In October 2003, MDRI investigators found eighteen year-old Jorge, diagnosed with autism, locked away in a cage in the Neuro-Psychiatric Hospital of Paraguay.  He had been detained in a six-by-six foot isolation cell for over four years.  Lacking toilets, Jorge had been forced to urinate and defecate in the very space where he was to sleep, eat and reside. The cells were completely bare, save for a wooden platform jutting out from the cell wall. Holes in the cell floors that should have functioned as latrines were crammed and caked over with excrement. The cells reeked of urine and feces, and the walls of the cells were smeared with excrement.  Jorge spent approximately four hours of every other day in an outdoor pen, which is littered with human excrement, garbage, and broken glass.

In response to the egregious human rights violations uncovered by MDRI, the Inter-American Commission on Human Rights (IACHR) mandated that urgent measures be taken by the government to protect the lives of those detained in the institution.
 
MDRI and the Center for Justice and International Law (CEJIL) signed a historic settlement with the Paraguayan government aimed at ending the improper detention of hundreds of people in the country’s state-run psychiatric hospital. Filed with the Inter-American Commission on Human Rights of the Organization of American States (OAS), the settlement was the first agreement in Latin America to guarantee the rights of patients to live and receive mental health services in the community.