Report on the results of a monitoring visit to the State Institution ‘Transcarpathian Penal Institution (No. 9)’

11.03.2023 Serhii Zuikov, Andrii Didenko, Oleksii Yaroslavtsev

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Shortages of personnel and equipment in the institution’s medical unit result in a violation of the prisoners’ right to medical care.

On 10 February 2023, a monitoring group consisting of an assistant to the People’s Deputy of Ukraine Kostiantyn Kasai, a member of the Public Council under the Ministry of Justice of Ukraine Serhii Zuikov, an assistant to the People’s Deputy of Ukraine Yaroslav Yurchyshyn, a coordinator of the Kharkiv Human Rights Protection Group (KHPG) programmes Andrii Didenko, as well as a journalist from the Information Agency “Poriad z vamy” (Beside you) Oleksii Yaroslavtsev, carried out a preventive monitoring visit to the state institution “Transcarpathian Penal Institution (No. 9)”. The visit was carried out within the framework of the DIGNITY Danish Institute Against Torture project. The purpose of the visit was to analyse the observance of human rights in the penal institution.

The head of the institution is Lieutenant Colonel of the Internal Service Ihor Zinoviiovych Turkalevych.

The monitors gained quick and unhindered access to the territory of the institution and had the opportunity to visit any posts and communicate with convicts on the condition of anonymity.

According to the institution’s management, there are 3.4 prisoners (convicts) per member of the administration. One psychologist works at the institution. During 2022, 980 people arrived at the institution. In 2022, 3 people died in the institution, and since the beginning of 2023, one person has died. 10 of the convicts are employed, 8 of whom are under labour contracts and 2 are under civil law contracts. The average monthly salary of the convicts is 6,646 hryvnias. There is a shop operating in the institution.

There are 12 people registered with HIV/AIDS. 1 person is registered as prone to suicide. At the time of monitoring, 4 prisoners and 19 convicts were registered as prone to self-harm; 6 prisoners were registered as prone to escape.

In 2022, there were 2 complaints regarding improper conditions of detention and improper provision of medical care; since the beginning of 2023, there has been 1.

In 2022, 52 people were released, 6 of whom were released on parole, and one more convict was transferred to a less severe type of punishment. Since the beginning of 2023, 3 people have been released and one person has been released on parole.

In 2022, 61 ambulance calls were registered; since the beginning of 2023, there have been 15 such calls. There are 8 persons with disabilities registered in the institution: 2 persons of group I, 1 person of group II, and 5 persons of group III. At the same time, there are no conditions in place for the detention of persons with disabilities. In particular, the monitors noted the absence of ramps, handrails, and other equipment in the facility.

In 2022, 43 cases of bodily injuries were recorded, 32 of which occurred upon arrival and 11 cases during the stay in the institution. Since the beginning of 2023, only one case has been recorded, which occurred during the stay in the institution.

In 2022, 11 long-term visits and 396 short-term visits were granted. For the period of 2023, as of the time of the visit, two long-term visits and 27 short-term visits had been granted.

In the event of a power outage, the institution is equipped with generators that ensure its full operation. There is also an “Invincibility Point” (Punkt nezlamnosti) operating at the institution.

General information

The State Institution “Transcarpathian Penal Institution (No. 9)” performs the functions of a pre-trial detention centre. The institution also has a maximum-security sector for the detention of life-sentenced convicts and an arrest house.

There were no minor prisoners/convicts at the time of the visit.

The monitors visited the rooms for receiving citizens, parcels, and conducting visits; the rooms for telephone conversations, checkpoints, the duty unit, the premises and cells of the intake ward, the arrest house, investigative offices, punishment cells, the medical unit, the maximum-security sector and the cells for life-sentenced convicts; as well as the cells for holding minor and female pre-trial detainees. The residential quarters for convicts left to work in household maintenance, the kitchen, the medical unit, and the laundry and bathhouse facility were inspected.

The repair of the premises is being carried out using funds from charitable aid. In the future, the institution’s management plans to create the first paid cell for women in Ukraine.

The institution provides an IP telephony service, which can be used, in particular, by pre-trial detainees. After making a call, such pre-trial detainees are informed by the investigator about the call, indicating the number of the subscriber called.

At the time of the visit, there was no one in the punishment cell, nor in the disciplinary isolation ward for holding life-sentenced convicts punished for disciplinary offences.

Most convicts have their own electronic tablets, which are kept in their cells. Internet access is provided by the institution.

There is no separate drinking water in the cells; water from the taps is used for drinking everywhere.

Transcarpathian municipal medical unit No. 9 of the branch of the Centre for Healthcare of the State Criminal-Executive Service (SCES) of Ukraine in Chernivtsi, Ivano-Frankivsk, Transcarpathia and Ternopil regions

The head of the Transcarpathian municipal medical unit No. 9 of the branch of the Centre for Healthcare of the SCES of Ukraine in Chernivtsi, Ivano-Frankivsk, Transcarpathia and Ternopil regions (hereinafter — the medical unit) is Yevheniia Ivanivna Tsimbota.

During the visit, the monitoring group freely inspected the premises of the medical unit, became acquainted with the conditions for the organisation of medical care for prisoners, and had access to medical records.

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

head of the medical unit — doctor — 1 post;
ultrasound diagnostic doctor — 0.5 post;
radiologist — 0.5 post;
infectious disease doctor — 0.5 post;
therapist — 1 post;
dermatovenereologist — 0.5 post;
phthisiatrician — 0.5 post;
psychiatrist — 0.5 post;
paramedic — 3 posts;
junior medical nurse — 1 post;
pharmacist — 1 post;
X-ray laboratory technician — 0.5 post;
medical nurse — 0.5 post;
dental nurse — 0.5 post;
laboratory technician — 0.5 post.

The following positions remain vacant:

dentist — 0.5 post (currently serving in the Armed Forces of Ukraine);
neuropathologist — 0.5 post;
narcologist — 1 post;
paramedic — 0.5 post;
medical nurse — 0.5 post.

The outpatient clinic includes:

office of the head of the municipal medical unit;
offices for medical consultations;
paramedic (nurse) office;

auxiliary diagnostic rooms (X-ray or fluorographic);
clinical diagnostic laboratory;

procedural room;

dressing room;
pharmacy;
dental office.

Offices have been equipped in the secure block of the pre-trial detention centre for conducting outpatient consultations for persons in custody and convicts.

The inpatient department includes: ward cells, isolation ward cells for infectious diseases, and premises for the staff of the municipal medical unit. The infectious disease isolation cells (wards for patients with active tuberculosis) consist of 3 wards with 10 beds, in which 9 patients with active tuberculosis were staying on the day of the visit.

During the inspection, the monitoring group established that inpatient medical cards (Form No. 003/o), in which all data regarding treatment and diagnosis in the inpatient department of the medical unit should be entered, were not opened for patients in the inpatient department, including data obtained during the examination of the convicted patient, with a list of prescriptions, which in turn indicates improper maintenance of medical records.

The premises of the medical unit require major repairs, and the walls in the cells are damaged by fungus.

The cells are not equipped with tanks for boiled drinking water and supply-and-exhaust ventilation. The toilets and sewage system are so worn out that they require immediate repair with the replacement of sanitary equipment.

The absence of such repairs leads to dirt, leaks, unsanitary conditions, and a persistent unpleasant odour, not to mention the potential serious harm to the health of prisoners due to keeping people in such conditions.

The inpatient department of the Transcarpathian municipal medical unit No. 9 of the branch of the Centre for Healthcare of the SCES of Ukraine in Chernivtsi, Ivano-Frankivsk, Transcarpathia and Ternopil regions, in violation of the requirements of the “Norms of entitlement to bedding, special clothing and special footwear (inventory property) for prisoners undergoing treatment in therapeutic and prophylactic institutions, institutions with the status of medical facilities and in medical units at penal 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 shoes) for persons undergoing treatment. As a result, persons staying in the inpatient department are dressed in daily clothes and do not have change-of-footwear, which does not ensure the proper sanitary state of the healthcare facility.

There are 12 HIV-positive persons registered at the dispensary (12 persons are receiving ART therapy). Tuberculosis cat. 5.1 — 29 persons. There are 73 persons suffering from mental disorders. In 2022, 16 immunological examinations (CD-4) were conducted; since the beginning of 2023, 2 examinations have been conducted. In the last 6 months, 2 virological examinations (viral load) were conducted. The number of rapid tests performed this year is 116. Registered as having disabilities are: 2 persons of group I; 1 person of group II; 5 persons of group III. At the same time, conditions for the detention of persons with disabilities are absent. In particular, the monitors noted the absence of ramps, handrails, and other equipment in the facility.

Due to the lack of a diagnostic laboratory and a fluorography or X-ray machine, prisoners do not undergo diagnostic examinations of the chest organs for the timely detection of respiratory diseases. That is, it is impossible to carry out early diagnosis of tuberculosis in the medical unit. In addition, there is no possibility of conducting a full preventive medical examination, which violates Clause 3 of Section II of the Procedure for organising 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.

According to the Record of results of preventive medical examinations at the Penal Institution (No. 9), a periodic medical examination was conducted for 29 persons this year. The medical examination was conducted by a therapist, as evidenced by the signature of the doctor of the relevant specialty in the record. Thus, there is a violation of Clause 2, Clause 3 of Chapter 3 of Section II of the Procedure for organising 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 August 2014 No. 1348/5/572 (hereinafter — the Procedure), according to which a therapist (or general practitioner — family doctor), a psychiatrist, and a dentist must participate in the preventive medical examination. The monitoring group established that the last dental appointment, according to the Dental Outpatient Appointment Log, took place on 22.02.2022, which in turn indicates that preventive medical examinations at the Penal Institution (No. 9) are incomplete due to the absence of a dentist and that there is a violation of the prisoners’ right to dental care. Furthermore, during the inspection of the dental office, the monitoring group found medical supplies that had expired.

In accordance with the requirements of Clause 7 of Part 1 of the Resolution of the Cabinet of Ministers of Ukraine dated 29 December 2021 No. 1440 “Some issues of implementing the programme of state guarantees for medical services to the population in 2022,” the National Health Service of Ukraine (NHSU) pays for medical services provided based on paper referrals for patients held in penal institutions and pre-trial detention centres of the State Criminal-Executive Service, until such time as the healthcare facilities of the State Criminal-Executive Service are technically capable of issuing electronic referrals. However, due to the lack of a registered declaration with a primary healthcare physician for the convicts, they are unable to receive the 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.”

According to data provided in the medical unit, 2 cases involving bodily injuries have been registered this year, including one for a person upon arrival, while another person received such injuries already while in the conditions of the institution. Upon studying the medical records, it was established that bodily injuries found on prisoners are not properly recorded by medical staff in medical cards. Moreover, contrary to the requirements of Sub-clause 2.1 of Section II of the Procedure for interaction between healthcare facilities of the SCES of Ukraine and healthcare facilities regarding the provision of medical care to persons in 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 staff of the facility do not draw up certificates that must detail the nature of bodily injuries, their size, and location.

Also, during the monitoring, it was established that the medical unit lacks a contract for the disposal of medical waste generated as a result of medical services provided to prisoners of the Transcarpathian municipal medical unit No. 9 of the branch of the Centre for Healthcare of the SCES of Ukraine in Chernivtsi, Ivano-Frankivsk, Transcarpathia and Ternopil regions.

Intake ward

The ward holds prisoners who are departing for court and investigative actions, as well as newly arrived individuals. The detention period is up to two hours. There is a toilet if needed. There is also a medical office.

Investigative offices

Meetings with lawyers and investigative activities take place in the investigative offices. A partitioned space is provided for life-sentenced convicts in the investigative offices.

The alarm button in the investigative offices is functional and is hidden under the table.

Household maintenance unit

The sleeping quarters are renovated and equipped to take into account the need for personal space.

7 persons, convicted for the first time for minor crimes, are serving their sentences in household maintenance roles. These persons are employed under civil law contracts and receive a monthly salary.

Cells

The cells for men are identical in size. Low-capacity cells are for 4 people:

Multi-occupancy cells are for holding 8 people:

Paid cells

The institution has four paid cells.

The cost of staying in a paid cell is 4,000 hryvnias per month per person.

Maximum-security sector

There are 24 life-sentenced convicts held in the institution. Most are kept in small cells.

There is also one multi-occupancy cell for holding 8 people. At the time of the visit, there were 7 people in the cell.

Convict P. asked a question: is the transfer to improved detention conditions for life-sentenced convicts compulsory, or is it his right? The convict justifies his refusal to be transferred to another colony with improved detention conditions by stating that he is serving his sentence in an institution near the place of residence of his relatives. In the event of such a transfer, it would be more difficult for his relatives to visit him.

The sector also provides workspace cells where convicts can work voluntarily. They manufacture candles.

It should be noted that life-sentenced convicts, as a form of volunteer assistance to the military, make so-called “trench candles” out of tin cans, cardboard, and candles.

The disciplinary isolation ward for life-sentenced convicts is almost never used.

As part of the “Fight for Life” project, an interview was recorded with life-sentenced convict Yaroslav Mysiak: