Report on the results of a monitoring visit to the State Institution ‘Lviv Penitentiary Facility (No. 19)’

05.03.2023 Serhiy Zuikov, Andriy Didenko, Olexa Yaroslavtsev

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In the outpatient department, prisoners suffering from active tuberculosis are held in inadequate conditions.

On 9 February 2023, a monitoring group, consisting of an assistant to People's Deputy of Ukraine Kostiantyn Kasai, a member of the public council under the Ministry of Justice of Ukraine Serhiy Zuikov, an assistant to People's Deputy of Ukraine Yaroslav Yurchyshyn, a KHPG programme coordinator Andriy Didenko, as well as a journalist from the ‘Poriad z vamy’ news agency Olexa Yaroslavtsev, carried out a preventive follow-up monitoring visit to the State Institution ‘Lviv Penitentiary Facility (No. 19)’. The visit was conducted within the framework of the DIGNITY Danish Institute Against Torture project. The purpose of the visit was to analyse compliance with human rights in the pre-trial detention centre and to ascertain the circumstances of the response to previously identified human rights violations in this institution. The previous visit took place on 13 August 2021.

The head of the institution is Lieutenant Colonel of the internal service Vadym Anatoliyovych Kutovyi.

The monitors gained access to the institution's territory without obstruction or delay, had the opportunity to visit any post or room, and to communicate with convicts on the condition of anonymity. The monitoring group was accompanied by the deputy head of the institution, Lieutenant Colonel of the internal service A. R. Sorokhan.

According to the institution's management, there are 3.6 prisoners (convicts) per member of the administrative staff.
Two psychologists work at the institution.
During 2022, 3,145 persons arrived at the institution.
During 2022, 24 persons died in the institution, and in 2023 — 1.
18 convicts are employed, all under employment contracts. The average monthly salary is 3,562 hryvnias.
There is a shop operating in the institution.
43 persons are registered as prone to suicide. In 2022, there were 2 suicides. 28 persons are prone to self-harm, and 5 are prone to escape. There are 14 malicious violators of the detention regime.
10 persons were released in 2022 due to severe illness.
There are 4 persons with disability group II and 8 with group III registered in the institution.
In 2022, 51 cases of bodily injuries were recorded upon arrival, and 26 during the stay in the institution. In 2023 — 7 cases upon arrival, and 3 during the stay in the institution.
In 2022, special means were used 7 times.
In 2022, seven long-term visits were granted. For the 2023 period, as of the time of the visit, one long-term visit has been granted.
There were 246 short-term visits in 2022, and 32 in 2023.

General Information

The State Institution ‘Lviv Penitentiary Facility (No. 19)’ has a long, four-hundred-year history. The institution performs the functions of a pre-trial detention centre; it has transit cells, as well as a maximum-security sector for holding those sentenced to life imprisonment.

The monitors visited the rooms for receiving citizens, parcels, and conducting visits, telephone conversation areas, control points, the duty unit, the premises and cells of the intake department, interrogation rooms, punitive isolation cells, the maximum-security sector, and cells for holding those sentenced to life imprisonment; cells for holding pre-trial detainees — minors, women, as well as those convicts who are in transit to other penitentiary institutions. Residential units for convicts left for maintenance work were inspected. The monitors also inspected the kitchen, the medical unit, the laundry and bath facility, and the educational premises for minors.

Outpatient Department of the Lviv Multidisciplinary Hospital No. 19, a branch of the State Institution ‘Health Care Centre of the State Criminal-Executive Service of Ukraine’ in Lviv region

The Outpatient Department of the Lviv Multidisciplinary Hospital No. 19 is a medical and preventive healthcare facility of the Health Care Centre of the State Criminal-Executive Service (HC-SCES) of Ukraine, intended for the provision of primary outpatient medical care to persons taken into custody and convicts serving sentences in the State Institution ‘Lviv Penitentiary Facility (No. 19)’, as well as secondary and tertiary (highly specialised) medical care to convicts in the healthcare facilities of the Ministry of Health of Ukraine.

The Outpatient Department of the Lviv Multidisciplinary Hospital No. 19 includes:

a general practitioner’s office,
a psychologist’s office,
a dentist’s office,

an infectious disease specialist’s office,
a phthisiologist’s (tuberculosis specialist) office,

a psychiatrist’s and narcologist’s office,
an obstetrician-gynecologist’s and dermatovenereologist’s office,
a treatment room,
a laboratory research room,
an X-ray room,

a day hospital,
a storage room for the main stock of medicinal products.

According to the staffing schedule, the following positions are filled:

general practitioner (family doctor) — 1 position,
dentist — 1 position,
psychiatrist — 1 position,
phthisiologist — 1 position,
radiologist — 1 position,
infectious disease specialist — 1 position,
obstetrician-gynecologist — 0.5 position,
dermatovenereologist — 1 position,
narcologist — 1 position,
paramedic — 5 positions,
X-ray laboratory assistant — 1 position,
pharmacy assistant — 1 position,
laboratory assistant — 1 position,
junior nurse — 1 position.

Unfilled position: laboratory assistant — 0.5 position.

Vacant position: head of the outpatient department — doctor — 1 position.

The medical unit's hospital has:

one ward for somatic patients, designed for 6 beds, in which 6 persons were staying on the day of the visit;

a tuberculosis block, consisting of 4 ward-cells with 15 beds, in which, on the day of the visit, 10 persons suffering from active tuberculosis were staying.

There are 66 HIV-infected persons under dispensary observation (65 persons are receiving ART therapy). In 2022, 99 immunological examinations (CD-4) were conducted, and 10 in 2023. Over 6 months, 35 virological examinations (viral load) were conducted. The number of rapid tests performed in the current year is 109. At the same time, dispensary observation charts for HIV-infected persons (form No. 030-5/o) have not been created for all HIV-infected individuals, which indicates chaotic data entry. In some cases, information about medical examinations and details regarding the collection of tests are absent entirely.

There are no conditions for accommodating persons with disabilities. Specifically, there are no ramps, handrails, or other equipment. At the same time, the institution carries out dispensary observation for 12 persons with disabilities, including 4 persons with group II and 8 with group III.

In the current year, 10 cases of bodily injuries were recorded, including 7 upon arrival and 3 cases within the institution. During the study of medical documentation, the monitors established that the bodily injuries present on prisoners are not being properly recorded by medical staff in medical cards. Contrary to the requirements of sub-paragraph 2.1 of Section II of the Procedure for Interaction between Healthcare Institutions of the SCES of Ukraine and Healthcare Institutions regarding the Provision of Medical Care to Persons Taken into Custody, approved by the joint order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 10.02.2012 No. 239/5/104, medical workers do not draw up certificates that should describe in detail the nature, size, and location of bodily injuries. According to the doctor, convicts working at catering facilities and baths undergo mandatory preliminary and preventive medical examinations in accordance with the resolution of the Cabinet of Ministers of Ukraine dated 23 May 2001 No. 559 “On approval of the list of professions, production facilities, and organisations whose employees are subject to mandatory preventive medical examinations, the procedure for conducting these examinations and issuing personal medical books”. However, during the inspection of personal medical books, the monitoring group noted the absence of tests for viral hepatitis in convicts working at catering facilities. The medical staff explained the lack of necessary testing by the shortage of tests.

Dispensary observation in the Outpatient Department of the Lviv Multidisciplinary Hospital No. 19 is carried out for 14 persons with mental disorders. At the same time, in violation of clause 8, part 5, chapter 2 of the Procedure for Organizing the Provision of Medical Care to Convicts Sentenced to Imprisonment, approved by the joint order of the Ministry of Justice of Ukraine and the Ministry of Health of Ukraine dated 15.08.2014 No. 1348/5/572, there is no isolation ward in the hospital for persons with mental disorders who pose a danger to others.

In accordance with the requirements of paragraph 7, part 1 of the Resolution of the Cabinet of Ministers of Ukraine dated 29 December 2021 No. 1440 “Some issues of implementing the program of state guarantees of medical care for the population in 2022”, the National Health Service of Ukraine (NHSU) pays for medical services provided based on paper referrals for patients held in penitentiary institutions and pre-trial detention centres of the State Criminal-Executive Service until the healthcare institutions of the State Criminal-Executive Service have created the technical capability to issue electronic referrals. However, due to the lack of a concluded declaration with a primary care physician, the convicts do not have the possibility to receive necessary medical services at the expense of the NHSU, which leads to a violation of the requirements of paragraphs 4 and 5 of Article 4 of the Law of Ukraine “Fundamentals of Ukrainian Legislation on Healthcare”.

The hospital ward of the Outpatient Department of the Lviv Multidisciplinary Hospital No. 19, in violation of the requirements of the “Norms of provision of bedding, special clothing and special footwear (inventory property) for prisoners undergoing treatment in medical and preventive institutions, institutions with hospital status, and in medical units at penitentiary institutions and pre-trial detention centres”, approved by the order of the Ministry of Justice of Ukraine dated 20.02.2012 No. 280/5, is not provided with hospital property (suit, gown, and hospital slippers) for persons undergoing treatment. In connection with this, persons in the hospital are dressed in daily clothing and do not have change-of-footwear, which does not ensure a proper sanitary state in the healthcare facility.

The Outpatient Department of the Lviv Multidisciplinary Hospital No. 19 houses a tuberculosis block, which consists of 4 isolation wards and is designed for 15 beds, and in which 10 persons suffering from active tuberculosis were staying at the time of the visit. According to Article 8 of the Criminal-Executive Code of Ukraine, convicts have the right to humane treatment and respect for their human dignity; convicts shall not be subjected to cruel, inhuman, or degrading treatment. At the same time, there is a violation of the prisoners’ right to receive proper medical care, equality, and respect for dignity in the institution. In particular, prisoners undergoing treatment who are in infectious isolation wards for tuberculosis patients are forced to be held in inadequate conditions: the premises need capital repairs, walls in the cells are damaged by fungus; the cells are not equipped with tanks for boiled drinking water and supply-exhaust ventilation. The toilets and sewage system are so worn out that they require repairs with the replacement of sanitary-technical equipment; the absence of such repairs leads to dirt, leaks, unsanitary conditions, a persistent unpleasant odour, and the creation of conditions that pose serious harm to the prisoners’ health.

Furthermore, the monitors discovered that in one of the isolation wards where patients with active tuberculosis are held, the heating radiator was disconnected from the general system. To avoid freezing, the prisoners were forced to heat the room with steam from a multicooker operating without a lid, which constitutes a fire hazard.

In addition, in violation of the requirements of the Fire Safety Rules in Ukraine, approved by the order of the Ministry of Internal Affairs of Ukraine dated 30.12.2014 No. 1417, registered by the Ministry of Justice of Ukraine on 05.03.2015 under No. 252/26697, most of the sockets used by prisoners are in an unsatisfactory condition, electrical wiring is exposed, the connections of wire cores are made, in some places without insulation; patients use electric heaters, thereby exposing themselves to the danger of electric shock.