6. HEALTH-CARE Rule 30: (d) In cases where prisoners are suspected of having A physician or other qualified health-care professionals, whether or not they are required to report to the physician, shall see, talk with and examine every prisoner as soon as possible following his or her admission and thereafter as necessary. Particular attention shall be paid to: contagious diseases, providing for the clinical isolation and adequate treatment of those prisoners during the infectious period; (a) Identifying health-care needs and taking all necessary measures for treatment; (e) Determining the fitness of prisoners to work, to exercise and to participate in other activities, as appropriate. Rule 31: The physician or, where applicable, other qualified health-care professionals shall have daily (b) Identifying any ill‑treatment that arriving prisoners access to all sick prisoners, all prisoners who complain may have been subjected to prior to admission; of physical or mental health issues or injury and any (c) Identifying any signs of psychological or other prisoner to whom their attention is specially directed. stress brought on by the fact of imprisonment, including, All medical examinations shall be undertaken in full but not limited to, the risk of suicide or self‑harm and confidentiality. withdrawal symptoms resulting from the use of drugs, Rule 33: The physician shall report to the prison medication or alcohol; and undertaking all appropriate director whenever he or she considers that a prisoner’s individualized measures or treatment; physical or mental health has been or will be injuriously affected by continued imprisonment or by any condition of imprisonment. 6.1. HEALTH-CARE PROVISION WHY IS IT IMPORTANT? Addressing physical and mental health needs Newly arrived prisoners may have pre-existing, untreated health conditions and/or undiagnosed mental health conditions. Physical and mental health conditions are likely to be exacerbated by imprisonment and should, therefore, be identified as soon as possible after admission so that the prisoner can receive appropriate treatment. If not properly managed, even those who have no health problems on admission may develop health issues during the course of their incarceration that they might not otherwise experience. 03 Prisoners often come from poor and marginalized backgrounds. As such, they may have experienced greater exposure to transmissible diseases, inadequate nutrition and had fewer opportunities to access good quality health-care. Additionally, they may have a history of substance abuse and may have a high level of substance dependency. In prison they may, therefore, suffer from withdrawal symptoms. They may also have neglected their physical health more generally, and some prisoners may have never been treated by a qualified doctor before their incarceration, particularly if they come from remote, rural areas. 04 Diagnosis and treatment of communicable diseases, such as tuberculosis (TB), hepatitis and HIV/AIDS in prison reduces the likelihood of such diseases spreading in the prison and in the wider community because of infection of other prisoners, staff members, visitors, or upon release of a prisoner. 05 The initial medical screening of a prisoner provides an important opportunity to identify prisoners at risk of suicide or self‑harm. It is particularly important to detect these signs at an early stage, as the risk of suicide or self‑harm is much greater than normal during the first days of imprisonment. Additionally, early identification of such risks can help to determine the safe and appropriate allocation and supervision of prisoners that have been placed on suicide/self‑harm alert. Guidance document on the Nelson Mandela Rules 6 02 143