A/HRC/43/49/Add.1 cumulative effect of these shortcomings is clearly incompatible with human dignity and amounts to cruel, inhuman and degrading treatment or punishment. (ii) Gendarmerie station in Anjouan 85. At the gendarmerie station in Anjouan, the Special Rapporteur was able to make only a partial assessment of the conditions, as he had to suspend his visit after confidential interviews were interrupted. The Special Rapporteur had received information that, just before his visit, up to nine detainees had been held in the same cell; however, at the time of his visit, there were four detainees in a cell of 15 m2, with no artificial light and only minimal natural light from a small opening above a brick wall. The authorities shoved food – provided by the family, not the gendarmerie – through a hole. There was no running water or sanitary installations. Detainees remained in the cell 24 hour per day, seven days per week with no exercise or fresh air. Only once a day in the early morning were they allowed to go to the toilet, wash and fill a plastic bottle with water. During the rest of the day detainees had to urinate in plastic bottles and defecate in plastic bags. There was no bedding; inmates slept on concrete benches to avoid the wet floor. No family visits were permitted. 86. In the view of the Special Rapporteur, the conditions of detention at this gendarmerie station clearly amount to cruel, inhuman or degrading treatment. Moreover, the practice of keeping inmates in cells located in gendarmerie or police stations beyond 48 hours, even if held under the authority of the pretrial judge, contravenes national law as these cells are not designed for long-term custody. (iii) Solitary confinement 87. In Moroni Prison, there were six cells for solitary confinement, each measuring approximately 1.5 m2, which is in clear violation of the Nelson Mandela Rules and even the Guidelines and Measures for the Prohibition and Prevention of Torture, Cruel, Inhuman or Degrading Treatment or Punishment in Africa (Robben Island Guidelines). In these cells, there was no artificial and virtually no natural light, no bedding, very limited ventilation, and, according to the director of the prison, inmates were held there for disciplinary reasons from between 24 hours and 10 days. However, during his visit, the Special Rapporteur spoke to two political detainees (suspected of an attempted coup d’état) who had reportedly been held for up to 55 days in prolonged solitary confinement in two of these cells, 24 hours a day, with only one toilet/hygiene outing of 15 minutes per day. The Special Rapporteur also heard several other allegations of solitary confinement for up to eight days in gendarmerie cells measuring 1 m2 or less (approximately 0.8 by 1.2 m). It must be emphasized that, in the view of the Special Rapporteur, the practice of solitary confinement for disciplinary or punitive purposes under the observed, grossly inadequate conditions amounts not only to cruel, inhuman or degrading treatment or punishment, but also to torture. 3. Lack of access to medical care 88. The Special Rapporteur met with officials from the Ministry of Health who openly acknowledged the lack of adequate health care in detention. The Special Rapporteur notes with serious concern that there are no routine medical examinations upon arrest or for new arrivals in the prison system. Health professionals have no specific training in illnesses or diseases that are common in prison populations. There are no regular medical check-ups of detainees, and no regular screening programmes are implemented (for AIDS, tuberculosis, hepatitis and so forth). 89. A doctor (a general practitioner) from the national health system reportedly visits detention facilities once a week, but there are no specific and registered procedures for accessing medical care. The Special Rapporteur was informed that a doctor examined a detainee only if requested, and many requests remained pending indefinitely. Reportedly, a detainee can be treated by a private doctor, but this could not be confirmed. No special screening or treatment programmes, such as breast cancer screening or vaccinations, are implemented for particular categories of detainees, such as women and children. 90. Medical rooms in the detention facilities are absolutely insufficient with no adequate equipment or even minimum basic medication and sanitary conditions. There is no budget 11