A/HRC/25/60/Add.1 hepatitis or HIV. In the prisons he visited, the Special Rapporteur documented at least one case of tuberculosis and a number of other suspected cases of infectious or contagious diseases. Many places of detention have not received new supplies of drugs since 2012 and are dependent on donations. The diagnostic centre at Nsawam prison was not operational owing to the lack of supplies and Ankaful prison had insufficient medicine to equip its medical clinic. A common feature of all prison infirmaries visited was the extremely limited and insufficient supply of drugs administered to inmates, regardless of the diagnosis and the need for specific medicine or treatment. As a result, inmates rely on relatives to buy their medication. Sanitation, sleeping arrangements, work and education opportunities 54. In the prisons visited, it appeared that most inmates had access to water and the use of a shower or bucket to wash. However, the level of hygiene was extremely poor owing to overcrowding. The authorities stated that three prisons produced soap and distributed it to the other prisons; however, inmates said that the limited amount of soap available led to frequent skin irritations and other preventable health problems. 55. Those who have access to a toilet often share it with over 100 prisoners and toilets are often overflowing with excrement. Lockdown is generally from 4.30 p.m. to 6 a.m., so at night the prisoners relieve themselves in buckets or plastic bags. The lack of light and ventilation and the heat exacerbate the oppressive nature of the cells. Most inmates sleep on the floor without a mattress, mat or blanket. In the rainy season, wet and damp conditions contribute to poor health. 56. The Special Rapporteur welcomes the efforts by the prison authorities to provide inmates with educational opportunities and skills training (e.g. tailoring, carpentry, weaving). However, as acknowledged by the authorities, those opportunities are very limited; less than 10 per cent of inmates have access to training or work opportunities, mostly owing to lack of resources. In particular, working materials and machines are outdated or need maintenance. Even when opportunities do exist, for example at Ankaful main camp, they are poorly attended by inmates. Some inmates said that their lengthy sentences did not motivate them to participate in any programmes. 57. Ankaful has excellent recreational facilities and at Nsawam there is a large field. However, Kumasi prison, located in the centre of town, has only a small concrete area for outside use. Communal prayer, in all faiths, appeared to be the main activity available. 58. The Special Rapporteur observed education classes at Nsawam and Kumasi prisons and a formal education programme is being introduced into the system, including at Tamale and Wa Central prisons, but it has not yet reached all prisons owing to a lack of infrastructure. Discipline 59. The Prisons Service Act applies progressive disciplinary steps of an incremental nature, from the temporary denial of some benefits, to loss of remission, to the implementation of more serious disciplinary procedures, such as solitary confinement for up to 28 days, hard labour for up to 28 days, a reduction in food for up to 7 days and corporal punishment in the form of caning. However, the official position of the Prisons Service on caning is that it constitutes a criminal offence pursuant to section 25 of the Act. 60. The Special Rapporteur inspected isolation cells used for major offences but did not see any inmates being held in isolation. In fact, many of these cells are not used for disciplinary measures but to house inmates temporarily, owing to overcrowding. The prison authorities stated that an inmate might be held in an isolation cell for between three and seven days but that isolation for prolonged periods was not a practice, even for serious disciplinary offences. In cases of severe misbehaviour, an ad hoc panel that includes a 11