A/HRC/31/57/Add.4 123. Like their counterparts for adults, many juvenile detention facilities suffer from excessive overcrowding. Adolescents spend most of their time in their rooms with little or no time spent in communal areas or outside. Many take their meals inside their rooms. 124. The Special Rapporteur is concerned at the lack of implementation of the socioeducational dimension of the juvenile justice system. Young people are supposed to continue their schooling at the socioeducational centres; however, classes are often cancelled due to a lack of guards available to oversee the classes. Similarly, recreational activities are also sparse or non-existent. 125. He notes with concern the absence of a functioning complaint mechanism allowing young people to submit complaints regarding their treatment without fear of reprisal or a worsening of the situation. 126. Both inmates and staff testified to a constant lack of basic provisions, such as blankets, soap, sanitary napkins, shaving blades, mattresses, plastic gloves and laundry service, leading to negative impacts on hygiene and health, including skin diseases and other maladies. 127. The Special Rapporteur did not visit the “connector” in the São Paulo-Guarulhos Airport, where in early 2015 it was reported that detained refugees and migrants held upon their arrival in the country waited many days to have their cases heard, under very poor conditions and without communication or access to lawyers or interpreters. The federal Government and local authorities took action to improve those conditions and the premises. 128. While physical, medical and nutritive shortages and inadequacies constitute an overall problem in Brazil’s penitentiary system, the Special Rapporteur stresses the asymmetrical impacts they have on certain groups, including women and girls (in particular while pregnant, giving birth or breastfeeding, of if they are accompanied by children) and persons with disabilities. Health services 129. From a medical point of view, with few exceptions, conditions of detention in places visited suffered from significant deficiencies regarding basic sanitation and access to drinkable water, edible food, and medical and psychological attention. 130. The extreme lack of sanitation found in most places visited, combined with the presence of highly contagious diseases — tuberculosis, leprosy and hepatitis — and overcrowding, have turned prisons, especially those for male inmates, into places where prevention of disease is a permanent and unmet challenge. 131. The national health plan for the penitentiary system and the national policy on comprehensive health care for people deprived of liberty in prison set out the principle that, in theory, the public health system covers all inmates. This is not the case in practice, however. Due to severe overcrowding, health services in prisons are critically lacking capacity to effectively accomplish their mission of providing basic medical attention to inmates. 132. All facilities visited had infirmaries, which provide a minimum of comfort and privacy; however, none had the adequate physical or technical facilities required for a thorough forensic examination. They had a basic staff of technicians and a sporadic presence of health professionals, mainly physicians, dentists and psychologists. The Special Rapporteur received numerous reports from inmates claiming they had not seen a doctor in months, or ever. In all of the prisons visited by the Special Rapporteur, he saw a doctor present in only one of them, a prison for women. 19