Contributor(s)Avocats sans frontières / independent experts
Organisation of health care
Ministry in charge
Ministry of Justice
Care is provided under the authority of the Health Division of the DGPR. Physicians are ‘attached’ to the DGPR. They are part of the prison staff.1
Ministry of Justice, INPT, CoE, “Manuel du droit pénitentiaire tunisien”, November 2019, p. 191. ↩
Tunisian prisons lack equipment and medical staff. The country has about 15 state-qualified nurses working in prisons. The authorities call on 400 prison officers, trained for three months by the Military Medical School, to assist them.
There are also nursing assistants. Some of them are seconded from the civil service, while others are part of the prison’s staff. Prisoners may act as nursing assistants.[^manual]
The medical unit of Mornaguia prison has better infrastructure. The number of health personnel remains insufficient.
The filmmaker Issam Bouguerra, who has been in remand detention for over a year in the Mornaguia prison, has encountered significant health issues. His father told Radio IFM that his son’s health was deteriorating by the day. The prisoner was reportedly considering suicide. However, prison management continued to refuse him medical care.
Access to health care
Health care is free
A medical examination is performed upon admission
A medical examination is arranged upon entry into prison. The person arriving first meets a nurse. The nurse screens for serious or infectious diseases, including HIV and tuberculosis. The prison doctor is required to meet with the prisoner within 72 hours of arrival. In practice, the examination may be carried out after 72 hours, particularly when there is a large number of arrivals.
A medical file is opened upon admission
The medical file contains reports, letters, results of medical examinations and other documents relating to the person’s state of health. This file is accessible upon written request.
Prisoners can access health care units after
an oral request
Requests for access to the health care unit are made to the dormitory head. They pass on the request to the staff. Cases deemed urgent are treated as a priority.
Medical examinations are carried out on a confidential basis
Consultations take place with supervisors present. Consultation rooms are small and poorly soundproofed.1
Ministry of Justice, INPT, CoE, “Manuel du droit pénitentiaire tunisien”, November 2019, p. 205. ↩
People arriving with a prescription must receive medical treatment without delay. In the absence of a prescription, the prison doctor decides on the treatment. The prisoner is then examined by a medical specialist.
Any treatment based on psychotropic drugs must be specifically prescribed by a specialist doctor.[^manual1]
Incarcerated people do not have the opportunity to consult a doctor of their choice.
The medication is free. There are no procedures governing their distribution. In practice, they are administered in diluted form in a vial. The patient’s name or file number is written on the bottle. The pharmacological properties may be altered by this procedure.1
Hospitalisation is subject to a request from the prison doctor.
The prisoner is handcuffed during their transfer. A guard is present at all times during hospitalisation. The patient is handcuffed to his bed, except when they are being examined.
The prisoner is required to leave the bathroom door “ajar” each time they use it.1
Ministry of Justice, INPT, CoE, “Guide du prisonnier en Tunisie”, November 2019, p. 73. ↩
People with tuberculosis are isolated from the rest of the prison population. They are placed in dedicated sections.
[COVID-19 epidemic / 2020-2022]
In 2020, the penal administration announced hygiene measure strengthening in prisons. The administration is planning for sterilization operations, the purchase of thermal cameras, and the creation of isolation cells. Newcomers are being examined in full before being placed in the cells. Special visiting rooms (allowing direct contact between prisoner and visitor) were suspended until further notice. The possibility of providing food parcels made by families (baskets) is limited. The administration is planning for the implementation of awareness and information campaigns for prisons and prison staff on appropriate preventive measures.
In 2021, the authorities allocated seven new units for incoming prisoners. The head of the National Authority against Torture stated that health protocols were not respected in prisons. He pointed to the lack of distancing and mask wearing and said that the facilities had become a hotbed of infection due to transfers between courts and prisons.
Mental health care
Persons suffering from mental illnesses are not held in specific facilities. They are incarcerated under the same conditions as any other prisoner.1
Prisoners and staff report serious problems such as suicides, self-harm and assaults. Care is mainly limited to the distribution of psychotropic drugs.
Ministry of Justice, INPT, CoE, “Guide du prisonnier en Tunisie”, November 2019, p. 43. ↩
No special monitoring or treatment is provided for prisoners with addictions.
The use of psychotropic drugs and narcotic products is widespread in prisons.