Is the Iranian Government Ignoring the Health Care Needs of Prisoners?

The provision of adequate medical care to prisoners is often hindered by a number of apparently administrative obstacles. Several reports from informed sources in Iran indicate that simple tasks such as the prescription and distribution of medications and the running of tests to more complex clinical treatments and surgeries are plagued with administrative problems that often leave prisoners untreated. Prison officials often cite funding shortfalls as a reason for the authorities’ failure to provide treatment to inmates, and one recently referred to the fact that the Prisons Organization owes 20 billion toumans (approximately $5.5 million) to health centers and hospitals across the country. With the exception of prisoners who have the means to pay for their own medical care, most prisoners who have limited means cannot afford the costs associated. As a result, access to medical care is often delayed or inadequate, and countless reports highlight that prisoners throughout the country in political and criminal wards alike can suffer from worsening symptoms for months before receiving treatment, and that some even die of preventable diseases in prison.

In October 2015, Arzhang Davoudi, a political prisoner held in Ward 12 of Rajaeeshahr Prison, was sent back to prison from Imam Khomeini Hospital in Karaj because Rajaeeshahr Prison was reportedly in debt to the hospital. Siamak Ghaderi, a journalist and former political prisoner, discussed similar experiences in an interview with IHRDC. “On several occasions during my prison term (2010-2014), specialist physicians and health centers refused to provide care. On most of those occasions they mentioned that the prison system had failed to keep its promises and pay its debts [to health care providers] as the reason for their actions.” Ghaderi recalled of the plight of two of his fellow inmates that, “[They were] both political prisoners suffering from problems with their spinal columns. On several occasions both were turned back from Tehran’s Taleghani hospital without receiving medical care. Not receiving medical care intensified their conditions. [One of them], who had become incontinent, was eventually released from prison after he was judged too sick to serve his sentence,” Ghaderi added.

Noting other problems such as shortages of medicines, Ghaderi added, “The optometrist and the dental office also would refuse to provide care until the prisoner provided his bank card to the health care provider and he could ensure that there were enough funds in his account. Given the fact that the Prisons Organization prohibits prisoners from carrying cash, sometimes ridiculous situations arose. For instance, if a dentist needed to extract an inmate’s tooth, he would ask the inmate to pay the fee with a phone card. But because phones were banned in the ward housing political prisoners, it was not common for political prisoners to use phone cards in lieu of money. Eventually the dentist agreed to accept cigarettes as payment, because cigarettes were used as currency among political prisoners.” Regarding the distribution of medications to prisoners, Ghaderi continued, “The same problem existed with respect to medicines as well. Sometimes, due to shortage of funds and debt, the prison pharmacy ran out of pain relievers or medications used to treat the common cold. Another cost-saving practice, less probable to happen to political prisoners, was that prison physicians would dissolve ten to twenty common cold pills in a 2-litre soda bottle. Then, 30 to 40 sick prisoners who were lucky enough to be sent to the prison clinic, were placed in a queue and each drank a portion of this mixture, and then they were returned to their wards. According to reports, shortages of medicine are a common problem in prisons, and the smuggling and sale of cold medicine and pain relievers has become a lucrative business.”

It should be noted that in June 2015 the Minister of Justice, the Minister of Health and the head of the Prisons Organization held a joint meeting to address the prisoners’ problems with respect to access to medicine and medical care. Seven months later, however, the prisoners’ issues in obtaining medical care have not yet been resolved.

The failure to provide adequate medical care to prisoners may be classified as cruel, inhuman or degrading treatment or punishment, which is prohibited under the International Covenant on Civil and Political Rights and the Convention against Torture. In addition, the United Nations Standard Minimum Rules for the Treatment of Prisoners as well as the United Nations Basic Principles for the Treatment of Prisoners call for the provision of adequate health care to inmates. Iranian domestic law also requires that prison authorities provide adequate medical care and treatment to prisoners. The Prisons Regulations, the latest version of which were promulgated in 2005, state that prison clinics must conduct checkups on each prisoner at least once a month and that all prisons must be disinfected at least once a month. Testimony obtained by IHRDC clearly establishes that these provisions are routinely ignored.