5.  The applicant was born in 1978 and until his arrest lived in Sarapul, the Republic of Udmurtiya. 6.  He was arrested on 18 October 2006. On 28 May 2007 the Sarapul Town Court convicted him of several criminal offences, including aggravated robbery committed by a criminal group, and sentenced him to six years and ten months’ imprisonment. 7.  After the arrest on 18 October 2006 the applicant was taken to a police station in Sarapul and shortly thereafter to remand prison no. IZ-18/1 in Izhevsk. Twenty days later he was admitted to prison hospital no. 4 (“the prison hospital”). 8.  The parties provided conflicting descriptions of the conditions of the applicant’s detention in the prison hospital between March and October 2007. 9.  From March to May 2007 he was detained with nine other sick inmates in cell no. 4, which measured 36 sq. m. Accordingly, each detainee was afforded around 3.6 sq. m of personal space. The living space was further diminished by six bunk beds and a table. The cell had a window measuring 150 by 150 cm and two lamps, only one of which was functional. Inmates were allowed to smoke in the cell. The ventilation system, which was switched on in the mornings and evenings, and a small ventilation window measuring 25 by 30 cm, was unable to ensure sufficient inflow of fresh air. The cell had a squat toilet separated by a metal screen from the sink, but not from the table or the door. 10.  In May 2007 the applicant was transferred to cell no. 1 which was not different in any aspect from cell no. 4, save for the facts that the cell had two windows and was located in the semi-basement and was therefore excessively humid. 11.  In late June 2007 the applicant was placed in cell no. 20. The conditions of detention there were satisfactory. It was designed for ten detainees but only accommodated five. 12.  Shortly after the applicant was returned to cell no. 4. He did not describe his further transfers between the cells, only claiming that the conditions of his detention had been deplorable. 13.  As to the general conditions of detention, the applicant argued that daily outdoor exercises were dispiriting, as the prison yard, secured by high walls, was gloomy and small, and the outdoor activities did not last longer than an hour, or were sometimes even shorter. 14.  The applicant used communal shower facilities which were in an appalling unsanitary condition. The floor was covered by a mixture of mud and detergent. Each detainee was afforded fifteen minutes to take a shower. 15.  The quality of food served in the prison hospital was poor and scarce. Dishes largely comprised of cabbage, potatoes and barley grit. Meat or fish was only served on public holidays. 16.  The applicant supported his claims with photos of the prison hospital and a dish served there. 17.  Relying on certificates issued by the prison hospital administration on 22, 23 and 24 April 2013, extracts from records of inmates’ transfers on 7 and 28 February, 27 March, 5 and 23 April, 7 August, 7 and 11 September, 1 October 2007, and a detailed plan of the prison hospital, the Government claimed that the facility had not been overcrowded. Their submissions may be summarised as follows:
Period of detention
Cell no.
Cell surface area (sq. m)
Number of detainees
28 February to 21 March 2007
4
37
7
21 to 27 March 2007
6 18.  Relying on photos of the prison hospital, written statements about the conditions of detention in 2007 made by three inmates in 2013, and on certificates issued by the prison hospital administration on 22 and 24 April 2013, the Government argued that the cell windows had allowed sufficient daylight so that inmates had been able to read and write. The cells had been equipped with four 40‑watt fluorescent tubes which had been lit from 6 a.m. to 10 p.m. At night the cells had been lit by security lights. 19.  A ventilation system had been installed in every cell. The natural ventilation had also been ensured through the windows. The heating system had properly functioned. 20.  Toilets in the cells had been separated from the main area by a partition for privacy. Due to the security considerations involved, punishment cells designed for solitary confinement had no such partition, but were equipped with a curtain. The applicant had been able take a shower once a week for at least fifteen minutes. 21.  The premises of the prison hospital had been in good sanitary condition, as it had been checked daily by staff members. The cells had been cleaned and disinfected every day. 22.  In addition to a daily hour-long walk in the prison hospital’s yard, the applicant had been able to walk freely during the daytime within sanitary block. 23.  The applicant had been provided with three hot meals per day and an extra allowance for ill inmates comprising bread, vegetables, meat, milk, cheese and fruit juice. 24.  Despite the Court’s request to produce the applicant’s complete medical record, the Government only submitted several illegible pages apparently belonging to his medical file. They further produced extracts from his medical history. The extracts contained fragments of information concerning the drugs prescribed. The following information on the applicant’s treatment may be deduced from the submitted documents. 25.  The applicant did not suffer from tuberculosis prior to his arrest. 26.  On the day of his arrest, 18 October 2006, the applicant was seen by a prison paramedic, who performed a general check-up, noting, inter alia, that the applicant’s lungs were clear. The next day a prison doctor confirmed that he was in good health. In late October a periodic chest X-ray showed traces of tuberculosis. The prison doctor studied the X-ray record and recommended the applicant’s transfer to the prison hospital. 27.  Five days later the applicant was admitted to the prison hospital. A sputum smear test performed on admission led to his being diagnosed with infiltrative tuberculosis at the stage of lung tissue destruction, with inactive Mycobacterium tuberculosis (“MBT”). Two days later a new X-ray test confirmed the diagnosis. 28.  Between 16 November 2006 and 11 January 2007 the applicant underwent inpatient anti-tuberculosis treatment in the prison hospital. There is no information describing the nature of the treatment. For unknown reasons it was unsuccessful. 29.  According to the medical records, in the following year the applicant “received standard anti-tuberculosis treatment”. However, he stated that between March 2007 and March 2008 he had only been given basic febrifuges and painkillers. During that period he was seen by the prison doctor on three occasions. No significant changes were registered. The size of the lung cavities remained the same. 30.  In the beginning of 2008, when a chest X-ray and tomography examinations registered a new focal point of infiltration in the right lung, the applicant’s doctor confirmed the extent of the deterioration of the applicant’s health. 31.  In early March 2008 the applicant was examined by a commission of doctors and certified as having a second-degree disability. A three-month drug regimen based on pyrazinamide, ethambutol, capreomycin and other medication was prescribed. According to the applicant, one of the drugs was out of stock. 32.  On 18 March and 1 April 2008 the applicant failed to see the attending doctor. 33.  In May 2008 the treatment regimen was amended with capreomycin removed and new drugs (rifampicin, cycloserine and others) added into the applicant’s daily drug intake. 34.  In the following two months the applicant interrupted his treatment for a period of two or three weeks, having refused to take some drugs and having gone on hunger strike. In the late June 2008 his tuberculosis transformed into MBT-positive form. 35.  Between July 2008 and March 2009 the applicant received inpatient treatment which had no effect on his medical condition. The deterioration of his health continued in the summer and autumn of 2009. 36.  An X-ray and a tomography examination performed in September 2009 indicated that the applicant’s lungs were filled with caseation. The applicant was taken for a month-long inpatient treatment in the hospital with his condition had been brought under control. By September 2010 his health had improved and the lung cavities had disappeared. 37.  According to his medical records, in December 2010 the applicant refused to take a few of the anti-tuberculosis drugs. In April, September and November 2011 he did not consult the attending doctor. 38.  In September 2011 tuberculomas replaced the lung cavities. In 2012‑13 calcifications and pulmonary fibrosis scars were only registered in the applicant’s lungs. The most recent sputum smear test in February 2013 did not indicate whether the applicant remained MBT‑positive. 39.  The parties did not submit information on the applicant’s further treatment. 40.  In the end of 2006 the applicant complained about the poor quality of medical care to the Ministry of Health of the Republic of Udmurtiya. By a letter of 17 January 2007 his claim was rejected. 41.  In the early 2007 he lodged a similar claim with the Service for the Execution of Sentences in the Republic of Udmurtiya. It was dismissed on 23 April 2007. 42.  In 2008 the applicant unsuccessfully complained to the Federal Ombudsman about his alleged lack of access to information about his health and diagnoses. His claim was not examined on the merits. 43.  He further complained of the lack of medical assistance to the prosecutor’s office of the Republic of Udmurtiya. On 21 August 2008 his complaint was dismissed. 44.  In 2010 the applicant lodged two claims with the Industrialnyy District Court of the Republic of Udmurtiya arguing that he had not benefitted from adequate medical care in detention. The claims were dismissed. According to the Government, the applicant did not appeal. The parties did not submit copies of the judgments.