Other problems which were repeatedly found relate to inmates being placed in prolonged solitary confinement to protect themselves or other inmates. This went on for many years in some cases, leading to social isolation. This too can constitute a massive affront to human dignity. The Commission variously suggested in such cases to examine, perhaps consulting external advisors, whether solitary confinement should be maintained or whether its conditions could be improved. It is also not acceptable that metal handcuffs and footcuffs are used in prisons not only for binding, but also for fixation. This entails a considerable risk of injury. Where fixation is indispensable, it may only be carried out using a suitable bandage system and under constant observation (direct supervision by an officer), as is already practiced in the vast majority of cases. 2. Land Police When visiting a police unit of a Land, the Joint Commission came across a security cell containing a stretcher on the ground with iron rings to which persons were fixed using metal cuffs. There was neither a bandage system, nor was there any provision for direct supervision by an officer. The acquisition of a bandage system and the implementation of direct supervision by an officer were ordered on the basis of the recommendation made by the Joint Commission. It should be stressed that the police occasionally do without fixation altogether. 9