(d)Prisoners sentenced to death 224.At Cotonou Prison, the prisoners sentenced to death showed documents indicating their problems of access to healthcare: when one of these prisoners had a health problem, he could put his name down to see the nurse. The nurse consulted with the prisoner through the bars of the cell door and never entered the cell. It was therefore impossible for these prisoners to have a proper medical examination by the nurse. The SPT recommends that medical consultations occur in an appropriate setting and never through the bars of a cell door. 225.The prisoners sentenced to death complained that, in addition to not being properly examined, they also had no access to specialist care. Two of the prisoners were blind and said that they had lost their sight while in prison without receiving specialist attention. Another showed his healthcare booklet in which he requests an X-ray because of persistent pain in the abdomen radiating to the back and left hip; no response was noted in the carnet other than the prisoner’s insistence. 226.The prisoners reported an additional problem of delay in access to the nurse. The delegation saw a book listing prisoners’ requests to see the nurse. It was clear that there were considerable delays before the nurse visited; for example, there was a string of names beginning on 26 February 2008, reaching nine prisoners in total until 7 March 2008 when the nurse came (a delay of 9 days from the first request). Still worse, a string of requests for medical attention starting on 8 April 2008 reached a total of nine on 12 May 2008, when the nurse finally came. The prisoner who made the first request had had to wait over a month to see the nurse. This state of affairs is unacceptable. Every prisoner regardless of his/her status has a right to prompt access to healthcare. The SPT recommends that the authorities take the necessary steps to ensure that every prisoner who requests to see the healthcare staff is able to do so without delay. (e)Access to hospital care 227.There appeared to be screening by non-medical staff of requests to be transferred to a hospital, as the request had to be made to the Régisseur, approved first by the Procureur, then by the Ministry of Justice, a procedure which, according the director of Cotonou Prison, could take between three days and a week. The SPT recommends that nonmedical personnel not be involved in filtering requests by prisoners to see a doctor. If health care staff at the prison recommends transfer to a hospital, the prison and judicial authorities should simply endorse the request for transfer. 228.In addition, the delegation was informed that, unless the prisoner was able to pay for hospital treatment and subsequent medicine, the transfer might never take place. The SPT recommends that, upon transfer to a hospital, healthcare and treatment be provided free of charge to detainees. 6.Staff 229.Staffing at the prisons visited was provided by the gendarmerie, including the director who belonged to the military hierarchy. At Abomey Prison, the director described the gendarmes as ‘apt’ for prison work, but confirmed that they had had no training specifically designed for the custody and care of persons deprived of their liberty. The SPT considers that training in law enforcement is not an appropriate preparation for work in a prison context. The SPT recommends that the authorities develop a special programme for the training of all custodial staff, which should include the rights of detainees, and establish a specially trained and separate service for prison staff of all levels. 230.The staffing levels were totally inadequate at the two prisons which received full visits. 231.At Cotonou Prison, the staff of 21 consisted of managers and guards including two women, as well as four nurses (one major). The staff worked primarily in the area inside the outer walls of the prison. In addition, 30 detached military personnel were responsible for perimeter security. They reinforced the capacity of the prison staff, by performing medical and judicial escorts and by assisting with full searches for drugs, weapons or mobile telephones. The director of Cotonou Prison was of the opinion that if the prison held 1000 instead of 2257 and if there were 100 staff, including 10 women staff, the prison could be managed without the prisoner control system. 232.At Abomey Prison, the director reported having a prison staff consisting of 4 senior officers, including himself, and 5 gendarmes for the custody and care of 1105 prisoners, as well as one nurse. The military personnel (8 at any one time) designated to guard the perimeter were reportedly not involved in extractions or escorts, which was regarded as the work of the prison gendarmes. 233.At Akpro-Missérété Prison, the director reported having 9 staff from the gendarmerie, plus an extra 10 gendarmes for security purposes. The military was expected to provide troops shortly. The director already felt that this was insufficient for the prison which housed 187 at the time of the visit; the self management system had taken over basis tasks such as roll calling and keeping keys to various rooms throughout the prison. It is unclear to the SPT how the arrival of the International Criminal Tribunal for Rwanda convicted prisoners will affect the organisation and staffing of Akpro-Missérété prison. 234.The SPT recommends that the number of prison staff be reviewed in order that staffing at each prison is sufficient to guarantee the safety of detainees and staff within the prison, without having to rely on involving prisoners in the basic management tasks of the prison. 235.Another issue of concern arises out of the lack of resources for essential functions, including transportation of detainees. Abomey Prison reportedly had no vehicles for this purpose. Escorts by the gendarmes were carried out on foot; the parquet was nearby, but the Court of Appeal was at the other end of the town. The director of the prison also indicated that some prisoners refused to walk to the Palais de Justice, and therefore the prison had to hire transportation, at its own cost. Escort duties further eroded the capacity of the prison staff to perform their role at the prisons visited.