Georgian prisons must provide detainees with effective medical treatment

20 December 2018

Ten months after Rusiko Maisuradze’s son started his prison sentence, his family noticed he was unwell. He was diagnosed with tuberculosis, and died five months later. Today, the European Court of Human Rights ruled that the Georgian prison authorities deprived him of effective medication for a prolonged period of time, which could have worsened his condition irreversibly and led to his death. Ms. Maisuradze was represented by EHRAC and the Georgian Young Lawyers’ Association (Tbilisi, Georgia).

What happened to Ms. Maisuradze’s son?

Mr T. was convicted and sentenced to prison in February 2008. From October 2008, his health began to deteriorate, and he was diagnosed with tuberculosis in December 2008. That same day, the doctor at Rustavi Prison No. 2 recommended his transfer to Ksani prison, the only prison in Georgia with adequate facilities for prisoners with tuberculosis. However, Mr T. remained in the prison hospital at Rustavi No. 2. He underwent five weeks of treatment, but proved resistant to the drugs. The prison doctor once again recommended his transfer to Ksani prison, but Mr T. was not transferred until January 2009, and his treatment was not changed. From March 2009, Mr T. complained that he was unable to walk. Following test results, Mr T. was finally prescribed a new course of treatment in May 2009, but died just two weeks later of multidrug-resistant pulmonary tuberculosis.

A preliminary investigation was opened into ‘premeditated murder’, which was terminated due to the absence of a crime, and concluded that Mr T. died from a natural complication of tuberculosis and that his medical treatment had been adequate.

How did this violate his human rights?

In today’s judgment, the European Court found that Mr T. did not receive effective medical treatment for over four months after diagnosis. The Court noted that even though the treatment he initially received had no effect and his condition sharply deteriorated, the authorities made no adjustment to their treatment strategy nor undertook further tests. This lengthy delay in providing treatment, aggravated by the swift progress of tuberculosis, was not justifiable. The Court concluded that Mr T. “was deprived of effective medication for a prolonged period of time. It cannot exclude the possibility that the absence of such treatment resulted in irreversible changes in his condition, leading to his death.” Although an investigation was promptly opened into his death, it was in respect of premeditated murder, which has a high evidentiary threshold and limited the scope of the investigation; it only sought to ascertain the immediate cause of Mr T.’s death and the adequacy of his treatment in very general terms. The Court held that the authorities “did not make a genuine attempt to find out whether it had been possible to suspect that the tuberculosis was resistant and perform the second susceptibility test earlier … or whether it had been possible to adjust the treatment strategy as soon as the ineffectiveness of the standard treatment had become evident. Nor did the authorities inquire into the reasons behind the delay of twenty-four days in starting the treatment”.  It therefore found a breach of the Government’s positive obligation to protect Mr T.’s right to life and the procedural obligation to ensure an effective investigation into his death, in breach of Article 2 of the European Convention on Human Rights.

The European Court ordered the Georgian Government to pay Ms. Maisuradze €15,000 compensation.

Why is this case important?

Prisoners’ human rights are poorly protected across the former Soviet Union, including Georgia. In 2012, videos were released showing violent and sexual abuse of inmates in Gldani Prison (where Mr T. was held), which led to widespread protests around the country. Prisoners are often not provided with adequate medical treatment, exacerbating the already poor conditions of detention. In Russia, with Memorial Human Rights Centre (Moscow), we won a case on behalf of an insulin-dependent diabetic man; the European Court found that Russia failed to provide him with adequate medical care for almost 20 months whilst in pre-trial detention. In 2016, the European Court ruled in the case of Azerbaijani human rights defenders Leyla and Arif Yunus, finding that the inadequacy of medical provision amounts to inhuman and degrading treatment. Moreover, prisoners’ deaths in custody are sadly regular occurrences. The Georgian Government admitted in December 2015 that it had violated the right to life of a man who, having refused to become an informant, was allegedly bullied by prison staff and prisoners, until he was found hanged in his solitary confinement cell.