Spatial features of Macedonian social care institutions

 

 Location

As said a great part of the institutions are located in towns, some even on quite central, prominent positions (11. Oktomvri, Topansko Pole, MIHB). This constitutes quite a comparative difference to geographical distribution in other countries, where institutions are usually located in countryside or on the peripheries of towns. This is a good feature now, when institutions are still in their place – residents have more opportunity for contacts with ordinary community members, are nearer to mainstream services they may need (especially health services) and have all amenities of cultural, economic and social life at hand. It is also a prospect for deinstitutionalisation since good locations provide good opportunities of either material income or a new social use.

Most of the institutions, even if they are in the urban area, are markedly separated from the environment and wider community by a wall or a fence or combination of both. Gates to the compounds are usually open, in some there is a guard at the gate in a small guard building. Control of entrance and exit is, however, apart from psychiatric hospitals, unobtrusive, and most of the institutions, even those accommodating the people with most severe intellectual disabilities, staff are not obsessed with danger, which would prevent the residents to stroll out of the institution. Nevertheless, the institution have an air of a world of their own, even if in some the area is sometimes used for the activities of people from the neighbourhood (Topansko Pole), the number from people from the outside that would enter the compound without a definite errand, unofficially, is next to nothing.

Spatial structure

Most institutions for children and adults under 65 years have outsized their shrinking populations. The extreme example is Topansko Pole, which was built to accommodate 300 children and is now hosting only 37 mostly adult residents. Even Demir Kapija, which has largest number of residents and gives off the impression of lack of space, has an empty institution on another locality.

Mostly the buildings were made for the purpose of the institutions from the fifties on (exception is Demir Kapija, which was built as military hospital between the two world wars). Architecturally it means that they are, as rule, big buildings similar to army barracks or schools. The architecture is quite modern in style, depending on the time they were built. This means that the buildings are big, ostentatious, expressing authority and official purpose. Since they were built not so long ago they are spacious, lucent with elements of panopticon principle: availability to be seen and controlled.  It also means that they were designed to pack in a lot of people in a collective manner of living (common dining rooms (canteens, refectories) common sitting rooms, lavatories and recreational spaces. The exception to this kind of layout are 11. Oktomvri institution for children, which has a pavilion type outlay, and similarly the old age home in Zlokućani, which is using the premade bungalows used to house the victims of the earthquake in 1963. This layout provides more diversity, privacy and atmosphere of civil-like life. Even if dwellers are only partly separated, still it is the compound system of the institutional kind, where the boundaries mark the authority of the institution and where the main building with the staff dominates and controls the space.

Every institutional complex (apart from Bitola) has few buildings. Often there is a central building for administration[1], then there are residential buildings, apart from these there are sometimes other buildings like kitchen, laundry or some technical workshops. Such an arrangement gives a complex an aura of rationality and purposefulness. On the other hand, the park with some recreational grounds (playgrounds, sports grounds, walk paths, benches etc.) situated in between the buildings and on the edges of the compound, gives the impression of serenity and an idyllic touch. Since these in-between areas are devoid of much activity other than people sitting or strolling like they are waiting for something very indefinite, it gives the compound also a sense of emptiness and desertion.

Claimer: This blog is intended as a part of Situation Analysis and Assessment/ Evaluation Report of Implementation of National Strategy on Deinstitutionalisation 2008–2018, which will be soon presented to the public within the EU framework project Technical assistance support for the deinstitutionalization process in social sector. For this blog, Vlado Krstovski and Andreja Rafaelič are considered to be co-authors.

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[1] In case there is only one building or the administration, or management is situated in a building also used for residence, or kitchen etc. still these offices are central and at hand. They are like second gate, since the business visitors do not need to go any further into the ‘hell’.