A/HRC/31/57/Add.2 course.”4 The current budget remains too low to provide prisoners with sufficient and nutritionally balanced food. At both Nsawam and Ankaful the Special Rapporteur received complaints about the poor quality of the food, which consists of porridge in the mornings and thin soups or banku (corn or cassava dough) for lunch and dinner and, occasionally, rice and beans at Ankaful; at least one prisoner in each facility complained about insufficient food. The authorities at Ankaful reported no food shortages and the existence of an agricultural programme, including an on-site vegetable patch; however, prisoners complained about the lack of fresh vegetables. The Special Rapporteur regrets that the Government has not yet established an independent body under the Ministry of Health to regulate and improve the quality of food, per his recommendation. 44. The “Agric” sector of the GPS, which comprises of 21 farming stations throughout the country, remains inadequately equipped and resourced, experiences seasonal shortages of food supplies, and suffers from very low levels of agro processing, dependency on rainfed agriculture, inability to buffer harsh climatic changes, and chronic post-harvest losses. Although the GPS stated that, with adequate irrigation and machinery, it could increase its yield and provide for all of its cereals and vegetable needs, it found that it was still not in a position to embark on the kind of large-scale production required to do so. To this effect, it intends to embark on a mechanization project and a Public Private Partnership (PPP) programme designed to foster the large-scale production of maize, oil palm, and livestock. The development of partnerships with the Ministry of Agriculture and the private sector with a view to obtaining resources, expanding the farming program to more prisons, offsetting food costs, and providing better nutrition, is also encouraged. Medical care and sanitation 45. The Special Rapporteur regrets that there have been no improvements regarding access to and quality of healthcare services in prisons. While Prison Regulation 134(1) requires medical officers to attend to prisons on a daily basis, the Service does not presently employ even a single medical officer. The Service reports that it employs a number of health aides, only “a few” nurses, and “a handful” of medical assistants, and that prison infirmaries lack the requisite medical equipment and personnel to provide even “basic first aid.” The Government faces a serious inability to recruit and retain healthcare personnel, and particularly mental health workers; the lack of essential medication, medical equipment, and ambulances remains pervasive. 46. The Special Rapporteur learned that the Nsawam infirmary is run by a full-time physician’s assistant, with visits by a Government-sponsored physician taking place at irregular intervals. The prison did not have an ambulance: if prisoners must be transported to hospitals, officers’ private vehicles are used. Inmates continue to suffer from conditions that are preventable and treatable. Forty-six inmates were in the infirmary at the time of the visit, reportedly suffering from respiratory tract infections, skin diseases, malaria, tuberculosis (TB), and HIV/AIDS, and authorities reported that an average of 40 to 60 inmates receive outpatient care daily. Routine screenings upon entry are not provided, despite the theoretical existence of a screening process. Nsawam’s diagnostic center and operating theatre were not operational. Although the authorities claimed that there was no shortage of medication, inmates interviewed complained that paracetamol is the only medication prescribed, if any is prescribed at all. They further reported a pervasive lack of medical attention and, in some cases, that officers demand payment in exchange for transferring inmates to hospital. Recent statistics on deaths in custody were not provided (in 2012, the most recent survey available, the Government reported 94 deaths in custody, all 4 Ghana Prisons Service, Project Efiase. 13