physical work for a month and undergo x-ray examination after seven days. The x-ray examination conducted on 26 August 2016 revealed no pathologies in the pleural cavity. G.Ch. communicated the explanations given by the doctor at the public hospital, according to which a cyst ruptured the lung. The trauma caused the fluid to leak into the lung and it collapsed. According to the doctor, such a grievous trauma could be also caused by the placement in a de-escalation room. It should be noted that upon the return to the penitentiary establishment, G.Ch. again was placed in the de-escalation room. The Office of the Public Defender of Georgia, on 2 November 2016, referred in writing to the Inspectorate General of the Ministry of Corrections of Georgia. According to Letter no. MOC41600999557, dated 7 December 2016, the infrastructure of the de-escalation room of penitentiary establishment no. 6 has been examined. It is noteworthy that the response received from the Inspectorate General does not address those major problems and key breaches that have been identified in the case of G.Ch. and focuses on the problems related to the toilet of the de-escalation room. Apart from the accessibility of medical personnel, the issue of the assisting personnel is also problematic. During the visit of the Special Preventive Group made to establishment no. 18,295 the patients in the long-term care unit complained about the performance of the paramedics employed by the establishment. According to the patients, the male paramedics are on duty only twice a week and in other days there are female paramedics on duty.296 According to the patients in the long-term care units, they prefer to be helped by the same sex paramedics in those procedures that involve stripping. Apart from this, female paramedics cannot help them to get up from the bed and sit down in a wheelchair. According to one of the prisoners, he has been unable to wash for two months. Another prisoner states that he has had to clean himself by wet towel for more than 2 years. He also claimed that he had to keep refusing therapeutic massage as he could not get on the massage table on his own. According to the statistical data posted on the official website of the Ministry of Corrections of Georgia, in 2016, doctors provided consultation on 40,646 occasions. It should be positively mentioned that, compared to 2015, the number of consultations provided is higher.297 However, as the result of the inspection carried out in 2016 regarding the consultations given by doctors to prisoners, it was revealed that regularity and frequency of the visits of the doctors providing consultation was not adequate in a number of establishments. Besides, there are problems concerning specialised doctors’ visits in the beginning of a year before the contracts between the Medical Department and the specialists are finalised. Timely delivery of consultations remained a problem in 2016. In a number of cases, prisoners have to wait for months to get an appointment with a doctor. It should be noted that the appointments for consultations are only entered in the consultation logbooks and there is no such entry in the medical records of a patient. There is a problem re295 17-18 January 2017. 296 According to the Medical Department of the Ministry of Corrections of Georgia, there are 4 paramedics in establishment no. 18. 297 In 2015, doctors gave consultation on 37 445 occasions. 136 HUMAN RIGHTS SITUATION IN CLOSED INSTITUTIONS