One of the people visible in the hospital corridor draws the attention of others. A woman dressed in black is accompanied on all sides by staff of the Penitentiary Service.
Together with four or five officers and the chief physician of the facility where she is being held, she is a prisoner who has been sent from the Lankaran Penitentiary Complex to a civilian hospital for a few hours of medical examination.
She is forced to move through this corridor, visibly uncomfortable under the curious stares of people living in free society. This is because the Lankaran Penitentiary Complex does not have qualified specialists to operate the equipment required for such examinations.
An X-ray machine has been delivered to the medical unit (the “sanchast”), but it has not been installed. When asked why the equipment has not been set up, the head physician says: “There is no specialist doctor who can operate it anyway.”
The facility also has ultrasound (cardiovascular ultrasound examination) and ECG (electrocardiogram) machines, but there are no qualified staff capable of using them.
Due to this shortage of personnel, prisoners are forced to go to civilian hospitals, accompanied by the intrusive and uncomfortable gazes of others.
For prisoners, the path to medical examination is both arduous and costly. First, they must convince staff, doctors, and the head physician that they are truly in pain and that their condition is worsening. If the illness is not visibly severe, it is difficult to convince anyone that they are suffering.
If they succeed, the documents are sent to the central administration, and a decision is made to send the prisoner to a civilian hospital.
Only then does it become clear that the prisoner must pay a “transport fee.” With no alternative, this “mandatory” payment for medical examination costs them 19 manats.
For prisoners with no income, the money is deducted from funds transferred to their accounts by their families once they are in the institution.
Under Article 10(2.5) of the Penal Enforcement Code, convicted persons have the right to receive medical assistance, including first aid, as well as outpatient or inpatient treatment depending on medical assessment.
However, the shortage of medical staff in the complex effectively deprives prisoners of this right. Not only is access to medical care limited, but in the women’s block there is not even a designated medical room.
When a doctor comes to the block, patients are examined either in the office of the women’s block shift supervisor or in a beauty salon. When an injection needs to be administered, the prisoners’ own cells are used.
On this occasion, however, a prisoner seeking an injection is offered the beauty salon instead. She is told that the shift supervisor, Zamin Aliyev, has instructed that injections should no longer be given in cells but in the salon.
The salon, however, has no place to lie down. Most importantly, its windows face the yard, making the interior clearly visible from outside.
Considering these conditions, the woman refuses to receive the injection in the salon.
However, not all prisoners who are given injections recover. For example, a 65-year-old woman has been complaining of joint pain for months. Her symptoms are being managed with various painkillers.
Without conducting any medical examinations, the doctor diagnosed her condition and prescribed treatment based solely on the patient’s description. Yet the treatment prescribed through this “visual examination” proved to be ineffective.
Having lost faith in the medical staff, the woman has begun seeking her own remedies through traditional methods (“folk remedies”).
Since last September, only once has a medical vehicle equipped with an X-ray machine visited the complex, during which prisoners were examined.
During this period, prisoners have also been taken for testing for HIV, hepatitis, or similar infectious diseases only once.
Although prisoners have the right to receive and access their medical test results, these are not provided to them. When they request the results, they are told: “If there had been anything serious, you would have been informed.”
When pain strikes at night, prisoners have no way to receive medical assistance. In this facility, which holds more than 1,000 inmates, there is no doctor on night duty.
If a prisoner develops high blood pressure or fever during the night, their only hope lies in their own estimation of symptoms and the partial, incomplete medical knowledge of fellow inmates.
Other prisoners assist by assessing changes in condition based on visible signs. After that, they request injections or medication from the guard on duty.
However, since the guard is not provided with a medical kit (“first-aid box”), they must contact the duty assistants of the head of the facility and try to locate medication from other blocks.
In many cases, the necessary drugs are found in the “first-aid kits” of prisoners themselves and are redistributed to those in need.
In effect, prisoners themselves attempt to compensate for the absence of on-duty medical staff and medication supply.
On another day, a prisoner suffering an asthma attack collapses to the ground. Standing over him are four senior officials, including deputy heads and duty assistants of the head of the facility.
There is no doctor among those who respond to the emergency call. The responsible officials explain that they were unable to find a doctor and therefore came themselves.
They ask another prisoner—who knows how to administer injections—to give the collapsed inmate an intravenous injection.
One of the deputies repeatedly advises him: “Take your time, be careful.”
Under the anxious supervision of the officials, the prisoner’s hand trembles as he attempts to find the vein of his fellow inmate.
In the event of a negative outcome, it remains unclear who would bear responsibility—the prisoner administering the injection, the deputies giving instructions, or the leadership of the Medical Main Department of the Ministry of Justice, which has not resolved the staffing shortage.
When complaints about lack of doctors, medicine, and medical equipment are raised, officials of the facility respond: “It is not our responsibility; the Medical Main Department must provide them.”
It is unclear when the Medical Main Department of the Ministry of Justice will address these problems. Until then, prisoners in need of medical assistance will continue to be treated by fellow inmates who know how to administer injections.
