Report on the results of a monitoring visit to the State Institution ‘Khmelnytskyi Pre-trial Detention Centre’

11.05.2023 Serhii Zuikov, Andrii Didenko, Oleksii Yaroslavtsev, Nelia Shpulak

This article was translated using artificial intelligence. Please note that the translation may not be entirely accurate.View the original article

In the medical unit’s ward cells, there is a violation of the convicts’ right to privacy, and some of the institution’s premises require renovation.

On 13 April 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 programme coordinator of the Kharkiv Human Rights Protection Group (KHPG), Andrii Didenko; as well as journalists from the ‘Poriad z vamy’ (‘Beside You’) Information Agency, Oleksii Yaroslavtsev, and ‘Suspilne Khmelnytskyi’, Nelia Shpulak, conducted a preventive monitoring visit to the State Institution ‘Khmelnytskyi Pre-trial Detention Centre’.

The visit was carried out within the framework of the project ‘Reducing the Suffering of Prisoners in the Context of the War in Ukraine’, funded by the government of Denmark in partnership with DIGNITY — The Danish Institute Against Torture. The purpose of the visit was to analyse the observance of human rights in places of detention during the war.

The head of the State Institution ‘Khmelnytskyi Pre-trial Detention Centre’ is Ruslan Serhiiovych Sukhorab.

General Information

The State Institution ‘Khmelnytskyi Pre-trial Detention Centre’ performs the functions of a pre-trial detention centre for holding individuals who are in the stage of judicial investigation and for whom a preventive measure of custody has been chosen by the court; individuals in the stage of judicial investigation; and convicted persons whose sentences have not yet entered into legal force.

Individuals sentenced to life imprisonment are held in the maximum-security sector.

The institution has two buildings. The cells are small; most are designed for 4-6 people, and the largest cell is designed for 12 people.

The monitors visited: the reception ward, investigative rooms, cells for female and juvenile detainees, cells for male detainees, disciplinary cells, the facility maintenance department, the bath and laundry complex, exercise yards, and the arrest house for women.

The monitoring group was accompanied by the deputy head of the institution, Vadym Volodymyrovych Ostapiuk; the head of the regime and security department, Oleksandr Volodymyrovych Trapezun; and the duty assistant to the head of the pre-trial detention centre, Volodymyr Anatoliiovych Kostiuk.

According to the administration, there are 2.2 prisoners for every member of staff. 1,271 people have arrived at the institution during the current year.

At the time of the visit, 4 people were serving disciplinary penalties in the form of placement in a disciplinary cell.

There are 12 people registered with HIV/AIDS. 17 people are registered as prone to suicide, and 12 are registered as prone to self-harm.

During 2022-2023, not a single complaint regarding inadequate detention conditions or improper medical care was recorded.

13 people have a disability: 1 is a disabled person since childhood; 3 have a Group II disability, and 9 have a Group III disability.

In 2022, 125 people were released, including two who were pardoned, and another person had their sentence conditions changed to more lenient ones. During the current year, 24 people have been released.

During 2022, 44 ambulance calls were registered; during 2023, there have been 10 such cases.

In the current year, one case of the use of physical force—handcuffs—was registered. During 2022, there were 27 cases of bodily injuries recorded upon arrival and 33 cases during stay in the institution. During the current year, there have been 5 cases recorded upon arrival and 7 cases during the stay at the facility.

The institution provided 118 visits using video conferencing, costing 40 kopecks per minute. During 2022, 1 long-term visit was granted; since the beginning of 2023, none have been granted.

During 2022, 43 short-term visits were granted through glass, and none were contact visits. During the current year, 27 visits through glass have been granted; 0 contact visits.

Access to the internet is provided through 8 tablets kept by the convicts. In the current year, 411 telephone calls have been made. IP-telephony services are also provided in the institution.

There is one psychologist working in the institution.

During the visit, the monitors examined prosecutorial response acts, logs, resolutions, and other documents related to the institution’s operation. About one hundred cameras are monitored via video recorders.

Some premises require renovation.

There is no ramp at the entrance to the Khmelnytskyi Pre-trial Detention Centre.

Medical Unit

The head of the Khmelnytskyi Municipal Medical Unit of the branch of the Centre for Health Care of the State Penitentiary Service of Ukraine in the Khmelnytskyi region (hereinafter referred to as the medical unit) is Tamara Viktorivna Babyshena.

During the visit, the monitoring group inspected the medical unit’s premises without hindrance, became acquainted with the conditions of medical care provision to prisoners, and had access to medical documentation.

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

Head of the medical unit — doctor — 1 position;
General practitioner — 1 position;
Dentist — 0.5 position;
Psychiatrist — 0.5 position;
Phthisiatrician — 0.5 position;
Radiologist — 0.5 position;
Infectious disease specialist — 0.5 position;
Obstetrician-gynaecologist — 0.5 position;
Ultrasound diagnostic physician — 0.5 position;
Dermatovenereologist — 0.5 position;
Paramedic — 4 positions;
Senior paramedic — 1 position;
Dental nurse — 1 position;
X-ray laboratory assistant — 0.5 position;
Pharmacy assistant — 1 position;
Laboratory assistant — 1.5 positions;
Junior medical nurse — 0.5 position.

The following positions remain vacant:

General practitioner — family doctor — 1 position;
Narcologist — 1 position;
OST (Opioid Substitution Therapy) nurse — 1 position.

The outpatient clinic includes:

The office of the head of the municipal medical unit;
The doctor’s consulting room;
The paramedic’s (nurse’s) room;
Auxiliary diagnostic rooms (fluorography),

Clinical diagnostic laboratory;
Manipulation room,

Pharmacy;
Dental office.

Paramedic’s bag:

The inpatient facility includes:

Ward cells;
Infectious isolation ward cells and premises for the municipal medical unit staff;
An isolation ward for individuals with mental disorders.

The infectious isolation ward cells (wards for patients with active tuberculosis) consist of 4 wards with 22 beds, in which 1 person with active tuberculosis was staying on the day of the visit, an inpatient cell with 6 beds, and two infectious isolation cells with 2 beds.

Patients treated during the current year: in the inpatient facility — 2 people; outpatient — 1,238 people; tuberculosis patients — 2 people.

During the current year, 59 people underwent a planned preventive examination.

During the visit, shortcomings were identified in the work of the Khmelnytskyi Municipal Medical Unit, leading to the violation of the rights of convicted persons and those held in custody at the State Institution ‘Khmelnytskyi Pre-trial Detention Centre’, in particular, the following.

Violation of the rights of convicts and detainees to receive primary, secondary, and tertiary medical care

In accordance with the requirements of point 7 of part 1 of the Resolution of the Cabinet of Ministers of Ukraine dated 27.12.2022 No. 1464 ‘Some issues of implementing the programme of state guarantees of medical care for the population in 2023’, the National Health Service of Ukraine (NHSU) pays for medical services provided based on paper referrals for patients held in penitentiary institutions or pre-trial detention centres of the State Penitentiary Service, until the healthcare facilities of the State Penitentiary Service are technically capable of issuing electronic referrals. However, due to the lack of declarations concluded by convicted persons and detainees with a primary care physician, they do not have the opportunity to receive the necessary medical services paid for by 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 the Legislation of Ukraine on Healthcare’.

Non-compliance with infection control and epidemiological surveillance for tuberculosis

In violation of the requirements of point 2 of Section II of the ‘Standard of Infection Control for Healthcare Facilities Providing Care to Patients with Tuberculosis’, approved by the order of the Ministry of Health dated 01.02.2019 No. 287 (hereinafter referred to as the Standard), the requirements for isolating individuals with tuberculosis are violated in the medical unit: wards for patients with a contagious form of the disease are used by more than one or two people (4 isolation cells with 22 beds); doors to the ward are not equipped with sealed thresholds or seals along the edges; air recirculation via mechanical ventilation is not ensured. Indeed, on the day of the visit, a patient with a contagious form of tuberculosis was staying in one of the mentioned wards. Other wards contained detainees and convicted persons, among whom there were no tuberculosis patients.

Detainees and convicts complained that they were unjustifiably placed in the infectious isolation ward cells, about inadequate detention conditions, the lack of exercise, and a ban on using a tablet.

Violation of the right of detainees and convicts to adequate sanitary and hygienic conditions in a healthcare facility

The premises of the medical unit do not meet the requirements of Article 22 of the Law of Ukraine ‘On Ensuring the Sanitary and Epidemic Welfare of the Population’. The medical unit’s ward cells require renovation: excessive dampness was found on the ceilings of some cell premises, the floor and bathroom are dirty and require repairs, and mattresses and bedding are damp, dirty, and require replacement. The walls have peeling paint in places, knocked-off tiles on wall panels, and old wooden floors, which complicates the disinfection of these premises; there is also no hot water supply. This negatively affects the therapeutic environment in the medical unit.

In violation of the ‘State Sanitary and Anti-epidemic Rules and Norms for Handling Medical Waste’, approved by the order of the Ministry of Health of Ukraine dated 08.06.2015 No. 325, the branch of the State Institution ‘Centre for Health Care of the State Penitentiary Service of Ukraine’ in the Khmelnytskyi region has not concluded an agreement with a specialised institution for the disposal of medical waste, due to which the proper collection, sorting, and disposal of medical waste has not been organised in the medical unit since the beginning of 2023.

In violation of Article 115 of the Criminal Executive Code of Ukraine, in some ward-cells, the requirements regarding the standard of living space per convict in inpatient treatment conditions (not less than 5 m2) are violated. Bunk beds are located close to each other.

In two infectious isolation cells designed for 2 beds, due to excessive grating, the standard for proper natural lighting is not met. Artificial lighting is also insufficient. The windows of the visited cell premises did not open, which limits the detainees’ and convicts’ access to fresh air and contributes to the formation of condensation, moisture, and mould.

The wooden floor has rotted, resulting in it having caved in in some places.

In the ward cells, there is a violation of the convicts’ right to privacy, namely: beds in most cells are located close to each other; sanitary facilities are not equipped with doors.

Convicted persons and detainees are not provided with drinking water. They draw water for consumption directly from the central water supply network or boil it themselves.

Violation of the rights of persons with disabilities (Article 9 of the UN Convention on the Rights of Persons with Disabilities)

12 people with disabilities are under dispensary supervision. Of them, 3 have Group II disability; 9 have Group III disability. At the same time, in violation of the requirements of the Law of Ukraine ‘On the Rehabilitation of Persons with Disabilities in Ukraine’, persons with disabilities do not receive proper diagnostic, treatment, and rehabilitation measures, despite information confirming persistent impairment of body functions caused by diseases or the consequences of injuries, which lead to limitations in normal life activity.
During the examination of the convicts’ medical documentation, it was established that not all individuals have individual rehabilitation programmes for such persons, and the recommendations of individual rehabilitation programmes are not implemented, due to which they do not receive proper diagnostic, treatment, and rehabilitation measures despite information confirming persistent impairment of body functions caused by diseases or the consequences of injuries, which lead to limitations in normal life activity.

Furthermore, in violation of the requirements of the State Building Norms of Ukraine V.2.2-17:2006 ‘Buildings and structures. Accessibility of buildings and structures for persons with limited mobility’, conditions for holding people with disabilities have not been created in the institution (there are no ramps, handrails, etc.).

Violation of the rights of persons with viral hepatitis C

During 2023, 100 tests were conducted in the medical unit using rapid tests for the presence of viral hepatitis C, of which 6 people were suspected of having the disease. Not a single person was receiving treatment for viral hepatitis C on the day of the visit. In violation of the requirements of the ‘Standards of Medical Care for Hepatitis C in Adults’, approved by the order of the Ministry of Health of Ukraine dated 15.01.2021 No. 51, persons with suspected viral hepatitis C do not undergo PCR testing, due to which they do not receive the necessary treatment, which may lead to a deterioration of their health and the spread of this infectious disease among the convicted (detained) persons.

Violation of the right of convicted persons and detainees to medical care and treatment methods

The medical unit has not organised the provision of opioid substitution therapy (OST) for persons with mental and behavioural disorders due to opioid use, in accordance with the ‘Procedure for Conducting Opioid Substitution Therapy for Persons with Mental and Behavioural Disorders due to Opioid Use’, approved by the order of the Ministry of Health of Ukraine dated 27.03.2012 No. 200.

Violation of the right to proper psychiatric care

17 people with mental disorders are under dispensary supervision. The monitors inspected the isolation ward for persons with mental disorders, which, according to the information provided by the medical staff, can be used if necessary.

Indeed, in violation of point 9 of the ‘Rules for the Use of Physical Restraint and (or) Isolation when Providing Psychiatric Care to Persons Suffering from Mental Disorders’, approved by the order of the Ministry of Health of Ukraine dated 24.03.2016 No. 240, the premises absolutely do not meet these requirements and violate the procedure for the use of physical restraint and (or) isolation when providing psychiatric care to persons suffering from mental disorders.

Expired medical preparations

In violation of point 2, point 5 of Section I; point 4, point 5 of Section III; and point 1, point 6 of Section IV of the ‘Rules for Storage and Quality Control of Medicinal Products in Healthcare Facilities’, approved by the order of the Ministry of Health of Ukraine dated 16.12.2003 No. 584, during the visit, monitors recorded an expired package of ‘STANDARD Q COVID-19 IgM/IgG Plus’ tests for detecting antibodies to the coronavirus in the medical unit premises.

Improper maintenance of medical documentation

During the current year, 12 cases of bodily injuries were recorded in the Register of Bodily Injuries. During the examination of the medical documentation, it was established that in the outpatient medical record 025/o, there are no certificates or photographs of the bodily injuries, as provided for in point 3 of Section I of Chapter II of 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 ‘On Approval of the Procedure for Organizing the Provision of Medical Care to Persons Sentenced to Imprisonment’.

Reception Ward

Premises for issuing parcels and packages:

A doctor examines new arrivals in the room where fingerprinting takes place.

There are 4 cells in the ward in total; 2 of them are used.

There is water and a bathroom in the cells.

Investigative Rooms

There are three investigative rooms. They are equipped for conducting video conferences and have panic buttons.

Facility Maintenance Department

12 people convicted for minor offences for the first time live in the facility maintenance department. Living premises are renovated with consideration for personal space.

Dining room:

Post for Juveniles and Women

There are 13 cells in total: 2 paid, one for juveniles, two for men, and 8 for women.

Educational activities can be conducted both online and offline.

In 2022, 4 people received a secondary education.

The cells are the same in size, designed to hold 4 and 6 people.

Drinking water is drawn from the tap.

A paid female cell is functioning, as well as one other paid cell for men.

Transit Cells

Two transit cells are functioning.

Cells for Detainees

The vast majority of cells are for 4 or 6 people.

There are cells designed for 12 people.

Exercise Yards

There is a tennis table in one of the yards.

IP-Telephony

Detainees can use IP-telephony services.

At the time of the visit, a female detainee was speaking on the phone. According to her, this service costs 7 hryvnias for 15 minutes. Relatives send the money, because of which she can communicate with her family every day.

Cells for Those Sentenced to Life Imprisonment

Those sentenced to life imprisonment whose sentence has entered into legal force are held separately from those whose court decision is under appeal.

A life-sentenced convict, Sh., has been serving his sentence for 22 years and claims that he was convicted unfairly and did not commit the crime. Perhaps, after examining the case materials and the arguments of the prosecution and the defence, he will become a subject of the ‘Fight for Life’ project.

Disciplinary Cells

At the time of the visit, three people were in a disciplinary cell for various disciplinary offences. Prisoner P. was placed in a disciplinary cell for 3 days for making moonshine.

There is a cell available for holding people with mental disorders, which has neither a toilet nor a washbasin. According to the institution’s administration, this cell is not used.