Ten years after a watchdog group uncovered deplorable conditions at Mexican institutions for people with disabilities, little has changed, even after government officials promised to take action.

A follow-up report from Disability Rights International released Tuesday describes people living in facilities littered with human feces and urine where individuals are tied to wheelchairs and lobotomies are still performed. People were found naked without access to treatment or even running water.

What’s more, authorities lack records of residents’ names, ages and even their reasons for being institutionalized. In fact, record keeping is so bad, that some individuals have essentially vanished, the disability rights group found.

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“These are Mexico’s most vulnerable citizens — abandoned children disappearing into a world of exploitation and abuse and people with disabilities forced to endure a lifetime of egregious human rights abuses in institutions,” said Eric Rosenthal, executive director of Disability Rights International and the main author of the report.

Residents of Mexican institutions include both people with disabilities and those referred to as “abandonados” whose families can’t or don’t support them. For many who have spent years in the facilities, however, the poor treatment — which the authors say amounts to torture in some cases — has left them worse off than they likely began. But without supports in the community, many families have little choice but to turn to the facilities, the report indicates.

After results from the initial Disability Rights International investigation were released a decade ago, Mexican officials pledged to enact reforms and begin including institution residents in the community. Notably, Mexico was among the first countries to sign onto the United Nations Convention on the Rights of Persons with Disabilities  in 2007.

However, so little has changed since the initial report in 2000 that some residents were found living exactly as they were when investigators first visited.