A/HRC/40/59/Add.3 3. Detention of juveniles 38. While acknowledging the Government’s efforts to ensure that juveniles are held in isolation, the Special Rapporteur noted with concern that, throughout Ukraine, adolescents from 14 to 18 years of age are accommodated in the same institutions as adults, under conditions which, considering their age and vulnerability, must be regarded as inadequately harsh. 39. The Special Rapporteur is of the view that the juvenile justice system should emphasize the well-being and best interests of the juvenile and ensure that any response to offences committed by juveniles remains in proportion to the circumstances of both the offenders and the offence. 40. All juvenile detainees in Ukraine should therefore be accommodated in institutions separate from adults, providing conditions that cater to their specific vulnerability and needs and to the best interests of the child. 41. Moreover, the Special Rapporteur recommends that pretrial detention of juveniles be used only as a measure of last resort and for the shortest possible period of time. Whenever possible, pretrial detention should be replaced by alternative measures, such as close supervision, intensive social care or placement with a family or in an educational setting or home. 4. Access to health 42. The Special Rapporteur is particularly concerned by reported shortcomings in access to medical care throughout the penitentiary system. The Special Rapporteur’s team noted that specialized medical services, such as gynaecology and dentistry, among others, were not always available due to a shortage of the required means of transportation and guarded wards in general hospitals. 43. Despite a high prevalence of drug addiction, special treatment for drug addiction is either lacking or is terminated upon a prisoner’s entry into a place of detention. The procurement of medication for prisoners with HIV and multi-drug-resistant tuberculosis seemed adequate for sentenced detainees but difficult to access for pretrial detainees. The Special Rapporteur is also concerned by the apparent shortage in mental health professionals including psychologists and social workers. 44. While the Special Rapporteur welcomes the envisaged transfer of responsibility for health care from the penitentiary administration of the Ministry of Justice to the Ministry of Health, he notes with concern the reported reluctance of some of the authorities concerned to complete this crucial change. In particular, the currently unclear supervisory chain of health professionals in detention centres may impede them from documenting and reporting injuries resulting from torture or ill-treatment. 45. The Special Rapporteur also notes with serious concern the reported failure of medical staff to conduct thorough medical examinations of detainees, despite existing regulations. Medical staff reportedly did not inquire about injuries or probe further for explanations. Many medical personnel are generally unfamiliar with the Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (the Istanbul Protocol), and in some places of detention do not consider it to be their duty to question whether observed injuries may be the result of torture and ill-treatment. C. Allegations of torture and ill-treatment 46. The Special Rapporteur is pleased to report that, in his meetings with the judicial, legislative and executive branches of the Government of Ukraine, all officials emphasized their unequivocal commitment to the absolute and non-derogable prohibition of torture and other cruel, inhuman or degrading treatment or punishment. 47. However, despite existing international, regional and domestic legal safeguards for the prevention of torture and ill-treatment, and despite a reported improvement in the recent past, the use of violence by law enforcement agencies and the Security Service of Ukraine 8