NPM overview

Facts and figures

Recommendations

Body searches

• The Ministry of Government is urged to progressively replace the exclusive use of tactile techniques in body searches with the use of non-invasive technologies through the acquisition of sensors and electronic inspection or detection equipment. These technologies can help ensure greater efficiency in the detection of prohibited substances and items, while reducing the discomfort and potential humiliation associated with manual searches. 
• The Ministry of Government is urged to provide ongoing training for staff responsible for conducting searches, both in non-invasive search techniques and in the importance of respecting the human rights and dignity of women deprived of their liberty. This includes raising awareness of the psychological and emotional impact that these practices can have on detainees, in accordance with Rule 33.1 of the Bangkok Rules, and such training should be facilitated not only by security agencies but also by internal mental health agencies (prison health), civil society organisations and technical experts from the Ministry of Health .
• The General Directorate of the Penitentiary System is urged to verify the protocol of searches, through supervisory visits in which compliance is certified, taking into account the differentiated approach to gender and human rights, especially for vulnerable groups.
  Disciplinary sanctions
• It is recommended that the General Directorate of the Penitentiary System should not practice the transfer between penitentiary centres as a disciplinary measure, but that the sanctions should be served in facilities designed for this purpose in such a way that they do not affect the technical progressive plan and family relationships.
  Conditions of habitability
• It is recommended that General Directorate of the Penitentiary System improve the conditions of habitability, through the renovations that have been stalled in CEFERE, and that they proceed to allocate funds for the tendering of renovation works in the other penitentiary centres of the country that include specific areas such as: isolation, conjugal visits, differentiation by profiles that comply with the minimum guarantees of habitability and access to basic services.
  Solitary confinement, isolation
• It is recommended that the General Directorate of the Penitentiary System limit the use of isolation measures to situations that are strictly necessary and justified for security reasons and for a period of no more than 15 days, otherwise it would be considered prolonged isolation, based on international standards on deprivation of liberty.
• It is recommended to the General Directorate of the Penitentiary System that in the case of women deprived of liberty with mental health conditions and psychosocial disabilities, measures such as isolation should not be used, but rather that they should be housed in special spaces for this type of population, according to their profiles. This is in accordance with the provisions of Numeral 5 of Article 46 of Law 55 of 2003, which reorganises the Penitentiary System. 

Health

•  It is recommended that the General Directorate of the Penitentiary System ensure, through the Ministry of Health, timely mental health care for women deprived of their liberty, in accordance with the provisions of Bangkok Rule 12. The constitution of another technical board for each penitentiary facility resources should be earmarked for the constitution of another technical board for each penitentiary facility.
• It is recommended that the Ministry of Government, together with the technical board of the facilities and the Ministry of Health, create and update a digital medical register of the female prison population suffering from these medical-psychiatric conditions and the treatment provided to them, in order to prevent these women deprived of their liberty from falling into crisis situations due to a lack of treatment.

Means of coercion

• It is recommended that the Ministry of Government implement mechanisms to supervise the use of means of coercion in women's prisons and that they respect human rights and a gender-specific perspective and apply disciplinary sanctions to their custodial staff or refer cases to the directorate of police responsibility for investigation in the case of external security and file complaints with the Public Prosecutor's Office in the event that cases of excessive use of force are identified.
• It is recommended that the Ministry of Government strengthen training sessions for internal and external security staff in the facilities on the appropriate use of force in order to avoid situations that could lead to ill-treatment or possible torture.
  Alternatives to detention
• It is recommended that the National Assembly of Deputies promote an initiative to revise the Penal Code and the Code of Criminal Procedure. This revision should focus on implementing alternatives to imprisonment in the phases of investigation and serving the sentence, based on a differentiated analysis and with a gender-specific perspective. This proposal should involve the participation of various sectors such as the judiciary, the Public Prosecutor's Office, the Ombuds Institution, the MNPT, civil society, among other actors.
• It is recommended that the judiciary strengthen the implementation of alternative measures to pre-trial detention (to trial judges) and to deprivation of liberty in prisons (to compliance judges), where the last resort is to avoid overcrowding in prisons, to favour mechanisms for re-socialisation and social reintegration and to ensure fairer and more adequate treatment for women in prisons, protecting their human rights.

Separation

• It is recommended that the Ministry of Government urgently allocate resources, within its budget, for the creation of a specialised centre for women who have committed less serious crimes, taking as a reference the El Renacer Penitentiary Centre which houses male prisoners, as this would not only significantly improve conditions for these women, but would also reduce existing discrimination based on gender and contribute to a fairer and more equitable penitentiary system, thereby guaranteeing respect for their rights and facilitating their rehabilitation and effective social reintegration.

Pregnant women

• It is recommended that the Ministry of Health and the Ministry of Government ensure that pregnant women receive adequate medical attention and prenatal care during their imprisonment to protect their health and that of the baby.
• It is recommended that the Ministry of Health and the Ministry of Government establish clear policies and protocols for the care of pregnant women in prison, including access to nutritious food, specialised medical care and dignified living conditions. In addition, it is essential to provide psychological and social support to these women, as well as to ensure that their rights are respected at all stages of pregnancy, childbirth and postpartum.
   

Detention Issues

Currently, in the Republic of Panama, despite the fact that the female prison population is only 4.96%, there are alarming levels of overcrowding in three of the four female prisons (CEFERE Panama, Llano Marin and Algarrobos).

In addition, there is no minimum-security prison for women prisoners who have committed non-serious crimes, unlike the male prison population, which has the El Renacer Prison, which constitutes clear discrimination against women prisoners who have committed minor offences, exacerbates overcrowding and is contrary to the distribution by criminological profile, affecting adequate re-socialisation.

Mental healthcare

It is imperative to address the mental healthcare of women deprived of liberty in prisons from a gender-specific perspective, taking into account issues such as pregnancy, their role as mothers and within the family, the care of children and other family members, elderly people, people with disabilities, some of whom are the sole breadwinners and leave the family deprived, situations that are aggravated in the context of imprisonment.

Mental healthcare and access to mental healthcare for women deprived of liberty in the country's women's prisons pose major challenges, ranging from timely medical care, monitoring of pharmacological and therapeutic treatments, participation in activities and programmes and, finally, healthy coexistence with the rest of the population.

This lack of a timely approach has adverse consequences for the emotional well-being, rehabilitation and re-socialisation of women in prison. 

In accordance with the above, common points were found in the women's facilities, such as the following:

• Absence of psychiatrists and psychologists in prisons, so that care must be provided externally, which implies the mobilisation of women prisoners to receive timely care, entailing the risk of missing appointments, which affects access to medication in a timely manner that affects crisis situations and violence of women prisoners suffering from these disorders, taking into account the lack of both human resources (external security for the transfer) and materials (lack of vehicle and fuel for the transfer).
• Lack of medicines (psychotropic drugs) in the pharmacies of the penitentiary clinics, as well as in the external health centres that serve to the female population of the facilities.
• Lack of mental health programmes or psychosocial care programmes, with a systemic approach, aimed at both women prisoners and custodial and administrative staff, in a way that allows them to manage crisis situations involving this population, as established in Bangkok Rule 33 and the National Mental Health Technical Administrative Regulations.
• Lack of spaces or cells for people who have additional psychosocial needs. 

In this regard, it is important to note that the Ombuds Institution of the Republic of Panama will continue to promote the health and overcrowding reduction roundtables with the participation of the DGSP, MINSA and the judiciary, with the aim of collaborating in the development of strategies that effectively address mental healthcare in prisons. 

These actions are also complemented by the education and board roundtables run by the Ombuds Institution.

Means of coercion

In Panama, there is a protocol on the use of coercive methods established in Law 55 of 2003 that reorganises the Penitentiary System; however, this is not based on a gender-specific approach, on the contrary, the guidelines do not distinguish between the male and female population, which leads to certain situations are generated in women's centres, namely: coercive measures, such as the use of physical force, handcuffs, shackles, the use of restraint devices (taser or stun gun) and the application of disciplinary sanctions,  are used as methods to maintain order and discipline within the facilities, which, if used excessively or inappropriately, without a gender-specific analysis, can result in ill-treatment, abuse and risks of torture towards women deprived of their liberty.

The lack of training of custodial and external security staff on the use of force and the protocol for its appropriate use has been identified, so that it does not constitute ill-treatment and possible torture of the detainees.

Body searches

Currently, in women's prisons, searches are carried out by external security units of the National Police and when there is any follow-up due to suspicion of a security situation in CEFERE Panama, there is an office of the Police Investigation Directorate (DIP) that is in charge of this function.

In the country's women's prisons, body searches are carried out on admission to the facility, as well as at every exit for medical, judicial or other purposes; in addition, this process is carried out for family visits, legal representatives and judicial authorities. 

On the basis of the above, searches are carried out manually, as the facilities lack sensors and electronic inspection or detection equipment to replace the use of tactile techniques that are often demeaning and humiliating. 

It is important to underline that these activities are carried out by female staff and in the event that children and adolescents are present during the visits, the searches are carried out by specialised units of the Police for Children and Adolescents, in private places away from the rest of the people and in the presence of their parents or legal guardian. 

There is currently a protocol for searches,37 established in Law 55 of 2003 that reorganises the Penitentiary System, which contains the guidelines to be used in the facilities; it contemplates procedures aimed at vulnerable groups.

Solitary confinement, isolation

Given the overcrowding, the sections that were previously considered for isolation have been transformed into common areas, no longer called isolation or reflection areas, but just another living area. In some facilities, women who have been sanctioned share space with others who have not been sanctioned, with periods of confinement that start at 15 days and in some cases are prolonged. Disciplinary isolation practices are not adequately managed, negatively impacting the mental and physical health of the inmates.

In the Colón Penitentiary Centre, the absence of a specific area to house women with disciplinary sanctions forces the sanctioned inmates to serve their punishment in the common cells. 

This results in the joint confinement of all prisoners in the cell, even those not sanctioned, for periods of 15 to 30 days, limiting their participation in daily activities.

This practice violates the rights of unsanctioned women prisoners and reflects the urgent need to reform confinement policies and improve prison infrastructure.

In the Female Rehabilitation Centre (CEFERE), the situation is serious due to the reuse of the maximum-security area for inmates with behavioural and mental health problems. This particularity also occurs in the women's facilities of Los Algarrobos and Llano Marín. In the case of CEFERE, the cells have bars and two to three women are placed in each cell, in an environment of isolation that aggravates their situation.

In the case of Los Algarrobos and Llano Marín, although the cells do not have bars, the area is small and very overcrowded. Similarly, the conditions in these areas for the three facilities mentioned are inadequate for the specific needs of the inmates, which negatively affects their mental health and violates their human rights.

Transfer as a disciplinary sanction

Another aggravating factor in this practice is that, although this measure can be imposed as a disciplinary sanction within the facility where they are serving their sentence, in other cases, due to the seriousness of the offence, they are transferred to other prisons located in other provinces of the country, which has a negative impact on family unity due to the geographical distances involved. 

Isolation as a segregation measure

Similarly, isolation can be implemented as a segregation measure for people who have mental health conditions or additional psychosocial needs, in crisis conditions, and who are not receiving therapeutic medical care or timely medication.

Impact on inmates

Prisoners in this space face prolonged isolation, which can deteriorate their mental health, and the lack of adequate separation and specialised programmes for each group represents a violation to their rights and specific needs.

Prolonged confinement can have devastating effects on mental and emotional health, contravening Nelson Mandela Rule 44. Lack of diagnosis and treatment for women with additional psychosocial needs can lead to crises and acts of violence, resulting in segregation and cruel treatment. 

This situation places them in a position of greater vulnerability, suffering stigmatisation and social exclusion, which increases the risk of ill-treatment by prison staff.

The physical conditions of these areas, with the exception of the Nueva Esperanza women's facility in Colón, are inadequate, with poor ventilation, lack of lighting and sanitary facilities in poor condition, which affects the mental health of the women and increases the risk of mistreatment.

CEFERE Panama, in particular, presents extreme unsanitary conditions in the confinement area, which have been denounced to the authorities as ill-treatment, inhuman and degrading.38

Other Relevant NPM Information on Women in Prison

NPM overview

Facts and figures39

Recommendations

Body searches

• Respect the dignity of women detainees and their privacy as women during strip searches.

• Ensure that staff are trained and professional in conducting strip searches, taking into account "women’s specific needs" and their sexual and reproductive health, as stipulated in the Bangkok Rules for the Treatment of Women Detainees.

Access to healthcare 

• Ensure greater access to prenatal care 

• Ensure the provision of an ambulance to the women's prison in the capital

Mental health

• Provide mental healthcare and monitoring for women detainees

Contact with the outside world

• Set up a bridal room

• Open women's prisons in every region so that women can stay close to their families.

Alternatives to detention

• Include alternatives to detention in the law for women, especially for non-recidivists 

Legal and judicial measures

• Correct the professional administrative status of female employees who work in the prison and grant them all the rights provided for by law

• Speed up trials to reduce the rate of pre-trial detention in women's prisons 

Detention Issues

Women detainees in Mauritania are generally held in two places: the women's prison in the capital Nouakchott, which is the only prison exclusively for women in Mauritania; and the women's section of the central prison in the economic capital Nouadhibou. Apart from these two facilities, there are no other detention facilities for women in Mauritania.

The overall detention conditions in the women's prison are generally good and offer good living conditions, the same for the detainees of the women's section of the Nouadhibou prison. 

Detainees in the women's prison are generally well treated and there is a good relationship, based on mutual respect between them and the prison administration. In this prison, they enjoy a certain degree of freedom of movement, which is rarely found in other prisons.

Given the conservative nature of Mauritanian society and the fact that the imprisonment of women in general, according to the Bangkok Rules, "may make their social reintegration more difficult",41 the competent judicial authorities in Mauritania do not tend to imprison women except in cases of serious offences, in which case the perpetrators are transferred to the capital's central prison or to a wing of the women's prison in Nouadhibou.

Accommodation and food

1. Accommodation

The overall environment of detention facilities for women and girls in Mauritania is appropriate in terms of architecture, there is no overcrowding, and it offers a certain degree of good living conditions for female detainees in many respects.

In the women's section of Nouadhibou prison, there are currently only two women detainees, so this section does not suffer from the problem of overcrowding for most of the year or during any of the visits made by the NPM teams. The occupancy rate in this ward currently does not exceed 10%.

As for the women's prison in the capital, which is the main place of detention for women in Mauritania, it is a medium-sized private building, enclosed by an external wall and with an external courtyard.

The main prison building consists of three wards, each with around 15 individual beds and a separate indoor bathroom. One other room has been added, which was previously used for training and entertainment. The prison also has an area reserved for visitors and a workshop to teach clothing dyeing. All areas of the prison have adequate natural ventilation and sufficient sunlight thanks to small openings and windows.

This prison, unlike many Mauritanian prisons, contains an isolation cell, which is used more for deterrence than for disciplinary measures, which are not used in this prison, as is the case in most Mauritanian prisons.

The prison has a capacity of 50 detainees. There are currently 48 detainees, including 12 foreigners of different nationalities. This means that the prison is close to full capacity at the moment but is not overcrowded yet.

The percentage of foreign detainees in this prison is relatively high because it is located in the capital, and because it is the only women's prison in Mauritania apart from the women's section of the Nouadhibou prison, which currently houses 2 foreign detainees. That said, the percentage of foreign women in Mauritanian prisons is around 28% (of all women detained in Mauritania).

Food

The women's prison has a clean and well-maintained kitchen. Three contract cooks work there in shifts, and some detainees help them on a set schedule.

This prison receives a daily share of various food items from the prison administration and provides 3 meals a day for the detainees, which are acceptable both in terms of quantity and quality.

The prison warehouse contains a supply of certain food items and cleaning products, such as rice, pasta, soap, bleach for sterilisation, etc.

Morning breakfast in the women's prison includes the necessary ingredients based on the local eating habits (bread, milk and sugar), as well as the vegetables that are used to prepare lunch and dinner.

In addition to the meals provided by the prison, the prison administration allows detainees to receive food and other necessities from their families. However, the prison administration does not offer a diet to detainees suffering from chronic illnesses such as diabetes, high blood pressure and HIV, contrary to what is stipulated in the current national and international legislation.42

Separation
In Mauritania, the rule of separating by category is applied in women’s detention facilities. In the women's prison and in the women's section of the Nouadhibou prison, detainees are separated depending on the nature of the offence, a misdemeanour or a crime.
However, despite the application of separating by categories in women’s detention facilities in Mauritania, the visiting teams noted the presence of three children living with their mother43 in the women's prison in the capital, in flagrant violation of the national and international legislation in this area, as the decree that sets out the internal regulations of prisons in Mauritania stipulates that it is forbidden to leave children over 18 months old in prison with their mother. 
The second violation observed in this respect was the presence of certain women who were detained in the women's prison in the capital and in the women's section of Nouadhibou, far from their social environment, in flagrant violation of the international standards, in particular the Bangkok Rules, which stipulate that "women should, as far as possible, be assigned to a prison close to their home",44 as well as the Nelson Mandela Rules.45 

Body searches

In detention facilities reserved for women, strip searches are conducted on two occasions: the first when detainees are placed in custody, and the second each time they are transferred to and from a detention facility.

In the women's prison in the capital, a team of female guards conduct strip searches on the detainees. The strip search usually takes place in the presence of a member of the National Guard responsible for security.

Visitors are only searched if they are suspected of carrying prohibited materials or materials dangerous to the security of the prison and its detainees.

Similarly, in the women's section of the Nouadhibou prison, 3 female members of the National Guard conduct strip searches of the detainees in this section. It should be noted, however, that these female guards need training in what is known as "women’s special needs" and their sexual and reproductive health, as stipulated in the Bangkok Rules for the Treatment of Detainees.46

Access to healthcare and mental health services

The women's prison has a health point that provides primary health care to sick detainees. It is staffed by a doctor and a midwife who provide services when needed. However, there is no private ambulance for the prison, but it benefits from the services of an ambulance shared by all the prisons in Nouakchott, which is available on request. This health point also examines and monitors the health of pregnant detainees.

As far as mental health is concerned, the prison administration does not provide care for women detainees suffering from mental health symptoms, or their families, in any of the facilities where women are detained.

However, the teams visiting the women's section of Nouadhibou prison were able to record the case of a woman suffering from depression and mental health issues. This prisoner complained to the NPM teams about her lack of access to medication and the absence of a specialist doctor to examine her.

This case is in fact a breach of the Bangkok Rules which state that "the medical examination of detainees shall be comprehensive, in order to identify their primary healthcare needs and to highlight: (...) their mental healthcare needs, including post-traumatic stress disorder and risk of suicide or self-harm"47 and to conduct a comprehensive medical examination to identify the detainees' healthcare needs in a range of areas, including mental health.

In order to fill this gap in the women's prison in the capital, the NGO Noura Foundation provided a psychiatrist who examined the detainees twice a week. But he stopped working some time ago after his contract with the above-mentioned charity came to an end.

In fact, these women's detention centres are not the only ones that are suffering from this shortcoming. Prisons and detention facilities as a whole, with the exception of the capital's psychiatric hospital, do not offer mental health services for their detainees.

NPM overview

Facts and figures

Recommendations

Body searches

• Increase the number of prison staff by recruiting more women to supervise people deprived of their liberty.

• Provide the prison administration with search equipment such as metal detectors. 

• Strengthen the capacity of prison staff in terms of search methods and techniques that respect human rights, particularly those of women.

Access to mental healthcare

• Provide the prison administration with healthcare officers specialised in mental health.

• Detain women suffering from mental health conditions in specialised centres.

Accommodation

• Provide adequate cells reserved for women in investigative units and detention centres.

Life in prison: regime and activities 

• Ensure that social and professional reintegration activities are implemented for women through vocational training.

Mothers in prison with their children

• Separate women with children from other detainees in order to guarantee their safety, and provide childcare and play areas for these children.

Detention issues

The prison system in Mali faces many challenges, including overcrowding, poor detention conditions and inadequate infrastructure. Women represent a small proportion of the total prison population.

The number of detainees awaiting trial, including women, far exceeds those that have been convicted. Pre-trial detention conditions can be particularly difficult due to the slowness of legal proceedings and overcrowding in pre-trial detention centres.

Detention conditions for women are marked by a number of challenges, including inadequate care for the children of women detainees', a lack of appropriate medical services and a lack of any effective post-prison aftercare. In addition, incarcerated women are often victims of violence, deplorable sanitary conditions and nutritional deficiencies.

These problems show that there is a significant gap between the laws and their application in practice, despite the efforts made by the authorities to improve detention conditions.

Body searches

1. Legal and regulatory framework

In addition to international texts, strip searches are regulated by Order no. 2016-4748/ MJDH-SG (29 December 2016) on the internal regulations for prisons and supervised education facilities. While this text makes strip searches and maintaining the register of strip searches the responsibility of the prison guards, it gives no indication regarding strip searches on women specifically, leaving it up to each facility to set the rules in its own internal regulations. 

2. In practice

During its monitoring missions, the CNDH noted that there were no strip search registers in some prisons and investigative units. In other facilities where the register does exist, it is not updated regularly and in accordance with the internal regulations and is often neither initialled nor stamped by the competent authorities. None of the detention centres have a search scanner.

The lack of female staff leads some prison staff to call on women from outside the prison administration to conduct strip searches, in particular members of local organisations. Although this practice is an alternative, it is not without risk. These women are not sworn in and are under no obligation of confidentiality, whereas prison officers are. 

It is therefore essential to find permanent solutions to facilitate strip searches on women deprived of their liberty. 

Access to mental healthcare

Order No. 2016-4748/ MJDH-SG of 29 December 2016 on the internal regulations for prisons and supervised education facilities provides for medical examinations to "detect the existence of any physical or mental illness and to take any necessary measures" (Article 51). 

However, in practice, these visits are not conducted regularly in some places and are not particularly focused on the mental health of women detainees. In fact, the absence of medical staff in some places limits women's rights to mental healthcare. In addition, medical records are not maintained properly. As with the strip search registers, in many facilities they do not exist, and in others they are neither initialled nor stamped by the competent authorities. 

During its last monitoring mission to the Bollé Re-education and Reintegration Detention Centre for Women and Girls in Bamako, the NPM team noted the presence of people with mental health conditions among the detainees and brought this to the administration's attention and urged it to take steps to manage these cases. 

Interviews with detainees revealed allegations of violations of women's rights. Some inmates complained of inadequate medical care, especially in terms of access to treatment and medication. They also complained about verbal and physical abuse by one member of the prison staff, who allegedly subjected them to sexual touching, insults and beatings. These allegations, if confirmed, could cause mental disorders in the detainees that are subjected to them. 

During the same monitoring mission, allegations were reported of paedophilia by other detainees, involving children who were staying with their detained mothers. 

Contact with the outside world

Conjugal visits are not provided for in the legislation governing the detention of women, even though they are essential to their development. 

Alternatives to detention

There are no specific legal alternative measures for women in Mali. However, in practice, women may be discriminated against. 

As a result, the number of women in prison remains well below that of men, in all prisons across the country, with the exception of Bollé Femmes, a detention centre exclusively for women. 

Similarly, in practice, magistrates rarely use detention warrants against women, whereas the opposite is true for men, for whom they seem to be the rule. 

In police and gendarmerie investigative units, there are a number of observations to be made in practice. Women are rarely detained or placed in cells for several reasons. Some investigative units do not have custody cells for women. And if they do, they are in poor hygienic conditions. In practice, they make the women sit in the courtyard or in the offices, but not in the cells. Sometimes they are even entrusted to the traditional authorities and to the customary and religious authorities who will vouch for them.

NPM overview

Facts and figures

Recommendations

Healthcare

• It is recommended that the Ministry of Health, in the medium term, work on the design and subsequent implementation of a comprehensive health model10 that guarantees access to healthcare without discrimination for persons deprived of liberty in the custody of the Chilean Gendarmerie. 

Contact with the outside world

• It is recommended that the National Directorate of the Chilean Gendarmerie, following the stipulations of Ext. Res. No. 490, which instructs on the authorisation and procedure for virtual visits[A1]  and Circular No. 118, in the medium term, guarantee free telephone calls or video calls for persons in prison with their significant others and lawyers, ensuring private, regular and quality communication. The possibility of making calls or video calls abroad within the system is encouraged in order to guarantee this right to non-nationals. 

Prison life: routine and activities

• In relation to the use of time, it is recommended that the Ministry of Justice, in the medium term, increase the offer and access to training, recreational and sporting activities, in order to contribute to improving the quality of life of women in prison, especially for those who are in pre-trial detention and who do not have access to this offer because it is a temporary prison stay, although the time is prolonged and there are no actions aimed at preventing the deterioration of mental health and contributing to their reintegration process after serving their sentence in prison.

Pregnant, postpartum and breastfeeding women

• In the absence of a national legal regulation governing prison life, the Ministry of Justice and Human Rights is urged, in the short term, to ensure that the rights of women prisoners and nursing mothers are incorporated into the proposed amendment to the Prison Regulations.11

• Meanwhile, the National Directorate of the Chilean Gendarmerie is recommended to comply with international standards that require special conditions to be provided to pregnant and nursing mothers during detention, especially for the treatment of pregnancy, childbirth and puerperium in all penal units of the country.

Foreign or indigenous women

• Considering the continuous reports of verbal and psychological mistreatment of women, particularly of the most vulnerable groups, such as foreign nationals or members of indigenous peoples, it is recommended that the National Directorate of the Chilean Gendarmerie should advance in the training of direct personnel and apply a zero tolerance policy with regard to such behaviour.

Alternatives to detention

• It is recommended that the Senate Commission on Human Rights, Nationality and Citizenship, in the short term, speed up the discussion and approval of the bill under discussion (bulletin No. 11.073-07), known as the "Sayen Law", which modifies the Code of Criminal Procedure, making pre-trial detention inadmissible for pregnant women and women with children under three years of age.

Detention issues

Body searches

The CPT has been made aware of women being stripped naked during searches of the premises, with the women being forced to remove their underwear and perform squats. The most commonly identified reason for these procedures is that an assault has been committed against a female officer or that a search for prohibited items has been carried out. Raids and body searches are carried out by prison staff of the same sex as the prisoner, not by health staff. A daily record of searches is usually kept, but it does not detail body searches but the procedure in general.

Persons in prison express concern and great discomfort at the situation experienced by their visitors. They are subjected to body searches, to undignified treatment, accompanied by a high economic cost, time, but also because there are regular changes in the list of items and quantities allowed that are often not communicated officially and in advance to the prison population, which directly affects family ties and, therefore, the levels of discomfort and tension in the population, along with perceptions of abuse and arbitrariness on the part of prison officials and/or authorities.

Solitary confinement, isolation

In Chile there are a number of reasons why a person may be subjected to solitary confinement: (1) disciplinary sanction, (2) maximum security measure, (3) personal protection or security, (4) form of prison population management, (5) isolation pending classification or transfer, and (6) isolation for health reasons. This includes women.

The Regulations of Penitentiary Facilities (REP) only regulate isolation as a sanction, stipulating the safeguards that must be taken into account when a person is placed in isolation, namely: notification of the grounds for isolation, fairness, timing and proportionality of the disciplinary measures, certification of the conditions under which isolation is carried out and daily visits by the prison authority, medical certification of the state of health of the person to be placed in isolation and judicial supervision of the isolation, among others. Isolation in maximum security facilities is not regulated in this regulation, but in circulars or resolutions for each prison. This means that maximum security facilities vary from one unit to another in terms of yard hours, activities offered and visiting and entrustment regimes. The rule stipulates for periodic review of the stay of persons under this regime.

In Chile, there is no regulation for persons who, de facto, are in isolation for reasons associated with personal security, awaiting classification or transfer, or for health reasons. The guidelines established in the SRP to respect the fundamental rights of persons held in isolation as a sanction should be extended to any person held in isolation. However, a number of worrying situations of prolonged and unregulated isolation have been noted: people who have been in collective isolation for more than 6 months for personal security, without visits or video calls; people in isolation for tuberculosis for more than 2 months without being able to contact their families because they have no cash to call on the public telephone; women isolated in pairs in the same 3x2 cell, for weeks and 24 hours a day, without a break or any contact with the outside; people with a mental health diagnosis shackled hand and foot to the bed in the health unit of the penitentiary.

The first factor of risk of torture or ill-treatment which the CPT detects with regard to the use of isolation has to do with the fact that, with the exception of isolation as a sanction, there is no clarity as to what is the prevailing norm in the regulation of the reason, duration, conditions and guarantees or safeguards in the rest of its uses. One of the main problems with the regulations governing the execution of custodial sentences is that the REP is a Decree of the Executive which is therefore administrative, not legal, and is supplemented by various administrative resolutions issued directly by the Chilean Gendarmerie. As they do not have legal status, the regulations not only leave room for arbitrariness and discretion on the part of the local administration of the execution of the sentence, but also prevent internal supervision and external control of the reasons, duration and conditions under which this measure is imposed.

The practice of isolation used in Chile affects a large part of the fundamental rights of persons in prison, mainly associated with the precarious access to information and justice, the lack of communication with the outside world, the precarious access to hygiene products or personal hygiene and clothing, and the severe and sometimes irreversible affectation of physical and mental integrity.

The Chilean Gendarmerie records show that, as of September 2023, there are 476 persons held in isolation for personal security, either by court order (99), for exhausted segmentation (356), for high public awareness (19) or for other reasons (2). The recorded length of stay ranges from 8 days to 2,343 days, i.e. more than 6 years, with an average of 105 days (3.5 months). 92% of the persons in this situation are men. About half of the people in isolation due to exhausted segmentation are in pre-trial detention (47.2%) (GENCHI, 2023b).

National regulations prohibit the isolation of "pregnant women and up to six months after the end of pregnancy, nursing mothers and those who have children with them" (Prison Regulations, art. 86, para. 3). The CPT has, however, become aware of the use of isolation of mothers with their infants. Although this is not considered to be common, three cases were identified where the patient was isolated for up to 47 days. The infants and children remained in isolation with their mothers, having the opportunity to attend the crèche and participate in their regular outings, but were then returned to isolation.

Use of means of coercion

In Chile, there have been violations related to the use of shackles, handcuffs or restraints on the beds of pregnant women during childbirth or immediately after the birth of the child. One Mapuche woman, Lorenza Cayuhán, gave birth shackled and in the presence of male guards. Cases were also reported in which women with recent reproductive losses were transferred to the penitentiary unit without waiting for sufficient time for their recovery and using short restraint measures (handcuffs). There were also cases where women who had miscarried were transferred to the prison unit without waiting for sufficient time for recovery and using short restraint measures (handcuffs).

Mental healthcare

In its visits, the CPT has observed that there is significant demand and concern about mental health conditions. Many report receiving medication, particularly antidepressants and anxiolytics, and having had consultations with a psychiatrist or psychologist, but not receiving regular mental healthcare or treatment. Health staff report that the main conditions are related to personality disorders, which are referred to the Technical Area or the mental health programme for diagnosis and treatment.

The mental health of the female prison population should be carefully monitored, especially in the context of increasing suicide rates inside prisons.[1] According to the Technical Area of the prisons visited, it is indicated that the main difficulties of women prisoners are associated with mental health, which are usually related to drug use and personality disorders.

It was reported that, in order to receive treatment for illnesses diagnosed prior to imprisonment, women are required to present documentation of their medical condition. This measure, while reasonable and understandable, is difficult for many women to comply with as it means mobilising family members or other persons. Even more so for those who come from other regions or countries. As a consequence to the shortage of personnel and health services referred to above, the waiting time for external care is long and has consequences for the timely delivery of diagnosis and treatment.

In general terms, the low number of health professionals inside the units, the very low supply of treatment for mental health conditions, the bureaucratic obstacles that exist for the accreditation of any health condition and, especially, the lack of diagnosis and timely attention to diseases or ailments are worrying. This, considering that death due to illness is the leading cause of death in the country's prisons.

Women in Special Situations of Vulnerability

Pregnant, breastfeeding women and mothers

During its visits, the CPT has identified a number of risk factors for abuse associated with pregnant women. In relation to prenatal care, there are barriers to accessing ultrasound scans, which are generally related to lack of vehicles and staff for transfers, and lack of coordination with public health units. This situation exemplifies the difficulties associated with the lack of integration of prison health into the national health system.

In general, the pregnant women have little information about their pregnancy processes and also about the protocols regarding childbirth and postpartum in prison. The lack of information not only makes it difficult to adequately monitor the perinatal health of pregnant women and their unborn children, but also increases the levels of stress and anxiety of mothers-to-be, which are accentuated by the limited support networks available to them while they are in prison. 

As to the delivery of the baby, the women interviewed stated that they were transferred in a special vehicle, ambulances or vans to hospitals. In most cases, the baby's father or other significant accompanying person is not part of the process, which is generally carried out in the presence of a police officer. Unfortunately, the CPT has followed up on two cases in which women defendants have given birth inside prison, in one of which an Amicus Curiae12 was filed and in the other case, following an ad hoc visit, urgent findings and recommendations were issued to the authorities.13

These findings warn about the occurrence of obstetric violence and discrimination against pregnant women in prison, a situation that not only involves the Chilean Gendarmerie, but also the health staff who assist women who are admitted to hospitals from prisons at the time of childbirth.

Women prisoners and staff report that there is little capacity to provide psychological and mental health intervention for mothers to adequately accompany the postpartum period in prison. The intervention professionals interviewed highlighted this as something pending and very necessary in the context of imprisonment.

In addition, the CPT’s monitoring of cases of infants born to sentenced women who had not been registered in the civil register while in the custody of the Chilean Gendarmerie has revealed a violation of the children's right to identity, given the failure to comply with the legal deadline (max. 30 days) for their registration, which also affects the children's access to other rights.

The CPT noted during its visits that, in the event of release, sentenced women generally have greater facilities than convicted women to leave the prison with their children and accompany them on their health checks. In the case of convicted women, these permits are more cumbersome and the rule is that they do not accompany them in cases of medical trips abroad, since in their cases it is the courts that must authorise departure. In this regard, the CPT is particularly concerned regulating and equalising access for children of convicted and sentenced mothers, and that access to healthcare for children without discrimination should take precedence over the procedural status of the mother.

A good practice observed relates to the coordination between the Ministry of Health and the C.P.F. Mayor Marisol Estay de San Miguel to register pregnant women at the clinic, allowing them access to benefits from public programmes.

At a structural level, it can be argued that access to healthcare for the entire prison population is not provided in the same way from one prison to another prisons, and there is also inequalities in access to healthcare between convicted and sentenced women who live with their children in prison. In many cases, it depends on the particular arrangements of the facilities with the local health network. The prison health authorities are aware of this situation and are concerned about it and are working together with the Public Policy Division of the Ministry of Health and Chilean Gendarmerie to improve access to healthcare for pregnant and breastfeeding women.

Foreign or indigenous women

The CPT has highlighted important findings on the situation of foreign women in Chilean prisons, the vast majority of whom have been charged. In the northern part of the country, a large number of them are charged with or convicted of offences under Law 20,000 on drugs, and many belong to indigenous peoples. The programme offer is extremely limited and lacks a gender perspective and an intercultural approach. There has been little or no contact with relatives and support networks to receive parcels, clothes, warm clothes or personal hygiene items, and they have to carry out activities such as washing the clothes of Chilean inmates to generate means, which puts them in situations of vulnerability. Foreign women in this area generally do not have coins to use public telephones – which cost approximately 0.4 USD per minute – and are not always enabled for calls abroad. The importance of consular assistance for contact with family members and information on their legal proceedings is noted. It has been observed that migrant women and women belonging to indigenous peoples suffer verbal abuse with insults from officials and other women in prison. 

LGBTIQ+ women

The CPT’s monitoring has highlighted several important findings on the situation of some transgender women in prison. It is noted that in general a heteronormative view prevails and that sexual violence continues to be perpetrated. Men's prisons have most of the sexual diversity modules, which segment this group in a differentiated way. Self-identification as LGBT+ when entering these modules is not always fulfilled in all cases, with people being integrated for security reasons. Deficiencies are identified in the provision of reintegration activities and in access to health services, especially hormone therapy for transgender people. Of concern is the lack of confidential reporting channels and situations of mistreatment, including sexual abuse, given the high exposure of this group to these risk situations. Although progress has been made in treatment and safety, stigma and exposure to physical and sexual violence persist.

Alternatives to Detention

The CPT is encouraged by the recent and progressive development of national jurisprudence aimed at decreeing house arrest for pregnant women or women who are mothers or have children under their responsibility, as can be seen in decisions handed down in different judicial instances, the Supreme Court, some Courts of Appeal (Concepción, Chillán and Puerto Montt) and some guarantee courts (Concepción, Los Ángeles, Chillán and Puerto Montt).

In Judgement rol 50967-22 of August 2022, the Supreme Court highlights the need to take into account specific international norms regarding women in prison with children, in order to develop optional measures and alternative measures to pre-trial detention and sentencing. In other judicial instances, the Court of Appeals of Concepción and Chillán issued rulings in July and August 202214 which, following the defence's request for amparo, substituted pre-trial detention for total deprivation of liberty at home, as established in article 155 a) of the Code of Criminal Procedure.

In June 2023, the Ministry of Justice and Human Rights published the "Plan de Trabajo Condiciones Carcelarias de Mujeres Privadas de Libertad" [Work Plan for Prison Conditions for Women Deprived of Liberty], which details measures to advance the improvement of prison conditions for women with a focus on habitability and social reintegration. Following a participatory consultation, the CPT submitted methodological and content comments on the plan, some of which were incorporated into the final version. The document recognises the increase in the number of women in pre-trial detention and the need to implement a gender-specific approach in the prison system, defining a series of measures and lines of work in the short, medium and long term. Despite the progress made, the CPT has observed that some short-term and medium-term measures have not made any progress.

Other Relevant NPM Information on Women in Prison

NPM Overview

Facts and figures

Recommendations

Food for children living with their mothers in prison

• It is recommended that the General Directorate of the Penitentiary Regime guarantee the allocation of a budget for food for children living with their mothers in penitentiary facilities, clarifying that food should be differentiated according to the child’s nutritional needs and age, in accordance with Article 27 of Law 2298 Law of Penal Execution and Supervision, of 20 December 2001, Article 106 (d), Article 107 (I) of Law No. 548 of 17 July 2014 Child and Adolescent Code, Article 73 (I) of the Constitution, Rule 48 of the Bangkok Rules, Principle 4 of the United Nations Declaration of the Rights of the Child, Article 3 (3), Article 24 (c) of the Convention on the Rights of the Child.

  Healthcare

• It is recommended that the General Directorate of the Penitentiary Regime should provide specialised healthcare for pregnant women and children living with their mothers in prison, in accordance with Article 91 (2) of Law No. 2298 of 20 December 2001 (Law on Penal Execution and Supervision), Articles 36 and 37 of the Constitution, Rules 18, 33.3, 51.1 of the Bangkok Rules, Principle 4 of the UN Declaration of the Rights of the Child, Article 24 of the Convention on the Rights of the Child, and Paragraph 27 of General Comment No. 7 (2005) Implementing Child Rights in Early Childhood.

  Alternatives to detention

• It is recommended that the Supreme Court of Justice issue instructions for the exceptional application of the ultima ratio precautionary measure of preventive detention to women with and without children investigated for crimes of possession of minimum quantities of controlled substances, in application of the gender-specific approach and the best interests of the child, in observance of Rules 57, 60 of the Bangkok Rules, Rule 3.2 of the Tokyo Rules, of the Declaration of Antigua Guatemala (OAS 2013) "For a comprehensive policy against the world drug problem in the Americas", in particular Points 10 and 18.

  Work and social reintegration programmes: routine and activities

• It is recommended that the General Directorate of the Penitentiary Regime implement productive work training programmes for women in prison, which will provide them with a basic economic income during their stay in prison and a job upon release, promoting alliances with civil society, private enterprise and public entities and companies, in accordance with Articles 181 and 183 of Law 2298 Law on Penal Execution and Supervision, of 20 December 2001, Article 68 of Law No. 294, of 31 July 2012, Law of the National System of Citizen Security, Article 74 of the Political Constitution of the State, Rule 96 and 98 of the Mandela Rules. 

Detention issues

In Bolivia, there is an accelerated growth of the prison population. As of November 2023, there were 1871 women in prison, and by June 2024, this figure had risen to 2150, representing an increase of 12.5% in just 7 months.

41.26% of women in prison are deprived of their liberty for offences related to controlled substances (drugs). 12.28% of the women in prison are accused of committing non-violent crimes (e.g. theft). This is followed by murder at 7.59% and homicide 4.12%. The problem of offences involving controlled substances has been a problem for more than a decade, as data from 2012 showed that percentage of women in prison for drug-related offences was 56%. In 2018, the percentage of this type of offences committed by women reached 31.62% and in 2023, the percentage of women in prison for offences under Law 1008 rose again to 41.26%. There is clear evidence that public policies to prevent crimes and for the social reintegration of women in prisons are not respectful of human rights, and one issue of concern is Law No. 1008 of 19 July 1988, Law on the Regime of Coca and Controlled Substances (Anti-drugs Law),18 which establishes disproportionate offences with respect to the act carried out. For example, a woman consumer with minimal quantities of marijuana can be sentenced to between 10 and 25 years if she cannot prove that the quantity of the controlled substance is for her own consumption (Articles 48 and 51 Law 1008). A legal loophole was revealed in Article 49 of Law 1008 (referring to consumption), and there is a need to establish a clear definition of the maximum amount that can be legally possessed for personal consumption in order to avoid arbitrariness on the part of the authorities. In addition to the deficient regulations, there is also the mechanical application of the law by prosecutors and judges, without considering international human rights standards, such as a gender-specific approach and the best interests of the child. The situation is aggravated by the fact that 65% of women are in prison without a sentence.19

The vast majority of women prisoners in Bolivia come from the most vulnerable sectors of society: poverty, lack of job opportunities and barriers to education. 78% of the women interviewed indicated that their income before entering prison was below the national minimum wage (USD 259),20 and 38% earned their income from informal jobs (without protection of labour rights). Women's testimonies about the motives for committing crimes refer to economic needs and deception or violence against them, and in the case of repeat offenders, reasons of discrimination and isolation from society, lack of work and drug addiction were mentioned.21 Although the General Directorate of the Penitentiary Regime reported22 that more than 40 work activities are offered to women in prisons, the information provided by the Bolivian NPM during visits to prisons shows a different picture: only 3 out of 10 women are doing some kind of work within the prison facilities, mainly in the area of cooking, product sales, laundry and hand weaving, with an average income of USD 50 per month. That is to say, 70% of the inmates are not engaged in activities that produce some kind of income, which is a major concern because 60% of the women interviewed indicated that they have children outside the prison and would like to support their families financially.

Mental healthcare

63% of the women in prison interviewed by the NPM did not have a medical examination upon entry to the penitentiary facility, neither physical nor mental.23 Although the medical examination is not carried out immediately, it is carried out in the months following admission. In Bolivia, there are 60 women prisoners suffering from mental health conditions,24 representing 0.7% of all women in prison. The most common diagnoses are schizophrenia, severe depression and anxiety. There are only 17 psychologists available, not only for the initial examination of the 2150 women prisoners but for the total prison population of 30,978.

Assessment of the mental health needs of women prisoner is not carried out with sufficient regularity and with many difficulties, resulting in women’s mental health needs not being addressed in a timely manner. For example, the San Sebastian prison in the municipality of Cochabamba does not have a psychiatrist, and women with schizophrenia must receive outpatient care. However, to leave the prison, they require a court order, which is delayed due to the procedural load in the courts and the lack of officers to guard the exit. In addition, outpatient psychiatric care is not free of charge. These obstacles mean that in practice outpatient releases do not take place as regularly as they should in some prisons.25 It has been identified that in some prisons women prisoners with a diagnosis of depression have no difficulty in leaving the prison to attend their outpatient appointments. However, the testimonies indicated that it is the women themselves who have to buy their medication.26

In addition to the lack of sufficient mental health staff, interviews with health professionals and with the Departmental Directors of the Penitentiary Regime27 reported that medical, psychological and social work staff in women's prisons also have to attend to men's prisons, being staff assigned not to one but to several prisons. In some jurisdictions, staff in charge of mental health are assigned additional tasks such as organising educational activities.28

Women prisoners with mental health conditions that could pose a danger to themselves or to the rest of the prison population share the same environments as other women and children, which causes problems among the inmates. Some women with mental health conditions have reported that they feel discriminated against by their fellow inmates because of their condition, receiving verbal attacks such as "crazy, take your pills".29

The training given to staff working with women in prisons does not include a gender-specific perspective, however, there are discussions between the prison administration and the Bolivian NPM for further training of prison staff. 

Solitary confinement, isolation

29% of the women in prison interviewed by the NPM stated that they had been sent to solitary confinement at some time, and of these 29%, 63% indicated that their sanction was for 5 to 10 days, and that the sanction was issued by the Director of the prison. 70% of the inmates who were sent to solitary confinement stated that they were heard before the sanction was issued, but to no avail. They also mentioned that adequate safeguards are not respected or established, as no medical visits are made to assess them physically or mentally, and additionally, when the inmates are in solitary confinement, they are not permitted to receive visitors.30

Women prisoners reported that isolation of pregnant women, breastfeeding women, women detainees with young children and women with psychosocial disabilities is not used in practice.31

The inmates reported that solitary confinement was only applied when the offence committed was serious or very serious, and when the offence was not serious, the inmates carried out punishments such as cleaning activities and help in the kitchen.32 However, in the Morros Blancos prison in the city of Tarija, solitary confinement for two weeks is common place, just for the fact of entering the prison for the first time, that is to say, this isolation is applied as a way of "acclimatisation" to their imprisonment. This practice was used in all prisons to prevent Covid-19,33 however, the national health emergency for Covid-19 was lifted in Bolivia in July 202334 so such measures should no longer be applied.

In the dialogues and interviews conducted with women prisoners in the various prisons visited, none of them mentioned that they had been places in solitary confinement for their safety or with their consent. This data reinforces the fact that prisons with a female population do not have high levels of violence among inmates.

On-site observations carried out by the Bolivian NPM observed that the isolation cells have different characteristics in each of the country’s regions, but that all of them are in poor condition. For example, in the city of Cochabamba, in the San Sebastian prison, the solitary confinement cell is an room of about 1 metre by 1.5 metres, where there is only space for a mattress on the floor, and it was observed that it was occupied by 3 women. There is no artificial light, no natural light and even less ventilation.35 On the other hand, the isolation cell in the Morros Blancos prison is much larger, 4 by 5 metres, has adequate lighting and natural ventilation, as well as a toilet. However, there are no cots, only blankets on the floor, and as this room is used by the new inmates, at the time of the NPM visit, there were 6 women in this cell.36

Recording of the use of solitary confinement is not uniform and, in many cases, the information is incomplete. 

Women in Special Situations of Vulnerability

55.39% of the women in prison are also pregnant women (5 women), mothers living with their children under 6 years of age in prisons (145 mothers), women with physical, intellectual and psychosocial disabilities (62 women), elderly women (60 women), LGBTQ+ (47 women), indigenous women (556 women) and Afro-Bolivian women (15 women), foreign women (86 women), women with HIV (46 women) and sexually transmitted diseases (10 women), drug-dependent women (42 women), whose needs are not met by the State in accordance with the differentiated approach established in international standards, which implies impairments that have a disproportionate impact on their lives while in prison. It has also become evident that data collection in prison registers is carried out without considering the differentiated approach, so that the categorisation of groups in situations of vulnerability is inaccurate and the registers are incomplete. This means that the problems and needs of these groups are invisible, and that there are no complete official statistics.

LGBTIQ+ women

47 women in prison have identified themselves as lesbians from the LGTBIQ+ community, who freely express their sexual preference; however, they perceive that they are discriminated against by their colleagues and by the police. According to information from the women interviewed, they indicated that some of their peers do not openly express their sexual identity due to reprisals.

Pregnant, postpartum and breastfeeding women

In all the prisons in our country with a female population, there are 5 pregnant women. Although the number of pregnant women is minimal, they do not receive the attention and accompaniment of a gynaecologist or obstetrician in the facility, who can monitor both the mother and the unborn child for complications that could put the health of both of them at risk. Similarly, her condition as a pregnant mother is not taken into account in order to obtain the benefit of house arrest or alternative precautionary measures to pre-trial detention. None of the penitentiary centres have separate and adequate rooms for women to give birth. Once they have been medically discharged, which is usually the day after the birth, they must return to the precarious conditions of their cells with their newborn baby, compounded by the fact that most of the cells have no toilets and are locked at night. In addition, conflicts arise with their cellmates due to the changes that a newborn child implies, for example, crying at night.

Women in prison with their children

A total of 145 children under the age of 6 accompany their mothers in prisons across the country. The prison authorities are failing to meet the basic needs of these children. The situation of these children in relation to their food is worrying, that is to say, in none of the penitentiary facilities do they receive a specific diet according to their age. In all cases, they are fed with the same food as their mothers, with the aggravating factor that the mothers do not receive any increase in the budget allocated to them by the State for food (1 USD per day).

Similarly, the health situation of children (under 6 years of age) is worrying, i.e. there is no specialised care from a paediatrician who can attend to the health needs of these children, as it is the general practitioner who attends to the entire prison population (men, women, boys and girls).

Likewise, due to the characteristics of imprisonment, these children find themselves in an environment that is harmful to their development, as they experience different situations typical of prisons, where there are acts of (verbal) violence between inmates, as well as interaction with inmates who use drugs and alcohol.

Finally, in terms of their development, there are no staff who can stimulate their motor and cognitive abilities, so the children’s development is affected. As a result of this isolation, the children lose permanent contact with their extended family, and in some cases the mother and child are abandoned by their family, which has repercussions and affects their emotional health and causes them to fall behind emotionally and educationally.

Older women

There are 60 women over 65 years of age who are interned in Bolivian prisons. They do not receive specialised medical care from a geriatrician. However, they receive a food supplement, as well as an income for the elderly provided by the State, and the great majority of them mentioned that they receive visits from their relatives.

Indigenous and ethnic minority women

In the detention facilities, there are inmates of Aymara, Quechua, Guaraní, Chiman and Afro-Bolivian origin. Most of them did not experience any communication difficulties during their court proceedings. In addition, the prisons are located in the department of the community to which they belong, so they are able to receive visits from their families. However, the inmates feel discriminated against by their fellow inmates because of their ethnic origin. The data provided by the prison administration36 was found to be inaccurate. For example, in the Cochabamba Department, where there is only one prison for women (San Sebastián Mujeres), there are 305 Quechua women and 138 women from the Aymara nation. However, there are no more than 300 inmates in San Sebastián.

Foreign women

In 2023, there were a total of 86 foreign women37 in Bolivian prisons: Colombia (18), Peru (17), Brazil (17), Paraguay (9), Argentina (7), Venezuela (5), Chile (3), Ecuador (3), Mexico (1), Spain (1), Portugal (1), Germany (1), China (1), Pakistan (1). 59% of them are detained for drug-related offences. Interviews conducted by the NPM identified that some of the foreign women had no contact with their embassies or consulates.
 

Alternatives to detention

Alternatives to pre-trial detention (bail, house arrest, probation, etc.)

Article 232 of the Code of Criminal Procedure37 stipulates that the precautionary measure of pre-trial detention is not appropriate for pregnant women, nursing mothers of children under one (1) year of age, who have under their guardianship, custody or care a child under six (6) years of age or a person with some degree of disability. The inappropriateness of pre-trial detention has limitations with respect to several offences38, among them, the prosecution of crimes of "drug trafficking and controlled substances" and "of patrimonial content that are exercised with physical violence on persons", which makes the gender focus with which it was conceived less applicable, since 41.26% of the crimes committed by women are related to the supply, trafficking and transport of controlled substances. This is followed by the crime of aggravated robbery with 10.37%, crimes that predominate in cases involving women for years,39 even more so if we add to this problem the fact that the offence of trafficking is classified as a crime regardless of the quantity and type of controlled substance found in possession or the fact of proving that the person is a consumer. In cases of property-related crimes, the criminal offence of aggravated robbery is used, which incriminates the woman without taking into account her degree of participation in the crime (women generally act as companions, watchers of the crime committed by their partners or friends).

Article 231 bis of the Code of Criminal Procedure establishes 9 alternative measures to pre-trial detention, which are not applied and are not based on a gender perspective for women.

Non-custodial sentences (suspended sentences, deferred sentences, community service, etc.).
Article 76 of Law No. 34840 provides for alternative sanctions, which will be ordered as long as the perpetrator is not a repeat offender, and the sentence does not exceed three years, or at the request of the person sentenced to imprisonment for more than three years who has served at least half of it (in the same way, they  should not be a repeat offender). Alternative sanctions to imprisonment may be applied, consisting of: fines,41 weekend detention,42 community work.43 In the event that they are granted, the authority must also dictate security measures44 in favour of the victims and their family environment, and the judge is empowered to order a behavioural plan for the sentenced person. These alternative sanctions are not applied in practice, given that, as they involve crimes of violence against women, which are subject to strong social and media pressure, judges are inclined to hand down sentences of more than three years, and it would then be up to another judge in charge of controlling the execution of the sentence to decide on the application of non-custodial sentences.
On the other hand, Article 431 (Deferred execution) of the Code of Criminal Procedure45 gives the possibility to defer the execution of the sentence in the case of a pregnant woman or a woman who has a child under one year of age; however, women do not agree to the deferred execution of the sentence, mainly due to lack of knowledge and inadequate legal advice, also due to excessive requirements to demonstrate the concurrence of legal domicile, as well as the requirements of surveillance and guarantors.
Regarding the serving of the sentence, Article 197 of Law 228946 establishes that inmates who are six months or more pregnant may serve the sentence imposed in house arrest for up to ninety days after giving birth, a benefit which is subject to the procedure foreseen for prolonged releases foreseen in Article 16747 of the same legal body. This measure, as well as the deferred execution of sentences, has requirements that are difficult for women prisoners to meet: It is not applicable to all crimes, it requires the serving of two fifths of the sentence, the presentation of guarantors and necessarily the accreditation of domicile, among other requirements.

Other Relevant NPM Information on Women in Prison

NPM overview

Facts and figures

Recommendations

Body searches

• The Ministry of Justice and Public Administration should inform all penal institutions about the necessity of keeping records of all undertaken comprehensive searches which will show who was searched, when, by whom, for what reason and what did the search find.

Contact with the outside world

• Provide conditions for women to serve prison sentences longer than 6 months in prisons closer to their place of residence. Until then, it would be desirable to allow them longer (family) visits, increase the number of video visits, etc.

Mental Health

• Intensify the monitoring of the mental health of women in the prison system, especially taking into account specific risk factors (for example, pregnancy, time after childbirth, etc.).

Healthcare

• Respect patients' right to privacy during medical examinations of the inmates. Prison officers can only be present when this is requested by the physician.

Life in prison: regime and activities

• Enable women in prisons who have not completed primary education to participate in adult education programmes.

Detention issues

Body searches

1. Legal and regulatory framework

Searches are regulated by the Act on Execution of Prison Sentences and the Rulebook on Security work in the Prison. Searches can be partial49 or thorough and they should be performed by a judicial police officer of the same gender as the person being searched, unless technical equipment such as a detector are used (in accordance with rules 19 and 20 of the Bangkok Rules).

The Rulebook on Security work in the Prison System also contains provisions on examination of body cavities (performed by a doctor in a separate room, in the presence of a judicial police officer of the same gender as the person deprived of liberty).

The norms regulating thorough searches go too wide and not clearly enough when defining the situations in which the inmates (both women and men) can be searched. Thus, searches can be conducted at different moments such as: during admission; at the moment of release; before and after escorting; prior to accommodation in a specially secured room devoid of dangerous objects; during the separation from other inmates; before being accommodated at a ward with a higher level of monitoring and isolation from other inmates; before being put into solitary confinement; every time prior to leaving a prison, a closed or a semi-open penitentiary and after every return; prior to and after receiving an unmonitored visit; following the return from a workplace to a prison, closed or a semi-open penitentiary if there are grounds to suspect that the inmate has in their possession or is concealing objects or matter the possession of which is not allowed.

1. In practice

During visits conducted by the NPM, some women prisoners complained about the same inmate being subjected to thorough searches several times a day. The NPM continues to point to this problem and keeps requesting the harmonization of the national norms with the international standards. 

A thorough search of a person is carried out by at least two judicial police officers of the same gender as the person being searched, in a separate room, without the presence of other persons, with a detailed examination of the person and an insight into the contents of the clothes, shoes and belongings of the person being searched. When undressing, a person first takes off the upper part, after which they put on their shoes, and then the lower part. When searching a person and their belongings, technical equipment (detectors, X-ray devices, mirror system, etc.) may be used.

The NPM’s recommendation on the necessity of keeping records of performed thorough searches was accepted, and a record is drawn up of each performed search, regardless of whether illegal items were found.

In practice, thorough searches of women are always carried out by women, without the presence of male judicial police officers. Intimate body cavity searches are carried out extremely rarely.
 

Women in special situations of vulnerability

The Act on the Execution of Prison Sentences contains provisions related to the protection of motherhood. It is regulated that pregnant women and mothers with the child they gave birth to while serving a prison sentence are provided with comprehensive health care related to pregnancy, childbirth and motherhood. 

Mothers with children in prison

According to the Act on the Execution of Prison Sentences,49 the child stays with the imprisoned mother at the request of the mother, if, according to the assessment of the competent centre for social welfare, this is in the best interest of the child, until the child reaches the third year of life, and exceptionally until the end of the prison sentence if the remaining part of the sentence is no longer than six months, after which the centre for social welfare takes the necessary measures within its jurisdiction. During the stay of the child with the imprisoned mother, the penal institution (i.e. prison) ensures that the child stays in a pre-school outside the penitentiary or prison.

According to the report of the Ombudswoman for children from 2021 , there is a difference in treatment in relation to the (non) separation of children from their mothers, i.e. there is a difference whether the mothers are convicted prisoners or remand prisoners. Children born while their mothers are in prison can stay until they turn three, while young children born shortly before their mothers are sent to pre-trial detention or prison must be separated from their mothers. As set out in the Convention on the Rights of the Child, children must have equal rights regardless of the legal basis for the deprivation of liberty of their mother.

Alternatives to detention

Alternative sanctions are still not satisfactorily represented, as pointed out in the NPM’s annual reports. This pertains to all, women included.  In 2022, as part of the Electronic Surveillance Project, equipment for electronic surveillance was acquired and a Supervisory Centre for Electronic Surveillance was established in the Ministry of Justice and Administration. In addition, the Ministry has started drafting the prerequisites for the application of electronic surveillance and pre-trial detention, and the Draft Rulebook on pre-trial detention in a home with electronic surveillance has also been drafted. 

The NPM considers that these measures will contribute to greater application of alternatives to detention, and will continue monitoring progress, including the existence and implementation of alternative measures specifically for women or any discrimination in application of existing alternatives.

Other relevant NPM information on women in prison

NPM overview

Facts and figures

Recommendations

Access to healthcare 

• Increase the number of nurses in prisons, by systematically including a female member of the medical team to better take into account the specific needs of women prisoners.
   

Sanitary facilities and personal hygiene

• Ensure that prison infirmaries are better supplied with products that meet the specific needs of women (discomfort linked to the menstrual cycle or the menopause).

• Improve the conditions under which women are held in Togo, with an emphasis on human dignity, in particular their right to a healthy lifestyle (better quality of water and food).   

Detention issues49

Body searches

a. Legal and regulatory framework

The current Togolese Code of Criminal Procedure and the new one currently being adopted do not define the circumstances and procedures for body searches in general terms. However, it should be noted that, in practice, the rules relating to searches of persons deprived of liberty set out in the Nelson Mandela Rules are observed.

b. The use of body searches in practice

Women detainees and those visiting relatives in prison are searched only by female staff and out of sight of male staff, although there are no indications to this effect. A booth is provided for this purpose. Alternative search methods are available and are often used in some of the country's prisons in an informal and non-harmonised manner (e.g. Atakpamé).

c. Registers

Information relating to body searches is not recorded in a specific register. Only information concerning the list of personal belongings at the start of custody, or deferral, is noted in the custody register or in the detention register, depending on the circumstances.

d. Invasive searches

Invasive body searches may be carried out in exceptional circumstances, by trained and authorised healthcare personnel if cases arise.

Solitary confinement 

a. Legal and regulatory framework

Togo's criminal law does not contain any legal provisions governing solitary confinement. In practice, however, solitary confinement is subject to administrative authorisation from the competent authority.

b. The use of solitary confinement in practice

Women may be placed in isolation for their own protection when they exhibit abnormal behaviour, but this is not systematic. In all cases, isolation is carried out with the consent of the women, taking into account the seriousness of the situation and depending on the availability of cells. The configuration of isolation cells is no different from that of ordinary cells. There is no record of the use of solitary confinement for women.50

Use of means of restraint 

a. Legal and regulatory framework

There are no national regulations governing the use of means of restraint to control women in detention.

b. The situation in practice

Restraints are not used on women in civil prisons. However, in psychiatric institutions, restraints are used to control all patients who exhibit violent behaviour.

Access to mental health care 

Very few persons deprived of liberty undergo an initial medical examination when they are admitted to the prison. The majority of detainees are integrated directly into the group without following any health procedure. This is due to the lack of material and human resources in prison infirmaries, which hinders prisoners' access to healthcare. Women's mental health care needs are not systematically formally assessed. However, the prison service takes the necessary steps to ensure treatment for women with mental health conditions. Serious cases are referred to psychiatric hospitals, and less serious cases are managed with the help of prison infirmaries.

Any detainee (male or female) with mental health conditions is referred to a centre for appropriate and adequate treatment. The only public psychiatric centre is based in the south of the country and can only accommodate a limited number of patients.
 

Women in special situations of vulnerability

Pregnant women and women with young children

Pregnant women and women with young children in detention are particularly at risk because there is no appropriate legal framework to protect this category of the prison population, and prisons and their facilities do not meet their specific needs.

It is important to note that the Children's Code provides for alternative measures to detention for this category of detainees, in particular article 441, which stipulates :

• “That a sentence other than imprisonment be considered first in all cases where a decision will have to be rendered against them; 

• That it is necessary to establish and promote measures to transform imprisonment into an institution for their treatment; 

• To create special institutions to ensure their detention; 

• To prohibit a mother from being imprisoned with her child".

However, these measures are rarely used in practice. 

NPM overview

Facts and figures

Recommendations

Solitary confinement, isolation

• Eliminate prolonged isolation and solitary confinement practices by implementing measures to ensure access to educational and work activities, access to the yard or outdoors for at least one hour a day, and regular communication with families. 
  Body searches
•  In the control of admissions, seek the use of alternative means to the procedure carried out by prison staff (officers or operators) for the screening of persons entering for visits. The progressive incorporation of technology that can replace more invasive methods of screening should be encouraged. Care should be taken to ensure that such technology does not harm the health of those who enter.  
  Healthcare
• Incorporate new external custodial staff into the unit for consultation days, without prejudice to the entry of permanent staff, as a strategy to guarantee access to healthcare for women. This proposal is a palliative measure to be applied immediately, while other mechanisms to solve and overcome the obstacles that have been identified continue to be analysed .
  Mental healthcare 
• Strengthen mental healthcare by providing adequate financial resources and the necessary number of professionals to form interdisciplinary teams, ensuring a comprehensive approach . 
• Guarantee access to specialised mental health services that ensure that women in prison receive the minimum standards required of any person using health services in Uruguay . 
  Alternatives to detention
• Prioritise the use of alternative measures through assisted home detention.
   

Detention Issues

In recent years, Uruguay has been registering a significant growth in the prison population, which as of 1 September 2023 reached 15,000 persons. The growth trend is also observed for women, whose share is higher than that of men, exceeding 1,115 on 31 July 2023, which represents approximately 8% of the total, in addition to 50 children with their mothers and 12 pregnant women. The level of overcrowding in prisons also affects women. In the only facility exclusively for women prisoners in the country (Unit 5 in Montevideo), the rate of overcrowding exceeds 160.53

Body searches
a.    Legal framework
Article 26 of the Prison Inspection Regulations approved by the National Rehabilitation Institute (INR) establishes the procedure to be used in cases where there are no scanners for checking prisoners. It stipulates that the check must be carried out by prison staff in a professional manner in such a way that it does not affect the dignity of the person.54 Article 28 expressly states that in the case of a "general inspection" the search must be in accordance with the Nelson Mandela Rules. Article 34 of the regulations also states that the inspection must be carried out by persons of the same gender, specifying the procedure in the case of transgender persons.
Body searches in practice

The penitentiary units where women are imprisoned do not have scanners for the control of visits, with the exception of units 3 (Libertad) and 4 (Comcar) where transgender women were housed.

Thus, although the visiting control mechanisms are regulated, the NPM has received regular complaints from prisoners about situations experienced by family members. These include aspects such as delays (in some units in spaces without or with little protection from inclement weather), variations in the criteria for authorising entry (mainly related to clothing) and the use of invasive body search mechanisms. In the monitoring carried out by the NPM, testimonies have been collected that show the existing difficulties in controlling the entry of LGBTIQ+ visitors.

Solitary confinement, isolation

As a result of the monitoring carried out by the NPM, situations of isolation and prolonged solitary confinement have been in the facility dedicated exclusively to women (Unit 5, Colón – Montevideo). Due to its size, this is the main establishment for women, located on the site where the Musto Hospital operated until 1996. The unit is divided into a ground floor and four upper floors and is organised into sectors 1, 2 and 3 (these in turn divided into "East" and "West") and levels 4 and 5 (which in turn are separated into two wings). This last level is considered maximum security. Each wing has cells facing a corridor through a metal door with a small barred window and a toilet. The building has serious maintenance problems, particularly with regard to the electrical and sanitary installations.

The information gathered during the visits and the analysis of the registers reveal situations of isolation and prolonged isolation used on a regular basis in level 5, some of them for an extended period of time.

The reasons for referral to this level are briefly recorded in the registers (together with notes that give an account of general movements), with a broad and loose definition of security as a criterion. Cases have been verified in which the decision is taken for reasons of internal security, assessment on entry to the unit, conflicts in other sectors and mental health issues.

These situations are observed in the context of the difficulties of Unit 5 to adequately guarantee the security of women prisoners. On level 5, as is also the case on level 4 and in sectors 3, activity is reduced to exits to an interior courtyard on the same floor. In these, contact with women from other sectors is limited by security criteria established by the unit, with no access to educational activities and work activities restricted to cleaning the area. The report produced by the NPM in August 2023 recommended that the authorities take the process of improvements made on level 5 (which involved temporary relocations on an alternative basis in only one of the wings) to end all forms of isolatiom.55

The NPM's monitoring has not found any situations of isolation of children in the units where they are housed with their mothers. 
In a women's prison unit, women with acute or chronic mental health conditions were found in a security sector, in precarious conditions of confinement and prolonged isolation, which contributed to the worsening of mental health disorders.56
Mental healthcare

Access to mental healthcare for women in prison differs according to the department of the country to which it refers, mainly due to the different healthcare providers and the characteristics of each unit.

The NPM has monitored units 4 (trans women), 5 (women) and 9 (women with children and/or daughters) within Montevideo, as well as the female sectors of units 13, 20 and 24 in the interior of the country. In the units of the capital, healthcare is provided by the comprehensive care service for persons deprived of liberty (SAI PPL) of ASSE. In turn, within Montevideo, there are also specific differences in the assessment during the admission of women and transgender women.

Women in prison units, unlike men, do not have a centre for admission, diagnosis and referral. However, transgender women are initially assessed in this space designed for men’s entry into the system. In this unit, a medical examination and an initial assessment of mental health status  of the individual is carried out, mainly looking for signs of acute disorders. The first approach to the INR gender unit is also made.

The units monitored by the NPM since 2019 have an initial assessment form that must be applied on admission by medical staff in all cases. This form includes a section that refers to "psychiatric history", i.e. "psychiatric pathology, treatments, hospitalisations (Y/N): when and where, self-harm attempts and consultations with psychology".

However, comprehensive screening to determine women's mental healthcare needs is not always implemented. The NPM has observed that the information is not always adequately completed and, in some cases, is not applied at the time of admission, for various reasons such as lack of medical staff or that only a superficial examination is implemented that mainly on the identification of injuries without completing the pre-established form. This situation has led the NPM to develop recommendations along these lines to ensure that the interview on admission is carried out uniformly in the different units and that the established minimum standards are met.

Specifically in reference to unit 5, in cases where a suicide attempt is identified, the medical staff on duty, in liaison with the psychiatry department, will carry out an initial assessment and determine, if deemed appropriate, will decide on referral to the emergency department of a public hospital.

The modality of care, as well as the staff available, differs from place to place. The SAI-PPL (ASSE) has set up a method of teleconsulting with the Psychiatry Department for Units 5 and 9. For Unit 4, where transgender women are held, there is a psychiatrist who attends in person. In the case of the units in the interior of the country, where the provider is DNASS, there is no psychiatrist, so consultations are carried out in the departmental hospitals. The exception is Unit 13 in Maldonado, where there is one psychiatrist who attends on Saturdays for the whole facility, which is not enough and here is a long waiting list for care.

Due to a variety of circumstances, prisoners currently only have the option oof teleconsultation, i.e. only Units 5 and 9 have psychiatric care in the unit and the others are subject to the availability of care providers as well as the possibility of fulfilling the consultations, for example due to problems with transfers due to lack of mobile phones or custody, among others.

On the other hand, SAI PPL of ASSE has a mental health team that is in charge of working with the directorates of all the Units, as well as engaging with persons in prison. In the case of women in Units in Montevideo, they have fortnightly consultations when deemed appropriate (in agreement with the women, i.e. it is not mandatory), while they have a monthly meeting with the management to discuss a comprehensive approach to the most complex situations from the different institutions.

It should be noted that the number of professionals involved in women's mental healthcare within the prison system is not sufficient to guarantee the right to access to the highest possible standard.

Although in some facilities, such as Unit 9 for women with children, workshops on mental health have been held for women prisoners with the main objective of raising awareness on the issue, in most of them there are no promotion and prevention activities. Likewise, there is no specific training or training that takes into account the gender perspective in the assessment and approach to mental health of women in prison.

Women in Special Situations of Vulnerability 

LGBTIQ+ women
During 2023, the NPM in Uruguay has focused its monitoring on the transgender population, including specific visits to Module 9 of Unit 4 where transgender women are housed within a male unit. One of the visits was carried out jointly with the Parliamentary Commissioner. At the time of the visit, there were 14 transgender women in the unit. According to what was observed, in general the accommodation conditions were uneven, as in some cases the cells had poor ventilation, no lighting, no hot water, and in other cases, although they were better, the electrical installations were precarious. Most of them had little or no activities.
Indigenous and ethnic minority women
As far as racial ethnic minorities are concerned, there is no official data on them, but some research56 indicates an over-representation of women who self-identify as Afro or black, which ranges between 24% and 27% of the prison population. Despite this data, there are no actions and/or mechanisms for the specific attention of this group.

Alternatives to Detention

In October 2022, Law 20075 was passed, which in its article 136 creates the National Directorate of Assisted Liberty Supervision, replacing the Office of Assisted Liberty Supervision, which means a change in status, while creating an instance of national scope, with a single directorate under the orbit of the INR. This new institutional framework takes charge of all judicial measures that provide alternatives to the imprisonment, such as probation, house arrest, periodic presentation at police stations, community service, use of ankle monitors, among others. 

The last legislative reform carried out by Law 19.889 (2020) has resulted in a toughening of penalties for crimes related to minor trafficking of psychoactive substances, by increasing the minimum penalties for criminal offences, with a strong impact on the number of women in prison. The modification made to Article 36 of Decree Law 14.294 resulted in the application of a minimum penalty of four years' imprisonment for different situations related to micro-trafficking, including when an attempt was made to bring psychoactive substances into the vicinity of or inside a prison facility. The consequence of the application of this legislation was the sentencing of a significant number of women with dependent children. Thus, after several proposals for changes and discussion on the issue, several articles were included in the last Law on accountability in order to respond to this situation. 

In this regard, the draft accountability bill (2023) incorporated an article 173 that amends Decree Law 14.297, by incorporating article 37 BIS to Decree Law 14.294 (among other changes). This article establishes the possibility of applying the general provisions provided for in Article 87 of Law No. 9.155 of 4 December 1933 (Criminal Code) for attempted offences. This proposal for changes, incorporated into the current accountability, aims to mitigate some of the effects of Law 19.889 in relation to the situation of women with dependent children. Without prejudice to this, it establishes as an accessory penalty the disqualification for a maximum period of five years from entering prisons and detention centres for adolescent offenders. 

Other Relevant NPM Information on Women in Prison

NPM overview

Facts and figures

Recommendations

Access to healthcare

• Increase the number of medical and paramedical staff that treat women detainees. 

Mental health

• Implement a strategy to protect the mental health of women in detention.

Sanitary facilities and personal hygiene

• Consider the specific needs of women in detention, especially with regard to the supply of personal hygiene products and clothing, as well as medical products. 

Alternatives to detention

• Encourage the use of non-custodial sentences.

Detention issues

Body searches

Legal and regulatory framework

Article 16 of law no. 2001-52 of 14 May 2001, relating to the organisation of prisons in Tunisia, stipulates the principle that "detainees shall be subjected to strip searches periodically and whenever deemed necessary, both at night and during the day." As a result, the legislator has given the prison administration complete latitude in the use it can make of this control measure, with no framework of any kind intended to limit the circumstances as much as possible in which a personal search can be ordered or to determine the procedures for its implementation, in particular its nature and frequency.

In this context, note no. 58 issued by the DGPR (the Tunisian prison administration) on 23 August 2019 provides all the useful and necessary clarifications. However, this is not the case with regard to the identified need to determine the nature of the searches that are authorised depending on the circumstances. In fact, by using the generic expression "search" without any other distinguishing details, the note has the same shortcomings as Law no. 2001-52 of 14 May 2001. However, in the principles set out in the preamble to the memorandum it should be noted, namely that any search of a detainee must be conducted "in conditions that preserve human dignity and physical integrity"; that it can only be conducted by staff who have received specific training and are of the same sex as the person concerned; and that it is implicitly forbidden to involve fellow detainees in this procedure in any way.

In addition, it is important to emphasise that note no. 58 of 23 August 2019 usefully determines, read in a limiting way, the situations in which a search should systematically be conducted. Therefore, all detainees are required to undergo a personal strip search when they are incarcerated. The same applies afterwards, when leaving the prison temporarily (for court hearings, appointments with the criminal records department or investigative services, hospital treatment, authorised visits to seriously ill relatives, authorised attendance at funerals and, more generally, during any activity outside the prison), or during any transfer from one prison to another.

In concrete terms, the search must take place before leaving the facility and must be repeated, depending on the case, either upon return to the facilities or upon arrival at the new facilities. Personal searches should also be conducted systematically within the facilities itself, both when a detainee moves around the premises (particularly for those assigned to a job) and when a detainee changes rooms.

In practice

While this set of regulations has the major advantage of precisely determining the situations in which a personal search should be systematically conducted by prison staff, it has to be said that, on the one hand, the situations provided for are very numerous and, on the other, that recourse to this measure is neither individualised nor detailed, contrary to the requirements set out in the international standards.

In this regard, memorandum no. 58 of 23 August 2019 affirms the obligation for all detainees to undergo a strip search before and after each visit. Having determined the situations in which a personal search should be conducted systematically, the aforementioned memorandum does not exclude the possibility that some searches, without being systematic, may be decided on an exceptional or more regular basis with regard to a detainee or a group of detainees, in situations other than those covered by the note.

The detention authorities keep records of the detainees' possessions that are seized upon their entry to prison. They report difficulties in managing the detainees' possessions that are seized upon entry due to a lack of storage space.

The frisk search is the most common type of search in Tunisian prisons. It is used extremely frequently. It should be noted that Note No. 58 of 23 August 2019 authorises the use of strip searches only in cases of extreme necessity. During a strip search, the person concerned is required to undress completely while keeping their underwear on to cover their private parts. The strip search must take place in a dedicated area, so that the person being strip-searched is shielded from the view of other detainees and the staff. The memorandum also specifies that all strip searches have to be conducted under the supervision of a prison security officer. Note no. 58 of 23 August 2019 explicitly prohibits naked strip-searches in Tunisian prisons.

Intimate searches

An intimate search or "cavity search" is a completely different kind of search from any of the others mentioned above, since it involves an internal bodily investigation that is inherently intrusive. Note no. 58 of 23 August 2019 explicitly prohibits such searches. On the other hand, it establishes that, in the event that there is "evidence" to suggest that the detainee is attempting to conceal prohibited objects or substances in their intimate organs, the person concerned must undergo an X-ray examination (or be examined using other similar equipment available to the administration) within the prison or, failing that, be transferred immediately to the hospital (after taking all the necessary safety precautions).

Searches on women visiting family members in prison

When visiting a detainee, all persons - family members, the detainee's lawyer, etc. - must undergo a series of security checks. Article 33 of Law no. 2001-52 of 14 May 2001 stipulates that family members who are allowed to visit their incarcerated relative must be searched. Since family visits take place in a visiting room with a separation system, members of a detainee's family are not required to undergo a personal search in Tunisian prisons. However, they are required to pass through a security portal and/or submit to a metal detector. In addition to this security measure, a number of control measures are in place. 

Solitary confinement, isolation

In the only prison dedicated exclusively to women in Tunisia, the rooms designated for solitary confinement are not used for this purpose, but rather to store their possessions. The prison management feels that the specific characteristics of women do not justify the use of solitary confinement as a means of punishment. Instead, it uses a progressive approach to punishing women in detention. It should also be noted that there are only two disciplinary isolation cells in Mannouba prison.

Solitary confinement is not used in practice for girls, pregnant women, breastfeeding women, women detained with young children and women with psychosocial disabilities.57 

The only situations in which solitary confinement is used in Tunisia's women-only prison are for health reasons. For example, when a woman is suffering from a contagious disease that poses a risk to others, she is placed in solitary confinement for a period of time determined by the attending physician. During its visit to Mannouba prison on 23 October 2023, the INPT was able to observe three women placed in sanitary isolation on doctor's orders due to a transmissible skin disease.

There is also an area for detainees classified as "dangerous" or in "security isolation". At the time of the INPT's visit, this area consisted of four cells that housed 29 detainees.

Use of means of restraint

Means of physical restraint are used when detainees are moving around outside the prison. The INPT did not observe any restraint beds during its visit to the facility. Nor did the INPT find any evidence of the use of medical sedation in prison.

Access to mental health care

The initial medical examination when a woman is first admitted to prison does not include the identification of mental health needs, including post-traumatic stress disorder and the risk of suicide and self-harm, despite the fact that the psychologist from the centre specialising in women detainees in Tunisia attends the entry visit with the doctor. However, opening a file and psychological monitoring are reserved for women detainees involved in cases that the psychologist at the prison considers to be serious.

There is no system for regular assessment of women's mental health care needs. In addition, women detainees do not receive mental health support and treatment.

Some prison staff were able to take a training course in cognitive and behavioural therapies. It should be noted that the INPT does not have a detailed inventory of all the training provided to staff. However, the information gathered during interviews with staff working at the prison led to the conclusion that the training provided to staff working in the women-only prison and the women's units does not include a gender perspective in order to be able to identify cases where women may be experiencing particular distress, to respond to women's needs and to refer them to specialist support.

Access to healthcare

The list of medicines available in the prison nomenclature does not include certain necessary medicines, particularly those prescribed for women, such as vaginal ovules prescribed for genital infections for women in detention, which means that the administration has to purchase these products from the budget allocated to the social security fund.

Contact with the outside world

The Law of 14 May 2001 says nothing about the possibility of a detainee and their spouse having a visit that allows them to meet in private, whether these visits take the form of "conjugal visits" (in the terminology of the Nelson Mandela Rules) or "long-term visits" (in the terminology of the European Prison Rules). According to international standards, not only should such visits not be excluded, but should be allowed in order to allow the persons concerned to have an intimate relationship.

Clearly, it cannot be deduced from the absence of any mention of it in the national law that intimate relations between spouses are not allowed. However, it has to be said that it is not explicitly authorised under prison law. This means that those concerned must either run the risk of being caught in the act and punished accordingly, or abstain from all sexual activity during the entire period of detention. It is important to remember that no legislative text states that the prison sentence or placement in pre-trial detention should have the effect of depriving the incarcerated person, let alone their spouse, of a normal sex life.

The possibility of getting married in prison

Apart from the fact that Law no. 2001-52 of 14 May 2001 does not say anything about it, there is no procedure for getting married in prison. However, in practice, a detainee has the right to marry, but without the possibility of "consummating" the marriage in prison. The request must be made to the prison administration or the Public Prosecutor (depending on the status of the person concerned, whether the detainee is convicted or in pre-trial detention), who may authorise the celebration of the marriage in the prison to which the civil registrar will have to travel. The detainee's spouse and witnesses must be granted permission to visit the prison.

Sanitary facilities and personal hygiene

Certain personal hygiene products are not issued systematically and require a doctor's prescription to justify the purchase. For example, a depilatory cream requires a medical prescription in accordance with prison regulations.

Women in Special Situations of Vulnerability

Pregnant women, breastfeeding mothers and women with children in prison 

Law no. 2001-52 of 14 May 2001 stipulates that "pregnant detainees shall benefit from prenatal and postnatal medical assistance", that "the necessary steps shall be taken to ensure that children are born in hospitals outside of the prisons" and that for children born in prison "it is strictly forbidden to mention their place of birth in civil status registers, extracts and copies thereof" (art. 8).

Law no. 2008-58 of 4 August 2008 inserted a useful article into the 2001 law stating that "pregnant or breast-feeding women detainees, during the period of pregnancy and breast-feeding, are incarcerated in an appropriate space built for this purpose, which offers medical, psychological and social assistance to the mother and child", adding that "the aforementioned space is guarded by female guards in civilian clothing" (art. 7 bis). This insertion was accompanied by an amendment to article 9 of the 2001 Law regarding the conditions of care for children born in prison, which now states that "children accompanying their mother, during their incarceration in the appropriate pavilion referred to in article 7 bis of this Law, are allowed to remain there until they are one year old, this period may be extended for a period of no more than one year, in which the best interests of the child are taken into consideration." However, it should be specified, on the one hand, that "children born in prison" are "subject to the same regime" and, on the other hand, that "the local competent Family Court rules, at the mother's request, on cases of extension." In any event, "on expiry of the period of admission of the child with its detained mother, the child shall be entrusted to its father or to a person chosen by the mother, failing which the prison administration shall inform the judge responsible for the enforcement of sentences, who shall refer the matter to the Family Court with local jurisdiction so as to order the appropriate measures with regard to the child" (art. 9 new). 

It is worth noting the change brought about by the 2008 law concerning the maximum age at which a child may remain with its incarcerated mother. By setting the maximum age at two years old, the legislator took a step back from the previous provisions set out in decree no. 88-1876 of 4 November 1988 on the special regulations for prisons. Article 9 of that decree provided that "children accompanying their mothers on admission to prison" could "be accepted and remain there until they reach the age of three." This was also the case "for pregnant detainees who give birth in prison." This period could "be extended at the request of the mother and with the agreement" of the prison administration. 

The development of appropriate spaces in the Mannouba, Sousse-Mesaadine, Sfax and Harboub prisons reflects the implementation of these provisions.

Alternatives to detention

Certain non-custodial sentences have been imposed on women, such as suspended or deferred sentences. However, community service and community treatment sentences are not applied to women in Tunisia on the pretext of gender specificities.

The Ministry of Justice has announced plans to use electronic bracelets for probation.  However, this project has not yet been implemented. 

NPM overview

Figures

Recommendations

Separation

• The Commission recommends that women be placed in facilities that are appropriate for them.

• Women should only be detained in small mixed facilities that meet the specific needs of women.

• Take steps to create a cell block reserved for women detainees, and not just separate women detainees from men by means of cells.

• Take measures as soon as possible to allow women detainees to walk around out of sight.

  Isolation

• Given the de facto isolation of women detainees and the fact that they are only separated from male detainees by their cells, and given the sometimes lengthy detentions, the Commission strongly recommends that women be placed in facilities that are appropriate for them or that alternatives to detention be considered.

  Access to healthcare

• Facilities housing women detainees should provide gender-sensitive health care, in accordance with the provisions in force. These services must take fundamental aspects into account such as free access to hygiene products, contraceptives and screening, as well as appropriate accommodation and treatment for pregnant detainees or mothers. 

• Ask sex-specific questions as part of the intake interview.

• Provide healthcare services with at least one female healthcare professional or doctor.

• Ensure that at least one female staff member is present during medical examinations, with the consent of the woman concerned.

  Contact with the outside world

• Family visits must always be guaranteed.

  Sanitary facilities and personal hygiene

• Considering the special hygiene needs of women, the Commission recommends allowing daily access to showers.

  Life in prison: regime and activities

• The Commission believes that cell confinement times of more than 20 hours are inappropriate and recommends that cell confinement times be reduced.

• Based on international standards, the Commission recommends implementing or expanding opportunities for meaningful activities for women detainees.

  Alternatives to detention

• Consider alternatives to detention for women detainees.

Detention issues

In detention, the needs of women can be very different from those of men, whether due to gender-specific characteristics or vulnerabilities due to possible violence suffered in the past. These differences affect all aspects of detention. As the Bangkok Rules now recognise, the needs of women detainees require specific attention and measures.59

In Switzerland, only three facilities (Dielsdorf, Hindelbank and La Tuilière) exclusively house women detainees. And not one of these three facilities was designed to detain women. For example, the Hindelbank prison is partly located in a former castle, which was converted into a charitable institution for women in 1866 by the Bernese authorities.60 The other prisons in Switzerland mainly detain men, but may have a section reserved for women or a few cells for them. It is therefore difficult to compare the treatment of women detainees in these facilities.

In Switzerland, a federal state, police legislation is mainly the responsibility of the cantons. In some cantons, women in police custody are transferred to a nearby prison to ensure that they receive adequate care; in other cantons, they are detained in the police station's cell block. In none of the cantons the Commission visited was there a directive on the treatment of women detained in solitary confinement. In practice, the Commission found that it is not systematically guaranteed.

Separation

When it comes to material conditions in small facilities61 and in mixed facilities, i.e. those that accommodate both men and women, women face more difficult conditions than men.
It is important to mention that, since 1er January 2007, the former provision of the Swiss Criminal Code62 (art. 46 para. 1), which provided for the separation of men and women in prisons, is no longer formally in force. However, the separation of men and women in closed prisons is still applied without exception.63 This separation is achieved by the existence of an area reserved for women or, in small facilities, by cells. Several women were detained for long periods in mixed facilities that did not have separate units reserved for women. In various facilities, they were placed in cells separate from those for men, which can lead to further isolation during their stay, with consequences for their psychological health.

Bearing in mind that women detainees may experience more difficult conditions and therefore find themselves in a discriminatory situation, it is the Commission’s opinion that women detainees should be placed in facilities that are appropriate for them or that alternatives to detention should be considered. Furthermore, family visits must always be guaranteed. In addition, women should only be detained in small mixed facilities that meet their specific needs.

Solitary confinement, isolation

a.    Legal and regulatory framework
 The Criminal Code stipulates the possibility of solitary confinement as a disciplinary sanction64 as well as the forms of disciplinary sanctions (arrests, as an additional restriction on freedom).65 The Criminal Code also stipulates that the cantons must issue disciplinary provisions regarding the execution of sentences and measures. These provisions define the constituent elements of disciplinary offences, the nature of the sanctions and the criteria for determining them, as well as the applicable procedure.

The cantonal directives differentiate between solitary confinement for disciplinary reasons or for safety reasons (self-aggressive or hetero-aggressive behaviour). For example, the directive issued by the canton of Berne specifies what clothing women have to wear when they are placed in a secure cell. However, the directive does not specify that pregnant women, breastfeeding women or women who have their children with them in prison may not be placed in a security cell.66 

b.    In practice
With regard to solitary confinement, the Commission found, when examining the records of disciplinary sanctions, that they were generally well kept and that all sanctions were the subject of a written decision with an indication of the means of appeal. Nevertheless, the Commission noted that the distinction between disciplinary measures and security measures was not always clear in practice.

In at least one case, at La Tuilière prison, the reasons for placement in disciplinary arrest were mainly psychiatric, according to the files consulted. Similarly, at Hindelbank prison, all admissions to the security cell in 2019 were related to acute self-harm. For both facilities, the Commission pointed out that a disciplinary order must be issued following a disciplinary offence, and security or safety measures in the event of self-aggressive or hetero-aggressive behaviour. Therefore, in cases of self-harm and suicidal tendencies, the Commission recommends that placement in a security cell should only be considered as a brief and temporary measure, and that the persons concerned should be transferred to a psychiatric hospital as soon as possible.

During its visits, the Commission rarely encountered disciplinary arrests that lasted more than 14 days.67 One of the problems identified by the Commission concerning solitary confinement relates to video surveillance. On several occasions, the Commission noted that male detention officers were supervising the video surveillance. For example, in Limmattal prison, both solitary confinement cells were under video surveillance, except for the bathroom area. During its visit, the Commission criticised the fact that video surveillance of women detainees was conducted by male staff.
Because of the small number of women in prison, women detainees often find themselves in a situation of de facto isolation.68 

Use of means of restraint

a. Legal and regulatory framework
The use of means of restraint is provided for in cantonal police laws,69 in ordinances and regulations concerning judicial execution, and in the law on the use of coercion and police measures in areas under federal jurisdiction. For example, art. 35 of the Regulations governing the organisation and staffing of La Tuilière Prison provides for the use of physical restraint.70 Article 134 of the Canton of Bern's Ordinance on Judicial Enforcement71 also provides for the use of coercive measures. 

b. In practice

The Commission mainly focused on the use of restraints during transfers as part of its visits to police stations and detention facilities. With regard to arrests and transfers by police officers, the Commission noted that in none of the cantons it visited was there a directive that prohibited the use of restraints on pregnant women.When police officers accompany a woman detainee for medical examinations outside of the detention facilities, not only are they restrained for the transfer, but they are sometimes even restrained during the medical examination. Some women detainees told the Commission that they preferred to avoid outside medical visits in order to escape the shackles and this humiliating treatment.

Access to healthcare 

In accordance with the principle of equivalence, healthcare in prisons must be equivalent to that available to the general population. Detainees should be offered services that are adapted to their individual circumstances, including sexual and reproductive health services for women. Detainees with mental health problems are considered a particularly vulnerable group. The Commission examined the gender dimension of healthcare, including psychiatric care, in detention and published its findings in a thematic report.72

As far as somatic care is concerned, the Commission found that facilities are making every effort to take gender-specific needs into account. Some facilities have guidelines on gender-specific care. Some detention officers have knowledge of certain requirements such as the Bangkok Rules. However, gender-specific questions are not systematically asked during the medical interview upon admission to the facilities. The Commission is of the opinion that these questions should be asked by female medical staff, if the woman in question wants them to. 

In women's facilities, external gynaecologists come in regularly for check-ups and examinations. In mixed facilities, gynaecological consultations are organised outside of the facility if necessary.73 A number of cases have been reported to the Commission regarding delays in being referred to gynaecological consultations. The Commission is of the opinion that all women's facilities must guarantee fast, low-threshold gynaecological care. 

Mental health

Detainees with mental health problems are considered a particularly vulnerable group. The Commission noted shortcomings in psychiatric care, particularly in small or mixed prisons. There is no psychiatric care specifically for women detainees. According to these facilities, this shortcoming is due to the small number of women detainees.

The Commission visited three special units for detainees suffering from mental disorders. However, these units are only accessible to male detainees. Given this discriminatory treatment, the Commission believes that special units should be set up to accommodate women detainees in need of psychiatric care.

Sanitary facilities and personal hygiene

In terms of access to gender-specific hygiene items, the practice varies across Switzerland. Apart from one exception,74 all the facilities we visited provide hygiene items for women free of charge, although some limit the number or make distinctions between the different items. In fact, some facilities only provide these items on request. 

The Commission believes that hygiene articles should be made available free of charge, in unlimited quantities and offering different choices (sanitary pads, tampons and other desired items). Access should be simple and discreet. Furthermore, daily access to showers for women detainees is not guaranteed in all facilities.

Life in prison: regime and activities

The detention regime itself can also be discriminatory. In several mixed facilities, women detainees are locked in their cells for 23 hours, except for their daily one-hour walk. Occupational activities, if available, are done in their cell. Although the detention period may be relatively short before their release or transfer, the Commission does not consider these prisons suitable for women.75 The Commission considers cell confinement of more than 20 hours inappropriate and recommends that cell confinement times be reduced. 

It is important to have a wide range of activities to ensure that detainees can make meaningful progress during their sentence. The European Prison Rules prohibit gender discrimination in the type of work that is offered.76 As women are in the minority in mixed prisons, work activities are often primarily designed to be suitable for men. 

The small number of women also plays a role in terms of access to occupational and sporting activities. Women-only facilities offer a wide range of occupations and sporting activities. However, in mixed prisons, women have less access to these leisure activities than men because there are fewer of them and they are housed in a separate unit. In the Delémont and Schaffhouse prisons, for example, men have access to workshops and workstations. Women, on the other hand, can only do simple tasks in their cells. Often, the tasks to be carried out are highly stereotyped in terms of gender (embroidery, ironing, applying false nails, etc.). 

Opportunities for physical activity are particularly important for physical and mental health during imprisonment. The Commission found that, in some mixed facilities, the exercise yards for women may be smaller and less equipped than those for men. In some of the facilities we visited, women detainees have no or limited access to the gym. For example, in one of the facilities we visited, while men had access for an hour, women only had access for 30 or 45 minutes. In Zurich Prison, women detainees have to share the access hours to the exercise yard with their male fellow detainees and therefore only have limited access to the exercise yard. The Commission believes that these practices are discriminatory.

The Commission is of the opinion that in specific cases, and if an isolated woman would like to, she should be allowed to take part in mixed group activities (sports or work).77

Staff

During its visits, the CNPT observed that, in virtually every facility (with one exception), there were both male and female detention officers working there. For example, during a visit to Zurich Prison (a mixed facility at the time), the Commission recommended that the facility should guarantee the presence of female staff at night and on the weekends.

Some prisons ensure in their staffing schedules that there is always at least one female staff member present. In some prisons, male detention officers can only enter the women's unit if they are accompanied by a female officer, while in others they are simply not allowed to enter the cells of women detainees.

Women in Special Situations of Vulnerability

From an intersectional perspective, the vulnerability of women detainees is further exacerbated by other factors, such as age, ethnic origin, disability, sexual orientation or gender identity. However, the Commission has noted that in terms of access to health care, the specific needs of elderly women, women of foreign nationality and lesbian and transgender women in particular are given very little consideration.

Other relevant NPM information on women in prison