A Time of Peace?

I wonder what peace looks like to you in your life. For some of us we enjoy moments of solitude in a quiet place, tucked up with a book, for others they relish the thought of being surrounded by loved ones amidst the joyful chaos of a busy Christmas-time house.

The Oxford English Dictionary lists one definition of the word peace as “freedom from anxiety, disturbance (emotional, mental, or spiritual), or inner conflict; calm, tranquillity.” However we may picture peace, it is safe to say we all long for that emotional peace described.

For the millions of people who will spend this Christmas in prison, it is unlikely they will experience any form of peace. Prisons across the world suffer from extreme overcrowding. Prisoners are often packed into spaces where the number of people far exceeds the designed capacity. This leads to poor physical health as infectious diseases can easily spread from one person to the next. The lack of personal space will lead to worsening mental health and increasing violent behaviour.

Whilst there may be valid reasons for people to be in prison, it does not justify the unsuitable conditions that currently exist.

Integritas comes face to face with the issue of overcrowded prisons and the harm this can inflict. It is vitally important that prisoners receive high quality healthcare to prevent further spread of diseases within the prison population.

As we look ahead to everything we enjoy about Christmas, let us remember those who are without peace or comfort.

If you feel able to donate, any amount will have a huge impact on the support Integritas is able to provide to prisoners

 Click here to donate

Ecuadorian prison riot kills over 100 prisoners

On Tuesday 28th September a gang-related riot broke out in an Ecuadorian prison. Prisoners pulled firearms on each other and set off explosives in what has been called the worst gang-related violence in Ecuador’s history. It wasn’t until Wednesday 29th that officials claimed they had the prison under control again, however neighbours of the Guayas prison complex claim to have heard explosions and gunshots early Thursday morning . Ecuadorian authorities said a major operation took place on Thursday 30th to regain control using 900 officers and army soldiers at which point a death toll of 24 prisoners was reported, later rising to over 100 as police worked their way through the prison.

The attack broke out when prisoners from one wing of the prison crawled through a hole and gained access to another wing of the prison which held their rival gang members. Local media reported that the killings may have been ordered from outside the prison highlighting a power struggle between Mexican cartels currently under way in Ecuador.

If this violence had occurred outside of a prison it would not be forgotten, it would be headline news and would be classed as a tragedy. But this event did occur inside a prison, and it was not headline news.

One of the purposes of a prison is to rehabilitate people so that they can re-enter society when their sentence is finished. Events like these call into question whether some prison environments actually achieve their rehabilitative purpose.

To read the BBC article follow this link: https://www.bbc.co.uk/news/world-latin-america-58733202

London's hidden homelessness

London photographer, Anthony Dawton, has spent 18 months highlighting how the homeless have coped during the COVID-19 pandemic. He says the conditions in which London’s homeless live is worse than refugee camps he has travelled to.

Around 2,600 people are estimated to be sleeping rough on any single night in the UK, according to government figures.

an expensive cycle

One third of prisoners leaving a UK prison have nowhere to live once they are released so it comes as no surprise that approximately 41% of the British homeless population has served time in prison. Some prisoners being released from prison are known to re-commit crime to prevent themselves from being homeless. According to the Ministry of Justice national statistics the current overall reoffending rate is 26%, costing £18.1 billion annually. That’s an awful lot of money!

an example of desperation

Anthony Kemp, aged 59, confesses to a murder he committed 38 years ago (aged 21) to avoid sleeping on the streets. He was later found guilty and sentenced to 15 and a half years in jail.

Whilst you may be thinking you are glad that Mr Kemp has been brought to justice, this situation highlights the level of desperation homeless people experience and the lengths to which they would go to to avoid being homeless.

Cheaper, safe option

So why we are not improving the rehabilitation and aftercare of prisoners to ensure that they can leave prison and not have to re-offend just to have a roof over their head? If this was to be achieved then you could pretty much guarantee that the re-offending rate would decrease along with the annual re-offending cost!

Everyone deserves a warm, safe bed.

To read more about Anthony Kemp please follow: https://www.bbc.co.uk/news/uk-england-london-58912035

Fiona Woodhead is our IT & Social Media Assistant

The Life Series: IPP

Imprisonment of any duration has a significant impact on a detainee's wellbeing. And whilst incarceration per se is near universal around the world, length of sentencing varies massively. For example, except for whole life orders, a life sentence in the United Kingdom (UK) is typically twenty-five years with the potential for reduction; in the United States of America (USA) though, receiving a determinate life sentence means dying in prison.

In this new series we will be discussing various issues associated with long-term including life-long incarceration. We will cover physical wellbeing, psychological consequences especially within the context of solitary confinement, indeterminate sentencing, and the thorny issue of 'life means life' sentences.

Leading gently into that theme, this first article looks at indeterminate sentencing within the UK…

What are IPP sentences?

A former tool of the UK's criminal justice system, the sentence of Imprisonment for Public Protection (IPP) was implemented through the Criminal Justice Act 2003. It was intended for criminals who had committed violent or sexual crimes, posed a threat to society and yet were not deemed to require life sentencing. An individual sentenced to IPP was set a minimum term of imprisonment. Once this term was completed, their case was reviewed by the Parole Board, which decided whether they were safe and ready to return to society. Release was never guaranteed and, even once granted, carried conditions including a license for indefinite recall to prison if further transgressions were committed. Once back in prison, further sentencing was once again indeterminate. 

Problems with IPPs

Whilst this may sound like an attractive proposition for dealing with a few prolific recidivists, the problem was that IPPs were too popular with judges. In total, a weighty 8711 IPP sentences were issued, many for low level crimes. Parole boards became over-stretched and many people languished far past their minimum terms with no indications of release dates. These and other problems with IPPs amassed, and eventually the legislation was repealed in 2012.

However, this change was purely prospective. So, despite the abolishment of IPPs, a year ago there were still 1895 IPP prisoners who had never been released and 1357 who had been recalled back to prison.

Thorough research by the Prison Reform Trust reveals the many and varied problems of IPPs:-

• One individual may face a longer sentence than another for committing the same offence.

• The psychological burden of an indeterminate sentence leads to despair and a lack of hope that in turn increases the likelihood of mental health problems and increased rates of deliberate self-harm.  

• Prisoners’ frustration can lead to disruptive behaviours, causing harm to themselves and others.

• The circumstances under which these prisoners find themselves make it very difficult for them to progress, for example by engaging with educational programs that would be viewed favourably by a Parole Board.

• It is impossible to predict accurately how someone will behave once released.

• Family and friends must live with the uncertainty of not knowing when their loved one will be returning to participate in daily family life.

Moving forwards?

It is truly troubling that there are so many IPP prisoners still behind bars.  It could be called unjust and inhumane.  Those outside of the UK often look upon its criminal justice system as a bastion of high standards. However, in this particular case the world should ponder and learn from the legislative disaster that was IPP sentencing.  

We call on those in positions of power to review each individual’s case as a matter of urgency. UK residents can help to bring about this change by writing to our MPs and voicing our concerns. And there is no better time to do this than now as the UK’s Justice Committee has recently launched an inquiry into IPP sentences with the aim of reducing the number of IPP prisoners:-

The large numbers of people being recalled to prison under IPP suggests there is no end in sight to the problems created by this flawed sentence. 

(Sir Robert Neill MP, Chair of the Justice Committee)

Whilst strictly speaking IPP sentences are not life sentences, their perpetual cycling between recall and indeterminate sentencing takes away prisoners’ hope of ever being able to return to normal life. Let’s be honest, they may as well be life sentences. So it’s time to kick them into the long grass once and for all. 

Do join me next time when we’ll be exploring the various health problems associated with long sentences, and also consider how we can work together to bring about change.

Dr Elinor Webb is one of our Health & Justice Fellows

If you have appreciated this article and would like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.

The Ms Maxwell Series: Is it torture?

This week we finish our series pegged around the topic of torture, which made British news headlines in early Spring 2021 when Ghislaine Maxwell’s brother, Ian, spoke out against what he felt were torturous conditions in her New York jail. She is apparently being continually observed in a 6x9ft (1.8x2.7m) cell with no natural light and terrible food & water rations.

Previously: is sleep deprivation torture?

During this series we have asked ‘What is torture?’, ‘How small is too small?’ for a jail cell, and ‘What’s diet got to with it?’. And most recently we asked, ‘Is sleep deprivation torture?’ Over in Europe, a landmark case in the European Court of Human Rights (ECtHR) concluded that sleep deprivation, used as part of five techniques used in interrogation, amounted to inhuman and degrading treatment, but not torture. For Ghislaine over in the United States of America (USA) though, sleep deprivation as a consequence of suicide monitoring during the night could be an over-reaction and indeed counter-productive, unless that monitoring matched her level of risk. Whether sleep deprivation is inflicted for the purposes of interrogation, suicide surveillance or it is a result of other biopsychosocial factors from living in prison, it can have lasting health consequences that no human deserves.

Conclusions

Is it ill-treatment?

If Ghislaine is indeed being held in a 6x9ft (1.8x2.7m) cell with no natural light, under constant surveillance, and with terrible food and water rations as her brother reports, then could this amount to ill-treatment? According to the Nelson Mandela Rules (NMR), which the USA (as a member of the United Nations (UN) General Assembly) has to abide by, it could well be the case:-

• Has she been held for 22 hours a day, for more than 15 consecutive days as defined as solitary confinement, so breaching rules 44 and 45?

• Has her microwaved food lost its nutritional value to the extent that it is inadequate for health and strength, so breaching rule 22?

• Has there been insufficient attention to minimum floor space and lighting in her cell, so breaching rule 13?

If the answer to any of these question is an objective yes, then it may fairly be said that she has been subjected to cruel, inhuman or degrading treatment.

But is it torture?

Moving on from an objective yes to the above ill-treatment questions, then - as torture is a subset of ill-treatment - it may be that Ghislaine is being tortured. Let’s see…

We can’t use the European Convention on Human Rights (ECHR) or its more detailed Convention on the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), as she is not being held in Europe. Even if we could use these conventions, they do not actually define the torture that they ban. Instead, ECtHR judges sometimes rule on whether a particular case of alleged ill-treatment could be said to amount to torture.

We can’t utilise the UN’s Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT) and monitoring by its mandated Subcommittee for the Prevention of Torture and Cruel, Inhuman or Degrading Treatment or Punishment (SPT) to inspect her jail and look for evidence of torture, as the USA is not signed up to OPCAT. And even if USA jails did qualify for SPT inspections, this monitoring body does not have publicly available standards by which to judge cell size, nutrition, lighting and sleeping conditions.

However, the USA is signed up to the UN’s more basic Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT). And according to CAT, torture requires a particular action to have:-

• caused severe pain or suffering, whether physical or mental;

  and

• been intentionally inflicted for such purposes as:-

  • obtaining information or a confession from the victim or another person,

  • punishment for a suspected or actual deed committed by the victim or another person,

  • intimidation or coercion of the victim or another person,

  • or discrimination of any kind;

  and

• been inflicted by a public official or other person acting in an official capacity.

Pain or suffering arising only from, inherent in or incidental to lawful sanctions such as corporal or capital punishment is specifically excluded.

So, to consider whether Ghislaine’s conditions are torturous according to the letter (as opposed to the spirit) of the USA’s legal obligations under the international humanitarian law it has chosen to sign up to, we must establish affirmative answers to all of the following questions:-

1. Is it causing severe mental or physical pain or suffering?

   • Severity is a completely subjective concept. In healthcare, we use a scale from 0 (no pain) to 10 (agony) for people to rate their pain. The major downside to this though is that one person’s 10 is another person’s 5. So this severity stipulation within CAT is the major sticking point for our conclusion.

2. Is its purpose to get information or a confession, or else to punish, intimidate, coerce or discriminate?

   • It’s difficult for third parties like us to establish the exact purpose or purposes.

3. Is it not a lawful sanction of corporal or capital punishment?

   • This is easy to answer. Yes, it is most definitely not a lawful act of corporal punishment.

4. Is it authorised or conducted by a state official?

   • Again, this is fairly easy to answer. Yes, it will be being authorised by her state prison managers and it will be being carried out by state prison officials (eg guards and cooks), although it’s possible that some of the poor cooking is being done by fellow prisoners.

Letter of the law

So, the long and the short of it is that no, according to the letter of the law, Ghislaine is not being tortured.

Spirit of the law

But really, is it right that a certain action may be judged torturous in one country yet non-torturous in another? Why is it that nations including ‘leaders of the free world’ such as the USA may belong to Club UN without ratifying OPCAT? Even signing up to the more basic CAT is optional. After all, Council of Europe member states are obliged to sign up to the CPT on top of the ECHR.

And as an aside, considering that information obtained under duress is often inaccurate, it is surely concerning that the majority (the USA along with China and Russia) of the five permanent members of the UN Security Council (the UN body charged with maintaining international peace and security) are OPCAT signatories.

But let’s return to the fact that what is deemed torture in one state is deemed non-torturous in another. Where is the equivalence? Where is the justice? So many of the world’s 11 million prisoners eat terrible food and live 24/7 in cramped, dark cells - with the full knowledge of their country’s officials. Others are kept alone for months and years at a time. At the very least, this is discrimination against people who are deprived of their liberty. It is surely perverse that we need to argue about semantics in order to decide if these poor people are being tortured! Just how malnourished, lonely, cramped and light deprived does a human being have to be before the law will consider protecting him or her?!

A higher law

As we are a Christian faith-inspired NGO, we also look to an additional set of rules to guide our work - God’s Laws as set out in the Bible.

The Bible has much to say about how to live in just societies. In a nutshell, it rests on how we treat one another. In the New Testament, Jesus teaches his followers ‘The Golden Rule’ as well as ‘The Greatest Commandment’:-

“So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.”

Matthew 7:12

Jesus replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment. And the second is like it: ‘Love your neighbour as yourself.’ All the Law and the Prophets hang on these two commandments.”

Matthew 22: 36-40

Loving our neighbours - that is, others living within our culture - as ourselves is a wonderful principle, regardless of one’s faith. Let’s ask ourselves, ‘Would I wish to live day in, day out in a tiny, dark cell? Would I want to eat bland, unhealthy food for breakfast, lunch, and dinner? And would I want to live my life under constant scrutiny?’ If our answers are ‘No, No and No’ then consider: ‘How can I not speak up whilst this is happening to my neighbours?’

At Integritas Healthcare, we advocate for those who are tortured or otherwise ill-treated because we believe that every human being is made equal with innate worth and dignity. We are called to treat everyone with the kindness and compassion we ourselves would want. Taking inspiration from Matthew 25:37-39, whatever we do in the service of others, we do in love of our fellow man and in our love for God:-

“For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.”… “Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.”

A glimmer of hope

We end this series with some recent good news that provides a glimmer of hope for prisoners in solitary confinement in the USA.

From next year, the State of New York has agreed to ban solitary confinement exceeding 15 days, so as to ensure compliance with the Nelson Mandela Rules. This new law will include screening for suicide risk and the development of rehabilitation units for those who would otherwise have been sent to solitary confinement.

It may only be one law, but it could be the start of a nationwide change in how detainees are treated within the USA’s penal system. It is also the beginning of being able to hold certain USA detention centres accountable for any discrimination against vulnerable patient groups who are disproportionately sent to solitary confinement and who are generally more poorly treated within many of the world’s penal institutions. So watch this space!

If you have been moved by this series on torture and you’d like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.

The Ms Maxwell Series: Is sleep deprivation torture?

We return to our series pegged around the topic of torture, which made British news headlines in early Spring 2021 when Ghislaine Maxwell’s brother, Ian, spoke out against what he felt were torturous conditions in her New York jail. She is apparently being continually observed in a 6x9ft (1.8x2.7m) cell with no natural light and terrible food & water rations.

Previously: What’s diet got to do with it?

After exploring the questions of ‘What is torture?’ and ‘How small is too small?’ for a jail cell, we discussed ‘What’s diet got to with it?’. The UN’s Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules) stipulate food must be nutritious and a detainee must have ready access to drinking water. However, whether or not allegedly inedible food could be considered ill-treatment amounting to torture as defined by the UN’s Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) is doubtful. Either way though, it’s neither necessary nor proportionate punishment for detainees to be without access to nutritious food and reasonable quality water.

Now: sleep deprivation

More recent news reports have shone light on new bruising around Ghislaine’s eyes, suggesting she is now suffering from sleep deprivation as a result of being woken by torchlight repeatedly throughout the night as part of her suicide watch.

The suicide prevention in jails and prisons guidance written by the World Health Organisation (WHO) recognises that adequate monitoring of suicidal prisoners is important to prevent deaths, especially during the night:-

Adequate monitoring of suicidal inmates is crucial, particularly during the night shift (when staffing is low) and in facilities where staff may not be permanently assigned to an area (such as police lockups).

The guidance also understands that the ‘level of monitoring should match the level of risk’. If Ghislaine’s New York jailors have conducted risk assessments that clearly identify her being high risk of suicide, then constant surveillance may be necessary for her own safety. However, if Ian Maxwell’s claims are true and her jailors are acting purely out of an excessive fear for their own reputation, then her level of monitoring is truly excessive and could even be counter-productive. And, as the Judge presiding over Ms Maxwell’s case has already suggested, she could have an eye covering to help her sleep despite frequent nightly checks. So why didn’t someone think of it before?

The Nelson Mandela Rules, which are designed to maintain a prisoner’s human rights and dignity, include guidance on sleeping arrangements:-

All accommodation provided for the use of prisoners and in particular all sleeping accommodation shall meet all requirements of health, due regard being paid to climatic conditions and particularly to cubic content of air, minimum floor space, lighting, heating and ventilation.

Darkness is essential for good quality sleep. As levels of light decrease at the end of the day our body produces the hormone melatonin, which causes muscle relaxation and the feeling of tiredness, which in turn initiates sleep. Light exposure during the night may impede this natural rhythm, provoking periods of wakefulness. Therefore, appropriate lighting, or lack of it, at night time is an important right for prisoners.

Sleep deprivation and interrogation

Historically, the technique of depriving a prisoner of sleep has been used for the for purpose of obtaining a confession or other information. Sleep deprivation was one of five techniques employed by the British Military as an interrogation method during the 1970s. In the European Court of Human Right’s trial Ireland v. the United Kingdom, it was concluded:-

... Although the five techniques, as applied in combination, undoubtedly amounted to inhuman and degrading treatment, although their object was the extraction of confessions, the naming of others and/or information and although they were used systematically, they did not occasion suffering of the particular intensity and cruelty implied by the word torture as so understood. ...

The Court concludes that recourse to the five techniques amounted to a practice of inhuman and degrading treatment, which practice was in breach of [the European Convention on Human Rights] Article 3.

Whether sleep deprivation is inflicted for the purposes of interrogation or it is a result of other biopsychosocial factors, what might be the health consequences?

The importance of sleep

It is common knowledge that a lack of sleep can impact health and wellbeing. In the short term, it reduces concentration and increases irritability. Ongoing sleep deprivation decrease the immune system’s defence against infectious diseases - not a welcome thought during a worldwide pandemic! It also increases the risk of heart disease and diabetes with serious consequences for life quality and expectancy.

How can prisoners achieve better sleep?

Achieving good sleep in prison is a challenge. The stress and chaos of prison life, sometimes compounded by drug and alcohol use, or a mental health problem, often lead to sleepless nights.

Many of the environmental factors in prison cannot be changed, but it is both easy and important to empower prisoners to choose small things that can have a positive impact on their quality of sleep. This is called ‘sleep hygiene’. Making these small changes also increases their sense of control, which is a rare and precious sensation for most of the world’s detainees.

PILs

Our picture-heavy, word-light Insomnia Patient Information Leaflet (PIL) has been designed especially to help prisoners with sleep hygiene. We are in the early stages of an ongoing project to translate our detainee-friendly PILs into multiple languages and make them freely available on our website. This will make them readily accessible to individuals and organisations involved in supporting many of the world’s 11 million detainees. If you have a heart for helping detainees improve their own health and wellbeing, you could donate to our work or (if you’re suitably skilled) join us as a translator.

So Is Ghislaine Maxwell being tortured?

Next time we will reflect on this series’ findings and decide…

If Ian Maxwell’s allegations are true, is Ghislaine being ill-treated in a manner that could be said to amount to torture?

Until then…

The Ms Maxwell Series: what's diet got to do with it?

We return to our series pegged around the topic of torture, which made British news headlines in Spring 2021 when Ghislaine Maxwell’s brother, Ian, spoke out against what he felt were torturous conditions in her New York jail. She is apparently being continually observed in a 6x9ft (1.8x2.7m) cell with no natural light and terrible food & water rations…

Previously: How small is too small?

After exploring the question of ‘What is torture?’, we looked at how to decide ‘How small is too small?’ for a jail cell. Ghislaine is in the United States of America (USA), which is not subject to inspections by the UN’s torture inspection committee, which anyway lacks published standards on living space. However, if she was transferred to a European jail, the Council of Europe (CoE) would be able to apply its own torture inspection committee’s living space standards and declare her solitary 4.9m² cell too small. Whether or not such environmental ill-treatment would be deemed to amount to torture would however be a matter of deliberation for judges at the European Court of Human Rights (ECtHR).

So what about her diet?

In his interview Ian Maxwell raised concern about Ghislaine’s food and water:-

The water that is provided through the prison is brown, and the food that she is given is very highly microwaved and basically inedible.

The Nelson Mandela Rules, which are designed to maintain a prisoner’s human rights and dignity, include guidance on nutrition:-

Rule 22:-

1. Every prisoner shall be provided by the prison administration at the usual hours with food of nutritional value adequate for health and strength, of wholesome quality and well prepared and served.

So is this true of Ghislaine’s food?

Her food is described as ‘highly microwaved’. But what does this mean? Mostly microwaved as opposed to boiled or grilled? Or microwaved for too long a period of time? Rather than speculating further as to the meaning behind this ambiguity, let’s inspect known facts.

Microwaving does not necessarily deplete food of its nutritional value. In fact, it can preserve certain vitamins and minerals better than boiling, which causes nutrients to leak into the cooking water. The very nature of a microwave is that it requires only a short period of time to heat food. However, over-cooking even by microwave does start to affect a meal’s nutritional value.

Still, there’s poor food and poorer food. Prisoners around the world have very different meals. Many have to consume unrecognisable soups and stews that are barely sufficient to sustain life, and others have reduced or even completely absent food rations as punishment.

And what about her drinking water?

Rule 22 of the Nelson Mandela Rules also states:-

2. Drinking water shall be available to every prisoner whenever he or she needs it.

But how much water does a human require? The International Committee of the Red Cross’ handbook Water, sanitation, hygiene and habitat in prisons states:-

The strict physiological needs of a human individual may be covered by 3 to 5 litres of drinking water per day. This minimum requirement increases in accordance with the climate and the amount of physical exercise taken.

The minimum amount of drinking water that must be available inside the cells and dormitories is in the order of 2 litres per person per day if the detainees are locked in for periods of up to 16 hours, and 3 to 5 litres per person per day if they are locked in for more than 16 hours or if the climate is hot.

Ghislaine does has ready access to drinking water though it is apparently brown, which of course doesn’t look appetising and may affect its taste. Such discolouration may be due to the corrosion of plumbing leaching lead into the water. However, running the water briefly before use should flush the system. Moreover, in New York City the water is monitored carefully, from delivery from upstate reservoirs to street-side sampling stations, to ensure the the risk of lead poisoning remains low.

Such safeguards do not protect many of our globe’s 11 million prisoners. Little data exists on how many have access to clean drinking water, but it definitely is a problem. In Brazil, for example, Human Rights Watch found that in some prisons water is available for only half an hour in the morning and half an hour in the evening.

What about her access to natural light?

According to her brother, Ghislaine has ‘no natural light’ in her cell. If true, this is a contravention of the Nelson Mandela Rules:-

Rule 13: All accommodation provided for the use of prisoners and in particular all sleeping accommodation shall meet all requirements of health, due regard being paid to climatic conditions and particularly to cubic content of air, minimum floor space, lighting, heating and ventilation.

Rule 14: In all places where prisoners are required to live or work:

(a) The windows shall be large enough to enable the prisoners to read or work by natural light and shall be so constructed that they can allow the entrance of fresh air whether or not there is artificial ventilation;

Of course, there are greater and lesser degrees to which thousands of prisoners around the world are deprived of their right to natural light. Some, apparently like Ghislaine, are kept in cells lacking natural light but are allowed outside daily for exercise in the fresh air. This latter fact complies with another Nelson Mandela Rule:-

Rule 23:-

1. Every prisoner who is not employed in outdoor work shall have at least one hour of suitable exercise in the open air daily if the weather permits.

A prisoner, found in a dark solitary confinement block where we assessed his dental hygiene and general health

Many others though are kept without natural, or indeed any, light 24/7:-

It’s been my sad duty to visit solitary confinements in many countries across the world. And I can confirm that many regimes still subject human being to darkened solitude. If they weren’t mentally distressed upon entering such environments, then the environment itself soon rectifies this. Why is this still going on in the 21st century?!

(Dr Rachael Pickering,
one of our medical experts)

And what are the likely health consequences?

A diet lacking in fibre can cause constipation, which may be linked to bowel inflammation and even perforation.

A diet with inadequate intake of key vitamins and minerals, can lead to malnutrition. Vitamin deficiencies can cause lethargy, breathlessness, palpitations, reduced vision, gum disease, and muscle wasting to name a few. Vitamin D deficiency, which is caused by dietary deficiency and lack of access to sunlight, may cause various symptoms including bone and muscle pain, difficulty walking, muscle weakness, and increased risk of fractures. It may also impact mental wellbeing, being linked to depression and schizophrenia.

Even without associated vitamin D deficiency, lack of exposure to sunlight may contribute to low mood and fatigue, due to the brain’s reduced production of serotonin and increased production of melatonin.

So is Ghislaine Maxwell being tortured?

Next week we will reflect on the findings within this series and consider…

If these allegations are true, is Ghislaine being ill-treated?

And if so, is it ill-treatment which could be said to amount to torture?

Until next week…

Dr Esme MacKrill

PS If you’d like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.

The Ms Maxwell Series: How small is too small?

Last week: what is torture?

Last week we started to revisit the topic of torture as it had made the British news once again when Ghislaine Maxwell’s brother, Ian, spoke out against the apparently torturous conditions in her New York jail. Mr Maxwell reported his sister is being held unnecessarily under constant surveillance, in a 6x9ft (1.8x2.7m) cell with no natural light, and with terrible food & water rations.

However, as we discussed, deciding whether Ghislaine is being tortured is complex. The United Nations (UN) Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) contains a complex definition of torture, which can be difficult to interpret. And, although the United States of America (USA) has signed the CAT, it has not signed the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). So the UN’s Subcommittee for the Prevention of Torture and Cruel, Inhuman or Degrading Treatment or Punishment (SPT) cannot inspect her cell within one of the USA’s many prisons and other places of detention.

Even if the USA was signed up to OPCAT, the SPT does not have published standards by which to judge whether - as Ian Maxwell claims - Ghislaine’s living space is indeed too cramped, too short on natural light & too lacking in privacy or if her food is really all that bad.

However, if Ghislaine was incarcerated in Europe, she would be held by a member state of the Council of Europe (CoE). All such states are automatically signed up to both its European Convention on Human Rights (ECHR) and its more detailed Convention on the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, which, through inspections by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), tries to ensure that the ECHR’s prohibition of torture is respected.

How small is too small?

So then, if for some reason Ghislaine was extradited to Europe, she and her cell may just be lucky enough to be inspected by a delegation from the CPT, which does have well-known standards. Let’s consider purely its standard on living space, which is the most objectively assessable of the complaints raised by Ian Maxwell on her behalf…

According to the CPT, each detainee should have ‘6m² for a single-occupancy cell + sanitary facility’ or ‘4m² of living space per prisoner in a multiple-occupancy cell + fully-partitioned sanitary facility’. By this definition then, Ghislaine’s single-occupancy 6x9ft (1.8x2.7m) cell - at ~4.9m² - is too small. Whether or not it could be considered ill-treatment amounting to torture - as per either the UN’s definition or the deliberation of judges sitting at the European Court of Human Rights (ECtHR) - is a far more complex, thorny question.

How does nelson mandela come into this issue?

Within International Humanitarian Law, prisoners’ basic needs must be met and their human dignity maintained. And so, in 2015, the United Nations revised its 1955 Standard Minimum Rules for the Treatment of Prisoners, now known as the Nelson Mandela Rules - as the late President of South Africa was, in his earlier years, very famously ill-treated whilst behind bars.

These 122 rules provide guidance on all aspects of a prisoner’s journey from admission right through to release. Regarding solitary confinement, rules 44 and 45 state:-

44. For the purpose of these rules, solitary confinement shall refer to the confinement of prisoners for 22 hours or more a day without meaningful human contact. Prolonged solitary confinement shall refer to solitary confinement for a time period in excess of 15 consecutive days.

45. 1. Solitary confinement shall be used only in exceptional cases as a last resort, for as short a time as possible and subject to independent review, and only pursuant to the authorization by a competent authority. It shall not be imposed by virtue of a prisoner’s sentence.

What about her lack of privacy?

We do not know the exact amount of time per day that Ghislaine is confined to her cell. We also do not know whether she is allowed day-to-day interaction with other detainees. However, in his interview Ian Maxwell stated the following:-

Ghislaine has been in prison now for nearly 250 days and counting… she is under 24 hour round-the-clock surveillance with ten cameras, including one that moves and tracks her movements. And on top of that there are four guards that are looking at her, and presumably there is another guard looking at the camera feeds. She is not allowed to move into the corners of her cell and she’s not allowed to be within two and a half feet of the cell door. That is her existence every day.

As we mentioned last week, Ian Maxwell intimated that - subsequent to Mr Epstein’s high profile suicide last year whilst in prison - Ghislaine is under constant surveillance due to the authorities’ fear that she too may try to end her life whilst in custody. However, he does not believe that she is a suicide risk, making this level of monitoring a ‘grotesque over-reaction’.

What should be done to prevent suicide in custody?

The World Health Organisation (WHO) has written guidance on suicide prevention in jails and prisons. This document explains that a thorough risk assessment process should be completed for every prisoner when they are admitted to the prison and advises on appropriate management techniques as and when necessary.

Adequate monitoring of truly suicidal prisoners is necessary, given that hanging can cause serious brain damage within three minutes and death within five to seven minutes.

The use of camera technology has become increasingly popular as an alternative to prison guard watches. Even so it still requires surveillance of camera footage and prompt action. The guidance say:-

Moreover, most inmates dislike constant observation if it occurs without emotional support and respect. Therefore, camera surveillance should never be utilized as a substitute for the officer’s observation of the suicidal inmate and, if used, should only supplement the direct observation of staff.

If Ghislaine’s New York jailors have conducted risk assessments that clearly identify her being high risk of suicide, then constant surveillance may be a necessity for her own safety. However, if Ian Maxwell’s claims are true and her jailors are acting purely out of an excessive fear for their own reputation, then her level of monitoring is truly excessive and could even be counter productive.

But what’s in a name?

However, let’s for a moment leave aside the varying degrees of both lack of privacy and cramped cells endured by Ghislaine and very many others of the world’s ~11 million prisoners. Instead, let’s consider the undeniable psychological and physical health consequences to keeping prisoners in any sort of secure environment where perpetual confinement and frequent observation are the orders of the day…

The COVID-19 pandemic lockdown has imposed on a massive percentage of the world’s free citizens has given us a tiny taste of the psychological sequelae of imprisonment. It is therefore unsurprising that detainees, especially those who have been kept in confined conditions, suffer from anxiety, panic, insomnia, paranoia, aggression and depression. These psychological symptoms in turn can increase the risk of self-harm and suicide.

Detainees kept under such conditions are also at higher risk of a range of physical effects such as joint and back pain, deterioration of eyesight, lethargy and cachexia.

Are such conditions ill-treatment? And could they be said to amount to torture, as defined by the UN’s CAT or as interpreted by the ECtHR’s judges? You try to decide. But either way, it’s neither necessary nor proportionate punishment for offending human beings in general to be kept in such conditions.

So what about her diet and exposure to sunlight?

Although the above symptoms may be caused purely by psychological stress, they cannot often be separated from the physical consequences of poor diet and lack of sunlight. And so next week we will focus on Ian’s claims that Ghislaine receives practically inedible food and is not given enough exposure to natural light.

How may such allegations be assessed?

What are the potential health consequences of such ill-treatments?

And are they ill-treatments that could be said to amount to torture?

Until next time…

Dr Esme MacKrill with Dr Rachael Pickering