A report by the International Observatory of Prisons published on Wednesday points to the lack of budget, personnel, equipment or suitable premises.
Endless delays, hospital appointments canceled for lack of an escort, handcuffed examinations under the eyes of a supervisor… In a report published on Wednesday July 6, the International Observatory of Prisons (OIP) denounces the very complicated access to care specialized for prisoners.
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First observation of this “dark” assessment, the delays in obtaining appointments: several months – if ever – for the specialties most in demand (dental care, physiotherapy, cardiology, ophthalmology), notes the report, which is only interested in physical care ( and not psychiatric). For care in detention – in the health units of prisons – it is the lack of staff, equipment or suitable premises and budget that are in question. Quoted by the OIP, caregivers describe the “D-systems” put in place: “self-rehabilitation” with random results prescribed for lack of a physiotherapist, the pain treated “with large prescriptions of morphine” despite the risk of addiction, dental procedures “by default” by practitioners sometimes reduced to simple “tooth pullers”.
Getting out of jail ‘to die’
Prior to the publication of the OIP report, Nora, whose brother has been imprisoned since 2015, described to the press the deterioration of his condition due to a lack of appropriate care. Very soberly, she listed her continuous pain for lack of suitable rehabilitation, her serious skin disease, her anxiety-depressive syndrome which makes her detention in an establishment classic. “very exhausting”. Delphine testified to the sometimes dramatic consequences of delays in treatment. His companion was entitled to the battery of tests necessary for the “size” detected on his body four months late, while his condition deteriorated visibly. He only got the right to get out of prison “to die” of this cancer, she related, moved and angry.
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Caregivers also experience “interference” of the prison environment, points out the report, in particular many “refusal” prescriptions (showers “medical”, special diets, medical beds – they do not pass the cell doors – crutches, prostheses…) For lack of personnel and equipment or for surgical operations, prisoners are released from prison for certain treatments (between 30,000 and 50,000 medical extractions for 2020, according to the authorities). These outings are very often canceled at the last minute, often for lack of an available escort, denounces the OIP. To the point that the doctor is sometimes forced to “Choose” between an emergency and an MRI “planned for months”, described to the press the head doctor of the Fresnes prison hospital, Anne Dulioust. On rare occasions, she noted, “by moaning a lot, we have both”.
Often also, recognizes the OIP, it is the detainee himself who cancels his medical appointment. Sometimes because of work or a visiting room (for security reasons, prisoners are generally not informed in advance of their extraction), often also by “fear of unworthy extraction conditions”of“humiliations” and some “violation of medical secrecy”assures the association.
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In theory, the prison administration defines four levels of “methods” escort, depending on the dangerousness of the detainee. But in practice, insists the OIP, “in the vast majority of cases, handcuffs and shackles are generalized”even maintained during medical consultations. “I had the handcuffs on my hands and the tie at the waist, on a leash like a dog”an inmate testified in the report. “I did my colonoscopy tied to the bed, with the escort present in the room”, wrote another. In the majority of cases and in violation of medical secrecy, the supervisor(s) remain in the room, sometimes even during surgical operations. These practices earned France a condemnation from the European Court of Human Rights (ECHR) in 2011.
Finally, the OIP regrets that medical leave, which would constitute a good alternative and would cost “cheaper”, are still granted too little. As for the suspension of sentence for medical reasons, notes the report, it is “above all requested in the context of the end of life, with the aim of allowing detainees to die in dignified conditions”.