Emergency health care for prisoners

21 February 2025 

By Mariana Torocheshnikova

An extract

Source: Radio Svoboda

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How to get medical attention in detention facilities. […]  

According to the calculations of OVD-Info’s project ‘Emergency Care’, over 160 political prisoners in Russia are currently in need of medical assistance to varying degrees of urgency. However, the medical facilities under the Federal Penitentiary Service [FSIN] are lacking both medications and doctors, and sometimes, according to human rights defenders, even the desire to treat prisoners. For example, municipal deputy Aleksei Gorinov, accused of spreading so-called ‘military fake news’, was not provided with the necessary medication until an outcry arose. According to human rights defender Anna Karetnikova, this was not intentional mistreatment. It was simply a case of ‘why provide medical assistance to someone if it can be avoided?’ Victims of such negligence, who died in custody in Russia, amounted to 1,917 people in 2021 alone. 

On a videocall with us are OVD-Info lawyer Maria Nemova, and a staff member of the human rights project ‘Political Prisoners. Memorial’ Anna Karetnikova. 

So why do prisoners, who need complex specialised medical care, end up in prisons and penal colonies? 

[Anna Karetnikova] The approach is completely indiscriminate, and no one looks at whether a person is sick or healthy. The main reason is that placement in remand prisons has long ceased to be a form of isolation, but a way of putting pressure on detainees. If a person is in a remand prison, then it’s easier to manipulate them, it’s easier to get a confession of guilt, and perhaps even testimony against other people, or a deal with the investigation. And if the person is sick, then it becomes significantly easier to manipulate them. 

But don’t the judges see the person when they make the decision to place them in custody?

The judges have no concept of what a remand prison and its medical care are like. They just don’t think about it. We have a system where each official is responsible for their own area of work. The judge only notes that they sent a person into custody, and that what happens to that person there is not their concern. 

Maria, there are quite a few legislative acts that regulate the provision of medical care in FSIN institutions. How closely does the practice align with the established rules? 

Unfortunately, it doesn’t always align. The rules themselves are flawed, and there needs to be more opportunities for releasing a person if they have an illness, or for providing them with quality care. But even the guarantees that exist on paper are far from always followed. The most basic health issues in confinement become a very big problem: a painful tooth, high blood pressure, poor vision. These are the most common complaints, and even with such simple requirements, it’s difficult to receive medical assistance. 

Anna, are there no doctors there?

There is usually a dentist, but if they are on leave and you have an abscess, it means that you will have to wait until the dentist returns from their vacation. If you have an ingrown toenail and the toe becomes infected, but there is no surgeon in your detention facility, then you might have to wait for them, hoping, God forbid, that you don’t develop blood poisoning. And of course, there is a shortage of medication, with supplies being provided on the basis of what is left over, according to auction-based principles. FSIN bids for medications at the lowest price, and while they are bargaining, patients are left without the simplest medications for months. There is also a lack of necessary medical equipment…everything is provided on this basis of ‘what is left over,’ and after the war began, they started saying ‘Well what do you expect, everything has gone to the front’. 

Maria, what kinds of illnesses do people in places of detention most often not receive adequate medication for? 

It would be better to say which types of illness are most common. But sometimes there are quite rare illnesses that are generally difficult for an ordinary doctor, who isn’t a specialist, to treat. For example, in the case of Egor Balazeikin, who has rather rare autoimmune diseases: behind bars, Egor cannot receive adequate specialised care. His parents manage to ensure that Egor is sometimes taken to a civilian hospital for medical examination, but for this, the remand prison or penal colony administration has to give permission. And if a person doesn’t have close family members or a lawyer on the outside, then it’s almost impossible to do this. 

But the person could die! A prisoner dying on an institution’s watch would surely be bad for them in terms of their performance assessment.

It’s a lack of humanity on the part of the government. In instances where a person is on their deathbed, they are likely to get some form of medical assistance, or may be released on grounds of poor health. However, anybody in a non-critical state is practically neglected. Sometimes people don’t receive medical assistance simply because a medical orderly took one or two weeks to find the time to review a patient’s notes and check for any mention of a specific medication. Often it takes writing a complaint to various places to get the most basic essentials.

Our campaign often helps in such cases by writing complaints and meeting with the heads of penal colonies and remand prisons. We have a contact form on our website OVD-Info and people can also write to our email address me*@*****fo.org or via our Telegram channel where you can find further information about our work.

This is generally the way to achieve results, and even ordinary people can make a difference this way. One successful case was when thousands of people signed a petition to help Igor Baryshnikov, which led to him getting a special catheter fitted. We sometimes do targeted fundraising for people in such cases. 

Anna, do the staff of remand prisoners and the medical staff there treat political prisoners differently from other prisoners?

Not in my experience. There are exceptions where for example an investigator from the FSB asks the operatives working on the same case to blackmail the detained person: admit your guilt and you’ll get instant treatment, but as a rule it’s difficult for all inmates (other than those who pay) to get transferred to a civilian medical unit.

Failure to move patients to civilian hospitals for treatment isn’t only because of the negligence of doctors, but also because of a lack of staff. It’s rather difficult to find people to put together the four-man escort required for each prisoner when they leave the prison. Civilian hospitals also don’t tend to like having “criminals” and those who accompany them, so it can often take three or four months to plan a hospital visit, even if an inmate urgently needs treatment. It could happen that whilst an inmate is being screened, their cancer goes from stage-two to stage-four. This happened to a political prisoner named Zakhar Zapirov. Because of them his cancer reached stage four, and it was only once he was beyond saving that the court changed his sentence to a fine.

And what are your observations, Maria?

We see the situation rather differently. Certain categories of inmates find it much harder to get medical attention, or don’t get it at all. This is the case for prisoners who have been convicted on charges of terrorism. Everyone knows that terrorism and extremism charges are often used in politically motivated prosecutions. One major case of this kind involving a lot of people was the Hizb ut-Tahrir case prosecuting Crimean Tatars. The defendants had serious health issues, and also had difficulties as they were put in punishment cells. Unfortunately withholding medical treatment can also be used to apply political pressure. 

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Translated by Annabel Pedgley and Friedrich Berg