Places of Medium-Term Deprivation of Liberty If any signs of an infectious or contagious disease are detected at a CIE, and given There is no written protocol the lack of appropriate isolation facilities, those affected are to be taken to hospital. for procedure if any signs of Nevertheless, there is no written protocol covering this matter. an infectious or contagious Medication is prescribed and dispensed by the medical staff, with the exception Medication is prescribed of those doses to be taken outside the staff’s working hours, in which cases the doses are prepared and given to the guards to dispense, normally in single-dose disease are detected. and dispensed by the medical staff sachets. During the visit to the CIE in Valencia one of the foreign nationals, who displayed clear symptoms of a mouth complaint in the form of a visible swelling of the gum, complained about not receiving healthcare. The explanation the staff gave was the person in question had not specifically requested such care; so a doctor was called upon to attend to the inmate. 264. Inmates are entitled to receive those vaccines and medication deemed necessary. There are no specific programmes for the treatment and rehabilitation of substance abusers, although there are inmates being treated with methadone. There is a need to introduce protocols or cooperation agreements to make this substitute available in those cases as required, given that its management is currently somewhat complex at times. There is access to those the 265. No special measures are adopted in the case of pregnant women, observing the instructions of the medical services. On the day of the visit to the CIE in Algeciras (Cadiz) there were three pregnant foreign nationals in custody, and they asked for help from the members of the NPM. The latter were informed that those women who are more than five months pregnant are transferred to another centre. Nevertheless, the hygiene and living conditions observed in the women’s block cannot be considered acceptable, and even less so for those that are pregnant or, as in the case of a Sub-Saharan woman, those that are ill. On the day of the visit to the CIE in Malaga, there were five pregnant inmates of foreign nationality. On a general basis, a protocol should be established for the case of pregnant women. No special measures are 266. No information has been forthcoming, either, on the existence of protocols for preventing suicides, with this being a matter that needs to be resolved. Likewise, psychological and psychiatric care for inmates needs to be improved, as it is almost non-existent except in severe cases, when the inmate is referred to the corresponding psychiatric services. Especially, it is essential to ensure the continuity of the treatment during the time spent at a CIE regarding those inmates undergoing psychiatric treatment. Psychological and 267. The food provided at the CIEs is prepared, handled and served by contracted The food provided is staff, either on the actual premises or at outside establishments. In the case of prepared and handled by the establishment in Tarifa, the food was delivered from the CIE in Algeciras (Cadiz), in isothermal containers. Nevertheless, following the visit we were informed of the installation of a kitchen at the Isla de las Palomas establishment. THE OMBUDSMAN OF SPAIN vaccines and medications deemed necessary. There is no programme for substance abuse adopted in the case of pregnant women. A protocol should be established for such cases psychiatric care needs to be improved. No information has been forthcoming on the existence of protocols for preventing suicides contracted staff on the actual premises or at outside establishments 117