Report on the Results of a Monitoring Visit to Sofiivska Correctional Colony No. 45
On 13–14 September 2024, in accordance with the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, taking into account the provisions of the United Nations Standard Minimum Rules for the Treatment of Prisoners and the decisions of the European Court of Human Rights, on the basis of Article 24 of the Criminal Executive Code of Ukraine — Visiting Institutions for Execution of Sentences — a group of monitors from the Kharkiv Human Rights Protection Group and the NGO ‘Defence of Prisoners of Ukraine’ carried out a routine visit to the State Institution ‘Sofiivska Correctional Colony No. 45’ (hereinafter, SCC-45, the institution, the facility).
The visit was carried out within the framework of the project ‘Reducing Prisoners’ Suffering in the Context of the War in Ukraine’, funded by the Government of Denmark in partnership with DIGNITY
— The Danish Institute Against Torture.
The visit was conducted by the following monitors:
- Didenko, Andrii Andriiovych — assistant to Member of Parliament of Ukraine Yaroslav Yurchyshyn, experience in monitoring visits since 2014;
- Zuikov, Serhii Yuriiovych — assistant to Member of Parliament of Ukraine Kostiantyn Kasai, member of the public council under the Ministry of Justice of Ukraine, experience in monitoring visits, specialises in issues of proper medical care provision;
- Tsvilyi, Oleh Volodymyrovych — member of the public council under the Ministry of Justice of Ukraine, extensive experience in monitoring visits, specialises in issues of torture, cruel, and inhuman treatment.
As a result of the visit, signs of criminal offences were discovered. The materials have been transferred to the competent state authorities.
The previous visit was carried out on 20 October 2023.
General Information
SCC-45 is a medium-security correctional colony for holding men.
The institution is located at: 3 Tsentralna Street, Makorty village, Sofiivka District, Dnipropetrovsk Region.
The head of the facility is Internal Service Lieutenant Colonel Oleksandr Yuriiovych Tsybulko.
The institution consists of a production zone, a canteen, a residential zone with SPS (social rehabilitation) sections, a QDD (Quarantine, Diagnostics and Distribution) section, a medical unit, a bath and laundry complex, a disciplinary cell/chamber-type premises/pre-trial detention centre (DIZO/PKT/SIZO) section, a shop, a library, and administrative premises.
According to the administration of the institution, the staff establishment consists of 222.5 positions. The actual number is 204.5 positions. The total staff shortage for the institution is 18 employees.
The planned capacity of the institution is 965 persons. The actual number is 288 convicts. There are 2 psychologists working at the institution.
In SCC-45, there are 12 operational SPS sections; 4 SPS sections are mothballed.
During the current year, 214 people have arrived at the institution.
In 2023, 9 convicts died; in 2024, 2 died. 38 people are employed under labour contracts, and 37 under civil law contracts (CPH-1).
From 01.01.2024 to 01.09.2024, 41 people have been held in the disciplinary unit (DIZO), 4 in the chamber-type premises (PKT), and 1 in the pre-trial detention section (SIZO). There are 7 people receiving treatment in the medical unit. On the operational-preventive register in the institution there were: 24 persons prone to self-harm, 0 persons prone to escape. There is 1 malicious violator of the custodial regime.
During 2023–2024, no complaints were recorded from convicts regarding inadequate conditions of detention and improper provision of medical care. 27 people have disabilities. The convicts have 31 tablets in their personal possession with access to the internet. 4 convicts have email addresses.
The monitoring group interviewed about 143 convicts.
Preliminary Remarks
The previous visit to SCC-45 by the monitoring group was carried out on 20.10.2023. As a result of the visit, the following recommendations were sent to the management of the institution and the penitentiary service:
- Cease the practice of using convicts for work during their two-hour disciplinary drills;
- Facilitate the practice of sending correspondence in sealed form to the Ukrainian Parliament Commissioner for Human Rights and the Prosecutor's Office;
- Contribute to raising awareness among convicts regarding their right to appeal against the actions (inaction) of the institution's administration.
The recommendations provided following the previous visit were not implemented. Moreover, during the visit, signs of criminal offences were recorded.
Facts discovered during the visit: torture and ill-treatment
1. During the monitoring visit, violations of the requirements of national legislation and non-compliance with international recommendations in the field of prisoner treatment were identified, leading to violations of the rights of convicts. During the visit to the institution, numerous complaints were received from convicts regarding ill-treatment, unpaid labour, and the criminal activities of the head of the institution, Oleksandr Yuriiovych Tsybulko, the assistant to the head of the institution (on issues of engaging convicts in labour and labour adaptation), Denys Anatoliiovych Yatsenko, and a group of convicts among the orderlies — N., G., Sh., V., S., A., S., and other unidentified persons, who, according to the convicts, are directed by the head of the institution for joint activities aimed at directly committing criminal acts.
Thus, during a confidential conversation, most of the prisoners reported that the convicts N., G., and Sh., to whom power had been delegated by the head of the institution, O. Yu. Tsybulko, were selling narcotic substances to convicts on the territory of SCC-45.
As the convicts note, the sale of narcotic substances took place according to the following schemes: convicts who intended to purchase a narcotic substance had to contact convict N. After that, with the help of his connections on the outside, they transferred funds to bank cards, the numbers of which were provided by N. After the financial transaction was completed, the convict had to inform convict N. or Sh. of the time and amount of the money transfer, who, after verifying the information, would hand over the narcotic substance to the convict.
Under another scheme, the sale of narcotic substances took place with the participation of the assistant to the head of the institution (on issues of engaging convicts in labour and labour adaptation), Denys Anatoliiovych Yatsenko, who transferred narcotic substances to convicts who worked in the sewing workshop and were not officially employed, as payment for work performed.
Furthermore, the convicts working in the social rehabilitation section of the institution noted that it was Denys Anatoliiovych Yatsenko who brought the narcotic substances into the territory of the institution and stored them in a safe in the sewing workshop, to which convicts N. and Sh. had access.
Indeed, during the monitoring visit, the assistant to the head of the institution (on issues of engaging convicts in labour and labour adaptation), Denys Anatoliiovych Yatsenko, stated that the majority of convicts working in the sewing workshop do not have labour contracts and do not receive wages because they are on an internship and undergoing training. However, the convicts noted that this information does not correspond to reality, that some convicts have been working under such conditions for over a year, and that payment for the work performed is carried out in the form of the transfer of narcotic substances to them. To confirm this, they brought plastic bags with remnants of narcotic substances and demonstrated them to the monitoring group in the presence of Denys Anatoliiovych Yatsenko and other employees of the institution, who were recording the event using body cameras.
It should be noted that the aforementioned plastic bags with remnants of narcotic substances, left on the floor of the sewing workshop, were collected by the employees of the institution, who did not draw up any documents and did not inform law enforcement agencies about this fact. In addition, the convicts reported that on the day of the monitoring visit, the convicts who were working without a concluded labour contract and were not receiving wages were ordered by the institution's management to write an application for training at various production facilities without specifying the date of completion on the application.
Furthermore, the convicts reported on the spread of criminal influence by the group of orderlies of the institution, to whom power had been delegated by the administration of the institution, which is based on an informal prison hierarchy with the aim of maintaining order and control over other convicts in the institution. Thus, during a confidential conversation, convict D. reported that starting from 31 August 2023, he became a victim of violent acts, including those of a sexual nature, by convicts V. and K. in the SPS unit No. 8.
In the course of these actions, convicts V. and K., with the aim of spreading criminal influence over other convicts, made a decision based on prison subculture to transfer convict D. to the lowest caste of convicts in the informal prison hierarchy — the social outcasts. As a result of these actions, convict D. suffered segregation and stigmatisation in the institution, which led to instances of discrimination and unacceptable restrictions in the recognition, exercise, and enjoyment of the universally recognised fundamental right to respect for human dignity.
The indicated unlawful actions in SCC-45 are systemic, as evidenced by the established facts of rights violations, which have been repeatedly recorded by human rights defenders, and numerous complaints from convicts. For example, in a video posted on the internet at the beginning of 2022, convicts in the QDD (Quarantine, Diagnostics and Distribution) section of the SI SCC No. 45 are seen relieving themselves on the faces of other prisoners, presumably in the presence or with the tacit consent of the staff.
At the same time, according to information provided by the convicts on 31.08.2024, in the SPS unit No. 12, in one of the sleeping quarters where convicts N. and G. were located while in a state of alcoholic intoxication, a conflict situation occurred between convict N. and convict K., who owed him money for narcotic substances he had received.
In the course of the conflict, N. decided to punish convict K., who owed him money, by transferring him to the lowest caste in the prison hierarchy, namely the category of convicts known as ‘social outcasts’, for which he invited two convicts, namely Sh. and K., who were classified in this category, and ordered them to beat the debtor.
It should be noted that N., before turning to convicts Sh. and K., had approached other convicts belonging to the category of social outcasts with a proposal to beat K., but received a refusal. After the beating, convict K. sustained significant bodily injuries. This event became known to a wide circle of convicts, who were outraged by the situation that had developed in the institution and decided to clarify the circumstances of the incident; they unauthorisedly left their local sectors and headed to the SPS unit No. 12, where, according to the convicts, a fight took place between the convicts.
During the monitoring visit, the convicts drew attention to their desire to cooperate with law enforcement agencies in light of the aforementioned events, their willingness to testify and provide material and other evidence of the unlawful actions of the institution's administration and the convicts from among the orderlies.
At the same time, the monitoring group was informed that the investigative department of the Police Department No. 9 of the Kryvyi Rih District Police Department of the Main Directorate of the National Police in Dnipropetrovsk Region is conducting a pre-trial investigation in criminal proceeding No. 12024041580000185, entered into the Unified Register of Pre-trial Investigations on 01.09.2024, on the grounds of a criminal offence provided for by Article 392 of the Criminal Code of Ukraine.
In its report on the results of the visit to Ukraine in 2020, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (hereinafter — the Committee) expressed serious doubts regarding the practice of using certain prisoners as ‘orderlies’ who perform functions of controlling other prisoners in residential premises and at work and report to staff about any incidents and regime violations.
Therefore, the Committee noted with concern during this visit that this practice had remained. Furthermore, unfortunately, despite the specific recommendations previously given by the Committee, the practice of using ‘orderlies’ is also officially provided for by the Internal Regulations of Institutions for the Execution of Sentences. As previously emphasised, the Committee believes that any partial abdication of responsibility for order and safety in prisons, which should be borne by the institution's custodial staff, is unacceptable.
Such a practice subjects weaker prisoners to the risk of ill-treatment and exploitation by other prisoners. The Committee calls on the Ukrainian authorities to take all necessary steps — including of a legislative nature — to put an end to this practice. No prisoner (in any penitentiary institution in the country) should have power over other prisoners. (CPT/Inf (2020) 40, paragraph 27).
Furthermore, the Committee, in its report on the results of the visit to Ukraine in 2023, calls on the Ukrainian authorities to develop and implement a comprehensive strategy to combat violence and intimidation among convicts and to overcome the phenomenon of the informal hierarchy among convicts with all its negative consequences. In this context, the prison administration should also rationalise the assessment of risks and needs, the classification and distribution of individual convicts with the aim of ensuring that convicts are not exposed to the influence of other convicts who may harm them. (CPT/Inf (2024) 20, paragraph 45).
Regarding the supply and sale of drugs and other prohibited items to convicts, the extortion of unlawful payments or privileges from prisoners, and other unlawful acts related to corruption in penitentiary institutions, the Committee, in its 2018 report, called on the Ukrainian authorities to continue to take decisive measures to combat corruption in penitentiary institutions through prevention, education, and the application of appropriate sanctions.
In this context, prison staff and officials working with the penitentiary system must receive a clear message that receiving or demanding privileges from prisoners is illegal and unacceptable and will be duly investigated and punished; this message must be repeated in an appropriate form and with appropriate frequency. (CPT/Inf (2018) 41, paragraph 99).
2. In violation of Part 1 of Article 115 of the Criminal Executive Code of Ukraine and Point 10 of the United Nations Standard Minimum Rules for the Treatment of Prisoners, it was established that in the sleeping quarters of the Quarantine, Diagnostics and Distribution (QDD) unit, the norm of living space per one convict is less than 4 m². Thus, in sleeping room No. 1, where 19 beds are located, the area of the room is 74.5 m². Therefore, the actual area per one convicted person was 3.9 m².
In its 7th General Report, the Committee notes that the problem of overcrowded residential premises leads to unhygienic conditions, a constant lack of privacy, and the overloading of medical services and the institution's infrastructure, and therefore requires correction. (CPT/Inf (97) 10, paragraph 13).
3. The equipment of the QDD unit does not meet the standards for the treatment of prisoners and the conditions of their detention in accordance with their needs. Thus, in violation of the requirements of the ‘Norms of provision with furniture, inventory and household items for medium-security correctional colonies’, approved by the Order of the Ministry of Justice of Ukraine dated 27.07.2012 No. 1118/5 (hereinafter — the Provision Norms), a number of premises are missing in the unit, namely: a room for storing the exchange stock of bedding, clothing, and special workwear; a storeroom for the temporary storage of dirty bedding, clothing, and special workwear; a wardrobe; a household/utility room; a drying room.
The absence of these premises leads to a violation of sanitary and hygienic standards. Thus, inadequate organisation of the storage of personal belongings complicates the maintenance of cleanliness and order in the premises where convicts are held, which worsens the overall sanitary situation in the institution. In addition, in violation of Rule 18.1 of the European Prison Rules, the beds in the sleeping premises of the unit are located right next to each other, which does not ensure the prisoners’ personal space.
4. The monitoring group in cells Nos. 2 and 3 of the DIZO (disciplinary unit) established a violation of Article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms, which ensures the right to respect for private life. Thus, in violation of Point 8 of Section VII of the ‘Procedure for the use of technical means of surveillance and control in correctional and educational colonies of the State Penitentiary Service of Ukraine’, approved by the Order of the Ministry of Justice of Ukraine dated 26.06.2018 No. 2025/5, video surveillance using installed security cameras in the specified premises was carried out in violation of the convicts’ privacy during their use of the toilet/bathroom.
In its 2012 report, the Committee criticised excessive interference with privacy through the installation of video cameras in prisoners’ living quarters: “The Committee agrees that video surveillance in cells can be a useful safeguard in specific cases, for example, when a person is considered to be of concern regarding the risk of self-harm or suicide, or if there are specific suspicions that a prisoner is performing certain acts in the cell that could jeopardise safety. However, any decision to apply video surveillance to a specific prisoner should always be based on an individual assessment of real risks and must be reviewed frequently on a regular basis. Measures must also be taken to ensure that prisoners subject to video surveillance have a guarantee of proper privacy when using the toilet or visiting the sanitary facility. Video surveillance is a serious interference with the private life of prisoners and makes the regime even more repressive, particularly when applied over a long period of time.” (CPT/Inf (2013) 23, paragraph 52).
Furthermore, the bathrooms in cells Nos. 1, 2, and 3 do not contain doors or sufficient partitions that allow for privacy, which violates the requirement of Rule 19.3 of the European Prison Rules.
5. In violation of the Provision Norms, there are no rooms in the DIZO unit for storing the personal belongings of convicts or a storeroom for the temporary storage of dirty bedding, clothing, and special workwear. The room for receiving convicts by the administration and medical staff is not properly equipped. In particular, a sofa and chair are missing.
6. According to Point 3.1 of the ‘Instruction on the conditions of labour and wages of persons sentenced to restriction of liberty or deprivation of liberty’, approved by the Order of the Ministry of Justice of Ukraine dated 07.03.2013 No. 396/5, labour is carried out on a voluntary basis on the basis of a civil law contract or a labour contract concluded between the convict and a natural person-entrepreneur or a legal entity for whom the convicts perform work or provide services.
At the same time, it was established that the administration of the institution uses the labour of convicts in the sewing workshop without pay for more than six months as trainees for the purpose of subsequent employment.
It should be noted that the violation of the right to labour is systemic in this institution and was recorded by the monitoring group in the production workshops, in the canteen, and in the bath and laundry complex. Thus, in violation of Article 119 of the Criminal Executive Code of Ukraine, Article 52 of the Labour Code of Ukraine, and the Instruction on labour conditions, the monitoring group established that the length of the working day for convicts employed in the canteen service is longer than 8 hours and reaches 10–14 hours per day, that is, over 40 hours per week, and the working week consists of six, and in some cases, seven days.
In particular, during the study of the logbook for checking the presence of convicts at their workplaces in the canteen, it was established that throughout the month, from 6:00 a.m. to 8:00 p.m., between 14 and 16 convicts were present at their workplaces in the canteen. At the same time, according to the information on the receipt of wages by convicts, only 7 canteen workers had labour contracts concluded and were receiving wages, while the rest were employed on an unpaid basis.
Convict K. was involved in work at the bath and laundry complex daily in the period from May to July 2024 inclusive, without payment for labour and without concluding a labour contract. During the study of the labour contracts concluded between the convict and a natural person-entrepreneur or a legal entity, the absence of a section on the rights and duties of the parties to the contract was established, which violates Point 3.1 of the Instruction on labour conditions.
In addition, during confidential communication with the convicts, the monitoring group was informed that for refusing to go to work, the administration, with the help of the orderlies, created unbearable conditions for the convicts in the institution, in particular in the form of violence and intimidation.
7. During the inspection of the canteen, it was established that there were no daily samples, which, according to Point 17 of Section V of the ‘Regulation on the organisation of food supply in the State Penitentiary Service of Ukraine for peacetime’, approved by the Order of the Ministry of Justice of Ukraine dated 15.06.2021 No. 2160/5 (hereinafter — the Regulation on food supply organisation), are stored in the canteen refrigerator at a temperature from plus 4 to plus 8 °C.
At the same time, according to Point 9 of Section V of the Regulation on food supply organisation, it is forbidden to issue food without taking a sample and making a note in the food quality logbook by a medical worker of the healthcare facility and the duty assistant to the head of the institution.
8. In violation of Point 5 of Section V of the Regulation on food supply organisation, the dishes served for lunch did not correspond to the menu schedule. These changes were carried out without the written permission of the head of the institution and the submission of the corresponding report by the deputy head of the institution for logistics and utility supply.
9. In violation of the requirements of the Provision Norms, the canteen lacks a wardrobe for canteen staff with a shower and toilet.
10. The monitoring group established a number of violations in the organisation of bath and laundry services for convicts and detained persons. Thus, in violation of the requirements of Point 2.11 of Section II of the ‘Regulation on the organisation of bath and laundry services’, the forced supply and exhaust ventilation system is not working in the bathhouse premises.
In violation of Point 2.14 of Section II of the Regulation, the institution has not ensured the provision of hairdressing services to convicts and detainees.
In violation of the requirements of Point 4.1 of Section IV of the Regulation, the worker servicing the bathhouse did not undergo an introductory briefing on occupational safety, as evidenced by the absence of the corresponding entry in the Logbook for registration of briefings on occupational safety at the workplace.
In violation of the requirements of the Provision Norms, there are no shower and toilet facilities for employees in the laundry.
11. According to official documentation, the staff shortage in the institution amounts to 18 positions, or 8.09% of the staff establishment. The shortage of middle and senior commanding staff is 6 positions (13.33%). The shortage of rank-and-file and junior personnel is 11 positions (8.33%). The shortage of civilian employees is 1 position (2.19%).
At the same time, in the Government of Ukraine’s report on the results of the 2023 visit, the Committee emphasises that ensuring a positive climate in a penitentiary institution requires the presence of a professional team of staff who must be present in sufficient numbers at any moment in time in places of detention. An insufficient number of staff can only increase the risk of violence and intimidation between convicts. The shortage of front-line staff also undermines the quality and level of measures offered to convicts and jeopardises the prospect of preparation for release and social rehabilitation.
In this regard, the Committee calls on the Ukrainian authorities to take decisive measures to significantly increase the number of staff in penitentiary institutions of Ukraine where a low level of staffing is observed, with the aim of strengthening the presence of security and surveillance service personnel inside the institutions. Measures must also be taken to put an end to the 24-hour shifts of staff on duty.
Medical Unit No. 45 of the Branch of the State Institution “Centre for Healthcare of the State Penitentiary Service of Ukraine” in the Dnipropetrovsk and Donetsk Regions
Head of Medical Unit No. 45 of the branch of the State Institution “Centre for Healthcare of the SP S of Ukraine” in the Dnipropetrovsk and Donetsk regions — V. V. Komisarova.
In the inpatient ward of the medical unit, there were 8 people on the day of the visit.
During the visit, the monitoring group studied the medical documentation, inspected the premises of the medical unit for their compliance with the requirements of the legislation of Ukraine and international standards, and identified shortcomings in the work of the medical unit.
1. According to Point 2 and Point 3 of Chapter III of Section II of the ‘Procedure for the organisation of medical care provision to convicts sentenced to deprivation of liberty’, 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 (hereinafter — the Procedure), a GP (or a general practitioner — family doctor), a psychiatrist, and a dentist must participate in the preventive medical examination.
At the same time, the positions of the therapist and psychiatrist in the medical unit are vacant, which indicates the incompleteness of the primary and preventive medical examination, due to which convicts and detainees do not receive proper medical care.
This violates Point 38 of the recommendations of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT/Inf(93)12-part) (hereinafter — the Committee), where it is stated that medical services in places of detention must be able to provide medical care and treatment, as well as an appropriate diet, physiotherapy, rehabilitation, or any other special care at the same level as that offered to patients in civilian medical facilities. Provision must be made for the availability of medical, auxiliary medical, and technical personnel, and appropriate premises, equipment, and apparatus must be provided.
2. According to the records of the injury logbook, in the period from 11.06.2024 to 18.08.2024, 12 cases of self-harm were recorded. On the operational-preventive register in the institution there were: 24 persons prone to suicide, 24 persons prone to self-harm.
At the same time, in violation of Point 41 and Point 69 of the Committee’s recommendations (CPT/Inf(93)12-part), the position of psychiatrist in the medical unit is vacant, which does not ensure proper prevention, diagnosis of mental disorders, treatment, supervision, care, and medical and psychological rehabilitation of persons held in the correctional colony who suffer from mental disorders.
3. In violation of the requirements of Subpoint 5 of Point 5 of Section II of the ‘Procedure for the organisation of medical care provision to convicts sentenced to deprivation of liberty’, 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 (hereinafter — the Procedure), for one patient who was in the ward for inpatient patients of the medical unit, the primary accounting documentation form No. 003/o “Medical card of an inpatient”, approved by the order of the Ministry of Health of Ukraine dated 14.02.2012 No. 110, was not created, in which all data regarding treatment and diagnosis in the inpatient ward of the medical unit should be entered, including those obtained during the examination of the sick convict, with a sheet of prescriptions.
4. During the study of the medical documentation, it was established that in the outpatient medical cards 025/o, photographs of existing bodily injuries are not attached to the compiled certificates, as provided for in Point 3 of Section I, 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 the organisation of medical care provision to convicts sentenced to deprivation of liberty”.
At the same time, the Committee in its report on the results of the visit to Ukraine in 2023 notes that any traumatic injuries detected during a medical examination should be photographed in detail, and the photographs, together with body charts, should be kept in the individual medical card of the person. (CPT/Inf (2024) 20, paragraph 82).
5. In the inpatient ward of the medical unit, there were 8 people on the day of the visit. In violation of the requirements of the Instruction on filling out the primary accounting documentation form No. 003/o “Medical card of an inpatient”, approved by the order of the Ministry of Health of Ukraine dated 14.02.2012 No. 110, the absence of the name and surname of the attending physician and their signature was established. The convicts who were in the inpatient ward reported that inpatient medical care is provided by the head of the medical unit, V. V. Komisarova.
At the same time, V. V. Komisarova is a doctor with a specialisation in “Organisation and management of healthcare”, whose tasks and duties do not include the implementation of prevention, diagnosis, treatment, and rehabilitation of patients. Medical staff could not provide information regarding who provides treatment to convicts who are in the inpatient ward and noted that currently, the positions of specialist doctors required for providing inpatient medical care are vacant. The indicated facts of improper provision of medical care to convicts indicate a violation of their rights to health protection and medical assistance.
6. In violation of the requirements of the Instruction on filling out the primary accounting documentation form No. 003-6/o “Informed voluntary consent of the patient to the conduct of diagnostics, treatment, and for the conduct of surgery and anaesthesia and to the presence or participation of participants in the educational process”, approved by the order of the Ministry of Health of Ukraine dated 14.02.2012 No. 110, the absence of signed informed voluntary consent for diagnostics and treatment from patients who were in the inpatient ward of the medical unit was established. This may indicate the absence of the patient’s voluntary consent for the application of diagnostic, preventive, and treatment methods to them, which is a violation of Article 43 of the Law of Ukraine “Fundamentals of Ukrainian legislation on healthcare” and Point 47 of the Committee’s recommendations (CPT/Inf(93)12-part).
7. During the inspection of the DIZO unit, the monitors established that upon placing a convict in the disciplinary isolation ward, it is practiced to attach a medical certificate to the file, which contains the state of health and according to the conclusion of which the convict can be held in the DIZO, PKT, or solitary confinement cell due to their state of health. The discovered facts attest that the institution's staff possess confidential information regarding the state of health of the convicts who are in the DIZO unit.
This violates the requirements of Article 39-1 of the Law of Ukraine “Fundamentals of Ukrainian legislation on healthcare” regarding the right of persons to secrecy about their state of health. At the same time, the Committee has repeatedly emphasised that the obligation of penitentiary doctors to certify the fitness of convicts to undergo disciplinary punishment is unlikely to contribute to the development of positive relations between doctor and patient.
In principle, medical staff should never participate in any part of the decision-making process regarding the application of any type of solitary confinement, except in cases where this measure is applied for medical reasons.
On the other hand, medical staff must be very attentive to the state of convicts who are in solitary confinement. Medical staff must be informed immediately of every such placement and must visit the convict immediately after placement, and then regularly, no less than once a day, and provide them with prompt medical care and treatment if necessary. Medical staff must inform the institution’s administration if the convict's health is subject to a serious threat due to solitary confinement. (CPT/Inf (2024) 20, paragraph 104). In addition, this contradicts points 43.2 and 43.3 of the European Prison Rules.
8. During confidential communication, the monitoring group received numerous complaints about an organised system of supply and sale of drugs to convicts on the territory of the correctional colony. At the same time, the medical unit has not organised the provision of Opioid Substitution Therapy (OST) for persons with mental and behavioural disorders resulting from opioid use, in accordance with the ‘Procedure for conducting Opioid Substitution Therapy for persons with mental and behavioural disorders resulting from opioid use’, approved by the order of the Ministry of Health of Ukraine dated 27.03.2012 No. 200.
Drug-dependent persons are not provided with social-psychological support, Cognitive Behavioural Therapy (CBT), relapse prevention, motivational interviewing, mutual aid groups, etc.
Thus, these individuals are deprived of the opportunity to receive OST, which violates their right to choose methods of treatment in accordance with Article 38 of the Law of Ukraine “Fundamentals of Ukrainian legislation on healthcare”.
At the same time, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (hereinafter — the Committee) in its report on the results of the visit to Ukraine in 2023 notes that entering a penitentiary institution is an opportunity to solve the problem related to drugs, and therefore it is important that appropriate assistance be offered to all interested persons; therefore, appropriate medical care must be available in all institutions.
The assistance offered to such persons must be diverse: substitution therapy programmes for persons with drug addiction must be combined with genuine psychosocial and educational programmes for persons with opioid dependence who are unable to stop using drugs. Furthermore, access to OST programmes in institutions must be easily accessible, and they must also be managed by penitentiary doctors, who must undergo special training on issues related to drug use. (CPT/Inf (2024) 20, paragraph 86).
9. During communication with the convicts, it was established that the medical staff continues the systematic practice of conducting medical examinations and medical procedures, in particular injections, to convicts through the bars. At the same time, the Committee criticises excessive security measures and considers such practices unacceptable, as they infringe on the dignity of prisoners, hinder the development of proper relations between medical staff and the patient, and potentially interfere with the establishment of an objective medical conclusion. (Report of the Committee on the results of the visit to Ukraine in 2009 (paragraph 129, CPT/Inf (2011) 29), in 2012 (paragraph 50, CPT/Inf (2013) 23)).
10. In violation of Point 37 of the Resolution of the Cabinet of Ministers of Ukraine No. 285 dated 2 March 2016 “On approval of Licensing conditions for the conduct of economic activities in medical practice”, the medical unit lacks a document confirming free access to the buildings and premises of the medical facility for persons with reduced mobility, the receipt of which is mandatory.
11. Dispensary supervision is carried out for 21 persons who have disabilities. Of them, group I — 6 persons, group II — 14 persons, group III — 7 persons. 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 given the availability of information confirming persistent impairment of body functions, caused by diseases or the consequences of injuries, which cause restrictions on normal vital activity.
During the study of the medical documentation of the convicts, it was established that not all persons with disabilities have individual rehabilitation programmes (IRP). Furthermore, the recommendations of the IRP are not fulfilled, due to which they do not receive proper diagnostic, treatment, and rehabilitation measures given the availability of information confirming persistent impairment of body functions, caused by diseases and consequences of injuries, which cause restrictions on normal vital activity.
12. In accordance with the requirements of Point 7 of Part 1 of the Resolution of the Cabinet of Ministers of Ukraine dated 22 December 2023 No. 1394 “Some issues of implementing the programme of state guarantees of medical service for the population in 2024”, the National Health Service of Ukraine (NHSU) pays for medical services provided based on paper referrals for patients held in institutions for the execution of sentences or pre-trial detention centres of the State Penitentiary Service, until the creation by healthcare institutions of the State Penitentiary Service of the technical possibility to issue electronic referrals is ensured.
However, due to the absence of concluded declarations with a primary medical 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”.
13. During the inspection of the defibrillator's functionality, it was established that the expiration date of the electrodes had passed. At the same time, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment recommended that medical services in all visited prisons (and all other penitentiary institutions in Ukraine) be equipped with life-saving equipment for doctors (Report of the Committee on the results of the visit to Ukraine in 2017 (CPT/Inf (2018) 41, paragraph 87)).
14. In violation of the Procedure for the organisation of medical care provision at primary, secondary (specialised), and tertiary (highly specialised) levels using telemedicine, approved by the order of the Ministry of Health of Ukraine dated 19.10.2015 No. 681, the medical unit staff is deprived of the possibility to make requests for telemedical consultation and receive consultation for the provision of medical care to convicts due to technical reasons.
15. In violation of the requirements of the ‘Norms of belonging of bedding, special clothing, and special footwear (inventory property) for convicts undergoing treatment in medical-preventive institutions, institutions with the status of medical ones, and medical units at institutions for the execution of sentences and pre-trial detention centres’, approved by the order of the Ministry of Justice of Ukraine dated 20.02.2012 No. 280/5, the convicted persons do not receive hospital property (a suit, gown, and hospital shoes). Convicts stay in the inpatient ward in their everyday clothes, sometimes with their own bed linen.
16. In violation of the “State sanitary and anti-epidemic rules and norms regarding the handling of 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 Healthcare of the State Penitentiary Service of Ukraine” in the Dnipropetrovsk and Donetsk regions has not concluded an agreement with a specialised institution for the disposal of medical waste, due to which the hospital, since the beginning of 2024, has not organised proper collection, sorting, and disposal of medical waste.
17. 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, not all persons with suspected viral hepatitis C undergo PCR testing, due to which they do not receive the necessary treatment, which can lead to a deterioration of their health state and the spread of the specified infectious disease among convicts and detainees. In this context, it must be noted that during confidential communication with convicts, the monitoring group received numerous complaints regarding the lack of treatment for viral hepatitis C. In addition, on the day of the visit, medicines for the treatment of viral hepatitis C were absent in the medical unit's pharmacy.
18. According to Point 7 of Chapter III of Section II of the Procedure, convicts working in catering facilities (except for work related to the positions of sellers, managers of food and clothing warehouses, storekeepers) and the processing industry, in children's homes, secondary general education institutions, vocational training units in special educational colonies, medical units (feldsher posts), and hospital facilities of the SPS (except for work related to the provision of medical care), laundries, bathhouses, rooms for long-term visits, dormitories, clubs, and at water supply and sewage facilities, 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”; for each convict of the specified category, the primary accounting documentation form No. 1-OMK “Personal medical book”, approved by the order of the Ministry of Health of Ukraine dated 21 February 2013 No. 150, registered in the Ministry of Justice of Ukraine on 23 April 2013 under No. 662/23194, is created.
At the same time, the monitoring group recorded the absence of personal medical books for 9 canteen workers and the results of examinations in the medical documentation conducted by specialist doctors (including laboratory, clinical, and other studies) necessary for admission to work at catering facilities.
19. In violation of the requirements of the Table of equipment for one workstation of a dentist and dental technician, approved by the order of the Ministry of Health of Ukraine dated 11.04.2005 No. 158, there is no dental X-ray apparatus in the hospital, which makes it impossible to conduct an in-depth dental examination of convicts and does not ensure the timely provision of proper dental care.
20. 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 reduced mobility”, no conditions for accommodating people with disabilities have been created in the hospital.
21. In violation of the Fire Safety Rules in Ukraine, approved by the Ministry of Internal Affairs of Ukraine dated 30.12.2014 No. 1417 (hereinafter — the Rules), the hospital premises are not equipped with fire extinguishing and fire alarm systems. In addition, the sockets in the wards used by the convicts are in an unsatisfactory technical condition, and electrical wires are not properly insulated. These violations can lead to electric shock and pose a threat to the life and health of the convicts in the inpatient ward and the medical unit staff.
22. The premises of the doctor's office and the X-ray room are not provided with fire extinguishers, which is a violation of the requirements of Point 3.6 of Chapter 3 of Section V of the Rules and a violation of Point 10.18 of Chapter 10 of the State Sanitary Rules and Norms “Hygienic requirements for the arrangement and operation of X-ray rooms and the conduct of X-ray procedures”, approved by the order of the Ministry of Health of Ukraine dated 04.06.2007 No. 294, registered in the Ministry of Justice of Ukraine on 07 November 2007 under No. 1256/14523.
Recommendations:
For state bodies to take necessary response measures with the aim of investigating the facts of crimes committed, providing an appropriate assessment, and bringing those involved to criminal responsibility.