not assisted when wishing to visit toilet

aa) Next to our grandmother was an old lady who had cancer and whom we also fed;
bb) Patients who are so ill they can stay in bed only are "given" food and drink simply so that the food is left to the nightstand near their bed and half and hour later its taken away with comment that the patient is not eating. How can patients so ill eat themselves??? Nobody is helping them there;
cc) I do not know whether the patient was fed;
dd) She was like dead body despite being alive, food was left at nightstand and she was unable to eat herself so they took it all off later, my mothers mind was very clear all time until she perished
ee) Food was not taken to the patient;
ff) When mother had better days she wished to go to WC herself but when I asked nursing staff for help they said their backs will get ill when they do that so I helped mom alone myself;
gg) I need to note that during all the time I spent at that hospital several older female patients asked for help, screaming from their bed, begging staff for water etc. But the answer was silence from the hospital staff - nobody moved to help them and they were not even ashamed despite I was there too;
hh) we were very worried for mother because there was even no assistance call button in the hospital room. Mother asked loudly for help to get to WC but no-one reacted despite she asked very loudly;
ii) Because the patient was old and ill at least someone from the staff could help the patient with eating, not speaking that the only time the patient was washed was when the relatives did that job themselves at the hospital;
jj) by that time father who had cancer and diabetes had been without food and drink for six days. That will exhaust even an healthy person. Turned out he had not been given at the hospital even the medications that he had been ordered and taken regularly at home;
kk) when the patient became bed-attached the staff seemed to lack any skill and also the will to offer modern nursing care;.
ll) one day I reached my mother at the hospital just before she was taken to procedure to install her feeding tube despite she was able to eat when assisted but no-one had asked us. We did not want the feeding tube installation procedure. It was clear they wished to get rid of the old woman quickly;

2.3. The care at the hospital can be illustrated as criminal negligence, patients are humiliated and treated in a way that causes severe suffering

mm) on the day when we went to take mother to home it turned out she had fallen to floor while on her way to the toilet and nobody came to help her before the lunch time. Mother said she had been on floor for hours and she had kept screaming for help all the time. It caused paralysis to her lower body and transfer to special nursing unit was needed. Four patients together with her in the same hospital room said that when mother had arrived there she was taken immediately to washing room where she fell again to the floor and then lied there on her urine;
nn) entering the hospital room we saw another shocking scene: my dad who had been nice and cheerful man was in bed with swaddling clothes and without a blanket, he had been given just some sheet that had fallen to floor, window was opened and his lips were dark blue and dry because no-one had given him water and he was unable to move himself enough to get it...The bed had been switched up from front side and as a result his body had fallen lower so he was unable to move even his only leg left. Where were nurses??? Had someone visited him at all??? I also note that there was no assistance call bell - so patient cant call help. He had also no voice due to his lung cancer that means he was also unable to scream for help;
oo) Young Russian staff member came and pushed him quickly up from shoulders despite his medical files indicate he has fracture in scapula. It seemed that no-one had even read his medical documents because he should not have been lifted up like that!!!
pp) When the condition of the patient worsened during the night patient had screamed for help several times, there was no help assistance call button, patient was asked to stay silent and sleep on, doctor was not invited and the patient had to wait for assistance until the relative reached the hospital;
qq) Dad had stroke and is paralyzed from one side, fed via tube and has brain injury. He fell from bed and got more injuries, should we take him somewhere else?

2.4. Patients in Estonian hospitals considered by staff inconvenient are illegally chained, despite the action is violation of the legislation

rr) On Sunday we took her to hospital and Monday morning we were called and told to take our mother off immediately because they claimed she is raving. She had been all her life a calm person who never had arranged war of words with anyone. It was hard to believe what we saw when we reached the hospital - she had been chained with belts to the bed at the hospital room. First thing she did when we arrived was to ask us to take her to another room where she started to count her money that felt weird because she was not the kind of person to suspect others. Now, later, we understand - she probably did not wish to leave her bag with money from her sight and she had seen that someone had tried to take something from her bag;
ss) Father has brain injury and is in hospital where his hands have been chained to each other, is that legal and allowed?
tt) Father of client chained, daughter worried.

2.5. Patients left with their excrement in bed for long time

uu) I asked them many times to change the diapers. Whether he was cleaned and washed during that time I do not know;
vv) I found many times mother in hospital bed with her excrement, she had also vomited, her mouth was dry and not clean. I washed her myself and also changed her clothes. She asked me every night not to leave her there but what could I do - she needed professional medical help so I could not take her home;
ww) They even do not wash patients. When my friend had been late with paying the bill immediate warning letter came that mother will be kicked off from the hospital;
xx) the room-mate at the hospital was kept by staff 24 hours in bed with excrement that looked like some kind of punishment because he had dared to push the assistance call button. He was brutally berated and as a result none of the patients at the hospital room had courage to push the assistance call button fearing the revenge by hospital staff.

2.6. Patient is left alone for long time and the condition of patient is not controlled, when patient dies hospital staff has no idea sometimes even on which day it happened

yy) no-one knew when mother passed off. Her body had been put away to cleaning woman messy room where all the working tools and chemicals of cleaners were -and her dead body;
zz) no-one had appeared to the hospital room door to find out how the patient was doing;
aaa) grandmother, 85 and in full sense, complained every time that nobody is visiting her for days, none of the doctors or nurses, no-one had told her about assistance call button, we found it and showed her how to use it.

2.7. No pain relief medications given

a) the horror for our family started in the evening when grandmother called and screamed she is having terrible pains. I asked her why she is not calling nurse and she said she had been screaming for help but no-one has came to her. I called the nurse on duty and asked her why she is not going to see my grandmother. The nurse replied claiming that my grandmother is not speaking the truth and there is nothing wrong with her. I then heard on phone how nurse was walking closer to my grandmothers room and I heard that terrible screaming again in nurse phone and I started to cry. I felt like my grandmother was tortured;
b) after the first shock I requested the pain relief medications for father because he had enormous pains in his broken shoulder blade.


2.8. Necessary health tests are not made and medications not given

c) At home she had a walking stick to help her moving but nothing to assist her had been given at the hospital, There was a table for eating and toilet chair next to her bed, but no toilet paper had been given;
d) we bought the medications to cure bed sores ourselves and took them to the hospital where we were told they do not have medications like that at the hospital;
e) I am afraid that because of her diabetes that was unstable and not treatable her situation worsened, its horrible to think whether at all and how often they were dealing with her. We got the impression that they just let her to die;.
f) my sister found grandmother once having high fever and breathing problems when she reached the hospital and asked the staff why nothing is done to help her. She was cursed by nursing staff who asked why do not we let an old woman to die and grandmother was taken to intensive care;
g) the picture that I will never forget and that forced me to write to you is from a day when I reached my mother at the hospital room and saw her face red and swollen and she had been chained by hospital staff and was whispering she is dying. I went into panic and called nurse who found out my mom had blood sugar problem, after some procedure then she felt finally better;
h) we had to beg for pain killers because nobody visited that hospital room;
i) he was ordered to have oxygen mask but one day it had disappeared and when we went to find out where it had disappeared there was no-one to ask, its like no staff in that hospital;
j) my mom has diabetes and she had been in hospital for quite some time when I found out she had not been even given any insulin shots despite at home she had to inject it 4 times a day!!!
k) despite the complaints and constant pains no medical tests were done to patients and no cure given, he perished due to enteritis;
l) the client got scabies from a nursing house, despite the son had told the nurse about the problem on skin when first signs had occured. When they got home the first aid ambulance that was called and came contacted the nursing house that was concerned who had complained;
m) client in nursing house has got skin infection but has not been taken to doctor, promised to hang himself;.
q) after hip joint operation the mother of the client got an high fever and dint make contact. Despite that she was transported from regional hospital back to local hospital where she was put into room for patients with no survival hope. The surgeon did not observe the wound and later it turned out the hip joint had been moved during the transportation. Patient had enormous pains, could not sit and has to suffer pain, was told no new operation. The X-ray was made only after relatives insisted;
r) mother who had a stroke is on nursing care, has got bed sores, severe bladder infection and hospital wants to send her home;
u) its well-known many cancer patients get heavy pains, we had visited in a year three times the doctor who advised us about pain-relief medications and how to take them. Now in hospital the pain relief medications are given chaotically.

2.9. Rooms can get ice cold during winters when staff opens windows

x) We found several times that the windows were opened despite it was still very cold in April, week and half after entering the hospital grandmother died because of pneumonia.
- Many similar complaints.

2.10. Instead of necessary care patients are injected/given huge doses of intoxicating drugs and/or chained to bed

aa) he had went to hospital being in full consciousness and walked to hospital himself but it took only less than day that he had became bed-attached patient, "demented elderly" who could not eat or drink without assistance;
bb) I got the feeling he had been given so much intoxicating drugs to keep him sleeping;
cc) after every day that passed I realized she is going to loose her sense, her arms were full of injection signs;
dd) grandmother health worsened every day, instead of getting better she was now attached to some tubes, her and legs were tied and swollen, they said its from injections;
ee) legs of the patient who had stroke have swollen during the nursing care, signs of injections on legs;
ff) it took few weeks to realize that the rehabilitation care in that hospital meant feeding the patient with pain-relief medications and giving bigger and bigger doses of sleeping pills. Around week after going to hospital grandmother started to see hallucinations. Two weeks later she was completely insane, all she said was plea to take her away from there. .... At home she did not understood anything, was unable to recognize us or that she was at home. Her tongue was so swollen we could not understand any word she said. In coming days no progress either. We were guarding her with all family. The recovery from the overdoses of intoxicating drugs at the hospital took 8 months;
gg) I do not know what that was they injected me, but it was really strong and had quick impact. ... Sometimes they hit me later to see whether it was strong enough so I will remain sleeping and will not cause them any trouble...
hh) the doctor gave the 81-year old (weight 50kg) too strong doses of pain relief medications that most likely caused her death. Because I accused the doctor I was told by doctor no time to write and give me the death certificate.

2.11. Patients and their relatives are verbally abused and humiliated, when patients or their relatives complain and ask for better care they are threatened to be kicked off from the hospital and the staff starts to persecute them

ii) mom was verbally abused during night because she had dared to ask assistance when she wished to go to toilet. She was berated and did not get help;
jj) doctor said we are abnormal people, adding he means all our family;
kk) doctor refused to talk to us;
ll) each time I asked about the condition of my mother I was berated.

2.12. Feelings of patients not taken into account, at some hospitals staff likes to demonstrate how helpless the patients are, arrogantly and without a tact also speaking about their death soon

a) We met at our sister´s hospital room. Doctor who was not the in charge of my sister´s case lead the meeting. He behaved terribly - asked a question from my sister and hearing hardly the answer noted ironically - you see, they are all like her here. I felt heart to the bottom of my heart with those words. I knew myself what the situation is, but I could still expect a doctor to give a polite explanation. Sitting in the doctor´s room it was obvious he did not wish to come to that meeting and he was not even familiar with the medical case of the patient;
b) The doctor said for a start "....how FUNNY it is - he (my dad) should actually be already dead by now." We saw no fun anywhere. When we contacted the doctor again after while to ask about the condition of father the doctor kept looking at the computer screen and said: "He will die, nothing to do!"
c) Doctor leaned to the sick boy, knowing he could not speak and behaving more politely than with me but still presented is question unpleasantly loudly and in irritated way like he was speaking with annoying and deaf old person: "Tell us Stanislav how old you are?" Boy tried to do his best to answer but it was not possible to understand. Doctor said loudly, victoriously and complacently: "I didnt heard what you said, repeat it!" The young patient tried again to get voice out from his mouth. The doctor then shouted: "I didnt heard how old you are?!" And five times like that. He could have continued that circus probably had I not interfered. I need to admit honestly I started to feel sick. I interrupted the doctor loudly saying "I heard he said he is 19!".

2.13. No modern nursing services offered

e) it looked like staff was never at work;
f) during the 4 months he was there we saw only 3 times some employees. One was cleaning lady, another was Russian employee, probably nurse who turned the patient who had pain and horrific bed sores, third time I saw staff member was when I went to take mother´s belongings on the day of her death;
g) when at first hospital she got at least some kind of therapy then at the nursing hospital where she was transferred she was left in same position every time we visited her;
h) I saw my dad with empty look, not shaved and not cleaned. After I asked the staff member for comb she made big eyes and shouted that she is not nurse, so that question to her is not relevant. Finally one upset staff member found a comb and announced they do not take care of the patients appearance. So we decided with family we will take care ourselves and we took all necessary tools with us every time we went to visit him at hospital;
j) is it normal that nursing home clients cant get out from the building in summer? What to do to get dignified service for the people, we have paid lot of money for that place?
k) Why the patient in comatose was not taken care? The 22-year old friend of client was in comatose and there seemed to be no nursing at all. Now the patient is out of comatose and needs therapies and good nursing, but its impossible to get it. Friend was made handicapped forever due to insufficient nursing.

3. Health care providers try knowingly to take steps that could cause the death of the patients (giving them overdose of drugs, withdrawing necessary medications, freezing the bed-attached- patients while leaving them next to opened window during chilly Nordic weather etc.

o) On May 5 nursers informed us mother had tried to commit suicide, she had tried to disconnect the cannula attached to her etc, blood transfer was needed because she had lost over a liter of blood. Mother insisted us later she did not do that and that doctors had done something wrong (at that point we thought mother has lost a sense but we are not sure about it any more). Mother had been illegally chained to bed;
p) almost immediately staff started to accuse my dad that he had been drinking all the chemicals that were meant to clean the hospital room!!! It became clear almost immediately they wish to get rid off of my dad as soon as possible;

4. Because there are few establishments offering nursing services in Estonia, relatives are pushed to pay bribe to maintain the service or get better service

q) when we were cleaning mother ourselves nurse came and shouted why we come to make her trouble and that we should know mother will not leave longer because of that, she also asked us for money;
r) doctor said that the time for my dad to stay at nursing care is over and he must be sent home. Then he asked in that meaningful way - I do not know whether we can still find some kind of solution to that. I understood immediately he was asking a bribe.

5. Money of patients stolen

Several cases reported, including staff member calling to relative and asking whether he knows the banking card code of the patient.

6. The complaints about abuse and medical service are not taken seriously. They are ignored, not admitted, patients who complain made to look ridiculous, humiliated, berated, threatened to be kicked off or to be punished in different ways. In some cases the poor quality is however admitted and the comment is it should be like that

v) There are tens and tens people in similar situations who do not know where to turn to get help because nobody is listening them and they are labelled liars who have communication problems;
w) when we looked for justice and answers we were asked whether we do not know that this is the place where people are sent to die and not to recover;
x) I then asked the doctor to look after her and not to interrupt the little therapy they had done. But the doctor got angry and said I should take my sister away if I do not like what they do;
y) grandmother was shaking in bed, eyes big from fear and looking towards door. I asked what had happened and she whispered into my ear that nurse had threatened her a day before and had told her that if she calls again it will end badly. When the nurse left she also took phone with her so grandmother could not call. I was so angry to hear that and I went to nurses room to ask for explanation. No sensible answer was given and of course they denied it. Their attitude changed for even worse after that;
z) no-one had name on her clothes neither told us the names when I said I wish to present a complain. They told me at nurses resting room - six of us against you, what you think who will believe you? Like I was there only to crash their mood;
aa) what happened when mother died was that the doctor did not answer the phone any more;
bb) Mother had mobile phone and dad called her every day. Every day. Mother was sane and spoke about her condition. Once when dad had been speaking to her phone the phone was left open and what my dad heard was unbelievable. Nurses who had came to hospital room after mother had called for help loudly were screaming at mother to shut up or she will be chained and locked alone into dark room. DO YOU UNDERSTAND WHAT IS REALLY GOING ON THERE??????????? Yes, I cant prove that because we had no tape recorder to record it. But I wish you to know how they work in that house. They lack any COMPASSION . (testimony from the letter of daughter to his mother´s doctor);
cc) after we had asked oxygen mask things went worse, because she was taken into section of dying people where she had to share the room with insane patient screaming days and night;
ee) then something unexpected and unbelievable happened - doctor jumped over the table and grabbed me with his hands. He grabbed my breast and I felt how his fingers were slipping behind my brassiere, and he gnarled and and teared it like dealing with a rag doll. I was so shocked I probably did not even defend myself (testimony by the lawyer of the Estonian Patients Advocacy Association about her encounter with a male doctor she had went to meet to talk about a client).

7. Severe shortages management of hospitals
a) management lacks the overview about patients, their cure and the activities of their employees;
b) hospital leaders justify the ignorance or unauthorized acts by staff when patients or their relatives reveal those cases;
c) there is complete lack of control about the quality of service and also no wish to improve the quality of service;
d) lack of regulations and supervisory tools to grant the quality of service;
e) there is no system to handle the complaints of patients or their relatives;
f) the qualification of staff offering nursing services is clearly insufficient.

The nursing services in Estonia are described in testimonies by relatives with following words:

a) empty and weird "meat industry";
b) I would like to talk screaming about the people who work there;
c) I wished to know whether the horrible stories I had about the hospital are true. When at the hospital I realized the situation is even worse;
d) patients have lost all hopes for survival, because they have been made clear they were taken there for one reason only: to die;
e) daily visits convinced me in even more horrific way what you had experienced;
f) the environment in that hospital is softly said dismal and inhuman;
g) its like horror film what we went through;
h) we would not recommend anyone to let you loved ones to hospital because the patients will not come out on their one legs from there;
i) the TV report about the hospital opened the old wounds - sorrow, pain of loss, anger...
j) I got a shock when I went to see my sister to that hospital first time;
k) because of this experience I know that in Estonia unfortunately there is no proper nursing care and no order to offer compassion to fatally ill and their relatives;
l) most horrible is that if you really wish to put a person to nursing hospital we do not have in Estonia such a place (for nursing care patients who should be supervised by doctors). You should watch instead how people are tortured and humiliated and you know from that place the patients do not come out alive;
m) I was in hysteria every night because I was unable to help her. Sometimes I was sitting for long time in car to calm down before I drive home. I was thinking what kind of people work there and how all were treated there, it was so inhuman you could talk and talk about these stories;
n) I am so sorry my mother had to suffer like that there for so long!
o) I was in tears when I watched the TV report about that hospital;
p) I cant believe that such nursing treatment is normal!? Human being was just kicked to some corner to die! And its exactly how it was. My dad died like that in 2010 and I have painful question whether there was anyone with him at all?! Was he in need of help and no-one went? Unfortunately that question will remain without answer forever....
q) we will be hunted forever with this negligence and indifference of hospital staff and the pain they caused. Are some parts of Estonian hospital system so down they cant offer even dignitive last days for humans...?
r) one doctor I know told me I should be grateful my dad was unconscious when in... hospital. He said he himself had taken his dad off from there because nobody had cared for his health there;
s) after that two hard months full of humiliation by hospital staff followed;
t) no, I do not wish to become old in a state where I am treated - when I fall ill or will be old - like an annoying meat body;
u) I felt frustrated again when I saw that same room, the doctor and the hospital. What had happened to her there was against all human principles. I can still not forget the lies etc. by the doctor... Such person should not work as a doctor. When you wish to know more I am ready to talk;
v) later at Tallinn funeral company one of the workers there told us that hospital is death factory;
w) last autumn also my grandmother was at the same hospital and the complaints could be same as aired in the TV program;
x) the experience was negative, to improve the situation I am ready to say few words - its terrific to even think about it all again;
y) I got a clear opinion that the hospital needed the patient only to get the money from Sickness Fund. Rehabilitation plan for my sister was compiled but it remained just a plan because it was not possible to implement it and the doctors who had compiled it had no interest to follow whether it was even used. But making such a plan is profitable - it takes money to those who compile it but it brings nothing good for a patient!
z) all the point of the story is that from a person who was going to die was taken off the dignity. It is hard for us to remember the suffering of father;
aa) I wish to say this kind of attitude is common in many nursing establishments;
bb) this place is like concentration camp, no medical treatment, no nursing, the food was extremely bad. Patients and their relatives are scared that if they dare to complain about anything they will be signed out.

The overview about the abuse of patients in Estonian hospital is compiled by Estonian Patients Advocacy Association 2011, and is quoted and highlighted also in annual Human Rights Report 2011 launched in April 2012 by Estonian Human Rights Centre. Contacts: www.epey.ee.

For more info about the abuse of patients, violation of human rights and the attempts to force Estonian authorities to compile and adopt Patients Rights Law and to take other necessary steps can be read at the website: fatalhospitalerrors.blogspot.com

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Anneli Reigas

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Estonian doctor: Inhuman treatment and errors in Estonian hospitals far not just seldom cases

"Estonian health sector needs urgent changes and the long time cover-up practice in medicine has to end. Health quality monitoring and objective complaints handling system are practically not existing in Estonia, people who reveal their own experiences about what they have witnessed in hospitals are punished with public revenge, hospitals themselves are often interested only about the money they get for treating patients and not the quality of medical treatment. As a doctor I can confirm that the horrible stories about the brutal experiences from the hospitals are just a tiny part of the disorganization in Estonian health care. As a doctor I keep being told by my patients about similar cases again and again. Unfortunately such publicly revealed cases also damage the reputation of those good doctors in hospitals who have nothing to do with this kind of behaviour and misdoings," said dr. Ivo Kolts, lecturer on anatomy at the Tartu University who attended a seminar about the violation of patient rights in Estonian hospitals and relevant proposals at the Conference Centre of the Parliament at Toompea on Monday, February 21, 2011.

The speakers at the seminar were Pille Ilves - the head of the Estonian Patient Advocacy Association, doctor Ivo Kolts - anatomy lecturer at Tartu university, Urmas Reinsalu - Head of Parliament Social Affairs Commission, MP Toomas Trapido who made a summary whether and what has changed for better in health sector since the last similar seminar at the Parliament Conference Centre nearly a year ago.

History teacher Endla Lindmäe spoke about her son´s case whom the doctors at Tallinn biggest hospital gave no hope at all for survival, left the 22-year old without relevant treatment that causes lot of moving problems still five years later, who was starved to 33-kg in Estonian hospital before the parents took their son home upon the advice of nurse who said he will otherwise die in days in hospital - but instead came out from comatose later at home and five years later has not even any brain damage.

The initiative to force Estonian government to admit the existing problems in Estonian hospitals and to encourage the government finally to compile and adopt Patient Rights Law was initiated last year by Estonian MP Toomas Trapido, myself and some other people who have faced the brutal treatment of their relatives in Estonian hospitals.

By winter 2011 two Estonian parties - Fatherland and Pro Patria Union and also Social Democrats have included the Patient Rights Bill into their parliament election program but the two biggest parties - the ruling Reform Party and Central Party have been still ignoring the need for Patient Rights Law and the need to handle the claims about the violation of human rights in Estonian hospitals.

Estonia government that compiled its last Human Rights Report to UN recently that was discussed in Geneva early February decided to ignore all the matter this time with excluding the Patient Rights Association first time ever from the list of NGOs who were asked to express their opinion and make proposals about the fresh report.

In January Estonian Patient Rights Association sent a letter to Social Ministry informing the ministry it withdrews from current medical quality commission that is considered not objective and its members are not punished even if they lied or falsificated documents. Estonian Patient Rights Association that has stressed repeatedly that human rights of patients are often violated in Estonia has made also several proposals to authorities to change the legislation and monitoring system and to set up a completely new health sector monitoring commission that will include also lawyers.

The summary in English about the speeches at the seminar will be added here later.

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