THE PENITENTIARY HEALTHCARE SYSTEM AND TORTURE PREVENTION MECHANISMS they are apparently saying truth because not always is it possible to perform a comprehensive examination in only a day, in a medical establishment with a narrow profile of services offered and lack of required equipment. Unlike regular citizens who are able to visit a medical establishment several times on subsequent days, prisoners have to register again in the electronic database of medical referrals and to wait for some period of time. With this situation on the ground, prisoners may not be getting the needed medical service on time that may lead to deteriorated health condition, which eventually constitutes a violation of the equivalency principle. In evaluating equivalency of the medical services provided locally at penitentiary institutions, one should take into account the existing medical infrastructure as well as the competence and expertise of the prison healthcare staff. We would like to welcome the changes effected at the Center for the Treatment of Tuberculosis and Rehabilitation. Although some problems remain in regard to both the Center and the National Center for Tuberculosis and Lung Diseases, it is safe to say that the medical services provided to TB patients within the penitentiary system are equivalent to (comparable with) those provided at civilian clinics. As regards the Medical Institution for Accused and Convicted Persons, its infrastructure and capabilities were deemed unsatisfactory and the institution has been under repair and re-equipment since September 2013. The repair was still ongoing by the end of the reporting period. As regards pretrial detention facilities and institutions for sentenced prisoners, their medical units can offer only a limited number of services. Normally, penitentiary institutions can offer services such as electric cardiography, ultrasound examination, X-ray, and sample-taking for general and biochemical blood tests and for lab tests on tuberculosis, hepatitis and HIV/AIDS. Despite their limited capabilities, the medical units of penitentiary institutions function as if they were secondary healthcare units, offering inpatient services. It is therefore impossible to meet the equivalency requirement in these conditions. To illustrate the existing medical needs within the penitentiary system, we are providing morbidity data in the below table. Table 7 № Cardiovascular diseases Diseases of the respirator system Digestive system diseases Urinary and genital system diseases Nervous system diseases Mental diseases Endocrine system diseases Hematologic diseases Diseases of sensory organs Infectious diseases Tuberculosis HIV/AIDS – newly detected Diseases of bones and joints; diseases of connecting tissues Skin diseases; sexually transmitted diseases Dental illnesses Acute surgical diseases Oncologic diseases Total Total 859 1 536 1 708 1 180 958 1 998 185 19 1 349 168 294 7 416 285 15 807 230 40 27 039 If we subtract dental cases (that can be dealt with locally in the penitentiary institutions) and TB cases (that can also be dealt with locally without taking prisoners to the National Center for Tuberculosis and Lung Diseases) from the total number of cases shown in the table, 11,064 will remain. Certainly, some of these cases may indeed be 2013 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Morbidity NPM Report 37