3. Adequate hygiene and health care Hygiene  Women’s specific hygiene needs should be adequately addressed. Ready access to sanitary and washing facilities, adequate quantities of essential hygiene products, such as sanitary towels and tampons, and safe disposal arrangements for blood-stained articles, are of particular importance. The failure to provide women in prison with such items can amount, in itself, to degrading treatment.21  All prisoners should have access to toilets at all times. It is not acceptable, in the absence of in-cell sanitation, to fail to provide ready access to toilets due to low staffing levels. Ready access to sanitation is all the more important for women, given their special needs during menstrual periods.22 Positive differentiation in terms of additional access to washing facilities may also be necessary.23 Health care  The health care provided to persons deprived of their liberty should be of a standard equivalent to that enjoyed by the population in the outside community.24 Ensuring that this principle of equivalence of care is respected as regards women in prison will require that health care is provided by medical practitioners and nurses who have specific training in women’s health issues, including in gynaecology. 25  To the extent that preventive health care measures of particular relevance to women, such as screening for breast and cervical cancer, are available in the outside community, they should also be offered to women in prison. 26  Adequate supplies of medication specifically required by women should be available in prison, allowing women who have begun a course of treatment before being incarcerated to continue it in prison. 27  The contraceptive pill, for whatever reason it has been prescribed, should not be withheld from women wishing to take it.28 A woman’s right to bodily integrity is not diminished by virtue of her imprisonment. Where the abortion pill and/or other forms of abortion at later stages of a pregnancy are available to women in the outside community, they should be available under the same conditions to women in prison.29  The CPT has encountered many women prisoners who suffer from severe personality and behavioural disorders, and/or have a history of self-harming, abuse and abandonment. Where such prisoners are not eligible for transfer to a psychiatric hospital, a multifaceted approach should be adopted, involving clinical psychologists in the design of individual programmes, including psycho-social support, counselling and treatment. The absence of such programmes may bring about an increase in incidents of self-harm and an excessive use of prolonged segregation.30 10th General Report on the CPT’s activities, paragraph 31; Estonia: 2012 visit, paragraph 60. Bulgaria: 2006 visit, paragraph 85. 23 Ibid., paragraph 55. 24 10th General Report on the CPT’s activities, paragraph 32. 25 Ibid., paragraph 32. 26 Ibid., paragraph 32. 27 Ibid., paragraph 33. 28 Ibid., paragraph 33. 29 Ibid., paragraph 32. 30 United Kingdom (Scotland): 2012 visit, paragraph 74. 21 22 4