Organisation of health care
Ministry in charge
the Prime Minister
Medical care in prison is the responsibility of the prison administration.
“Prisons are subject to monitoring by the chief doctor of the region or prefecture, and the inspection by the medical service of the prison administration.” (Penitentiary law, article 124).
Every prison facility has a health care unit
Each prison has one infirmary (Penitentiary law, article 125).
The infirmary is provided with the same equipment as a public clinic. It allows access to general care and treatments, and ensures the isolation of contagious diseases.
Number of medical staff (FTE)
This number includes all medical professionals, in particular nurses, doctors and psychologists.
In December 2018, the ratio of medical staff to prisoners was one doctor for 891 prisoners, and one dentist for 1351 prisoners. On the same date, the number of staff specialising in psychology was 39.1 One psychiatrist (FTE) is listed for all prisons.
The year 2020 saw the building of new health units and the renovation of old ones, the upgrading of equipment and the purchase of ambulances. Medical teams were expanded with the hiring of 12 general practitioners, five dental surgeons and 19 additional nurses. They are also assisted by 19 volunteer doctors.
Most prisons do not have a “permanent doctor”.
The medical team is usually made up of one general practitioner (full time or for regular visits), nurses and sometimes, a dentist and a psychologist.
General medical care (such as tests and biological analysis), hospitalisation, dentistry, and psychological treatment are delivered inside the prison.
Many prisons do not have a permanent doctor. The prison administration has agreements with public and private doctors. The doctors have to regularly visit the prisons to ensure medical coverage.1
Three health units were built in Jeddah, Borkan and Larrache prisons, and one dental clinic in Midelt Prison. A stand-alone X-Ray unit was installed in Ain Sebaa Prison to detect tuberculosis. A “remote medical consultation” platform was also launched to provide greater medical care coverage.
There are no separate units for prisoners in hospitals.
Access to health care
Health care is free
A medical examination is performed upon admission
The penitentiary law states that “every prisoner should be seen by the director of the prison or by the official in charge of social services as soon as possible after their admission to prison. The director or official should inform the public ministry of any visible impairment or symptoms.”
The prisoner has to undergo a medical and psychology examination in the three days following their admission. The medical visit should allow the prison staff to:
- identify existing illnesses (contagious or infectious) or potential health problems and to provide the necessary treatments.
- support prisoners likely to suffer from drug withdrawal during their imprisonment.
- help identify potential injuries picked up in custody.
- evaluate the mental state of prisoners and, in particular, assist those at risk of self-harm.1
Morrocan penitentiary framework, DGAPR 2016-2020 strategy, law 8. ↩
A medical file is opened upon admission
Prisoners can access health care units after
- a written request
- an oral request
Access to the health care units can also be given based on observations by the prison director.
Medical examinations are carried out on a confidential basis
in most cases
A female prison guard is present during medical examinations of female prisoners, when the healthcare worker is not female (Penitentiary law, article 125).
Continuity of care is ensured throughout the imprisonment.
Medicines are dispensed by nurses, doctors or psychologists.
Hospitalisation of prisoners takes place upon medical advice, when the head doctor believes that the illness can not be treated in prison or in case of risk of an epidemic. Sick prisoners are then admitted to the nearest public hospital. The prison doctor “can at any time order that the prisoner be sent back to the prison if they believe the prisoner can be treated there.” (Penitentiary law, article 136).
The prison director informs the prison administration about the hospitalisation and for those awaiting trial, the judicial authority. They decide on which security measures to put in place, such as an escort or supervision by the police or the gendarmerie (penitentiary law, article 137).
Physical health care
The prison administration puts programmes in place to guarantee access to adequate medical treatment, especially for the care of prisoners with tuberculosis and those living with HIV/AIDS1 The care of the sick, especially from tuberculosis remains insufficient.
DGAPR, “2018 activity report”, pp. 95-96. ↩
The prison director, in agreement with the doctor or local authorities, has to take measures to prevent and to fight against contagious and epidemic diseases. The measures put in place are specifically, quarantining and disinfecting rooms, belongings and bedding (penitentiary law, article 127).
The prison administration organises campaigns on prevention and awareness of contagious and epidemic diseases. They mainly concerned AIDs, tuberculosis, syphilis, diabetes and included vaccination campaigns. The administration does not share the content nor the details of these campaigns.
Prisoners suffering from contagious diseases are assigned to separate rooms in the hospital or infirmary, or in a separate area of a wing. (Morrocan penitentiary framework, DGAPR 2016-2020 strategy, law 3).
Prisoners in Rabat were among the first ones eligible for their first dose of the COVID-19 vaccine. They were to receive the second dose 28 days after the initial injection. As of 25 March, about 77% of incarcerated people over age 60 had been vaccinated in 85% of prisons, while the rest was still waiting. On 27 May, 4,400 prisoners had been vaccinated, of a total of 11,500 eligible, as well as all prison staff. The vaccination drive then targeted prisoners over age 45 and those with chronic illnesses that could lead to complications.
Awareness projects are led in the prison along with risk reduction measures. The administration does not share the content nor the details of these campaigns.
Mental health care
Prisoners suffering from mental disabilities are not placed in specific facilities. They are supervised inside the prison by prison medical staff. They are usually given medication and placed under medical observation.
Specific care can be given in hospitals 1 for prisoners with mental health issues. The number of psychologists is insufficient: 39 “staff specialising in psychology” in 2018 for the entire prison population (83 757 prisoners).
Those judged to be criminally irresponsible (totally or partially) are detained in prison. In 2018 they represent 6% of prisoners suffering from mental disabilities. The administration confirm that they are in discussion with the CNDH “to find an immediate solution” 2
Prison guards undergo a three hour initial training on caring for people suffering from mental illnesses. Prisoners who self-harm are monitored by a psychologist when one is present in the prison.
On 16 April 2020, the prison administration has launched a digital platform offering counselling and support to staff and prisoners during the Covid-19 pandemic.
Psychologists help those with addictions. The administration organises projects of awareness, notably the National Program for mental health prevention and the fight against addiction. Five prisons have centres for the study of addiction. Five new centres are in the process of being built in the Tanger 1, Fès, Marrakesh, Aït Melloul and Oudjda prisons.
Those following methadone substitution treatment in Ministry of Health centres can continue this treatment in prison. The number of prisoners following this treatment is 152 in 2018. 1