CAT/OP/GAB/1 strictly separate from adults, in conformity with the Standard Minimum Rules for the Treatment of Prisoners. (vi) Children 85. The Subcommittee expresses its concern at the current punitive approach taken towards juvenile offenders, reflected in their frequent detention for minor offences. The Subcommittee is also concerned that there is no emphasis on the educational dimension of the system for minors. In practice, there are few or no educational activities or psychosocial support to help children or adoles cents reintegrate into society. 86. The Subcommittee recommends that children and adolescents only be deprived of their liberty as a measure of last resort, for the shortest possible period of time, 10 and that their imprisonment be reviewed on a regular basis. The Subcommittee recommends that the authorities provide psychological intervention and build up the school and vocational training offered to children and adolescents in detention to prepare them for reintegration in their communities and society. 11 (vi) Access to health care 87. The Subcommittee visited the hospitals of the prisons in Libreville, Port -Gentil and Lambaréné and noted the devotion of the prison medical staff, despite the extremely difficult conditions in which they work. The Subcommittee regrets that no structured organization exists to meet health-care needs in the country’s prisons. Health care depends on the initiative of the prison director and relies on the goodwill of staff and financial support from the families of detainees. 88. The infirmaries are poorly equipped and lack qualified staff. The only medical conditions actually treated in the prison system are malaria and tuberculosis, although treatment of the latter is often unsatisfactory (see below). Other medical care, including inpatient care, is at the expense of the families of detainees. The only medications given out freely are quinine and paracetamol, which are unsuitable for treating the most widespread needs (skin problems, infections, parasites, gastroenterological problems and neurological problems linked to vitamin deficiencies). Lambaréné prison is, however, an exception, due to the personal initiatives taken by the Director. In view of the prison population and the absence of regular care, the number of temporary transfers for medical treatment is rather low. Some prisons, furthermore, do not have any means of transportation to take the prisoners to the hospital so that visitors are asked for a “contribution” to a fund used to provide services such as taxis for inmates. 89. The Subcommittee is alarmed by the high prevalence of certain diseases, including tuberculosis, in the prison environment. In 2012, for example, over 18 per cent of the prison population of Libreville Central Prison had tuberculosis. The efforts of the nursing staff come up against barriers related to prison conditions, including the lack of isolation wards for the sick, the lack of privacy, lack of ventilation and limited access to appropriate medical care. The Subcommittee is concerned by the emergence of resistant strains, which are becoming increasingly difficult to treat. 90. The Subcommittee observed that the medical equipment was out -dated and there were inadequate numbers of staff, who were poorly qualified, underpaid and __________________ 10 11 GE. 15-10283 In accordance with the United Nations Standard Minimum Rules for the Administration of Juvenile Justice (Beijing Rules), adopted by the United Nations General Assembly in resolution 40/33 of 29 November 1985. United Nations Rules for the Protection of Juveniles Deprived of their Liberty, rules 38 and 39. 17/24