Every prison facility must ensure it offers first aid to prisoners, and this must take place in an infirmary.
Emergencies are first attended to on-site before being referred to the nearest health centre.
The CPT’s delegation again found, in 2021, that these infirmaries were poorly equipped. None of them had basic emergency medical equipment: defibrillator, nebuliser, electrocardiograph….¹ Medical care is provided by a team of at least one doctor and two nurses.² Specialists (dentists, psychiatrists, etc.) sometimes work on a full-time or part-time basis.
The CPT reported, in 2018, that no dental care had been provided in Bacău prison since 2013. In this same prison, medical consultations had been drastically reduced to a mere 90 seconds per prisoner on average, due to lack of personnel.³
At Iaşi prison, consultations with a medical doctor only take place on certain days. The number of daily consultations is therefore substantial, between 70 and 100. The CPT observed the absence of a secretary to manage medical consultations and appointments. The general practitioners are therefore charged with a heavy administrative load.³
During its visit in 2019, APADOR-CH observed there had been no head doctor at Miercurea Ciuc prison since 2014.⁴
None of the establishments visited by the CPT had an operational dental service, with the exception of Galaţi Prison. At Mărgineni prison, the management stated that an agreement had been reached with a local dentist for one day of consultations every two weeks. Prisoners complained, in all the institutions visited, that they were not able to benefit from any dental care, including urgent care. The supply of dental care seemed to have deteriorated further since the 2018 visit. Many prisoners would show poor oral hygiene, cavities and gum disease. Some prisoners had apparently pulled out their own teeth, while others reported having difficulty eating any food due to ongoing dental pain.¹

The prison service is obliged to ensure continuity of care throughout the period of imprisonment.

The working hours of medical staff in detention and pre-trial detention centres would not guarantee that medicine distribution could always be carried out by themselves or in their presence. The permanence of medical assistance was not ensured.¹
The CPT observed during its visit to Bacău in 2018 that prisoners do not receive medical instructions. Prisoners do not know how often to take medications nor the dose prescribed. Medications meant to be injected (subcutaneously) are given to prisoners to be swallowed in cases of extreme pain. The CPT described this practices as ‘dangerous’. It noted that vials given to prisoners remain in cells and encourage a black market.²

Most prisoners suffer from dental problems. Hepatitis C and HIV/AIDS are also quite prevalent in prison. The World Health Organisation reported that in 2020, 4.7% of the prison population was diagnosed with hepatitis C, 4% with COVID-19, 4.1 % with hepatitis B and 1.9% with HIV.

Prisoners likely to transmit a contagious disease are placed in quarantine in a cell managed by medical personnel.

The CPT reported, in February 2018, the absence of a global programme aimed at reducing risk for prisoners, which would ensure that condoms or syringes are readily available to prisoners.¹ It obsvered, in May 2021, that condoms were only made available to prisoners receiving conjugal visits.²
The World Health Organisation reported, on 15 February 2023, that all penitentiary institutions in Romania provide condoms, but none distribute syringes.³

In Bacău, Gherla and Iaşi prisons, all the files of persons suffering from contagious diseases are marked ‘CVMC’ (medically contagious vulnerable cases, Caz Vulnerabil Medico-Contagios). This abbreviation systematically appears on medical, disciplinary and legal files. The CPT noted the lack of medical discretion due to this practice and regrets the stigmatisation sick people may suffer from. It states that medical personnel can inform the guards of the medical condition of each prisoner on a case-by-case basis. The CPT recall that this information should only be transmitted when strictly necessary or must be done with the written consent of the relevant prisoner. It recommends that the practice of ‘CVMC’ be abolished with immediate effect.¹

Many prisoners suffer from mental disorders that require medical attention. They are most often placed together with the other prisoners. They do not all receive psychiatric care.
The CPT observed that in Iaşi prison, prisoners are given excessive medication. In 2018, at least 21% of this prison’s population regularly consumed at least one psychoactive drug. The CPT reports the case of an apathetic prisoner, apparently sedated and unresponsive to external stimuli. He was not taking the right medications.¹
The CPT’s delegation met many prisoners suffering from mental illness or personality disorder who did not receive appropriate care.
The number of specialised caregivers was insufficient. At Mărgineni Prison, 109 people received psychotropic treatment, but no psychiatrist visited the facility. In Giurgiu Prison, 398 people received psychotropic treatment; a psychiatrist was only present one day a week.
Most people with mental illnesses were held in large collective dormitories. Conflicts with other prisoners were difficult to avoid. As a result, they were regularly moved from one dormitory to another, which further affected their mental health.
The prison administration decided to create four units dedicated to the placement of prisoners suffering from severe mental illnesses. A ward for each category of regime was created in the prisons of Iași (open regime), Craiova (closed regime), Gherla (maximum security) and Bucharest-Jilava (semi-open regime). The CPT’s delegation noted the lack of a dedicated unit in Craiova. The 98 people identified as suffering from severe long-term mental illnesses were placed in cells with others in the closed-regime units.²

Most prisons do not have psychiatrists or specialised infirmaries. The CPT confirmed the stigmatisation of persons suffering from mental disorders by prison guards and other prisoners.¹

Prisoners suffering from opioid dependence would be referred to a prison hospital for assessment and treatment, in accordance with the national programme. However, medical staff in those prisons visited were not qualified to initiate opioid agonist therapy (OAT), even in the event of a withdrawal emergency.¹
The law provides that inmates imprisoned for crimes relating to drugs or alcohol should be obliged to undergo treatment.² Organisations visit facilities to help combat substance use disorders, offering prisoners an opportunity to receive methadone treatment.