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Gulag Healthcare

Below is a featured exclusive translation from an upcoming issue of Lev Ponomarev’s weekly human rights bulletin about access to medical treatment inside Russia’s Federal Service for the Execution of Punishments (FSIN). The All-Russia Public Movement «For human rights» “Chronicles of Political Persecution in Present-Day Russia” Issue No. 6 (124), 20 February 2008 Inhuman FSIN Medicine Notes of a suspect The incident with Alexanyan has shown society an example of something that has over many long years become the norm in SIZOs and colonies.

As the deputy chief of the Butyrki SIZO for medicine explained to me, it is a lot simpler to “certify” [1] a person – and there are fewer unpleasantries involved – than it is to send him or her for treatment to a hospital. He spoke with bitterness – at this time, a criminal case was being investigated based on the fact of the escape of a suspect from the prison ward of hospital No. 20 in Moscow. The doctor himself was a suspect merely because he had permitted the transfer of the osteomyelitis patient to the hospital. He was saved from prison thanks to his having served under live fire in Chechnya.Going out for exercise, I once happened to see in the corridor the corpse of a young – no older than 30 years – person. Later, I found out that the death had occurred from a chronic asthma attack. An order has been issued in the FSIN on prohibiting the passing through from the outside of any medicines, including inhalers. His mother pounded on every door for 3 weeks in order to pass through an inhaler, without which her son could not live. They explained to her that everything necessary is in Butyrki. Finally, the deputy chief took the inhaler, promised to pass it through, made a phone call, and immediately returned it. He explained to the mother that her son had died that night. I will note – this was a suspect who died, someone who is not yet considered guilty before a trial. And besides, nobody would have dared sentence him to death for theft. Of course, there is a lot of smoking going on in the cells, and the ventilation is horrible, but at the FSIN, the investigators, and the judges can not be unaware of this.So Alexanyan was lucky that everybody spoke out for him – from simple people to the US Department of State. He is still alive.It so happened that one night another suspect became very ill. The cell knocked with plates on the iron door, and not only forced the DPNSi [2] to come, but also to call for an ambulance. The doctor made the diagnosis – perforation of a duodenal ulcer: emergency lifesaving surgery. The DPNSi said: “Give him an injection – in the morning, let the chiefs decide, but I’m not going to wake up the UFSIN duty officer because of a zek”. The doctors explained that the person would not live till morning. People were found in the cell who promised to tell about this to the procurator.This sick person later told me that the surgeon, entering the operating room, asked: “What kind of evil-doer is this who is shackled to the operating table with handcuffs, and even with security in the operating room?” “He is not a highway robber, not a killer, but what if he – runs off?”, they explained to the surgeon. It was the solidarity of the cell, and not the benevolence of security, that saved the person’s life.For the sake of fairness I will note that not only our judges assess the life of Russians cheaply, but also in the European Court of Human Rights in Strasbourg. At the end of 2006, the mother of one inmate, sentenced to 4 years, was awarded 20 thousand euros because he had been deprived of life. During the course of many hours in the colony they were deciding – to take him to a hospital or not to take him, at a time when his stomach ulcer was bleeding. As a result, they took him in an «autoZK» [an ordinary prison transport truck—Trans.], along the way they shook him up, and on the operating table the blood was flowing out of him. For comparison: in that same court, a Frenchman was awarded 3.2 million euros because the authorities had bought out his land at the market price, after which they did not do anything with it for many years.In the «Matrosskaya tishina» SIZO a surgeon, having examined me during the time of an acute attack, explained that it was early to send me on life-saving indications, they had no analgesics, while he could not permit the filling of a hot-water bottle with boiling water for the relief of pain, because I could squirt from it at security in the face. Therefore a single-place commercial cell with shower, toilet, television and refrigerator (in 2003 – $7,000 dollars per month) in the «Matrosskaya tishina» SIZO is not the worst thing they could have done with Alexanyan – a person who is not poor and famous.I have met three sorts of doctors in the FSIN. The first – like in the Ryazan SIZO – openly say that a sick zek is one who has been brought on a mattress to the medical unit. The rest are fakers.The second, apparently, are lazy – they can not work much. Therefore they render only minimal aid. Such I met in Butyrki, in «Matrosskaya tishina», in the Bryansk SIZO. In the latter, the doctor asked me what medicines I had, heard me out and said that the ones they had were less effective, therefore he proposed to continue self-treatment.The third – former military doctors – are compassionate, they do everything that can be done and a few things that are not supposed to be done by orders of the FSIN. For example, in 2006, according to FSIN norms, 200 thsd. rubles were released for a colony of 1200 persons for the purchase of all medicines, instruments, and dressing material. Scalpels, clamps, needles – are not cheap. And for the treatment of even a few gravely ill people you need expensive medicines.As a result – aspirin, baralgin, cytramon – in short supply due to lack of money. The doctor wants to give out medicines, but can not. In such cases, individual doctors unofficially permit relatives to pass through the necessary medicines with [food] products under their control. When the deputy chief of Butyrki stopped doing this, there were threats of writing a collective complaint about him to the FSIN. “Go ahead and write”, he said to the enraged mothers. “Then they will praise me there because at last I’m scrupulously carrying out their order”.There are decent people in «the land». For example, they passed medicines from relatives through to me out of solidarity: after all, I had worked 18 years in medicine. And besides, mine was clearly a “contract” case. Therefore, when the «feedbox» [3] in the cell opened up at nights, and the duty [medic] said: “Mikhail, a person in the next cell is having a heart attack”, I passed through vaolcordin (it contains alcohol – a strict prohibition!), and the person survived until morning. Or baralgin – and an attack of renal colic was arrested. At times the SIZO duty medic simply did not have medicines. Although the duty [medic] ought to have been fired for «organization of inter-cell communication».Guilty of the sufferings of Alexanyan, as of the majority of sick people who were shut up in a SIZO long before trial, are first and foremost the judges. In the more than 4 years spent in the SIZO (of these – 2.5 years before trial!), I acquired new illnesses. For example, I sat together with someone who had tuberculosis. The doctor explained that he has the non-infectious, and not the infectious, form – nothing to be afraid of. To the question of in what manner he had determined that the form of the tuberculosis was non-infectious, if the patient was coughing up blood, it was proposed to me to quit being a smart-aleck. In March 2006 alone an ambulance came to me 4 times to the Basmanny court. Different brigades of doctors insisted in one voice on immediate hospitalization in hospital No. 20. Every time, judge N. Dudar refused in writing (on the ambulance’s incident report sheet). “We will judge, and not heal”. Her explanation was simple – since they had brought me to court from the SIZO – that means I am healthy. When I was feeling so bad that I could not get to the «autozak» [same as autoZK—Trans.], they would bring me to the medical/sanitary unit, in which the medic would explain: “Not to deliver to the court – that’s a State of Emergency. Possible only with infectious patients under quarantine”. He didn’t take me: “Here are two ampules with spirit of ammonia – one for the trip to court, the other – for the road back”. Using this very same argument, judge N. Dudar stopped satisfying defense petitions on calling an ambulance. Therefore Alexanyan’s words about how they can deliver you to court in a coffin too – this is not a metaphor, this is our life.I will note that the convoyers [guards responsible for “delivering” prisoners to and from the SIZO—Trans.] in the Basmanny court are incomparably more humane than the judges. Seeing how I was vomiting, what injections the ambulance doctors had made, they tried to ease my suffering. For example, 2-3 times a day they would fill a hot-water bottle with boiling water, sit me in a cell with non-smokers. Seeing that during the pronouncement of the verdict standing in handcuffs I started feeling ill, they insisted that I sit, and the remaining 7 hours (until 22:00 on Friday) I heard the verdict of the court sitting.No medical documents about the most incurable illnesses are an argument for Russian judges, if the procurator needs to hold a person in jail for a long time before the verdict for an “admission of guilt”. In so doing, the judges openly spit on the norms of the law. This is associated with the fact that the majority of them worked earlier in the procuracy and are always ready to help “comrades in arms” in the struggle with criminals. In Art. 221 of the CCP RF is written that for a person found in detention, the trial must begin no later than in 1 moth after receipt of the case file by the court. In my case, the case was sent to the court on 25.03.2004, while the preparatory session took place on 09.06.2005! Nobody punished judge N. Dudar for the extra 13 months. Because the verdict, like in other “contract” cases, had been issued long before the transfer of the case to the Basmanny court. To expect that the causing of harm to a stranger’s health will force a judge to take thought is pointless.It is good that with Alexanyan the power, albeit under pressure, has manifested rationality.What is bad is that with thousands of ordinary people, found in an analogous situation, nothing of the sort takes place. As a result, hundreds die. It remains simpler for medical personnel from the FSIN to certify the death of a person than to treat him. While judges appear to consider themselves (ah, but how sincerely?) not to be accessories to these sufferings and deaths. Their motto “You shouldn’t have committed the crime, then you wouldn’t have ended up in the SIZO” says only that the principle of presumption of innocence has nothing whatsoever to do with our judiciary system.M. Litvinov[1] Certify – aktirovat’ – to draw up a death certificate.[2] DPNSi – duty assistant of the chief of the SIZO.[3] «Feedbox» – «kormushka» – a window in the cell door for passing through food and documents.