‘Unsanitary conditions and poor-quality food products’ — a monitoring visit to Drohobych Penal Colony No. 40
The institution has operated continuously as a penal facility since 1911; construction was completed back during the Habsburg era of the Austro-Hungarian Empire. The state institution ‘Drohobych Penal Colony No. 40’ is a medium-security correctional facility. However, the atmosphere in the colony is ‘multi-regime’ because the institution holds convicts of all security levels — minimum, medium, and maximum. The institution has a sector for those sentenced to life imprisonment, as well as for individuals held in cell-type premises by court order.
During the visit, the monitoring group examined documentation concerning the colony's operations, medical records, and inspected utility rooms, living quarters, doctors' offices, the X-ray room, wards, and other premises of the hospital and medical unit for compliance with the requirements of Ukrainian legislation and international standards.
General Information
The Psychiatric Ward of the Lviv Multidisciplinary Hospital No. 19, a branch of the State Institution ‘Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast’, is located on the institution's premises.
According to official data provided by the head of the institution, the staff consists of 288.5 established positions, with 217.5 positions actually filled. During the current year, 353 people have arrived at the facility. There are 11 social and psychological service units operating on the colony's grounds, with 3 units currently mothballed. At the time of the visit, 832 people were held in the institution, 69 of whom were in the social rehabilitation section. The cost of maintaining one prisoner per day is 46 hryvnias 76 kopecks.
During the current year, 14 people have been released on parole. 52 people are employed under employment contracts, and 103 convicted persons are employed under civil law contracts. The average monthly salary is 4,102.28 hryvnias. No one has been released from the institution due to severe illness. During 2023, 7 cases of bodily injury were recorded in the institution, 2 of which occurred upon arrival at the facility.
This year, 78 long-term visits and 159 short-term visits have taken place. There are 3 psychologists working in the institution. There are 37 people on the register for self-harm tendencies, 4 people for flight risk, and 94 people classified as malicious offenders.
Medical Unit No. 40 of the branch of the State Institution ‘Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast’
The head of the medical unit is Oleksandr Sevastianov. The medical unit's inpatient facility has 5 wards for somatic patients, designed for 12 beds, and 1 infectious isolation ward for patients with tuberculosis, designed for 4 beds. According to the staffing schedule of the medical unit, the following positions are filled: Head of Medical Unit — Physician — 1 position; General Practitioner (Family Medicine) — 1 position; Psychiatrist — 1 position; Dentist — 1 position; Radiologist — 1 position. The position of junior medical nurse is vacant — 1 position.
The positions of Head of Department (1 position) and Psychiatrist (1 position) are vacant. Patients treated during the current year: in the hospital inpatient ward — 124 people; in the medical unit inpatient ward — 29 people; outpatient — 299 people. Dispensary supervision is provided for: somatic diseases — 321 people; HIV-positive individuals — 32 people (30 of whom are receiving ART); tuberculosis (cat. 5.1) — 30 people. Mental disorders — 98 people. On the day of the visit, there were 2 people in the medical unit inpatient ward, one of whom was in the psychiatric ward of the Lviv Multidisciplinary Hospital No. 19.
During the monitoring visit, shortcomings were identified in the operation of Medical Unit No. 40, which lead to violations of the rights of convicts at the SI Drohobych Penal Colony No. 40, in particular:
1. Failure to provide medical assistance
Due to the lack of signed declarations with a primary care physician, convicted persons are unable to receive necessary medical services funded by the National Health Service of Ukraine, 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 Health Care’.
2. Violation of the rights of persons with disabilities (Article 9 of the UN Convention on the Rights of Persons with Disabilities)
Dispensary supervision in the medical unit is provided for 24 persons with disabilities. Of these, 7 have Group II disability, and 17 have Group III disability. During the examination of the convicts' medical records, it was established that the recommendations of the Individual Rehabilitation Programme (IRP) are not being implemented; consequently, they do not receive proper diagnostic, therapeutic, and rehabilitation measures, despite information confirming persistent impairment of body functions caused by diseases and the consequences of injuries that cause restrictions in normal life activities. The institution has not created conditions for the accommodation of persons with disabilities; the psychiatric ward inpatient facility is located on the second floor (there are no ramps, handrails, etc.).
3. Failure to adhere to infection control and epidemiological surveillance
The medical unit is equipped with only one isolation ward for infectious patients, which makes it impossible to simultaneously house patients with dangerous infectious diseases separately from each other and from other convicts. The medical unit does not adhere to the requirements for the isolation of patients with tuberculosis; the ward is used by more than one or two people (1 ward-cell for 4 beds); the door to the ward is not equipped with a sealed threshold or edge seals; air recirculation via mechanical ventilation is not provided.
4. Violation of the rights of persons with hepatitis C
Since the beginning of 2023, 168 people have been tested in the medical unit using rapid tests for hepatitis C (hereinafter — HCV), with 22 people showing suspected infection. Individuals with suspected hepatitis C do not undergo PCR testing, and as a result, they do not receive the necessary treatment, which may lead to the deterioration of their health and the spread of this infectious disease among convicted and detained persons.
5. Violation of fire safety rules
The premises of the medical unit are not equipped with fire suppression or fire alarm systems. Furthermore, the doctors' office and the X-ray room are not equipped with fire extinguishers. This fails to ensure safe conditions for patients in the inpatient facility and may pose a threat to their life and health.
6. Lack of equipment, medical products, and medicinal supplies in the medical unit
On the day of the visit, the dental X-ray machine was not working due to repairs, which makes it impossible to conduct in-depth dental examinations of convicts and does not ensure the timely provision of proper dental care. During an inspection of the medical unit's first-aid kit in the dental office, expired medicines were found. During the inspection, the absence of a defibrillator was established.
7. Improper storage of medicines received from relatives
The medical unit lacks a separate cupboard for storing medicines received from relatives. Moreover, medical records lack applications from the relatives of convicts and detainees, or other persons, regarding the transfer of medicines or medical supplies. In the disciplinary isolation unit (DIZO), monitors inspected a first-aid kit and found medicines that had passed their expiration date.
8. Violation of medical documentation procedures
There is no register for tracking the results of preventive medical examinations at the SI Drohobych Penal Colony No. 40, which indicates that preventive examinations are not being conducted properly.
The outpatient medical records (form 025/o) lack attachments in the form of photographs of existing bodily injuries. The record number for convict L. and convict B. is missing; it should correspond to the patient registration sequence number specified in the ‘Register of recorded facts of bodily injuries in persons arriving at the Drohobych Penal Colony No. 40’. In the ‘Register of recorded facts of bodily injuries in persons arriving at the Drohobych Penal Colony No. 40’ (Inv. No. 112), sequence numbers are also missing. Furthermore, the column ‘Date and time of submission of information to the prosecutor, full name of the official who signed it’ is not filled out in the said register. These facts indicate that the documentation of bodily injuries is in an improper state.
Psychiatric Ward of the Lviv Multidisciplinary Hospital No. 19, a branch of the State Institution ‘Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast’
There were 36 people in the psychiatric ward inpatient facility. In the psychiatric ward of the LMH No. 19, according to the staffing schedule, the positions of 1 psychiatrist and 4 paramedics are filled.
The psychiatric ward inpatient facility has 12 wards, designed for 45 beds, 2 of which are for those sentenced to life imprisonment. Some premises are in a dilapidated state. Some patients lack bed linen, and there are unsanitary conditions and exposed electrical wiring in the premises, which creates a danger to the life and health of patients.
It was established that inpatient medical records (Form No. 003/o) were completed for only 27 patients. For the remaining patients undergoing treatment, these documents had not been filled out. Upon examination of the existing inpatient medical records, it was found that they lacked information regarding diagnoses upon admission, patient complaints, medical history, life history, objective condition of patients, preliminary diagnoses, examination plans, and treatment plans. Regarding treatment, the medical records contained entries only stating that it was being carried out in accordance with prescription sheets.
In one of the wards, a treatment bed was discovered equipped with straps for fixation during the application of physical restraint to patients. The fixation straps had characteristic stains on the inner surfaces, indicating their rather prolonged use. At the same time, according to medical staff, physical restraint had not been applied to patients, and they had received the bed when it was already in use.
1. Violation of the right of detainees and convicts to proper sanitary and hygienic conditions in a health care facility
The premises of the psychiatric ward of the hospital do not meet the requirements of Article 22 of the Law of Ukraine ‘On Ensuring the Sanitary and Epidemic Welfare of the Population’. The wards are in some places dilapidated; the walls in the ward premises have mould in places, peeled paint, and missing tiles on wall panels; the floors are old wood, which complicates the disinfection of these premises. Furthermore, the psychiatric ward of the Lviv Multidisciplinary Hospital No. 19, a branch of the SI ‘Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast’, does not have a lease agreement for state real estate. Convicted persons do not receive hospital property (hospital suit, robe, and shoes) and remain in the inpatient facility in their everyday clothing, sometimes with their own bed linen.
2. Violation of the right of convicts and detainees to information about their health status, methods of treatment, and improper record keeping
In violation of the requirements of subparagraph 5 of point 5 of Section II of the Procedure, not all patients undergoing inpatient treatment in the psychiatric ward of the hospital have the primary accounting document form No. 003/o ‘Inpatient Medical Record’ filed. It was established that the inpatient medical records No. 003/o lacked the patient-signed informed voluntary consent for diagnostics and treatment, and the patient-signed informed consent for treatment in a psychiatric institution.
This may indicate an absence of voluntary consent from patients for the application of diagnostic, preventive, and treatment methods and is a violation of Article 43 of the Law of Ukraine ‘Fundamentals of the Legislation of Ukraine on Health Care’.
3. Violation of the right of convicts to psychiatric assistance
Dispensary supervision is provided for 98 people with mental disorders. At the same time, the inpatient facility lacks an isolation ward for persons with mental disorders for convicts who pose a danger to others.
Maximum-security sector
To house those sentenced to life imprisonment, the institution has multi-bed cells for persons who have served more than five years and have shown positive behaviour, and low-capacity cells for holding convicts in twos or threes.
Kitchen/Catering Unit
At the entrance to the institution, a vehicle was noticed containing potatoes of poor quality, effectively 40% waste. The potatoes are being brought into the institution's territory for food.
In the kitchen, sanitary rules are not observed; in particular, monitors noticed prepared fried fish upon which flies were crawling. There is a staff break room in the catering unit premises.
Disciplinary isolation unit/Cell-type premises (DIZO/PKT)
One person was in the DIZO, having been subjected to a disciplinary penalty of 7 days. The premises are in need of repair. During the inspection of the first-aid kit, medicines that had exceeded their expiration date were found.
Minimum-security sector
Monitors consulted with the convicts, informing them of their right to appeal to the Human Rights Commissioner, to send correspondence in sealed envelopes, etc.
COMMENTS AND RECOMMENDATIONS
- Repair the premises of the psychiatric hospital ward;
- Provide the inpatients with bed linen;
- Ensure the safety of electrical wiring;
- Pay greater attention to the quality of food products brought into the institution;
- Conclude a lease agreement with the Psychiatric Ward of the Lviv Multidisciplinary Hospital No. 19, a branch of the SI ‘Health Care Centre of the State Criminal-Executive Service of Ukraine in Lviv Oblast’;
- Ensure the preparation and completion of inpatient medical records (Form No. 003/o) for all patients undergoing inpatient treatment in the psychiatric ward.
The preventive monitoring visit to the SI Drohobych Penal Colony No. 40 was carried out by representatives of the NGO ‘Protection of Prisoners of Ukraine’, the NGO ‘Kharkiv Human Rights Protection Group’, and EPLN. The monitoring group consisted of an assistant to the People's Deputy of Ukraine Kostiantyn Kasai; members of the Public Council under the Ministry of Justice of Ukraine Serhiy Zuikov, Hanna Skrypka, and Oleh Tsvilyi; an assistant to the People's Deputy of Ukraine Yaroslav Yurchyshyn; KHRPG programme coordinator Andrii Didenko; expert of the working group of international partners of Ukraine on prison reform Hugues de Suremain; and forensic medical expert Kostiantyn Zaporozhtsev. The visit was conducted 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: analysis of the observance of human rights in places of deprivation of liberty during the war.
Date of visit: 10 July 2023