Unsatisfactory level of training for medical personnel for confirmation or upgrade of qualification; Kits for urgent medical assistance lacking medications, medical equipment is not used in accordance with the purpose (the ultrasound machine is not used due to the absence of a qualified specialist). A monitoring visit to Artemivsk remand prison on 16 October 2014 showed that there were 38 patients with infectious tuberculosis at the isolation ward, which created an extremely dangerous epidemiological situation in both the facility and entire city of Artemivsk. In addition, there were 2 persons with insulin dependency form of diabetes who had not received any injections for several weeks. The situation with procurement of medication and medical equipment at the facility was unsatisfactory. The last transfer of procurement funds took place in July 2014. The medical unit lacked medication for hypotension, bleeding, pain, inflammation, and spasms, there were no rubber gloves, drip systems, syringes etc. Territorial medical establishments of the MoH of Ukraine refused to provide medical assistance for the special population in violation of the joint order of the Ministry of Justice and Ministry of Health of Ukraine №239/5/104 dated 10.02.2012 “On the Procedure for cooperation between healthcare institutions of the State Criminal Executive Service of Ukraine with healthcare institutions in provision of medical assistance to detained persons”, which further complicates the critical situation of medical assistance in remand prisons. During visits, there were multiple instances recorded when patients admitted to regular treatment (following preliminary examination) were discharged in 3 days with a diagnosis “almost healthy”, which is confirmed by the relevant records in the journal of patient registration. These instances took place in relation to patients with pneumonia and rheumatism with contagious endocarditis and mitral valve deficiency. The said fact calls for further inspection since during monitoring visits to Shostka correctional colony (#66) and Berdychiv correctional colony (#70) there were complaints by prisoners about infringements of the rights of ill prisoners admitted to general hospital at Temnivka correctional colony (№ 100) through coercion to refuse treatment. Interviewed inmates also stated that early discharge prior to completion of treatment is used as a punishment for violations (for instance, smoking outside of designated areas). During monitoring visit to Mariupol remand prison on 19 November 2014, it was established that there were two prisoners with firearm leg injuries at the medical unit. This constitutes a violation of current legislation as they are in need of specialized medical assistance. In addition, despite requirements of the Cabinet of Ministers decree #205 dated 25 June 2014, there were 24 persons with contagious tuberculosis at the cells of tuberculosis unit. The said persons must receive treatment either in specialized units of tuberculosis treatment hospitals of the State Penitentiary Service of Ukraine, or at tuberculosis treatment facilities of the Ministry of Health of Ukraine. On 9 October 2014, a visit to Starobilsk remand prison showed that only disinfection specialist and pharmacist were present from the entire medical unit staff. According to their professional duties, they do not provide direct medical assistance. Staff of the human resources service failed to clarify to the monitoring group who was 136

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