Report on the visit to the Dej Penitentiary Hospital

1. On April 5, 2001, the representatives of APADOR-CH visited the Dej penitentiary hospital.

The building of the hospital was built between 1893-95. Until 1997, the building was a detention unit of the Gherla penitentiary. Following major refurbishment works this unit was transformed in a hospital that can compare with the civilian hospital, maybe even cleaner.

The hospital has triage, internal diseases, ophthalmology, otorhinolaryngology, intensive care and surgery units. Although most of the detainees committed here come from the penitentiaries in Transylvania, the ophthalmology and otorhinolaryngology units receive detainees from all over the country. The hospital needs more space and the Dej Court – operating in the same building – is willing to give away 6 rooms. The discussions, which were in an advanced stage, were however halted. It is not known who had this initiative (the leadership of the Justice Ministry or the General Directorate of Penitentiaries). APADOR-CH requests the General Directorate of Penitentiaries to make all efforts to take over those 6 rooms, absolutely necessary for the well functioning of the hospital.

The accommodation of the sick detainees follows the rules of the Health Ministry network, that is, by types of affections, rather than the legal status (police custody, convicts, repeated offenders). The only penitentiary norm applied also here is the separation of minors from adults.

Due to the fact that the Dej hospital does not have farming land or a farm, the supply is provided either from other penitentiaries (the main meat supplier is the Pelendava penitentiary) or from the market, based on a selection of supplies.

Since the number of medical specialities in the hospital is rather low, the cases when the sick detainees need to be transported to Cluj for consultations (about 60 km from Dej), especially for cardiology, are quite common. According to the doctors, around 50% of the detainees committed here have cardiovascular problems. The ECO Doppler equipment and employing a cardiologist would be extremely beneficial for the sick detainees and would make the work of both the medical and the guarding staff easier. The ECO Doppler equipment is indeed very expensive (between USD 10 and 100 million, depending on performance) yet each trip to Cluj costs around ROL 500,000 and they make around 200 such trips a year (spending around ROL 100 million each year), without taking into account the death risk and the liability of the medical staff, as well as the efforts of the two or three non-commissioned officers escorting the sick detainees only when off duty.

The hospital also needs an "Elisa" line for tracking HIV, hepatitis B and C, tumours etc. The cost is much lower than the ECO Doppler equipment (around ROL 100 million).

One of the priorities of the Dej hospital is an ambulance with all the necessary equipment for emergency interventions. Currently the hospital has only one Dacia ambulance without the adequate equipment. APADOR-CH requests the General Directorate of Penitentiaries to provide the financial support for the procurement of a functional ambulance.

APADOR-CH also requests the General Directorate of Penitentiaries to urgently solve the problem of employing the second surgeon, without whom the surgery unit – well equipped – cannot function. Only simple operations can be currently performed in the hospital, such as cysts or lipomas, while the modern and high performance equipment cannot be used.

The representatives of the association were informed that the General Directorate of Penitentiaries intends to issue separate rules of internal order for the hospitals within its network. This is a most welcomed initiative since it is normal that the sick detainees to benefit from a more permissive regime than the healthy ones. APADOR-CH suggests that the maximum punishment for infringing these rules to be the admonishment and to give up the denial of the right to receive parcels. The association considers that it is neither logical nor humane for the sick detainees to have to wake up at 5:00 a.m., only because this is the penitentiary rule. The association suggests to the General Directorate of Penitentiaries that the futures rules for the hospital within its own network to be also applied to the medical cabinets and infirmaries from the penitentiaries.

3. The detention conditions

3.1. Headcount

The Dej hospital has a designed capacity of 210 detainees, out of which 26 are reserved for the healthy detainees providing services for the penitentiary. As of the day of the visit of the APADOR-CH representatives, there were 182 sick detainees in the hospital, that is, very close to the full capacity of 184. Out of the 182 detainees, 8 were in police custody, 9 were convicted in the first instance, 164 had final convictions and one was a petty offender. The Dej hospital does not accept women and no minor detainee was committed in the hospital at that day.

The medical staff is made up of 10 physicians, one pharmacist, two biochemists and 31 nurses. For covering all the staff needs, two more doctors should be employed (out of whom, one should be a surgeon) and 10 nurses.

The guard unit has only 46 officers and non-commissioned officers. This number is insufficient for the required tasks, out of which the escort is the most difficult. It should been mentioned that one of the evaluation criteria of the work in the penitentiary hospital is the "hospitalisation index" (the number of entries and exists of detainees), which makes that medical staff to shorten as much as possible the hospitalisation period. This results in a relatively high number of transfers from and to other penitentiaries. The guards escort the transferred detainees only when they are off duty (the work programme is as follows: 12 hours work followed by 24 hours off). According to the estimate of the hospital management, 16 more officers and non-commissioned officers would be necessary for this unit.

It is remarkable that the sick detainees committed in this hospital are not handcuffed either during hospitalisation or during the transfer to other penitentiaries or to Cluj for medical consultations, unless in exceptional cases. In the year 2000, there was a detainee who became extremely agitated. For immobilising him, they used medical straps rather than handcuffs, and only for a few hours, for calming him down. It should also be mentioned the fact that the hospital does not have isolation rooms and the intervention units (made up of three persons) has never been used. The representatives of APADOR-CH insisted that the hospital should give up to the punishment of denying the right to receive parcels, at least until the moment when the national economic situation will improve and the state will be able to provide the food for detainees (see also the recommendation of the UN Special Reporteur against Torture, who visited Romanian penitentiaries in 1999).

3.2. The hospital

All the medical wards are very clean, syringes, gloves and other single use materials are used. The contaminated materials are kept in chloramine and once every three days are taken to the incinerator in Gherla (the hospital has not received the ecological approval to build its own incinerator).

The biochemistry laboratory performs analyses (sugar content, urea, coagulograms, electrophoresis etc.) exclusively for detainees. It is forbidden to perform analyses for the staff.

The hospital is well supplied with medicines and has a good collaboration with the warehouse in Cluj, who is also ensuring the transport. All medicines are kept in cabinets and are distributed to the sick detainees on a daily basis.

As it was mentioned before, the surgery unit – well endowed with high performance equipment – cannot be used yet since it lacks the second surgeon to team up with the one already employed.

At the ground floor, in rooms with two beds, there were 26 healthy detainees, who were transferred in Dej for work.

At the first floor there is the medical unit – detainees with chronic diseases (69 beds, two specialised physicians and five nurses) and the ophthalmology unit (25 beds, one specialised physician and three nurses).

Special cases:

• in room 20:

• detainee Petre Serban, 59, has a 4 year sentence and suffers from ischemic cardiopathy and spondylosis, with low recovery chances;
• detainee Sorin Pompiliu Voinea, 42, convicted to 12 years in prison for misappropriation of funds, has a diabetes, early foot arteritis and – most serious – severe form of blood pressure (up to 250/140), which the doctors say they cannot control;
• detainee Alexandru Sabau, 69, with no final conviction, yet arrested for one year and three months, suffers from hypertension, cervical spondylosis , extrasystoles and severe depression;
• detainee Stefan Ghenea was brought here from the Poarta Alba penitentiaries. He wishes that, after checking out, to be transferred to the Galati penitentiary since his two minor daughters live there, while his wife is dead;
• in room 15: detainee Viorel Balota refuses to eat for three months now (since January 4, 2001). He was arrested for rape in November 2000 and taken to the lockup of the Bihor County Police Inspectorate. Balota asserts that he is innocent and that his life was a nightmare in the police lockup, where the police officers agitating the other detainees against him. They were beating him, did not let him sleep and verbally abused him. He complained to the leadership of the County Police Inspectorate about the treatment he had been subject to, yet no measures were taken. Although at the beginning of this year, he complained to the Military Prosecutor’s Office, until the date of the visit made by the representatives of the association, no reply has been received. The refusal to eat as a last resort. Although Viorel Balota continues to refuse the food, when he was brought to the Dej hospital he accepted the perfusions. The detainee weighted 100 kilos when he was arrested. He has now less than 60 kilos and his condition is very serious. The doctors say that even if he started to feed again, some effects remain irreversible.

At the second floor there is the surgery unit (45 beds, one specialised physician and three nurses), operations room and the intensive care unit (16 beds, one specialised physician and five nurses).

Special cases:

• la camera 43:
• detainee Dumitru Racila, 56, has a 15 year conviction, out of which he has served 4 years. The left side of his body is paralysed, most likely following a stroke. Between October 2000 – January 2001 he benefited from a sentence interruption. According to the doctors’ opinion, he stands no recovery chance;
• detainee Vasile Gurzau, 55, convicted to 4 years for conning, is in the same situation as Racila, only that he can use – with great difficulty – his left foot. Both detainees need permanent care;
• detainee Teofil Tudor, 56, convicted to 18 years, out of which he has served 8 and half years. He suffers from cardiac insufficiency (stage III/IV). He requested to be transferred to the Colibasi penitentiary since his entire family lives in Dragasani, Valcea. APADOR-CH requests the General Directorate of Penitentiaries to approve this transfer – with which the doctors from Dej would agree – or at least a temporary transfer to allow him to see his family;
• detainee George Tocanel, 61, convicted to 15 years, out of which he has served 10 years. He suffers from ischemic cardiopathy, cardiac arrhythmia with extrasystoles, high blood pressure;

• in room 35:

• detainee Vasile Serban, 75, convicted to 3 years and 4 months for manslaughter. He was transferred from the Oradea penitentiary with a suspicion of obliterating chronic arteriopathy, nausea, shaking and numbing legs;
• Liviu Lupsa, 62, is a petty offender. The Cluj court turned an unpaid fine of ROL 800,000 to 80 days in prison, although he requested to perform community work. He has an anginal hernia and his left foot is amputated from the knee following an accident that happened in 1970.

The visited rooms were clean and the bed covers were in a rather good condition. The disinfection is made on a quarterly basis or whenever is necessary. There is no overcrowding, yet even if there are relatively few detainees in each room (maximum 16), the lavatory (one water closet and one sink) is not sufficient, the more that the lavatory from the first floor was in a very bad condition: only four showers were functioning and the ceiling and walls peeled off, with bits of plaster fallen. The hospital management said that this was due to the infiltration from the second floor lavatory and that repairs that had been made were faulty, yet since the one-year guarantee period is not over, they will force that company to do the works all over again.

The hospital provides the detainees with pyjamas, soap, toothpaste, detergent and even towels (from a donation).

The detainees can watch TV practically all day long. However, unfortunately, many rooms did not have a din TV set; the hospital only has 10 TV sets, out of which only 7 were working. The representatives of APADOR-CH were impressed by the fact that the TV sets were donated by the staff. The association requests the General Directorate of Penitentiaries to consider the possibility to increase the number of TV sets, since watching TV and one hour of exercise a day are pretty much the only available activities for the sick detainees.

3.3. The food ward

The food is prepared for three categories of sick detainees: no diet, diet for various diseases and separately, the diabetics, who receive a food supplement – eggs and cheese – between meals. The 26 detainees used for work also benefit from food supplement. The menu in the day of the visit included the following:

• breakfast: no diet – tea, marmalade and lard; regime – tea, marmalade, margarine and cheese; diabetics – tea, margarine, cheese, milk, cream;
• lunch: no diet – noodle soup and bean ragout with meat; regime – rice soup and pasta with meat; diabetics – potato soup and green beans with meat;
• dinner: no diet – vegetable hotchpotch; regime and diabetics – same plus milk.

On the day of the visit, 16.193 kilos of meat and 1.6 kilos of lard were taken from the warehouse.

If the regime food and the food for diabetics had meat, the no diet meal had more lard. The representatives of APADOR-CH have constantly emphasised the fact that in most of the visited penitentiaries, the so-called "ham" (a lot of lard with a bit of meat) is presented as "meat", which is obviously not the case.

With this exception, the meals cooked in the Dej hospital looked better than in many other penitentiaries visited by the representatives of the association. In fact, no sick detainee complained about the food quality.

3.4. Socio-educational service

Due to the fact that most of the sick detainees spend little time in the hospital the activities of this unit consisting from two officers (one having a social assistant training) and a civilian technical employee are extremely limited. As mentioned before, the main entertainment for the sick detainees is the television. In the rooms where there are no TV sets, they have nothing else to do than listen to the radio programmes from loudspeakers (between 5:00 a.m. and 10.00 p.m.).

The library has very few books (around 200 titles) and 10 newspaper subscriptions (out of which 5 to "Adevarul de Cluj").

The service has no programmes unfolding and it would not have the necessary space since there is no club. The few activities (meetings with a part-time orthodox priest and, once a week, with the representatives of the "Stanca veacurilor" association) take places in the corridors.

3.5. The visit ward and correspondence

Although there are only four seats in the visit room, the hospital leadership considers this is enough, since over a half of the sick detainees have no visits. Due to the very scarcity of visits, the scheduling in alphabetical order is not necessary.

The correspondence and parcels are picked up and delivered daily (from Monday to Friday).

Although the detainees with a phone card can make calls two or three times a month, the phone calls are limited to 5 minutes and the supervisors listen to everything they say. Since they receive no visits – many of them because their families cannot afford to travel to Dej – the telephone remains the only direct communication means. The representatives of APADOR-CH requested the hospital management to give to the limitation of phone calls. Moreover, the association re-emphasises that the "secrecy of correspondence" – guaranteed by the Constitution – also covers the telephone conversations. Therefore, the supervisors accompanying the detainees to the telephone should keep the distance during the conversation, so that they see what the detainee is doing but not to hear what he says.

The same as in other visited penitentiaries, the detainees may lend their phone cards to one another only with the approval of the prison master. The representatives of APADOR-CH understand the fear of the officers that the detainees may take advantage from lending phone cards or may force the weak ones to give them away. However the "small traffic" among detainees is common for any product (cigarettes, food, clothes etc.) so that the restriction regarding the lending of phone cards is not justified.

It should also be mentioned an Order of the General Directorate of Penitentiaries requesting the penitentiaries to record the hour and duration of the phone calls made by the detainees. The representatives of APADOR-CH wonder which is the use of such measures.

Conclusions:

• With certain exceptions, the Dej penitentiary hospital offers detention conditions and health care comparable with the hospitals from the network of the Health Ministry;
• APADOR-CH requests the General Directorate of Penitentiaries to give all its support to the Dej hospital for urgently solving the following problems:

• employing the second surgeon, without whom the unit cannot function;
• providing the hospital with an ambulance equipped for rapid interventions;
• The association would also like to mention other problems – which, although not top priority, have a major role in the well functioning of the hospital – for which it needs the help of the General Directorate of Penitentiaries:

• taking over from the Dej Court a wing with 6 rooms, for which there is already a principle agreement;
• procuring an "Elisa" line for the hospital;
• increasing the number of medical and guard staff;
• APADOR-CH requests the General Directorate of Penitentiaries to consider the possibility the procure an ECO Doppler equipment for the hospital, taking into account the fact that at least a half of the sick detainees have heart problems and that a lot of money and energy is currently spent on transporting them to Cluj;
• Due to the lack of cultural-educational activities, the association requests the General Directorate of Penitentiaries to provide a number of television sets (the 7 existing TV sets are donated by the staff);
• APADOR-CH requests the management of the Dej hospital to give up to limiting the phone calls to 5 minutes. Not even the internal rules do not include this mention;
• The association supports the idea of issuing separate internal rules for the penitentiary hospitals, in the sense of a getting such rules as close as possible to the regulations for the civilian hospitals. APADOR-CH considers that such regulations should also apply to the medical cabinets and infirmaries from penitentiaries.

Manuela Stefanescu
Valerian Stan