NPM Overview

Facts and figures1

Recommendations

Contact with the outside world

• Consider avoiding as much as possible the application of sanctions regarding the right to receive visits, which may have a negative impact on the process of reintegration of women deprived of liberty.

Life in prison: regime and activities 

• Organise more initiation, qualification, requalification, improvement and specialisation courses for women detainees.

• Take the necessary steps to conclude service contracts with companies, to provide work opportunities for women deprived of liberty while serving their sentence.

Sanitary facilities and personal hygiene

• Set up accommodation rooms with properly equipped sanitary facilities for people with disabilities, in accordance with the provisions of Art. 1, para. (6) from the Annex to the Order of the Ministry of Justice no. 2772/C/2017.

Prison staff 

• Increase the number of staff in the operative, medical and social reintegration sectors in women’s prisons

• Provide training and certificate to supervisory agents in the provision of first aid, through trainers of the General Inspectorate for Emergency Situations - IGSU.

Overcrowding 

• Address the problem of overcrowding in prisons during some periods, in accordance with the provisions of art. 1, para. (3) from the Annex to the Order of the Ministry of Justice no. 2772/C/2017 for the approval of the mandatory minimum norms regarding the accommodation of persons deprived of liberty. 

Detention issues

Accommodation and food

Body searches

a. Legal and regulatory framework

The procedure for conducting searches of persons deprived of liberty is described in the Regulation on the safety of places of detention subordinated to the National Prison Administration, approved by Order of the Minister of Justice no. 4800/2018.

Detailed records of body searches are mentioned in the Regulation on the safety of places of detention under the National Prison Administration, approved by Order of the Minister of Justice no. 4800/2018 and in Government Decision no. 157/2016 for the approval of the Regulation for the application of Law no. 254/2013. 

b. In practice

According to the documentation verified during NPM visits and the interviews conducted with women detainees, there is no indication that body searches of women are carried out systematically without an individual assessment. 

Body searches of women detainees and visitors are carried out by women staff as required by law. During body searches, the privacy and dignity is respected according to the relevant legal provisions. The NPM is not aware of any complaints from persons deprived of their liberty regarding the way body searches are carried out. 

Invasive body searches are performed only in exceptional circumstances, by a trained and authorized medical professional, according to legal provisions. In situations where, during the searches, there are indications that prohibited objects are hidden, both the control of the body cavities and that of the bandaged wounds, prostheses and plaster casts is carried out by the specialised medical staff.

Solitary confinement, isolation

The use of isolation is strictly regulated and appropriate protective measures are provided according to legal provisions.3 Isolation is prohibited - and is not used in practice - for girls, pregnant and nursing women, women in prison with their young children and women with psychosocial disabilities. 

During its monitoring work, the NPM found that the disciplinary sanction of solitary confinement was applied only in case of committing a serious, repeated disciplinary offense. The sanction did not apply to pregnant women or women with their children up to one year old in prison, in accordance with the relevant legal provisions.

There is no indication that solitary confinement is routinely and disproportionately used against women or certain categories of women. There are situations in which women are placed in isolation for their own protection according to Government Decision no. 157/2016 for the approval of the Regulation for the application of Law no. 254/2013. The conditions of the cells used for isolation are appropriate and meet the legal provisions.

Means of restraint

During its visits to prisons, the NPM found that pregnant women and women with serious health conditions were exempted from the use means of restraint, according to the relevant legal provisions. In case of negative events in which women detainees are involved, they were resolved through dialogue, with the provision of specialised assistance from medical, psychological and social professionals.

Means of restraint are also prohibited for women during labour, childbirth and after birth,  and not used in practice. There are no indications that restraints are used against women or certain categories of women in a disproportionate or discriminatory manner.

Women in special situations of vulnerability

An initial assessment of vulnerability is carried out by a commission established according to the legal provisions, on the occasion of the individualization and establishment of the execution regime, based on the criteria set by law. During the execution of sentences, when  one of the possible situations of vulnerability intervenes, the appointed commission meets and analyses the situation of the prisoner in order to assess the vulnerability. In 2023, in the penitentiary units that accommodated women serving a sentence, 25 inmates were included in this category. 

Pregnant and nursing women and women with children in prison

Pregnant women, women who give birth during the detention period and those who have children under the age of one year under their care do not carry out work activities in a toxic or harmful environment, cannot extend their working day beyond 8 hours and are provided with the necessary food, including for children, according to the legal norms in force.

The administration of the place of detention ensures the necessary conditions so that the mother, at her request, can take care of her child in appropriate conditions, until the child is one year old. Children under the care of mothers deprived of liberty are provided with vaccinations, according to the National Program of Immunizations.

Medical assistance and the monitoring of the child's physical and psychomotor development through periodic evaluations are carried out by a family doctor or paediatrician from the public health network, in compliance with the provisions of the framework contract that regulates the conditions for the provision of medical assistance, medicines and medical devices in the framework of the social health insurance system and the methodological rules for its application.

During one of the visits made by the NPM to women’s section of the Craiova Penitentiary, two inmates were pregnant, one of them with twins. These were recorded at the medical office, were monitored monthly and, starting from the 6th month of pregnancy, they were transferred to the profile section of the Bucharest - Rahova Penitentiary Hospital, for the supervision of the pregnancy and the provision of specialised medical assistance. 

At the level of all places of detention for women, spaces designed for visiting mothers with children are set up. During 2023, 261 visits for relatives were granted at the mother and child spaces set up at the level of penitentiary units.

Other Relevant NPM information on women in prison

NPM overview

Facts and figures

Recommendations

Solitary confinement

• The measure of solitary confinement should be applied only in extreme situations, taking into account the needs of the person and providing sufficient guarantees to respect her right to a due process.

Mental health

• To increase the number of staff, especially the number of psychologists and social workers.

• A screening program for women with mental health conditions in the penitentiary system should be established on a regular basis and not only applied when a person enters prison.

Detention issues

Solitary confinement 

1. Legal and regulatory framework

Under the Bulgarian law, solitary confinement is the most severe disciplinary punishment in prison. Therefore, the procedure and conditions, including the offense to which it can be applied, should be clearly specified in the law.

A person can only be isolated in a penal cell for serious or systematic violations of prison rules. According to the Bulgarian law, solitary confinement in a penal cell can be imposed for a maximum period of 14 days for adult prisoner and 3 days for juvenile prisoner.

If a convicted person has two or more punishments of solitary confinement and none of them has been served, the stay in a penal cell may be extended up to 20 days, but not more than the total number of days with which he or she is punished.

Upon admission and release from a penal cell, a mandatory search shall be conducted on the prisoner. During their stay in a penal cell, persons deprived of liberty shall not have any right to use food deliveries.

The conditions in the penal cell and the items which the convicts may keep shall be determined by the rule for application of the law. The penal cells shall be located in high security areas, ensuring isolation from the rest of the premises.

Rooms arranged as punishment cells shall meet all hygiene and health requirements - they shall be free from moisture, have direct access to daylight, be well locked, heated, have ventilation facilities and a secure bed. 

Solitary confinement can only be imposed by written order of the competent authority.  The order for disciplinary punishment of solitary confinement in a penal cell is subject of appeal before the Administrative court within three days of its announcement.

Prisoners isolated in a penal cell shall be visited by a medical specialist every working day. The medical examination shall be carried out on site, unless the case requires otherwise. By request of the prisoners the medical examination shall be carried immediately.

The undertaken medical examinations shall be certified in the relevant written documents, which shall be attached to the medical file of the convicted person.

2. The use of solitary confinement in practice

According to the information provided by the women’s prison, the number of women held in solitary confinement as disciplinary punishment has decreased over the past few years, which is considered as a positive trend. 

However, despite the safeguards introduced in the law and the possibility to appeal the measure, it should be noted that the risk of violating the right to due process is high. In this regard, it is worth noting that, even if the measure is appealed, the court's assessment is usually formal and based on documents submitted by the prison administration. Furthermore, prisoners cannot always afford a lawyer or provide enough witnesses for their case. 

Another problem at legislative level is that appealing against the measure does not stop its execution. That means that, if the court delays in issuing its decision, and the prisoner's appeal proves to be justified, the person will have suffered an unlawfully imposed measure. In such a case, the only defence left is to sue for compensation for non-pecuniary damage resulting from the execution of an unlawful act. 

Solitary confinement has a number of negative effects on women detainees, making it necessary to provide them with additional and effective rehabilitation support. Isolation in women can lead to high levels of depression, contributing to feelings of doom and a sense of loss of perspective in life. 

Possible measures to support women detainees include expanding opportunities for voluntary work and involving them in rehabilitation activities, minimising the negative effects of isolation by involving them in cultural, informational and sporting activities, and enhancing the professional competences of prison staff in order to adequately respond to the individual needs of each woman.

Access to mental healthcare

Healthcare for persons deprived of liberty with mental health conditions in Bulgaria is subject to special regulation which establishes the conditions and procedures of healthcare in correctional facilities. In general, findings from the NPM revealed several shortcomings in relation to healthcare in prison, such as: poor quality; lack of medical professionals; neglect of detainees' complaints, untimely referral of detainees to external specialists for diagnosis and treatment, and poor sanitary and hygiene conditions.

Healthcare of detainees with mental health conditions is provided in the medical centre of all prisons in Bulgaria and in the Specialized Hospital for active treatment at the prison in Lovech (SHAT). If necessary, healthcare for detainees may also be provided in other healthcare facilities. 

Тhere are two units in the Specialised Hospital at Lovech’s prison: one unit for men, with a capacity of 40 beds, and one unit for women, with total capacity of 10 beds. In addition to this, there is a stationary unit in every prison where persons with mental health conditions are placed until they are transferred to the Specialized Hospital.

The person deprived of liberty shall be informed about the offered healthcare services and all medical activities shall be carried out after the person has given their informed consent. Any additional healthcare service beyond the offered volume of healthcare may be provided at the patient's request and their own expense, at prices set by the health establishment. Medical, financial and statistical records shall be kept and stored at the Hospital. Every detainee with mental health conditions shall be prescribed, free of charge, the necessary medication for their treatment upon discharge from the hospital. Inmates from all over the country are admitted for treatment in the Specialised Hospital. 

One of the main recommendations by the NPM over the years has been that all prisons must employ a specialist psychiatrist to monitor prisoners with mental health conditions. From December 2022, psychiatrists in prisons are on civil contracts. 

According to the most recent data, one psychologist works with about 200 prisoners and one social worker with 100 prisoners The NPM has repeatedly recommended to increase the number of staff, especially the number of psychologists and social workers. However, so far authorities have not taken measures to implement this recommendation, alleging lack of funds for salaries.

According to the Bulgarian legislation, the initial training of prison’s staff shall include health-related information on: 

• the external signs of emergency conditions and the actions of staff in the event of the need for somatic emergency care and psychiatric emergency care;

• signs of withdrawal states in alcohol and/or drug dependence and initial actions to manage them;

• characteristic features of mental health conditions, suicidal attitudes and ways to prevent self-harm;

• involvement of non-medical professionals in the design of programmes for persons with addictions (alcohol and/or drug). Consultants from other medical facilities may be brought in to assist in the healthcare of detainees.

In case of suspected mental health condition of a person deprived of liberty, the inspector-psychologist, in cooperation with a psychiatrist at the prison medical centre or an external psychiatrist, shall conduct clinical-psychological and psychiatric examinations to clarify the diagnosis. Detainees with alcohol and/or drug dependencies or at risk of suicide shall be supervised by the psychiatrist, who, together with the inspector-psychologist and the inspector for social activities and educational work, shall draw up a program for their treatment.

On admission to a prison, detainees shall be placed in a reception ward for a period of 14 days to one month, and juveniles shall also be supervised by a tutor, a doctor and a psychologist. After the initial medical examination, detainees are consulted by a psychiatrist and a psychologist, who necessarily give an opinion on:

• the detainee's mental health state and their characteristics, such as suicidal tendencies, self-harm and aggressive behaviour;

• the symptoms of drug and/or alcohol dependence and the measures to be taken during the sentence.

Findings from the NPM revealed, over the years, the high percentage of women detainees with mental health conditions or who later develop them while in prison. In October 2019, during an inspection carried out at the women’s prison, it was found that 42 women had mental health conditions.  

In this regard, the NPM recommended that a screening program for persons with mental health conditions in the penitentiary system should be established on a regular basis and not only applied when a person enters prison. This recommendation has not yet been approved by the Ministry of Health.

Contact with the outside world

According to the Execution of Penalties and Detention Act, visits shall be carried at least twice in a month. Besides that, the convicted persons have the right of correspondence and phone calls. The allowed time for a visit is up to 60 minutes by order of the Chief Director of the Chief Directorate for Execution of Penalties.

The distance of Sliven Prison (307 km away from the capital Sofia) and other populated areas inevitably creates obstacles for regular visits. It is therefore recommended to consider extending the visiting hours for women serving their sentences far away from their permanent addresses. Another measure which could be taken to ensure the right to have contact with family and the outside world is to grant home leave to women who have good behaviour. 

Other relevant NPM information on women in prison

NPM overview

Facts and figures

Recommendations

Solitary confinement

• Prison should ensure that all women inmates who are not in solitary confinement can spend at least eight hours outside their cell every day and take part in meaningful activities, including at weekends.

• Prisons should ensure that women inmates who are at greater risk of suicide and self-harm are met with knowledge-based preventive measures, such as increased human contact, care, and meaningful activities. Solitary confinement should never be used to prevent self-harm and suicide.

• The local health units in prisons should ensure the daily supervision and follow-up of women inmates in solitary confinement. Health units should also ensure that it has a comprehensive overview of completed supervisions of such inmates.

Use of means of restraint

• The use of restraint beds in prisons should be abolished, considering the high risk of inhuman and degrading treatment associated with the measure.

   

Body searches

• Prisons should ensure that male staff are not present during body searches performed on women inmates.

Healthcare

• The local health units should ensure that inmates have access to a woman doctor.

Detention issues

Through numerous prison visits and in its 2016 thematic report on women in prison, the NPM has expressed its concern that women inmates in high-security prisons are collectively afforded inferior conditions compared to men. Additionally, the proportion of women inmates with mental health conditions rose considerably during the period 2010 – 2019.

In March 2023, the NPM conducted an unannounced visit to a high-security prison exclusively dedicated to women - Bredtveit Prison - and the Zulu East wing at Ullersmo Prison. The visit took place because of increasing concerns regarding conditions at Bredtveit Prison and the transfer of female inmates to Ullersmo men’s Prison in January 2023 as an emergency measure due to many serious incidents of violence and self-harm. The visit revealed that the inmates at Bredtveit Prison were living under critical and even life-threatening conditions. The seriousness of the situation and the need for urgent measures led the NPM to notify the Ministry of Justice and Public Security of the conditions in a letter dated 23 March 2023.

Body searches

In Norway, body searches may be performed under the Execution of Sentences Act.15 Until 2021, body searches were performed as strip searches without any clear legal requirements of concrete risk assessments by prison staff. As a result, these measures were applied routinely, on both women and men inmates, upon admission to prison, in connection with movement and transfers out of prison, and before and after visits.

The practice of routine strip searches without risk assessments has been consistently criticized by the NPM after its prison visits. This led, firstly, to gradual changes in the modalities of how body searches are performed, including for women. Secondly, NPM recommendations were later picked up in the case law of the Norwegian Supreme Court, which in several judgments has held that routine strip searches in prison amount to ill-treatment contrary to article 3 of the European Convention on Human Rights (ECHR).

Men staff are very rarely present during body searches. In cases where this has happened, as far as the NPM has been able to ascertain, the male officer has had his back turned or stood outside a door kept ajar.

Body cavity searches may be performed under Section 29 of the Execution of Sentences Act. A medical opinion shall be obtained and taken into account when considering whether this measure shall be implemented. The procedure may only be carried out by health service personnel.

Solitary confinement

1. Legal and regulatory framework

Generally, the applicable national legal framework that authorizes the use of solitary confinement as an administrative measure is set out in the Execution of Sentences Act, Section 37. A stricter form of solitary confinement - in security cells without any furniture - is provided for under Section 38 of the same act. Moreover, the use of restraint beds is also allowed under Section 38. The Courts may also impose solitary confinement on prisoners on remand to prevent the destruction of evidence if the legal requirements in the Criminal Procedures Act Section 186a are met.

No legal rules or regulations exist that explicitly prohibit the use of solitary confinement for women in particularly vulnerable situations, such as pregnancy. However, there are stricter legal requirements to subject inmates under the age of 18 (including girls) to solitary confinement.

Solitary confinement may also be imposed as a control measure when necessary to maintain ‘peace, order and security’. This legal requirement leaves a lot of leeway to prisons and does not reflect that solitary confinement must only be used in exceptional cases. By law, ongoing assessments must be made of whether or not the use of solitary confinement is necessary, and the stay must be brought to an end as soon as this is no longer the case.

Norwegian legislation allows for prolonged solitary confinement for up to a year at a time, contrary to human rights standards. The Ministry of Justice and Public Security has recently proposed several legal amendments to the provisions on the administrative use of solitary confinement as an attempt to address these shortcomings.

2. The use of solitary confinement in practice

While the use of Court-ordered solitary confinement has decreased in the last decades, the use of solitary confinement as an administrative measure remains.16 In recent years, official statistics from the Correctional Services on the use of solitary confinement in security cells and on the use of restraint beds suggest that women inmates are disproportionately affected by these measures.

The NPM’s visit conducted in March 2023 revealed serious failings at Bredtveit Prison, the Norwegian Correctional Service’s regional office and within the prison health service. During the period 2018–2022, the prison recorded a doubling of women inmates being placed in solitary confinement in their cell (from 36 inmates in 2018 to 77 in 2022). Since 2018, the prison has more than doubled the number of inmates it has placed in security cells, (from 27 decisions in 2018 to 92 in 2022). A security cell in Norway is a bare cell with only a plastic mattress and a squat toilet. Food and water are pushed in through a hatch at floor level and no washing facilities are provided for the inmates. Most of the communication between the inmate and staff takes place through small hatches or plexiglass. While in a security cell, inmates are deprived of virtually all control over their own lives, to a far greater extent than that which follows from the imprisonment itself. 

Most of the decisions concerning placement in security cells that were reviewed by the NPM did not fulfill the applicable statutory requirements. Many cases indicated poor conflict prevention, and threats or violent acts that could have been foreseen. Examples include stress and worry in connection with impending court hearings or frustration over inactivity and a lack of association with other inmates, which in turn contributed to further escalation which was then dealt with by placing the inmate in a security cell.

The prison’s efforts to fulfil the requirement of ongoing assessments consistently appeared to be very inadequate. The NPM observed numerous examples of decisions being made in the afternoon to place an inmate in a security cell until the following day. In some cases, the inmate was described as being calm when the decision was made and there was no information in the documentation to indicate that the inmate needed to remain in the security cell.

3. Health-related risks of solitary confinement

In Norway, the prison health service is run by the municipal authorities as primary health care  provider, even if the services are localised within the prison. Some prisons also have the regional specialist health services present. What is known as ‘the import model’, where the health service is independent of the Correctional Service, supports the medical personnel’s independence of the Correctional Service. The import model is intended to ensure that medical personnel never partake in administrative decisions on sanctions or in enforcing sanctions. 

Findings from the NPM visit conducted in March 2023 revealed that efforts made by the prison to prevent the adverse health effects of solitary confinement were also inadequate. The NPM found virtually no documentation that indicated that inmates who had been in solitary confinement (placed in isolation in their own or a reinforced cell) had been offered the opportunity to engage in social contact, which met the minimum requirement of two hours of meaningful human contact per day. The NPM also found no examples of inmates in security cells being given the opportunity to get out into the open air, even when their stay in a security cell lasted several days. 

There was a dedicated resource team at the prison that was responsible for preventing solitary confinement damage by following up on and activating individual inmates. This resource team was doing an important job, but it had very limited capacity and was therefore unable to meet the needs of inmates in solitary confinement at the prison. 

The visit and subsequent review of documentation revealed that the prison had failed to comply with the requirement that solitary confinement must only be used in extraordinary cases, as a last resort and for as short a period as possible. It appeared that the prison consistently had a low level of understanding of both the considerable health risks linked to solitary confinement and the legal limits of its use. The Norwegian Correctional Service’s eastern regional office, which is responsible for the execution of sentences at Bredtveit, also appears to have failed to identify these shortcomings. 

The follow-up of inmates in solitary confinement by the municipal healthcare department at Bredtveit prison was found to be inadequate. The department did not independently consider the health-related consequences of using solitary confinement and security cells for individual inmates. They also had no general overview of how long inmates spent in solitary confinement or the reason for the solitary confinement, not even in cases where the solitary confinement was justified through suicide risk. The NPM found no systematic recording of injuries suffered by inmates while they were in solitary confinement. The municipal healthcare department also lacked procedures for supervision in connection with exclusion and the use of security cells. There was no evidence to suggest that they carry out daily supervision of inmates who had been excluded from interaction with other inmates, even though the Directorate of Health’s guidance stipulates that such supervision must be carried out.

Means of restraint 

In Norway, the use of restraint beds is regulated by the Execution of Sentences Act Section 38. The Act provides for the use of restraint beds, security cells and other approved measures of restraint, in all situations covered by Section 38. 

The NPM’s thematic report ‘Use of restraint beds in Norwegian prisons’ (2020), showed that over 30% of cases of inmates being placed in restraints in the period 2013–2018 concerned women. This included some of the longest periods spent in restraints. Additionally, the decisions analysed showed that women inmates who had been placed in restraint beds, more often had been restrained several times, compared to men inmates in restraint beds. Five of the seven inmates who had been put in restraint beds four times or more were women. The NPM’s visit conducted in March 2023 revealed that, in many cases, the inmate was carried from the third floor to the security wing, which forms a ground-floor extension, wearing handcuffs. 

Contact with the outside world

Legal and regulatory framework

Visits in Norwegian prisons are regulated by the Execution of Sentences Act Section 31. According to the Guidelines to the Act, visits shall normally take place in a dedicated visiting room, and it is up to the prison to decide, based on local conditions, how often an inmate can receive visitors and on which days visits can be received. As far as practically possible, inmates should be allowed at least one visit per week, lasting at least one hour.

Contact with family: the situation in practice

Because very few prisons in Norway receive women inmates, women risk being detained in prisons far away from their homes. This means that it will be difficult for some inmates to receive visits from family, particularly their children. This is especially the case for children who are too young to travel alone and children who do not live in the same country as their mother. Being detained far away from their family makes contact by telephone particularly important. However, this is limited to only 20 minutes for all inmates.17  If there are special reasons and capacity allows, extended phone time can be granted. However, presently, this remains at the discretion of the local prisons.

Women in special situations of vulnerability

Women with disabilities

Women inmates with mental health conditions are particularly vulnerable to experience solitary confinement, restraints, and use of force because of inadequate efforts to ensure a healthy prison environment tailored to their needs. Between 2018 and 2022, Bredtveit Prison recorded a twenty-fold increase in self-harm incidents. Despite this, the prison had no system in place for identifying and following up the risk of self-harm and suicide, both upon admission and during the stay in prison. The prison largely dealt with self-harm and indications of suicide risk by solitary confinement and the use of force. A review of decisions made concerning the use of security cells during a sample period showed that 16 out of a total of 23 decisions were taken because of concerns about self-harm and suicide risk. 

The NPM encountered inappropriate and routine escalation of intrusive measures: from isolation in the inmate’s regular cell to placement in a security cell and, in some cases, the use of a restraint bed. The use of solitary confinement and force may reduce the likelihood that inmates at risk share information about their mental health and suicidal thoughts with the staff. There was also a lack of awareness of how the prison’s own operation, detention conditions, and use of solitary confinement impact all its inmates and could increase the risk of mental health conditions, self-harm, and suicide.

Foreign women

Foreign women are a in a situation of heightened vulnerability as they are far away from their homes, and family. Language problems can result in inmates being poorly mapped on arrival and in their special needs not being identified. This could place foreign women in a vulnerable situation with an increased risk of isolation. Contact with their family is therefore very important to this group of inmates. Yet, it has emerged during several of the NPM’s visits that women who had children in another country found it difficult to maintain good contact with their children. 

According to the Regulations to the Execution of Sentences Act, telephone calls shall normally be paid by the inmates themselves. The NPM has been informed by foreign inmates at several prisons that financial limitations make it difficult to make international calls since they are more expensive than domestic telephone calls in Norway. In addition, the Regulations limit telephone calls in high-security prisons to a total duration of 20 minutes per week, provided capacity allows (as described above). At the local level, extended phone time can be granted if there are special reasons and capacity allows.

Other relevant NPM information on women in prison

NPM overview

Facts and Figures

Recommendations

Body searches

• Body searches should only be carried out in the presence of two prison guards of the same gender as the searched person.

• Body searches should generally be conducted in a way that the person being subjected to the search only undresses one part of the body at a time. 

• Body searches with removal of clothes shall be documented in writing due to the intensity of the infringement. The staff shall record the purpose and the specific circumstances of the body search in order to ensure subsequent reviewability and preclude abuses.

Accommodation and food

• In general, women’s sections shall be run as shared accommodation.

• Women should only be held in closed detention in justified individual cases.

Life in prison: regime and activities

• The range of occupational opportunities for women detainees should be expanded. Women detainees should have the opportunity to get to know various employment types in different companies.

• It is highly recommended to ensure that men and women detainees work together in the prisons’ own companies.

Sanitary facilities and personal hygiene

• It is necessary to ensure that the increased need for hygiene of women detainees are taken into account, especially during their menstruation.

• During their menstrual cycle, women should have the opportunity to take a shower every day without having to ask for it.

• The range for sanitary articles available to women detainees should include tampons (in different sizes).

Pregnant and nursing women

• Pregnant women must get the same medical exams which pregnant women outside prison  have access to, i.e. regular preventive health check-ups offered to them within the so-called “mother-child-booklet”. 

• Pregnant women should give birth outside the correctional institution, i.e. in a regular hospital, and should have access to a midwife or a female prison staff with experience in childbirth while in prison, prior and after the birth of their child. 

Older women

• Prisons must ensure that the detention rooms are equipped for older women with disabilities, that medical and nursing care is provided and that the staff is adequately trained.

Detention issues

The Austrian NPM has focused its attention on the situation of women in prison since the beginning of its activities in 2012. Findings revealed that women in prison were discriminated against in many areas, especially due to their small number in prison, including with regard to employment. Their employment rate was lower compared to men, and the activities were mostly limited to cleaning or simple tasks, which can be compared to household chores, such as ironing. 

The Austrian Federal Ministry of Justice followed up on the NPM’s recommendations and, in 2016, it adopted a decree on the “Minimum standards for women in Austrian correctional institutions”, setting the standards for the accommodation and treatment of women in remand and in penitentiary institutions. 

Body searches

Women have to undergo searches in rooms intended for this purpose, when they are admitted or transferred to a correctional institution. The same obligation applies upon release. These examinations are body searches which entail the removal of clothes, and they are mandatory for all inmates, men and women. Body searches with removal of clothes are also carried out when an inmate is transferred to a specially secured cell in case they pose a danger to others or themselves. 

Law requires that body searches with removal of clothes can only be carried out in the presence of two prison guards of the same gender as the searched person, and when persons of the other gender are absent. 

However, findings from the NPM revealed that in some cases these requirements are not met.19  Women deprived of liberty reported instances when they were not allowed to put on their underpants before uncovering their upper bodies. They also reported that they had to squat, cough and spread their legs without any specific reason. The prison guards inspected all body orifices. Women detainees found these proceedings very humiliating and unpleasant. Some women also reported that the door to the room in which they had to undress was open or not completely closed so that third parties (male staff) could see inside the room. In one correctional institution, a camera monitors the body searches of persons deprived of liberty, which can then be seen on a monitor at the prison guard’s base.20

Women in special situations of vulnerability

Pregnant and nursing women

Another major issue in relation to women in detention are always pregnant women and mothers of small children. Sensitive areas are the care of pregnant inmates, the procedure of giving birth and whether the baby or toddler should stay with the mother in the detention facility and for how long. In Austria, there are currently26 five children who are in prison with their mothers. These inmates and their children are housed in a specific ward for women with children. Four children were born in detention in 2018. On average, children stay with their mothers in prison for 144 days.27

In relation to pregnant women in prison, the most important recommendation from the NPM is that these women must get the same medical exams which pregnant women in the “outside world” have access to, i.e. regular preventive health check-ups offered to them within the so-called “mother-child-booklet”. The NPM further recommends that pregnant inmates should give birth outside the correctional institution, i.e. in a regular hospital, and that they should have access to a midwife or a female prison staff with experience in childbirth while in prison, prior and after the birth of their child.

Older women

As of 1 February 2024, 632 women were in prison: 600 of them are under the age of 60; 14 of them are between the age of 60 and 65; and 18 of them are older than 65. At the moment, the oldest female inmate in Austria is 92 years old. She was sentenced to 12 years in prison at this advanced age, which means that she will most likely remain in prison until her death. 

The demographic development is also reflected in the prison population, i.e. inmates are getting older and are reaching an age at which they will inevitably need more care. The Austrian NPM draws attention to this and to the fact that solutions need to be found to guarantee that these inmates can age and die with dignity. Older inmates have other needs and requirements. They want quiet living and a place of retreat. Prisons must provide settings, which take this into account as well. It must be ensured that the detention rooms are equipped for older women with disabilities, that medical and nursing care is provided and that the staff is adequately trained.

Since the number of women in prison is significantly lower than the number of male inmates, the number of elderly women in prison is even lower. This inevitably means that the specific needs of elderly women in prison are addressed even less.

Other Relevant NPM Information on Women in Prison

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,31 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.32

Other Relevant NPM Information on Women in Prison

NPM overview

Facts and figures33

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",35 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.36

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 mother37 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",38 as well as the Nelson Mandela Rules.39 

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.40

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"41 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 model53 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.54

• 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 Curiae55 was filed and in the other case, following an ad hoc visit, urgent findings and recommendations were issued to the authorities.56

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 202257 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),61 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.62

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),63 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.64 Although the General Directorate of the Penitentiary Regime reported65 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.66 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,67 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.68 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.69

In addition to the lack of sufficient mental health staff, interviews with health professionals and with the Departmental Directors of the Penitentiary Regime70 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.71

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".72

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.73

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.74

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.75 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-19,76 however, the national health emergency for Covid-19 was lifted in Bolivia in July 202377 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.78 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.79

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 administration80 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 women81 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 Procedure82 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 offences83, 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,84 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. 34885 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,86 weekend detention,87 community work.88 In the event that they are granted, the authority must also dictate security measures89 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 Procedure90 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 228991 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 16792 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 partial96 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,97 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