CAT/OP/BRA/1 C. Healthcare 36. The SPT considers that the situation of healthcare in most facilities it visited was extremely worrying. Overall concerns included the lack of financial, material and human resources and the subordination of health services to the security services. 37. In police stations there was no access to doctors. A physical examination (“corpo de delito”) was performed on detainees shortly upon their arrest and normally before their admission to the police station. All detainees interviewed by the SPT stated that this examination was superficial and conducted in a perfunctory manner. 38. Medical examinations and the proper recording of injuries incurred by persons deprived of their liberty constitute important safeguards for the prevention of torture and illtreatment, and in combating impunity. 16 They can also protect police and prison personnel against false allegations. States must carry out a prompt and impartial investigation wherever there is a reasonable ground to believe that an act of torture or ill-treatment has been committed.17 Such examinations should be carried out in private by a health professional trained in the description and reporting of injuries, include an independent and thorough medical and psychological examination, and the results be kept confidential from police or prison staff, and shared only with the detainee and/or the detainee’s lawyer, in accordance with the Istanbul Protocol. 39. The SPT recommends that all detainees be offered a medical examination as soon as possible after their initial detention. Such examination must be independent, free of charge and conducted in accordance with the Istanbul Protocol. The SPT also recommends the establishment of a system that guarantees prompt, free of charge access to medical care and treatment for those under police custody whenever necessary. 40. In prisons, medical assistance was irregular and in most cases access to medical staff was granted only after long delays. In addition, there was no medical staff at night or during weekends. Medical staff was insufficient and unqualified inmates were involved in the provision of healthcare. For example, in one prison the SPT was told that there was only one doctor present once a week to attend to more than 3,000 inmates. 41. The SPT recommends that medical assistance in prisons be made available 24 hours/day, and seven days a week. Working conditions, including salaries, of medical staff should be adequate, so as to attract qualified personnel. Inmates should not be involved in the provision of medical services. 42. According to information received, inmates were not given a medical examination on entry to prison. Inmates further indicated that access to medical care was often at the discretion of prison guards or of “faxinas” (other inmates working for the institution). 43. The SPT recommends that the State party ensure that a health professional examine every inmate as soon as possible after his or her admission and thereafter as necessary, in accordance with international standards. 18 Inmates should be able to seek professional medical assistance in confidence and without their request being obstructed or filtered by guards or other inmates. 16 17 18 8 Committee against Torture, General Comment No. 2, CAT/C/GC/2, para. 13. UNCAT, art. 12. Standard Minimum Rules for the Treatment of Prisoners (SMRTP), rule 24; Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment (“Body of Principles”), principle 24.