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Health Care Problems of Women Prisoners

08.06.2015

Gogi Gakharia, head of Penitentiary department, Tamta Demurishvili, head of medical department.
 Natia Gogolashvili

Electronic queue of prisoners’ routine operations, medical examinations, post-surgical treatment, providing non-effective medications, nonexistence of pharmacies in correctional facilities – this is a short list of those problems that N5 women correctional facility prisoners talk about. 

“Women prisoners complain about the fact that the referral base of Ministry of Corrections and Legal Assistance is common for female and male prisoners. They think that there should be a separate base for women prisoners. At this moment, 288 women and up to 10 000 men prisoners are serving their sentences in Georgia. Women prisoners often require treatment according to their special needs. However, as long as there is no separate referral base for women prisoners, they have to wait for months in line of the medical referrals common base to get treatment. This is severely affected on their health. Accordingly, the special needs of women prisoners are ignored by this program,”- says the lawyer of Human Rights Centre Tamar Lukava. 

According to the head of medical department Tamta Demurishvili, selection of prisoners is not done according to their sex, because the electronic queue places women and men prisoners in equal conditions: “Electronic queue is one. There is no separate for women and men, because the main point is the health condition of patients. Prisoners have right to pay for their surgery, but this does not mean that they are preferred in the line. This would be a material discrimination of those prisoners who cannot afford the surgery. Also, according to the article 14 of Patient Rights, selection of potential patient is based on medical criteria, without taking into account other factors.”

According to Tamta Demurishvili, the referral process is as follows: the doctor of facility addresses the medical department, and then the medical department reviews the solicitation within the reasonable time. If the solicitation is upheld, a serial number is assigned to a prisoner, which is defined according to territorial principle, ambulatory and inpatient services. It is worth to mention, that during the planned referral, a prisoner is selected in accordance with the queue. 

In the case of emergencies, an immediate hospitalization of prisoners is provided. Also, the west and east parts of Georgia have separate electronic queue and are regulated independently. 

Public Defender points out in 2014 Parliamentary report, that it is necessary to improve the electronic base of medical referrals, in order to provide medical service for prisoners in short period of time. 

“Medical department defines the queuing according to territorial principle, ambulatory and inpatient services. It is unfortunate that Public Defender’s recommendation on future improvement of medical referral base, to avoid the delay of medical services, was not taken into account. It was proposed to differentiate the electronic queue according to acute and chronic nature of decease, dynamics of decease, health condition of patients, impact of decease and other factors. Accordingly, we think that it is necessary to improve the electronic base of medical referrals, because individual needs of patients are not taken into account when defining their serial number. The queue is dependent not on clinical factors, but on quantity of patients waiting for the service and permeability of medical facilities,” -written in Public Defender’s report. 

According to the information received from the medical department, at this stage, in 2015, 39 prisoners (11- urgent; 20-outpatients; 8- stationary), were transferred to the medical facility N18; 91 prisoners were transferred to public hospitals (18- urgent; 61-outpatients; 18- stationary). 

Majority of women prisoners, interviewed by us, complain about medical services. In particular, they outline that there are delays in receiving medical services. In addition, they do not receive brand name drugs and complain about the quality of generic drugs,” – says the co-director of Human Rights Centre, Nino Tsagareishvili. 

“After surgery, if necessary, the patient stays in a public clinic for 2-4 days, in the case of exception even for 1.5-5 days. According to the condition of a prisoner, in the case of necessity, the prisoner is transferred from the public clinic to the N18 medical department for prisoners and the accused. In addition, in prison N5 there is a medical unit, where patients can receive postsurgical and medication treatment,”- says Tamta Demurishvili.

According to the women prisoners, the problem is to provide postsurgical treatment with quality drugs. The head of the medical department says that the Government is responsible for the quality of drugs: “the patients in the correctional facilities receive medicaments based on doctors’ prescription, within the basic list of penitentiary health care. All medicaments, which are provided to patients, have their state registration number, which means that the state is responsible for the quality of medicaments and it is beyond the competence of the medical department.”

According to the report of Public Defender, replacement of the prescribed drugs remains problematic. 

“By establishing the basic list of medicaments for penitentiary health care, the Ministry of Correction and Legal Assistance defined the list of those medicaments which it takes obligation at its own expense. Also, according to the order of Minister of Correction and Legal Assistance on May 30 2011, exceptional cases have been established. Under this exception, a prisoner can receive a medication that is not included in the basic list. The monitoring revealed that the medical personnel of prisons prescribe the patients those generic drugs that are available on the expense of the Government. Because of this fact, prisoners’ right to buy brand name drugs at their own expenses is restricted,”- written in the 2014 report of the Public Defender. 

“10 000 Lari are allocated monthly for medication. If the doctor states that the generic does not give results, then we buy the brand name drugs. Patients also have rights to buy medication at their own expense. Amendment 3 of order N31 of Minister of Correction and Legal Assistance is about the list of basic medicaments for the penitentiary health care system. If necessary, we buy medicaments that are not included in the basic list, but if substitution for prescribed drug is included in the list and has the same indication, the latter is provided,” –says Tamta Demurishvili. 

In N5 correctional facility, the prisoners cannot buy the medicaments at their own expense because of non-existence of the pharmacy. According to the Head of the medical department, the private companies decided to leave correctional facilities. 
“There was “Aversi” drugstore in the N5 prison 1 year ago, but it stopped functioning because the prisoners were not using it. The prisoners have no need to buy medicaments in the pharmacies of the prison. This is why there is less interest from private companies,” – says Tamta Demurisvhili.

According to the head of medical department, a very important change is planned in the penitentiary system: as long as this year is announced as a year of disabled people, all correctional facilities will be adapted for the disabled persons. According to Tamta Demurishvili, each correctional facility will provide one adapted cell for disabled persons. 

This article was published within the frameworks of the project Monitoring State of Women and Juvenile Prisoners in Georgia which is implemented by Human Rights Center in partnership with Office of Public Defender of Georgia, by the financial support of Embassy of Bulgaria.
The article does not necessarily reflect the views of the donor. Human Rights Center bears sole responsibility for the content of the report.

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