4. RESTRICTIONS, DISCIPLINE AND SANCTIONS and cooling. The provision of a dedicated external yard to enable exercise for prisoners in isolation is also required, and separate sanitation, eating, cooking and medical facilities may also need to be provided.”256 72 The Technical Guidance for Prison Planning also points out that isolation cells should not be considered part of the overall prison capacity, so that if prisoners are removed from the general population and put in isolation there must be a space for them to return to following the period of isolation. Isolation cells should never be used as a means to alleviate overcrowding.257 4.3. THE ROLE OF HEALTH-CARE PERSONNEL RELEVANT RULES: THE ROLE OF HEALTH-CARE PERSONNEL Rule 46: 2. Health-care personnel shall report to the prison 1. Health-care personnel shall not have any role director, without delay, any adverse effect of disciplinary in the imposition of disciplinary sanctions or other restrictive measures. They shall, however, pay particular attention to the health of prisoners held under any form of involuntary separation, including by visiting such prisoners on a daily basis and providing prompt medical assistance and treatment at the request of such prisoners or prison staff. 256 257 sanctions or other restrictive measures on the physical or mental health of a prisoner subjected to such sanctions or measures and shall advise the director if they consider it necessary to terminate or alter them for physical or mental health reasons. 3. Health-care personnel shall have the authority to review and recommend changes to the involuntary separation of a prisoner in order to ensure that such separation does not exacerbate the medical condition or mental or physical disability of the prisoner. 73 As mentioned in Chapter 6, paragraph 103 of this guidance document, the UN Principles of Medical Ethics (Principle 3) point out that “It is a contravention of medical ethics for health personnel, particularly physicians, to be involved in any professional relationship with prisoners or detainees the purpose of which is not solely to evaluate, protect or improve their physical and mental health.” 74 Rule 32(d) of the Mandela Rules reiterates the absolute prohibition on physicians and other health-care professionals from engaging, actively or passively, in acts that may constitute torture or other ill‑treatment. 75 Daily visits by health-care staff to those held in involuntary separation are important to assess the impact of segregation on prisoners’ physical and mental health, including indications of suicidal tendencies or self‑harm, and also to detect any signs of torture or other ill‑treatment. The fact that medical staff will visit prisoners undergoing such punishment on a daily basis can itself act as a deterrent to ill‑treatment. 4 WHY IS IT IMPORTANT? 256. Ibid, p. 112. 257. Ibid, p. 111. Guidance document on the Nelson Mandela Rules 111