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Jason Strother

By Jason Strother, freelance journalist

Visitors to the Cheongdo Daenam Hospital pass through a makeshift white tent and ascend a small flight of steps that leads into the only open entrance. At the doorway, staff check temperatures and inquire about other potential COVID-19 symptoms.

There is no signage or anything else to indicate the psychiatric ward that had occupied the building’s top floor. A woman registering guests claims she knows nothing about such a unit.

A year ago on Feb. 20, 2020, authorities announced South Korea’s first death from the new coronavirus at this medical center in North Gyeongsang Province, sparking a nationwide public health emergency.

All 102 patients in the closed psychiatric ward contracted the disease; eight of them lost their lives.

That tragedy, now overshadowed by many larger outbreaks, gave new momentum to a small but vocal movement that has for many years pushed for the complete deinstitutionalization of people with mental, physical and developmental disabilities from all types of congregate centers.

Activists and formerly institutionalized people feel greater urgency because of COVID-19. They say that living inside these facilities was already dehumanizing, and that now the health and safety of those in the care system are in more danger.

The United Nations has warned that people with disabilities who live in residential care facilities face “heightened risk” of infection due to underlying health conditions and inability to socially distance and are more likely to experience “human rights violations, such as neglect, restraint, isolation and violence” during the pandemic.

In the United States, at least 100,000 deaths, or 40 percent of all COVID-19 fatalities as of November, happened in group homes for the disabled and elderly, the Kaiser Family Foundation reported.

In Korea, around 25,000 people with physical and developmental disabilities live in institutional settings, according to the government’s latest figures. Most have an intellectual impairment or an autism spectrum disorder.

The South Korean Ministry of Health and Welfare (MOHW) reported 260 coronavirus infections and one death in centers for people with disabilities as of the end of January. Officials do not keep track of coronavirus cases specifically in psychiatric hospitals.

While South Korea has avoided the high number of COVID-19 infections and deaths that many other countries have experienced, the outbreaks in the Cheongdo Daenam Hospital’s psychiatric ward and other residential care facilities have pulled back the curtain on a system that goes largely unnoticed by the public.

Large institutions for people with disabilities are considered “socially unacceptable” on the same level as “cemeteries and garbage dumps” — places that most people don’t want near their homes, a disabilities researcher explained to me while reporting on this topic.

For those reasons, many of these centers have been placed in isolated areas, far away from communities as well as from scrutiny,

The origin of Korea’s institutional care system can be traced back to the early 20th century’s now-discredited practice of eugenics, which compelled authorities to separate people with mental illness and severe disabilities from their communities.

Korea’s first COVID-19 victim at the Cheongo Daenam Hospital’s psychiatric ward might have lost all connections to the outside world.

The unnamed man was a 63-year old with schizophrenia who had resided in the facility for 20 years, according to the Korea Disease Control and Prevention Agency.

No details about his life prior to his hospitalization were released, but advocates say he is emblematic of many people who spend their entire lives in institutions.

Many disabled people had no say in their institutionalization. Some do not have the ability to ask for their release due to their impairment, or are held back by bureaucracy; others might fear an inaccessible world on the outside and resign themselves to their predicament.

Some institutionalized people were abandoned by their families because of financial burden or stigma — what the researcher calls “the tragic history of disability” in Korea.

Some activists accuse the government of further cutting institutionalized people off from any connections to their original communities during the pandemic.

Health authorities have imposed a policy that restricts access to and from all residential care facilities in an attempt to keep out the virus.

Critics say this “cohort isolation” is abusive and doesn’t actually protect residents.

In January, disability rights protesters held a memorial in Gwanghwamun for those victims and demonstrated in front of the Shina Rehabilitation Center in Seoul. Advocates have urged the UN to investigate how the government’s quarantine strategy has impacted these people’s rights.

The deinstitutionalization movement has won support from the National Human Rights Commission of Korea, which has called for the abolition of involuntary admission into psychiatric units and the transformation of these hospitals into community care centers that house fewer patients in a less confined setting.

And in December, 68 National Assembly lawmakers proposed legislation that sets a 10-year timeframe to close all residential care centers for people with disabilities and, if passed, would increase support for those individuals to live independently in their communities.

MOHW’s disability rights division says it’s also committed to deinstitutionalization and pledges to close all large facilities, but has no deadline. The government is currently operating a Community Care Initiative, which integrates housing and medical or assistive care for those who want to leave the care system and, during its current trial run, can accommodate up to 3,700 people with disabilities.

One year after Korea’s first COVID-19 death, more voices are speaking up for some of the country’s most vulnerable citizens.

As for the Cheongdo Daenam Hospital, it appears to be distancing itself from the role it inadvertently played in this movement.

While the psychiatric ward is still an option on the hospital’s answering service, calls are not picked up. On another extension, an employee confirms that the unit is no longer in business.

Please direct comments or questions to [english@hani.co.kr]

This work was supported by the National Geographic Society’s COVID-19 emergency fund.