DETENTION MONITORING TOOL FACTSHEET psychological support for victims. In particular, victims of gender-based violence and sexual abuse are likely to experience extreme and prolonged psychological damage, which can be exacerbated by concerns over a possible pregnancy or sexually transmitted disease. Indications of ill-treatment should be accurately documented, with a detailed description of injuries, in line with the Istanbul Protocol.48 Medical staff should use body charts to indicate the exact location of any injury or mark, and should additionally take photographs of the injuries, if possible. Any statement made by the person as to the origins of the injuries should be noted down, and the medical professional carrying out the examination should indicate whether these explanations could be consistent with the objective medical findings.49 It is also good practice for prison healthcare staff to keep a dedicated register of traumatic lesions, often referred to as a ‘trauma register’, which can, inter alia, help to provide an overview of the prevalence of inter-prisoner violence. Commonly, prison healthcare services in Europe keep some kind of register on traumatic lesions of prisoners. For example, in 2012, Greece introduced specific registers for injuries and incidents of ill-treatment in all prisons.50 If staff reasonably believe that injuries or other signs are indicative of torture or ill-treatment, they should automatically report their findings to the competent medical, administrative or judicial authority,51 regardless of an official complaint or allegation.52 However, in respect to women prisoners who have been subjected to sexual abuse or other forms of violence before or during detention, the Bangkok Rules make an important exception to the automatic reporting requirement, thereby recognising that in some circumstances women may not wish to take legal action against the perpetrator(s).53 Healthcare professionals working in prisons should be specifically trained in order to gain the necessary competence in the documentation and interpretation of injuries, as well as to ensure full knowledge of the reporting obligation and procedure.54 What could monitoring bodies check? • Are comprehensive medical screenings, including for signs of ill-treatment, undertaken by a medical professional within 24 hours of the arrival of all prisoners? • Are persons who have been involved in inter-prisoner violence, or who have experienced the use of force by prison staff, routinely presented to a member of the medical staff? Are measures subsequently taken to prevent future incidents? 6 | • Are medical examinations conducted in line with international standards – including maintaining full confidentiality and, in the case of female prisoners, by female healthcare staff? • Is a regulation in place outlining the precepts of documenting and reporting injuries? • Is a trauma register in place? • Have physical injuries of detainees been accurately documented? • Do healthcare professionals working in prisons have body charts and photo cameras at their disposal for the proper documentation of ill-treatment/injuries? • Are medical professionals working in prison specifically trained in documenting injuries and in the procedures to follow in case of an injury indicative of ill-treatment? • Have detected injuries that are indicative of ill-treatment been promptly reported to the relevant authorities, if necessary with the consent of the alleged victim? Allegations of ill-treatment A functioning complaints system is an important prerequisite for effective investigations into allegations of ill-treatment. Upon arrival at a detention facility, prisoners should be informed of the various existing avenues of complaint and the procedures to approach these bodies.55 A variety of mechanisms should be in place to receive prisoners’ requests and complaints about any aspect of their treatment and the conditions of their detention. Persons in custody should be enabled to personally approach the director of the facility or their representatives on a regular basis, as well as to complain to the higher prison authorities and ministry responsible for the prison system.56 Additionally, they should have unrestricted access to independent external bodies, such as national human rights or ombudsman institutions, National Preventive Mechanisms, judicial authorities and others.57 The Imprisonment Code of Georgia stipulates that all prisoners can request the provision of items necessary for filing a complaint, as well as support for matters such as identifying the correct addressee or access to interpreters, free of charge. In 2015, Georgia���s Ombudsperson reported that 90 per cent of prisoners had access to envelopes, paper, pens and a complaints box.58 Penal Reform International and Association for the Prevention of Torture | Incident management and independent investigations