CAT/OP/BRA/3 facilities visited, the Subcommittee observed that the cells were in such a state of insalubrity as to be unfit for use. A number of inmates reported that they did not have sufficient toilet paper, detergent, soap or toothpaste, and had to ask visitors to provide such supplies. In most facilities, the Subcommittee also observed a lack of clean bedding and beds, which were often shared by inmates due to overcrowding. The Subcommittee further noted a lack of proper ventilation in most prisons and pretrial detention facilities. Where present, fans were insufficient to allow for adequate circulation of air in hot, humid and overcrowded cells. 53. The Subcommittee requests that the State party provide to detainees sufficient hygiene products to satisfy generic and specific needs, as well as towels, sheets and clothes, to ensure a basic level of health. It further requests that the State party remove from service, as soon as possible, cells that do not meet international occupancy standards. 3. Health care 54. Regarding preventive and curative health care, the Subcommittee notes with serious concern that according to 2014 statistics provided by the Government, at least 768 out of 1,258 prison units in Brazil lack a medical office or clinic. 8 In a number of detention facilities, the Subcommittee observed that existing health units lacked adequate financial, material and human resources. 55. The Subcommittee also observed that in several facilities in Pernambuco, medical assistance, including emergency assistance and dental care, was not consistent and was administered by insufficiently qualified staff or by unqualified inmates who, in some instances, were serving as pharmacists and even prescribed medication to other inmates. In addition, in some of the facilities visited, detainees were not given medical examinations upon arrival or screened for infectious diseases. In contrast, the Subcommittee was pleased to note that in April 2015, a nurse had been hired at the Everardo Luna Centre for Criminal Observation and Screening to screen the entire prison population for tuberculosis and to provide medical care for those affected with tuberculosis. However, the Subcommittee notes that such measures must be widely implemented throughout Pernambuco, a state where the prevalence of tuberculosis is reportedly almost 100 times greater than that of the general population. 56. The Subcommittee reiterates its recommendation that all detainees be offered a free medical examination as soon as possible after their initial detention, and again after they are moved to prisons. Physicians’ comprehensive findings should be recorded in a register established for that purpose, and in the case of allegations or signs of torture or ill-treatment further assessments should be conducted. Medical examinations should always be carried out in conformity with the principle of medical confidentiality: no person other than medical personnel should be present during the examination. 57. The Subcommittee received credible reports that in some areas, inmates give birth in handcuffs. The Subcommittee was particularly alarmed at reports that pregnant inmates do not receive proper obstetrical care, and that in October 2015, an inmate in the Talavera Bruce prison, in the Gericinó complex in Bangú, gave birth in an isolation cell. The Subcommittee received conflicting information from the Government and other sources as to whether this inmate received medical assistance during the birth. 58. The Subcommittee requests a copy of the report on the investigation of this incident, and also requests information concerning procedures observed for detainees 8 See www.cnj.jus.br/files/conteudo/arquivo/2015/11/080f04f01d5b0efebfbcf06d050dca34.pdf. 13