7.  The applicant was born in 1955 in the village of Z., the Omsk Region. Until his arrest he lived in the village of O. in the same region. 8.  The applicant suffers from various illnesses, including rectal cancer. He has twice had colorectal surgery, in 1994 and 1995, and has been certified as having a second-degree disability. 9.  On 1 November 2006 the applicant was arrested on suspicion of committing, with accomplices, large–scale bank fraud by abuse of position. After being questioned by the police the applicant was released. 10.  Two days later, the Kuybishevskiy District Court of Omsk authorised his detention pending investigation. The court concluded that he could abscond or hamper the investigation if released and that he had attempted to influence witnesses after they had been interviewed by the police. The applicant was taken to remand prison no. IZ-55/1 in Omsk. 11.  The defence appealed, stating that the applicant had serious health problems and was therefore not fit enough to exert pressure on witnesses. The defence also referred to the non-violent nature of the offence and the fact that it was not a particularly serious crime. 12.  On 13 November 2006 the Omsk Regional Court rejected the appeal, endorsing the reasoning of the District Court. 13.  On 27 December 2006 the District Court extended the applicant’s detention until 14 March 2007. Despite arguments by the defence that his health was fragile and that he was unable to receive the necessary care in the detention facility, which did not employ a proctologist, the court, after examining medical evidence submitted by the prosecution, found that his health condition did not call for his release. Having cited the risks of the applicant absconding and obstructing justice, the court also noted that the case was complex and that the investigating authorities were proceeding with it with due promptness. The applicant’s continued detention was therefore warranted. 14.  The defence challenged the detention order, referring mainly to the applicant’s deteriorating condition and a lack of adequate medical care in detention. They stated that the applicant was in need of constant medical assistance, supervision and treatment in a surgical department of a hospital. 15.  On 29 December 2006 the Regional Court, without addressing the defence’s arguments, found the detention order to be lawful and well‑founded. 16.  On 9 March 2007 the District Court concluded that the circumstances which had called for the applicant’s arrest and detention had not changed. His further detention was necessary so that the authorities could complete the investigation. The detention was extended until 14 June 2007. 17.  On 14 March 2007 the Regional Court upheld the detention order, stressing that the accused’s health was not the decisive factor in the assessment of the need for detention. The court also noted that Russian law guaranteed medical treatment to every detainee. 18.  On 9 June 2007 the applicant’s detention was extended until 14 September 2007. The court endorsed its previous reasoning, namely the risks of absconding and influencing witnesses and the necessity to complete the investigation. 19.  In appeal statements, the defence disagreed that there was a risk of influencing witnesses, and cited the applicant’s serious health condition and the detention facility’s continued failure to ensure his transfer to a hospital. The lawyers also argued that the investigative authorities had been idle in the previous three months. 20.  On 18 June 2007 the Regional Court upheld the detention order without going into the defence arguments. 21.  On 31 August 2007 the Tsentralniy District Court of Omsk extended the detention until 1 November 2007, given that the bill of indictment had not yet been drafted or served on the applicant. 22.  The detention order was upheld on appeal on 10 September 2007, including a specific reference to the detention authorities’ consent to ensure the applicant’s prompt admission to a civilian hospital if necessary. 23.  Another extension followed on 29 October 2007 when the Regional Court ordered that the applicant had to remain in custody until 1 December 2007 because one of his alleged accomplices had not yet finished studying the case file. The court noted that there were no grounds for concern about the applicant’s access to medical aid since the authorities had made assurances about his transfer to an adequate medical facility if needed. 24.  On 6 February 2008 the Supreme Court of Russia upheld the detention order of 29 October 2007, finding it to be well-reasoned. 25.  In the meantime, the pre-trial investigation was closed and the applicant was committed to stand trial before the Russkaya Polyana District Court of the Omsk Region. 26.  On 30 November 2007 the Russkaya Polyana District Court held a preliminary hearing in the case in which it extended the applicant’s detention in view of the continued presence of the factors which had initially warranted his arrest. 27.  On 13 December 2007 the Regional Court dismissed an appeal against the extension order, noting the lawfulness and reasonableness of the District Court’s findings. 28.  In early 2008 the applicant sought release from detention on medical grounds. He cited colorectal surgery, which he had undergone in December, and his inability to take part in court hearings for three or four months given his need for bed rest. 29.  On 8 February 2008 the District Court found that the circumstances justifying the applicant’s continuous detention had ceased to exist. His health condition had become serious. Against that background the gravity of the charges no longer sufficed to justify continued detention. The court ordered the applicant’s release against a written undertaking not to leave his home town. The criminal proceedings against the applicant were stayed. Three days later the applicant was released from detention. The release order became final. 30.  The parties have not provided any information on subsequent progress in the case. 31.  Following admission to remand prison no. IZ-55/1 on 3 November 2006, the applicant was examined by the prison doctor, who noted that he had twice undergone colorectal surgery and that he was suffering from various illnesses, including coronary disease, angina pectoris, mild hypertension, moderate obesity, chronic gastritis and chronic enterocolitis. 32.  In December 2006 a large part of the applicant’s sigmoid colon prolapsed and fell out of the rectum, resulting in the development of faecal incontinence. On 21 December 2006 a generalist surgeon from Omsk Regional Penitentiary Hospital no. 11 (“the Penitentiary Hospital”) examined the applicant and prescribed the use of adult absorbent briefs and the washing of his intimate areas twice a day. A consultation by a proctologist was recommended. 33.  The authorities did not provide the applicant with adult absorbent briefs. It is apparent from a certificate signed by the detention authorities that the applicant received a small number of absorbent briefs from his relatives. 34.  According to a written statement by Mr. P., a detainee who claimed to have shared a cell with the applicant between November 2006 and January 2007, the applicant complained of acute pain which intensified during the night. On a number of occasions the applicant lost consciousness owing to unbearable pain. A doctor called by inmates only gave painkillers to him. The applicant could only walk by taking small steps as walking caused a great deal of pain. He had to endure the pain each time he wanted to go to the prison shower room, which was located in the basement area of the prison. The authorities did not give him any hygiene products. Even toilet paper was supplied by his relatives. 35.  On 6 January 2007 the applicant was admitted to the medical unit in the remand prison. Six days later, at the request of the applicant’s lawyer, the head of the colorectal department of the State Regional Civilian Hospital, Dr N., examined the applicant in the remand prison and found his condition to be moderately serious. The applicant was diagnosed with a serious dysfunction of the anal sphincter and the presence of rectal strictures. An inpatient in-depth examination in a civilian hospital, as well as rectal surgery, was prescribed. Dr N. noted that the detention authorities were unable to ensure that the applicant receive the necessary examinations or provide him with treatment owing to a lack of equipment and medical specialists. Dr N. stressed that any delay in treatment could lead to complications and even death. 36.  At the end of January 2007 the applicant was seen by a prison surgeon. Considering the applicant’s condition to be satisfactory, the doctor concluded that there was no urgent need to perform surgery or admit the applicant to hospital. The applicant was, however, relieved from morning physical exercises, marching drills and lifting weights. 37.  On 2 February 2007, again at the initiative of the applicant’s lawyer, a senior doctor from the State Regional Civilian Hospital, Dr Z., visited him and recorded a further deterioration of his health in the form of an inflammation of the prolapsed part of his bowels. The doctor interpreted the inflammation as a serious complication which could result in the patient’s death if urgent medical examinations and treatment did not take place. He stated that the penitentiary institutions were unable to perform a fibre endoscopic examination of the colon and a multislice computed tomography, the tests required for the correct diagnosis and treatment of the applicant’s condition. The doctor endorsed the recommendations made on 12 January 2007 and added that bed rest was required. 38.  On 22 March 2007 the applicant was admitted to the Penitentiary Hospital where, by means of an endoscopy, he was diagnosed with dysfunction of the sphincter, and prolapse and inflammation of the sigmoid colon. Treatment with drugs was prescribed. The treatment was meant to reduce the applicant’s pain and help cure his secondary illness. 39.  On 2 April 2007 Dr Z. visited the applicant and confirmed the diagnosis. The doctor established that the inflammation had progressed, the patient’s health had deteriorated and that the overall state of his health had become serious. He was in need of urgent colorectal surgery. 40.  On 10 May 2007 the applicant was sent back to the medical unit in the remand prison, where he stayed for eleven days. Treatment with painkillers in that period was unsuccessful and the applicant was re‑admitted to hospital, apparently with a complication of his heart conditions. 41.  At the end of May 2007 Dr N. examined the applicant and noted further progression of the inflammatory process and the aggravation of other illnesses. He insisted on an in-depth medical examination and surgery, noting that surgery could only be performed after bringing the applicant’s heart-related problems under control. 42.  The applicant was taken back to the prison medical unit at the beginning of June 2007. However, re-admission to the Penitentiary Hospital followed after just seven days. The applicant was again sent back and forth between the two institutions in August 2007. In that period he received painkillers and antispasmodic drugs. His condition deteriorated further. The attending doctors recorded enlargement of the prolapsed segment of the bowel and that the surrounding skin was macerated and oedematous. 43.  On 20 and 27 June 2007 the applicant’s lawyer arranged for an ultrasound examination by an independent doctor, who recorded pathologic changes in the liver and suggested that they could, in fact, be a sign of metastasis caused by the developing colorectal cancer. A liver puncture test was required for the correct diagnosis. 44.  On 9 August 2007 the applicant was released from the Penitentiary Hospital and sent to the remand prison, where he stayed for a month. 45.  On 16 August 2007 the applicant was examined by a surgeon from the Penitentiary Hospital who confirmed the necessity for colorectal surgery on the patient “in due course in the very near future”. 46.  Eight days later Dr N. stated that owing to the deterioration of the applicant’s condition he was in need of urgent colorectal surgery. Any postponement, in his view, could lead to irreparable damage, including the applicant’s death. 47.  According to a written statement by Mr S., who shared a cell with the applicant at the beginning of autumn 2007, at the time in question the applicant looked very sick. He had a sallow complexion, was thin and exhausted. The applicant could only take small steps when walking and supported the lower part of his abdomen. A pungent smell surrounded him. Mr S. helped the applicant to bathe. The applicant’s perineum was inflamed. A bleeding segment of bowel the size of a fist prolapsed through his rectum. The applicant was not provided with incontinence wear and had to wash himself in a sink with cold water. 48.  After another stay in the Penitentiary Hospital, from 6 September to 3 October 2007, the applicant was taken back to the prison medical unit. In the notes accompanying his discharge the doctors noted that the applicant was suffering from stage 2 colorectal cancer. They recommended colorectal surgery after the applicant’s release from detention. 49.  On the following day the applicant was taken back to the Regional Hospital as an urgent case as his condition had become worse. 50.  In the meantime, on 1 October 2007 he had lodged an application with the Court and had also asked for the application of an interim measure under Rule 39 of the Rules of Court. He wanted an indication to the Russian Government that he should be allowed to have colorectal surgery, an X-ray computer tomography and a paracentesis of a space-occupying lesion of the liver. 51.  On 3 October 2007 the applicant had a new ultrasound examination. It was unable to give a definite answer as to whether the changes in the applicant’s liver were indeed caused by metastasis. 52.  According to a medical certificate issued in the Penitentiary Hospital on 29 October 2007, the applicant’s health condition was considered to be satisfactorily and stable with no signs of negative trends. The detention authorities repeatedly insisted that there was no need for urgent surgery. 53.  On 23 November 2007, following receipt from the Government of information on the applicant’s state of health, the Court decided to apply Rule 39 and to draw the Russian Government’s attention to the urgent necessity of the applicant having the following medical procedures: colorectal surgery in a specialist hospital, an X-ray computed tomography, as well as a surgical puncture of the space-occupying lesion of the liver. 54.  Between 21 and 26 November diagnostic tests indicated by the Court were performed. They revealed no signs of liver metastasis or space‑occupying lesions. 55.  On 26 November 2007 Dr N. examined the applicant. He observed a tumor-like stained mass measuring 10 cm in diameter with an opening measuring 1.3 cm, surrounded by coarse cicatrix. The doctor again urged the authorities to perform colorectal surgery. 56.  The applicant’s fellow inmate, Mr R., in a statement submitted to the Court, wrote that in November and December 2007 the applicant’s state of health was serious. The applicant was stained with faeces, being unable to control his defecation function. He had to defecate in a standing position, supporting the prolapsed bowel, otherwise his rectum began bleeding. The faeces were liquid and flowed down his legs. He had to wash himself with cold water as no hot water was available in the cell. 57.  On 24 December 2007 the applicant was admitted to Omsk Regional Hospital where a colostomy was performed. After a month-long stay, the applicant was discharged from the hospital back to the prison medical unit. Seventeen days later he was released from detention. 58.  On 14 October 2008 the Court decided to lift the interim measure indicated under Rule 39. 59.  According to the applicant, he underwent inpatient and outpatient treatment in various hospitals after his release. 60.  The parties provided conflicting descriptions of the conditions of the applicant’s detention in the remand prison. 61.  On the applicant’s admission to the remand prison, on 3 November 2006, the administration found him unfit for detention in a cell for common occupation and ordered his confinement in a cell for single occupation. An order to that effect was issued and the applicant signed it. 62.  Relying on certificates issued by the administration of the remand prison in December 2011 the Government claimed that the facility had not been overcrowded. The applicant had been detained in ten different cells which fully complied with regulatory standards. Lavatory pans in the cells had been separated from the living area by a partition. The Government’s submissions may be summarised as follows:
 
Period of detention
Cell
no.
Cell surface area (sq.m.)
Design capacity (pers.)
Height of the partition
(m.)
3 November 2006 to 4 January 2007
143
21
6 1.1
8 to 16 June 2007
232
40
10
ceiling height
10 August 2007
39
-
-
-
10 August to 6 September 2007
249 63.  According to the Government, there was hot and cold water in the cells. The facility had had separate shower rooms. The applicant had been given a bucket for his daily washing needs. 64.  The applicant disputed the idea that he had been put in a cell for single occupation and stated that no such order had ever been issued by the detention authorities. He stressed that he had always shared a cell with other detainees in the remand prison. To support that statement, the applicant submitted a certificate issued by a remand prison official on an unspecified date, apparently between 2006 and 2007. 65.  In 2012 the applicant’s lawyer questioned three inmates, Mr P., Mr. S. and Mr R., who stated that they had been detained with the applicant in overcrowded cells. One cell had measured 41 square metres and housed between eighteen and twenty detainees, while two of the cells had measured between 18 and 20 square metres and had accommodated at least eight detainees. Each inmate, including the applicant, had thus been afforded between 2.05 and 2.5 square metres of living space. 66.  The applicant submitted that during his detention in the remand prison he had only been able to take a shower once a week. However, acute pain while walking had sometimes prevented him from using the shower even on those occasions. After each instance of uncontrolled defecation he had had to wash himself while standing over the lavatory pan, exposed to the view of his cellmates. The partitions were low and therefore could not provide any privacy. No special arrangements had been made for him by the authorities. 67.  In their statements, Mr P., Mr. S. and Mr R. also confirmed the applicant’s submissions about the lack of any possibility for him to take regular showers and about the conditions in which he had had to perform the daily washes caused by his illness. The inmates described the insults that the applicant had had to endure as a result of the need to wash himself in front of his cellmates. The three former detainees stressed that the applicant had had to make amends for the inconvenience he had caused to his fellow detainees by, for instance, giving them cigarettes, tea, or other valued products supplied by his relatives.