1 Health in Armenian Prisons: General Picture Artur Potosyan Yerevan, Armenia Mobile:

2 Current Situation: Overview of Armenian Prison Service - Governed by the Criminal Executive Department of the MoJ (since 2001) - 15 establishments (including Central Hospital for Prisoners) - 4 types of CEE: closed, semi-closed, semi-opened, opened prisoners as of Dec 20, 2006

3 Health impairment risk factors: Prisoners as a target group (1) - Concentration of people related to crime - Highly marginalized status and stigma - Depression and other mental issues - Underestimation of self-health - Concentration of people related to crime - Highly marginalized status and stigma - Depression and other mental issues - Underestimation of self-health

4 Health impairment risk factors: Prisoners as a target group (2) - Transmission of BBI (poor knowledge on HIV/Hep/TB etc, risky behavior: :: substance abuse: 5-36%, :: sharing of injecting supplies: % :: sharing of tattoo equipment: 62% :: homosexual patterns: 9.7%. - Hygiene/Sanitary conditions - Transmission of BBI (poor knowledge on HIV/Hep/TB etc, risky behavior: :: substance abuse: 5-36%, :: sharing of injecting supplies: % :: sharing of tattoo equipment: 62% :: homosexual patterns: 9.7%. - Hygiene/Sanitary conditions

5 Recent Developments: Penitentiary reform started in Transfer of authorities (from the MoI to the MoJ) - Circumstances: a. CEPA Opinion No. 211 (2000) b. Armenia’s accession to the CoE on Reason: the need to demilitarize and humanize the Armenian penitentiary system

6 Two pillars The nature of the Reform: Two pillars 1. The reorganization of the institutional framework Armenian Prison Service governed by the Criminal Executive Department of the MoJ. 2. A legislative review Carried out by the Department of Legal and Judicial Reforms of the MoJ

7 Legislative Review: Key laws adopted 1. Law on the Status on the Penitentiary Service - enacted in Law on the Treatment of Arrestees and Detainees - enacted in Criminal Executive Code - enacted in Law of Penitentiary Service - enacted in Ministerial Decrees, including the Internal Regulation for Pre-Trial Detention Facilities

8 Health services in Prisons: Key actors Carried by separate units of CED of MoJ: 1. Medical Service Unit 2. Socil-Psychological-Legal Support Unit

9 - Central Hospital for Prisoners (about 80) - Medical and SPLS representatives in other 14 establishments: avg. 6 Health services in Prisons: Personnel/Medical Staff

10 The scope of Med. Services Central Hospital for Prisoners Hospital (inpatient) care: - Dep. of General Surgery - Dep. of General Therapy - Dep. of Psychiatry - Dep. of Narcology - Dep. of Infection diseases - Dep. of TB - Stomatology Unit - Dep. of Diagnostics/Lab - Dep. of Radiology

11 Mainly ambulatory (outpatient) care, some have few beds - General therapeutic service - Ambulatory (“small”) surgical service - In some places- stomatological service The scope of Med. Services Other establishments

12 Recent improvements: “On-ground” pluses - Centralized purchase of a wide scope of medical/lab equipment and medicines - Harm Reduction initiatives (SEP in 4 places) - Renovation of some medical premises and fully refurbishment of some buildings (TB) - “Patient” approach prevails over “Prisoner” - Prisoners recognize their rights - Other factors positively impacting of “overall wellbeing” of prisoners - Centralized purchase of a wide scope of medical/lab equipment and medicines - Harm Reduction initiatives (SEP in 4 places) - Renovation of some medical premises and fully refurbishment of some buildings (TB) - “Patient” approach prevails over “Prisoner” - Prisoners recognize their rights - Other factors positively impacting of “overall wellbeing” of prisoners

13 Still existing Gaps/Challenges: Minuses we have - No structural links to the MoH and other health/med institutions (e.g. NIH) - Lack of specialists - No continuous educational/development programs for personnel - Poor medical monitoring/QA system - Still there are “out of date” medical instruments, kits and equipment - Lack of services available or scope of existing services - No structural links to the MoH and other health/med institutions (e.g. NIH) - Lack of specialists - No continuous educational/development programs for personnel - Poor medical monitoring/QA system - Still there are “out of date” medical instruments, kits and equipment - Lack of services available or scope of existing services

14 References - WHO Europe: Status Paper on Prisons, Drugs and Harm Reduction (May 2005) - Amnesty International: Armenia. Conclusions and Recommendations of the United Nations Committee against Torture - Report On the Activities of the Public Monitoring Group at the Detention Facilities of the Penal Services of the Ministry of Justice of the Republic of Armenia 2005 Thank you for your attantion!