A/HRC/46/26/Add.1 52. There appears to be a shortage of qualified general health professionals to provide the adequate assessment, documentation and interpretation of trauma and injuries. There is also a general lack of basic health care, dental care and psychiatric support for detainees. The lack of forensic medical training, infrastructure and support in the country renders the investigation and documentation of torture and ill-treatment difficult and in many cases impossible. Deaths in custody are poorly investigated and autopsies are not conducted in the country. 53. There are no health prevention programmes or medical awareness programmes for specific prevalent conditions such as HIV/AIDS, tuberculosis or drug addiction (with the exception of the specialized drug rehabilitation centre). 54. From a medical perspective, the sleeping conditions, quality of food and ventilation are inadequate in many places of detention, and inmates’ access to fresh air, physical work and recreational activities is clearly insufficient and in some cases, the cause of illness. 55. The Special Rapporteur also notes with serious concern that, despite existing regulations, it was reported that medical staff do not conduct examinations thoroughly; that they do not enquire about injuries or probe further for explanations. Many medical staff are not familiar with the Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (Istanbul Protocol) and, in some places of detention, do not consider it their duty to enquire whether injuries observed may be the result of torture or ill-treatment. 56. The Special Rapporteur stresses the importance of transferring responsibility for the health care of detainees and prisoners from the prison administration to the Ministry of Health or the relevant provincial ministry of health, as the current supervisory chain in detention centres may prevent health professionals from documenting and reporting torture or illtreatment in complete independence. C. Complaints mechanisms and accountability 57. The Special Rapporteur notes with serious concern that, except for visits by the National Preventive Mechanism and the Human Rights Commission, in no place of detention is there a truly independent, effective and accessible complaints mechanism for persons deprived of their liberty to send confidential complaints directly to an independent oversight body. While in some institutions complaints forms are made available, most inmates are not aware of their existence. When inmates submit written complaints to the Prison Director or to the Commissioner of Prisons, the Human Rights Commission, the People’s Majlis or other external oversight bodies, their correspondence is systematically censored by correctional officers and either transmitted or held back at the officers’ discretion. D. Separation of remand detainees from convicts 58. According to the Prisons and Parole Act, remand detainees should be held separately from convicted prisoners. However, that is not the practice. The Special Rapporteur observed that pretrial and remand prisoners were held in the same cells. The Malé custodial centre and the Dhoonidhoo pretrial detention centre held juveniles in separate cells but in proximity and view of cells that held adults. E. Material conditions 59. In all the institutions visited, the Special Rapporteur assessed that the infrastructure and the conditions of detention were incompatible with respect for human dignity and may amount to cruel, inhuman or degrading treatment or punishment, or even torture. 60. The Special Rapporteur regrets to report that the conditions of detention he observed in the Malé custodial centre were extremely poor; no sleeping or seating facilities were available in any cell. The prisoners slept on the bare floor and prison guards indicated that mattresses were provided only upon prescription by a medical doctor. There was no yard 9