1.1 Obiski v zavodih za prestajanje kazni zapora in mladoletniškega zapora 1.1 Visit to prisons and juvenile prisons Pri ogledu ZPKZ Ig v delu zdravstvenega varstva in zdravniške oskrbe je izvedensko mnenje prav tako podal doc. dr. Milan Popovič, dr. med., specialist splošne kirurgije, ki sodeluje z DPM kot zunanji izvedenec (izvedenec). Prostora za preglede in izvajanje medicinske oskrbe po izvedenčevem mnenju nista primerna, saj pacientu ne omogočata zasebnosti in zaupnosti. Prostor, v katerem je zdravnik, je neposredno povezan s prostorom, v katerem je medicinska sestra. Zdravnik nima svojega delovnega prostora. Tudi ginekološka miza je postavljena na sredino ambulante, kar po mnenju izvedenca ne zbuja prijetnega občutka. Te razmere se kljub prejšnjim priporočilom o preureditvi prostorov še vedno niso spremenile. Tudi UIKS se strinja, da je preureditev prostorov nujna – a na voljo nimajo potrebnih finančnih sredstev – in da je v vsakem primeru ustreznejša rešitev gradnja novega objekta. Ambulanta je opremljena z mizo za nudenje medicinske oskrbe, kovčkom s pripomočki za reanimacijo in kisikovo bombo, manjka pa ji mobilni voziček, namesto katerega uporabljajo zajemalna nosila, kar v določenih zdravstvenih stanjih ni primerno. UIKS je pojasnila, da se pristojna zavodska zdravnica ne strinja z uporabnostjo mobilnega vozička v zavodu, saj za nujno medicinsko pomoč vedno pokličejo Reševalno postajo Ljubljana in ne bi bilo smiselno pacienta prestavljati z enega vozička na drugega, s čimer se DPM ne strinja. Po izvedenčevi ugotovitvi ZPKZ Ig ne razpolaga s pravo bolniško sobo, ki bi bila nujno potrebna za primere nujnih stanj, akutnih bolezni in pri poslabšanjih kroničnih stanj. Bolniška soba bi morala biti za ta namen primerno opremljena s pripomočki za izvajanje zdravstvene oskrbe pacientk. Pohvalno pa je, da razpolagajo s sobo za nosečnice oziroma dojilje. UIKS je odgovorila, da zavod ima bolniško sobo, a je res, da je ta preurejena v prostore za namestitev nosečnic in mater z otroki, uporablja pa se tudi kot bolniška soba, ko v zavodu ni nosečnic. UIKS je pojasnila tudi, da bi, če bi bila izkazana potreba po namestitvi v bolniško sobo, tako osebo nemudoma namestili v eno od sob s sanitarnimi prostori. Za zdravljenje odvisnih od različnih psihoaktivnih snovi in v splošnem tudi za vzgojo zaprtih oseb skrbijo pedagog, psihiater, sociolog in diplomirani psiholog in višji svetovalec, ki vse skupaj koordinira. Odvisnim pomaga z višjepražnim programom tudi Društvo Projekt Človek. Odvisni, običajno jih je 10 do 20, so na redni substituciji z Methadone in Suboxone. V ZPKZ Maribor – Odprti oddelek Rogoza DPM ni zaznal nobenih resnih pritožb zoper zdravstvo. V ZPMZ in KZ Celje je bilo ugotovljeno, da je pred vhodom v delovne prostore prazen, dokaj utesnjen hodnik. V njem ni ne klopi ne stola, da bi se čakajoči lahko usedel. Prav tako ni sedečega ali ležečega vozička za sprejem pacienta v primeru nenadnega slabega stanja. Izvedenec opozarja, da pacienti, ki se zdravijo z injekcijami, ne morejo stati in čakati na hodniku. Stene so prazne, brez posterjev z zdravstvenovzgojno vsebino, ki bi popestrili neprijazen prostor in hkrati delovali informativno. DPM je na zato na podlagi izvedenčevih priporočil predlagal, da se stene na hodniku opremijo s posterji izobraževalnih vsebin, sam hodnik pa s stoli, in da se pridobi sedeči in mobilni voziček. S hodnika je mogoč neposreden dostop v delovni prostor medicinskih sester, od tam pa v ordinacijo splošne medicine ali stomatološko ordinacijo. Tako je prostora za nemoteno delovanje ambulante zelo malo, še posebej pri medicinskih sestrah, kjer ga ni niti za stol ali voziček. Tudi ambulanta splošne medicine ne razpolaga s kaj več prostora. Zobna ordinacija predstavlja skladiščni prostor za vse, za kar medicinske sestre in zdravnik nimajo prostora. Med enim in drugim prostorom je ena bolniška postelja, ki stoji na drugi strani hodnika. DPM je ob tem predlagal, da zavod v sodelovanju z Zdravstvenim domom Celje prouči možnosti za preureditev pohištvenega dela v prostoru, kjer delajo medicinske sestre in kjer je stomatološka ordinacija, tako da bi bilo delovanje obeh ordinacij prostorsko popolnoma ločeno. 48 poročilo o izvajanju nalog DPM v letu 2014 DržavnI preventivnI mehanizEm po Opcijskem protokolu h Konvenciji OZN proti mučenju in drugim krutim, nečloveškim ali poniževalnim kaznim ali ravnanju When reviewing medical and health care in Ig Prison, an expert opinion was also provided by Dr Milan Popovič, a specialist in general surgery, who cooperates with the NPM as an external expert. The room for examination and provision of medical care were unsuitable according to the expert, because they deprive the patient of privacy and confidentiality. The doctor’s room is directly connected with the nurse’s room. The doctor has no working area. The gynaecological examination table is in the middle of the infirmary, which gives rise to discomfort. These conditions have not changed in spite of the past recommendations about rearranging the premises. The Prison Administration of the Republic of Slovenia also agreed that the rearrangement of premises is urgent, but it did not dispose of the necessary financial means, and the construction of a new facility was in any case a more suitable solution. The infirmary was equipped with a table for the provision of medical care, a resuscitation kit and an oxygen bottle, but lacked a mobile table, instead of which a stretcher was used, which is inappropriate for certain medical conditions. The Prison Administration of the Republic of Slovenia explained that the prison’s general practitioner did not agree with the use of a mobile table, since they always called Ljubljana ambulance service in emergencies, so it would thus not be sensible to transfer a patient from one table to another; the NPM does not agree with this assessment. According to the expert‘s opinion, Ig Prison did not have a suitable infirmary for the treatment of urgent conditions, acute diseases or worsening chronic conditions. In this case, the patient room would require equipment for treating female patients. However, it is commendable that a room for pregnant or breastfeeding women is available. The Prison Administration of the Republic of Slovenia replied that the prison had a patient room which had been rearranged for the accommodation of pregnant women and mothers with children, but was also being used as a patient room when no pregnant women are in the prison. It was also explained that if the accommodation of a person in the patient room was necessary, the person would be immediately accommodated in one of the rooms with sanitary facilities. The treatment of people addicted to different psychoactive substances and the general well-being of prisoners is provided by an educator, a psychiatrist, a sociologist, a graduate psychologist, and a senior adviser who manages the coordination. The Projekt Človek Association is also helping drug addicts with their high-threshold programme. The addicts, usually between 10 to 20 prisoners, are on regular substitution with Methadone and Suboxone The NPM did not learn of any serious complaints about medical care in Rogoza Open Unit of Maribor Prison. In Celje Prison and Juvenile Prison, an empty, quite stifling corridor was noticed upon entering the working premises. No benches or chairs are available for waiting people to sit on. There is also no wheelchair or mobile table for admitting patients in an emergency. The expert also pointed out that patients being treated with injections should not be standing and waiting in the corridor. The walls were bare, without posters with health educational content which would enliven the unfriendly space and also be informative. On the basis of the expert’s recommendations, the NPM proposed that walls in the corridor be equipped with educational posters, and that the corridor be equipped with chairs, a wheelchair and a mobile table. Direct access to the working premises of nurses was enabled from the corridor and from there into the general practitioner’s consulting room or the dentist’s consulting room, which allowed very little room for the uninterrupted functioning of the infirmary, especially in the nurses’ area, where not even a chair or a wheelchair could be fitted. The general practitioner’s consulting room also lacked space. The dentist’s consulting room served as a store for everything that the nurses and the doctor did not have space for on their premises. One patient bed located on the other side of the corridor was between two rooms. The NPM suggested that the prison, in cooperation with Celje Community Health Centre, study the possibility of rearranging the furniture in the nurses’ section and the dentist’s consulting room so that the functioning of the consulting rooms is completely separated. IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2014 National Preventive Mechanism under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 49