By VLADIMIR ISACHENKOV
The Associated Press

RUSSIA - More than 50 patients have died in two deadly fires in as many days in Russian clinics, where permanently locked safety exits and other glaring abuses of fire safety rules contribute to the nationwide record of about 18,000 fire deaths a year - several times the rate in the United States.

Nine patients of a clinic for the mentally ill in Siberia died Sunday in a fire that local workers tried to extinguish on their own for 1 1/2 hours, failing to instantly call the fire service. A day earlier, 45 women died in a fire at a drug treatment center in Moscow when they were trapped behind locked gates and barred windows.

The deadly accidents underlined a rampant neglect of fire safety rules and official sloppiness, which helped make Russia one of the world's leaders in the number of fire deaths. Some commentators also said that psychiatric wards and drug treatment centers have been plagued by inhumane approaches to their patients dating from Soviet times.

"Thick iron bars on the windows, iron doors and cruel treatment are intended to subdue hospital patients," Kamilzhan Kalandarov, a member of the Public Chamber, a Kremlin-appointed rights body, was quoted as saying by the RIA Novosti news agency. "The death toll in a Moscow fire wouldn't have been that high without barred windows."

Security measures were severe at the drug clinic in Moscow, as in similar institutions in Russia, because authorities fear some drug addicts could try to flee.

Kalandarov called for stronger public oversight over drug and psychiatric clinics to make them more transparent and end abuses of patient's rights.

The fire in the Moscow clinic erupted in a wooden cabinet in a kitchen at one end of a second-floor corridor. The main exit was blocked by a locked gate that staff members could not open in time, and the only other way out was cut off by smoke, Russia's chief fire inspector Yuri Nenashev said.

Inspectors who visited the hospital in February and March had recommended its temporary closure because of safety violations.

Other officials said the hospital's personnel had not spotted the fire on time, and launched a criminal inquiry into possible charges of neglect of duty.

Nenashev said he was "90 percent certain" the blaze resulted from arson, and some reports said the fire could have been started by a patient.

Sunday's fire in the psychiatric hospital in Taiga, a town in the Kemerovo region of central Siberia, about 3,500 kilometers (2,200 miles) east of Moscow, erupted shortly after midnight local time (1700 GMT Saturday).

Nine patients of the clinic died and 15 were hospitalized, said Valery Korchagin, a spokesman for the regional branch of Russia's Emergency Situations Ministry. About 200 other patients escaped unhurt, he said.

Korchagin said that hospital officials tried to extinguish the blaze on their own and were slow to report it to officials. "They only reported it 1 1/2 hours after the fire started," he told The Associated Press by telephone.

Russian television stations showed the hospital's two-story building engulfed by fire and a line of half-dressed patients walking through a blizzard. A rescue worker carried one patient, clad in pajamas, who was unable to walk.

Korchagin said that some patients suffered fractures as they jumped out of windows, and some received burns.

The cause of the fire was not immediately clear, he said. Local prosecutors were looking at arson as a possible cause, the ITAR-Tass news agency reported.

A fire also erupted Saturday at another mental clinic in the village of Troyanovo in the Tver region, some 200 kilometers (about 120 miles) northwest of Moscow, but rescuers quickly evacuated around 300 patients and no one was hurt, said Arsen Grigorian, the head of the local Emergency Situations Ministry's branch.

Experts say fire deaths have skyrocketed in Russia since the collapse of the Soviet Union, in part because of a disregard for safety standards.

Permanently locked safety exits were the main reason behind the death of 43 people in a November 2003 fire at a dormitory for foreign students and numerous other deadly blazes.