National Preventive Mechanism Interviews with the medical staff made it clear that they had not taken any training on issues of provision of medical service to children with special needs. They think that participation in such educational activities and familiarization with new approaches to medical service and habilitation/rehabilitation of children would help them a great deal in their daily activities. The medical rooms in the boarding schools are very small; the institutions (the Akhaltsikhe Boarding School, the Chiatura Boarding School, Boarding School No. 202) do not have a medical isolation ward for temporary placement of beneficiaries in the case of a contagious disease. Medical units adjacent to the medical rooms are non-functional (the Akhaltsikhe Boarding School), and the medical rooms are not equipped with weighing scales and a height measure, which makes it impossible to conduct monitoring on physical development (the Akhaltsikhe Boarding School). The monitors found expired medicines (ampules of Dimedrol and Analgin) in the medical rooms (the Akhaltsikhe Boarding School, Boarding School No. 202). The logs on the use of medicines were not maintained (the Kutaisi Boarding School No. 45, the Akhaltsikhe Boarding School No. 7) or were maintained in a non-standard manner. MAINTENANCE OF MEDICAL DOCUMENTS The boarding schools do not keep logs of cases of hospitalization, unfortunate accidents, injuries, and other issues. They maintain logs of daily medical services differently from one another (without observing a common standard); The documents do not contain necessary basic information (the Akhaltsikhe Boarding School, the Tbilisi Boarding School No. 202). The staff of the institution soften do not have a list of beneficiaries that includes their diagnoses and disability status. The Akhaltsikhe Boarding School No. 7 does not have a single complete medical case file. None of the case files includes assessment of retardation of mental development (with the exception of one child). There are no logs on injuries, treatment, or supervision. In Boarding School No. 202, there are no logs on acceptance and transfer of medicines; there are also no logs on hospitalization, contagious diseases, and vaccination. Several boarding schools do not maintain logs on medicines subjected to special control, and these medicines are issued together with other medications (the Tbilisi Boarding School No. 202, the Chiatura Boarding School No. 12). Boarding School No. 200 also fails to maintain a log on injuries and self-injuries. In the boarding schools, medical cards are maintained incorrectly; in some of them, entries are only made once a year, and even these entries are incomplete and the information does not reflect the dynamics corresponding with the diagnoses (boarding schools of Akhaltsikhe No. 7, Kutaisi No. 45, and Tbilisi No. 202 and No. 203). In the case of chronic diseases, the progress of the diseases is not supervised adequately (boarding schools of Akhaltsikhe No. 7, Kutaisi No. 45, and Tbilisi No. 202 and No. 203). The medical history of a beneficiary of Boarding School No. 202, 16-year-old A.Ch., diagnosed with diabetes mellitus type A and diabetes insipidus, does not include entries about insulin treatment. The same is the case with a beneficiary of the same boarding school, S.M., diagnosed with diabetes mellitus type A, decompensated form, severe form (Wolfram Syndrome). In both cases, the monitors saw the diagnoses in Forms #100 issued by Givi Zhvania Pediatric Clinic. The medical cards issued by the boarding school did not contain this information. Thus, lack of information by the medical staff, on the one hand, and their failure to fulfill their obligation as doctors to make entries, on the other hand, cause ineffective maintenance of medical documents. www.ombudsman.ge NPM Report