medicines were not used, they were withdrawn and they were waiting for directions from the health centre for further action. Of the basic medical devices, the clinic has a blood pressure apparatus, a blood sugar meter, but the tapes are expired, and a thermometer that is not functional. 3.2.3. Healthcare The healthcare in the Prilep Penitentiary is provided by a single doctor- psychiatrist, with whom the institution has concluded a contract for performing services and two nurses, who are employed with a contract for a period of 6 months (through a project and have no information about what will happen next with their employment), although according to the Law, the health sector is under the competence of the Ministry of Health. The doctor - psychiatrist comes to the prison once a week, but more often if necessary, and the nurses are present in the prison clinic every day from 8:30 to 12:30 (their engagement contract was concluded one month before the visit to the institution). The convicted persons are registered for medical examination with an oral request through the officials from the Prison Police, and having in mind that most of the medical examinations in the Prilep Penitentiary are conducted by the hired psychiatrist, there were cases when the convicts waited for a medical examination for 3-4 days. Emergency medical services are also used quite often, and from there doctors refer convicts to a specialist if necessary. Due to the irregular presence of a doctor in the Institution the measure solitary confinement is not applied at all. Namely, the psychiatrist does not issue medical certificates for the convicts, which would confirm that they are in good health so that they can endure a measure of solitary confinement. As for the addictions of convicts who are being treated for opiate addiction, diazepam and trodon have been prescribed for years, although these medicines are not for treatment for opiate addiction according to evidence-based medicine, but evidence-based therapy for the treatment of opiate addiction is unavailable in the Health Centre, nor is it available in the General Hospital in Prilep. It is available exclusively in the Regional Centre for prevention and treatment of persons who use or are addicted to drugs in the Clinical Hospital Bitola. During the conversations with the officials, the NPM team was informed that, in the Institution, there were cases of loss of consciousness caused by these medicines, during which they pulled the unconscious person’s tongue (this is not a procedure that should be done in such cases, which suggests that training is lacking). Such states of loss of consciousness and cramps are possible in the case of intoxication with “trodon” (when there is too much) or in the case of abrupt cessation or abrupt reduction of “diazepam” and “trodon”. Long-term use of these medicines makes them insufficient after a certain period of time and to achieve the same effect it is necessary to increase the dose, so it is not recommended long-term treatment of opiate addiction with “trodon” but with “methadone” or “buprenorphine”. www. ombudsman.mk 121