Ankara Medical Chamber (Ankara Tabip Odası –ATO) and Human Rights Association’s (İHD) Ankara Branch have issued a report on the violations of the right to health in prisons. ATO Secretary General Dr. Ali Karakoç and ATO Human Rights Committee Member Dr. Nihat Bulut attended the press conference on behalf of ATO that was held on September 12, 2018 at İHD’s Ankara Branch.
İHD Central Executive Committee Member Nuray Çevirmen, who read the joint statement on behalf of İHD Ankara, stated that the report was prepared through an examination of the letters alleging violations of the right to health sent by sick inmates in Central Anatolia Region prisons alongside with applications lodged by prisoners’ families and lawyers to İHD’s Ankara Branch.
Ms. Çevirmen indicated that one of the most significant causes of violations of patients’ rights proved to be the obstacles before sick prisoners’ access to treatment, adding: “One of the main reasons for this situation is the high number of inmates and convicts incarcerated in prisons.”
Ms. Çevirmen noted that there were 1,154 sick inmates, more than 400 being critically sick, that could be ascertained in overall Turkey and invited the Ministry of Health and the Grand National Assembly of Turkey’s Human Rights Investigation Commission to investigate sick inmates’ conditions and to offer solutions alongside with implementing reformatory regulations.
ATO Secretary General Dr. Ali Karakoç speaking after the press conference underlined that the conditions of sick inmates have been deteriorating and indicated that the fact that Koçer Özdal, who lost his life at Ankara Numune Hospital, was kept in handcuffs until the very moment he died was unacceptable. Dr. Karakoç said that ATO Human Rights Committee had been receiving applications regarding gross rights violations during access to and receipt of healthcare services and problems in treatment and asked for an immediate improvement in the conditions of sick inmates.
This report was prepared through an examination of the letters alleging violations of the right to health sent by sick prisoners in Central Anatolia Region prisons alongside with applications lodged by prisoners’ families and lawyers to İHD’s Ankara Branch. The report was supported by the medical reports and analyses results of some patients collected during the preparatory stage. Within the scope of the report the documents of 128 sick inmates whom İHD could determine from Afyon Dinar T-Type Closed Penitentiary Institution, Bolu F-Type Closed Penitentiary Institution, Eskişehir H-Type Closed Penitentiary Institution, Kayseri-Bünyan T-Type Closed Penitentiary Institution No. 2, Sincan Women’s Closed Penitentiary Institution, Kırıkkale F-Type Closed Penitentiary Institution, and Tokat T-Type Closed Penitentiary Institution were evaluated. Some of the sick inmates, who had been incarcerated in Central Anatolia Region prisons and had contacted us before, were excluded from the study as their data could not be collected.
One of the most significant causes of violations of patients’ rights in prisons proves to be the obstacles before sick inmates’ access to treatment.
It is known that being incarcerated by definition causes anguish and pain for any individual. An individual’s being deprived of his/her liberty to decide for himself/herself forms the basis of this pain. Yet prisons and the correctional system should not aggravate this anguish and pain inherent in the nature of incarceration itself and should not instrumentalize them as a tool of punishment. International standards, conventions, and protocols require that patients’ rights should be allowed to be exercised by individuals who are deprived of their liberty with no difference between them and the other sections of the society. Within this context, the CoE’s European Prison Rules, Appendix to Recommendation Rec(2006)2, Part I states: “All persons deprived of their liberty shall be treated with respect for their human rights.”
In Turkey, Article 6 § f of the Law on the Execution of Sentences and Security Measures (Law No. 5275) enshrines the right to life and health with the statement: “It is imperative that all preventive measures shall be taken to protect convicts’ right to life and their bodily and mental integrity in penitentiary institutions.”
One of the most basic reasons for the problems experienced in having access to the right to health in prisons is the high number of inmates and convicts incarcerated in prisons. According to the fact sheet communicated to the Grand National Assembly of Turkey’s Petitions Commission by the Ministry of Justice, 246,426 inmates and convicts are incarcerated in 449 prisons with a capacity of 211,274 persons. According to this latest figure, there are 35,152 inmates in prisons exceeding their total capacity. According to the 2017 activity report of the Ministry of Justice, the bidding process for 53 new prisons has been finalized and the construction of 27 prisons was completed in 2017. The high ratio of incarcerated persons to the overall population of the country renders Turkey one of the highest contenders in the world with regards to the issue. In our country, where there is such a high number of inmates and convicts, the violations of the right to health increase accordingly.
It is observed that rather significant problems are seen in incarcerated patients’ access to the right to health. These are notably:
- Physical examination and treatment in handcuffs,
- Transportation by police wagons with single-person sections,
- Prolonged and belated referrals,
- Failure to extend health reports to patients in spite of such requests,
- Handing reports stating “eligible to stay in prison” to critically sick inmates who are not able to stay in prisons or the failure to improve prison conditions,
- Subjection of inmates to discriminatory and hate speech during their tests and treatments,
- Failure to refer patients to hospitals and belated follow-ups on the grounds that external security problems could not be resolved,
- Belated transfer of health files of inmates who are transferred to other prisons, belated supply of medicine in the new prison that the inmate was transferred to, the absence of a physician specializing in the related medical field who would be able to follow-up the patient in the prison that the inmate was transferred to or in the city/province hospitals that the prison is located in,
- Food with poor nutritional value, non-supply of dietary food, failure to make sufficient use of day light, problems in access to clean water, failure to heat up the prison in line with the climatic conditions of the city that the prison is located in, failure to supply the inmates with adequate sanitizers, making inmates share cleansing material that should have been handed to each inmate for his/her personal hygiene, restrictions in access to warm water which creates challenges against the treatment of diseases and expedites the spread of contagious diseases.
The recent mortality rates in prisons reveal the necessity that the problem of sick inmates should be resolved without delay. Sick inmates lose their lives either in prisons or outside shortly after they are released upon their conditions become critical. In 2017 and 2018, 25 sick inmates have lost their lives because of various diseases, 10 of which were heart attacks, as was learnt from patients’ relatives who got in touch with IHD. Whether the first responder healthcare staff who would provide first aid to the patients who lost their lives due to heart attack were on a 24-hour call or not and within which time period emergency ambulance services and hospital services were provided following first response to these patients should be reviewed. It should also be remembered that the better emergency healthcare services are the less will be the risk of losing a patient.
This study conducted with limited resources in prisons of the Central Anatolia Region is only able to demonstrate the tip of the iceberg. The necessity to carry out a comprehensive and scholarly study to expose the challenges in access to the right to health and to offer solutions is inevitable. Individuals deprived of their liberties are among the vulnerable groups in the society. Those who are both deprived of their liberty and who have chronic diseases, have limb loss, women, juvenile delinquents, children who are kept in prisons with their mothers will without doubt be affected by poor health conditions more than anyone else. There are 1,154 sick inmates, more than 400 being critically sick, that could be determined in overall Turkey. In spite of the fact that this figure is indeed known to be much higher, the Ministry of Justice does not provide a clear-cut figure on the issue.
Given this grave situation that we have presented, we call on the Ministry of Justice, the Ministry of Health, and the Grand National Assembly of Turkey’s Human Rights Investigation Commission to take immediate initiatives to investigate the conditions of sick inmates, to come up with solutions, and to implement reformative regulations. When the universal human rights values are taken into consideration, the right life and the right to have the most appropriate access to healthcare services cannot be disregarded. Sick inmates, who are known to be deprived of their right to decide and act for themselves, should immediately be treated and appropriate treatment conditions should be created. Moreover, the execution of the sentences of critically sick patients who cannot be incarcerated in prisons should immediately be suspended.
Click here to read the full report in Turkish.
Ankara Medical Chamber & Human Rights Association, Ankara Branch