To treat the prisoners are civilian doctors, not doctors of the correctional system, according to Russian human rights activists. The subordination of medical workers of the Federal service of punishment execution (FSIN), the Ministry of health will eliminate “mutual responsibility” in which doctors are guided by the interests of the agencies, not the patients, will improve conditions of detention and reduce the number of appeals to the Strasbourg court. These findings are contained in the report “Prison medicine”, which was prepared by the Director of the human rights organization “Area law” Sergey Petrakov. The document is available .
The study was conducted based on the analysis of ECtHR judgments, the statistics of the Federal penitentiary service, reports of the Public monitoring commissions (PMC), materials of criminal cases and appeals from prisoners and their relatives in the “Area law”.
Now in the FSIN 133 hospitals, 56 health correctional institutions for tuberculosis patients and nine medical correctional institutions for drug addicts; in the budget departments a separate line dedicated to the medical care. So, in 2013, to drugs prisoners were allocated 1.98 billion rubles., for the purchase of medical equipment — 394 mln, lead authors of the report data of the Federal penitentiary service.
However, medical care in prisons and colonies is one of the most frequent causes for complaints to the ECHR, the human rights activists claim. According to the Prosecutor General’s office, in 2015 in the places of deprivation of liberty died 3977 accused and convicted persons. Over the past five years, Russia on the decision of the Strasbourg court paid €565,5 thousand as compensation. “This is only the visible part of the iceberg: the authorities understand that on the complaint of the European court decides in their favor, and are offering compensation to the applicant,” — said..
Without the right personnel and Finance
Insufficient funding of medical institutions of the Federal penitentiary service obviously. In 2013, the FSIN has requested more than $ 6 billion roubles on drugs, and 3.8 billion roubles for medical equipment, and got significantly less.
However, the key problem is the lack of specialists, the report said. Due to the low level of prestige is the outflow of qualified personnel, and recent graduates are not ready to take the vacant places. The most scarce specialties — infectious disease specialists, neurologists, oncologists, surgeons, dentists and gynecologists. And this despite the fact that, according to Petryakova, who was a member of the PMC in the Chuvash Republic, the salary of civil an infectious disease doctor and medic in the structures of the FPS about the same — 20 to 22 thousand.
Another serious problem is the lack of cooperation between the territorial bodies of the Federal penitentiary service and civilian medical centers. In conversation with the study’s author noted that all of the data contracts of this kind secret: even when the FPS announces an agreement with hospital in the Leningrad region, it does not specify neither the services nor the name of the institution. But if such contracts are concluded, the administration institutions are not always willing to provide the transportation of the patient, say human rights activists.
The main reasons for the high mortality rate among prisoners, overcrowding, lack of ventilation, being in the same room as smokers and non-smokers, as well as lack of vitamins, notes Petryakov. It can solve a new prison, but this also requires increased funding in the billions. For example, the cost of the prison complex “Crosses-2” on 4 thousand places amounted to 12 billion rubles.
Among the diseases that lead to death of prisoners, in the first place cardiovascular diseases (23.5% of deaths), followed by HIV (19.4 per cent), injury and poisoning (16.2 per cent) and cancer (10.9 per cent). The share of all other diseases have 22.4% of deaths, the report said.
In February 2015, the head of the organization of medico-sanitary provision of the Federal penitentiary service of Russia Sergey Sparrow noted the growing increase in the number of diagnosed cases of HIV infection in prison. The number of HIV positive among prisoners compared with 2013, rose 5.1%. The problem is complicated by the fact that in HIV-infected simultaneously with HIV often find tuberculosis. The presence of two severe diseases called “turbowicz,” reads the study.
Currently the procurement of antiviral drugs for the FSIN provides the Ministry of health. The total amount of the Federal penitentiary service for 2015 on antiviral drugs was 2.3 billion RUB; in fact, the drugs were received from only 1.98 billion RUB, According to the website of public procurement, in 2015, the auctions for the purchase of a number of drugs for the needs of the jailers did not pass.
Another possibility to reduce the number who died from disease in prison — this is an early release of seriously ill prisoners, according to the report. But it is not always possible due to issues of a legal nature, the social Advisor to the Director of the Federal penitentiary service Anna Karetnikova. “Doctors, judges argue that in addition to the severity of the disease must necessarily take into account the gravity of the crime, and their inertia is the same,” says Karetnikau.
She considers the withdrawal of doctors from the control of the FPS half-measure: “it is not clear what to do with medicine in remote areas where the colony is a city — forming enterprise and more doctors around”.
To improve the situation of prisoners, it is necessary to return the rule of law under which the institution of the FSIN could get any staff members of all NGOs which have been spelled out in the Charter monitoring of the colonies, said the Executive Director of the movement “Russia sitting” Olga Romanova.
In a press-service of the Federal penitentiary service was unable to immediately comment on the proposal of the “Zone of law”.