Places of detention. How quarantine is experienced in Ukrainian prisons, hospices and long-term care facilities for persons with intellectual and psychosocial disabilities disabilities

Vira Yakovenko, a monitor of the National Preventive Mechanism, who has been working there for eight years, told NV about the places of detention, how people are experiencing quarantine there, and how human rights inspections are carried out in custodial institutions.

Ahead of the Human Rights Day celebrated on 10 December, NV media and the UN Human Rights Monitoring Mission in Ukraine are publishing a series of stories about how the pandemic has disproportionately affected people in vulnerable situations and why it is important to put human rights at front and center of the COVID-19 response.

On 18 November 2020, the Ombudsperson Office announced that one of the care recipients died at the Radomyshl long-term care facility for persons with intellectual and psychosocial disabilities in Zhytomyr region due to complications from the COVID-19.

Monitors of the National Preventive Mechanism (NPM) found out about a woman with signs of the disease on 12 November during a visit to the long-term care facilities for persons with intellectual and psychosocial disabilities. The patient had a temperature of 39.3° and saturation of 89%, while the normal rate should be not less than 95%. She was not isolated from other people cared for in the facility.

According to NPM monitors, the staff of long-term care facilities for persons with intellectual and psychosocial disabilities did not provide the woman with proper medical care and refused to call an ambulance for her hospitalization. The ambulance arrived only after persistent persuasions from the monitors and immediately hospitalized the patient. However, she died three days later due to a very serious condition.

Long-term care facility for persons with intellectual and psychosocial disabilities is just one of several dozen types of places for deprivation of freedom.  They are public or private institutions where people are detained, imprisoned or cared for following a ruling of a court, an administrative or another authority. Such persons do not have discretion to leave these places and are not able to exercise this will due to financial or health conditions.

The National Preventive Mechanism is an independent body established under the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. NPM monitors make regular unscheduled visits to places of detention, such as prisons, pre-trial detention centers, psychoneurological care facilities, hospices, etc to verify the conditions in which the care recipients of such institutions reside. In particular, monitors check whether basic human rights, such as the right to privacy, are being violated, and whether the people have access to food, sleep, fresh air, and so on.

NV reporter Sasha Horchynska spoke with Vira Yakovenko, a regional coordinator of Poltava region Commissioner for Human Rights, an NPM monitor and a head of a separate branch of the NGO in Poltava region, about how visits are carried out during the quarantine and what are the biggest difficulties monitors are facing due to coronavirus.

How has quarantine affected the work of NPM monitors? What has changed?

NPM Monitors is the only supervisory institution in Ukraine that directly engages members of the civil society in visits to places of detention. And we were the first to visit the NPM during the lockdown. The format of the visits was completely changed.

Our task, in addition to monitoring human rights, was also to check what was happening inside the institutions, whether the people in these institutions were provided with personal protective equipment, whether these institutions were ready for the coronavirus and protection of people from it.

Firstly, we visited penitentiaries. In Poltava, where I work, it was the penitentiary institution №23, which serves as a pre-trial detention center, penal colony №64, and the Kremenchug correctional colony. Then we also started visiting other places of detention, in particular the Maltsev Regional Clinical Psychiatric Hospital in Poltava, where there is a department of involuntary treatment for the people who have committed crimes but can not be brought to responsibility through court.

What are the biggest challenges you faced while working during the lockdown?

The biggest challenge is to enter the institution and not harm the people inside. Therefore, monitoring visits were carried out in full individual equipment. These are protective equipment that includes a suit, respirator, visors, boot covers, goggles and more.

That is, the number of visits remained the same as before the introduction of quarantine. What we paid attention to has changed a bit, because a new aspect has appeared - the coronavirus.

If we talk about the work of the system as a whole - coordinators, representatives of the Commissioner for Human Rights, this lockdown has led to a change in the format of their work. For example, we, the regional coordinators, have to provide consultations to residents once a week and receive people according to a certain schedule in a clearly defined place - I have the consultation time from 14:00 to 17:00.

But our workload during the quarantine increased. There is no personal consultations for citizens anymore, but instead people started writing, calling, communicating with us via the Internet. We work from home remotely but the number of people in our lives has increased – for me personally, it has increased tenfold.

According to the UN Human Rights Monitoring Mission in Ukraine, the situation for persons in places of detention remained particularly precarious given that many detention facilities are overcrowded and are not fully able to comply with prevention measures such as physical distancing and provision of personal protection equipment.

What is the risk for people in detention to get infected with the coronavirus?

Risks are minimized. First, because none of the heads of such institutions is interested in getting the coronavirus. Of course, I can't speak about all the establishments. But from what I saw personally during our visits is that the management did everything to protect people inside such institutions from COVID-19 infection.

Ukraine responded harshly to the coronavirus back in the spring, when we had 600 cases a day. So now when we have 12,000 new cases a day, we need to be especially careful.

As reported by the UN Human Rights Monitoring Mission, the number of confirmed COVID-19 cases and deaths in the penitentiary system remains small on the Government-controlled territory.

The Mission is concerned however, that the number of cases amongst penitentiary staff grew exponentially in October and November, as it puts detainees and prisoners’ health at increased risk of infection. Neither early release programs for older persons or the individuals with underlying health conditions, nor alternatives to detention have been put in place to reduce the health risks associated with COVID-19 among detainees. The Mission therefore urges the Ministry of Justice to strengthen protection and prevention measures among penitentiary staff, medical personnel and inmates, in particular by testing all suspected cases of COVID-19 among detainees.

Do people in detention facilities have access to all necessary personal protective equipment and medical services?

In Poltava region I can say that there were and are enough individual means of protection. These are disinfectants, masks, and so on. Masks were given to all persons leaving the detention center to court.

Penal colonies were completely closed during the lockdown: the number of people who could go in and out was minimized. Electronic means of communication and telephones were used for communication.

As for the access to medicine, this aspect is currently provided by the Health Center of the State Penitentiary Service of Ukraine. [The official website of the institution informs that as of 20 November 2020, 573 cases of COVID-19 were registered in penitentiary institutions and pre-trial detention centers including 7 prisoners, 15 convicts, 463 employees of State Penitentiary Service of Ukraine, 88 employees of the Health care center of State Penitentiary Service of Ukraine].

In addition, it should be noted that apart from the coronavirus, there are other medical problems like high blood pressure, pancreatitis and other commonplace diseases that need to be diagnosed and then treated.

To better understand what's going on, let's take a look at how it works now in regular non-penitentiary facilities. If, for example, we want to get to the hospital for a routine examination, we must take certain actions. One of these actions is to pass a test and get a referral from a family doctor.

What problems do we have because of the coronavirus? The first is the re-profiling of some hospitals for patients with COVID-19. That is, the number of hospitals has decreased. The same thing automatically happens in places of detention. That is, the issue of access to routine diagnosis and routine treatment during a pandemic is high on the agenda. There were no transfers between prisons during the lockdown in Ukraine. This means that the people who are in prisons could not get to the planned operation or examination. Of course, in cases where there was a need for urgent medical intervention, an ambulance was called from the Ministry of Health.

To date, even though the transfer process has resumed, problems with access to routine diagnostics still exist.

The Mission reported that the COVID-19 pandemic exacerbated pre-existing deficiencies in healthcare in pre-trial detention facilities and penal colonies, such as a lack of specialized medical care, including sexual and reproductive health services, and a shortage of psychologists. In addition, transfers of prisoners and detainees to hospitals were delayed due to COVID-19-related restrictions.

Let`s imagine, a person who is in a pre-trial detention center or prison has a fever. Will he/she be provided with appropriate basic drugs - such as antipyretics?

It all depends on what exactly to consider basic drugs. If these are the drugs that are purchased by state, they are given to such places.

As for the medical examination: if there are full-time doctors in the penitentiary institution, they will come and do their job. And if there are no such doctors – for example if there is a vacancy for this position – then, accordingly, no one will just come there. Situations are different in each case and we need to look at specific circumstances.

In general, the reform of prison healthcare, as well as the reform of general healthcare, is a very difficult issue, especially during the pandemic.

It is important that all those in detention must be provided with testing in case of suspected COVID-19 infections and with medical care they require. In addition, restrictions on contact with the outside world should be effectively replaced with alternative means of communicating with family and friends, and other measures taken to mitigate the negative impact of restrictions on the mental health of prisoners, including women.