Ghana’s criminal justice and mental health practices need critical attention to be more humane

ACCRA (14 November 2013) – At the conclusion of his visit to Ghana, at the invitation of the Government, from 8 to 14 November 2013, Juan E. Méndez, the United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment expressed his appreciation for the full cooperation extended to him during his visit, in particular in regard to unrestricted access to all places of detention and unimpeded access to interview detainees in private.

“I visited prisons in the Greater Accra, Ashanti, Central and Western regions and am deeply concerned about the situation of overcrowding in prisons - giving rise to other human rights violations such as poor quality and quantity of food, poor hygiene, lack of adequate sleeping accommodation, insufficient air ventilation, a high risk of contamination of diseases such as malaria and tuberculosis as well as very limited access to medical treatment, recreational activities or work opportunities.”  The expert added, “these conditions constitute in themselves a form of cruel, inhuman and degrading treatment.”

The Prison Service states that the official ratio of capacity to actual population in the whole country is 140% (9,875 capacity and 14,101 inmates). Based on simple calculations made at various prisons and additional information received by their authorities, the overcrowding rate in some places is easily between 200 to 500%, especially if the original capacity of each facility is reasonably assessed on grounds not of number of beds but of minimum space for each inmate.
“The Government conveyed its commitment to applying a human rights approach to the criminal justice system.  The Justice For All programme addresses overcrowding in part by having judges holding temporary courts at the prisons to review cases for those who have been held in remand (pre-trial detention) for months or years. I urge the Government to expand the scope of this project to also review the lengthy sentences imposed for possibilities of appeal and other review. I met inmates who have been sentenced to 50, 65 and up to 145 years, and have no way of seeking appellate review” said Mr. Méndez.
Prisoners sentenced to lengthy terms do not have opportunities for pardon or amnesty, in contrast to those condemned to life or to capital punishment. The lack of remission of sentence regarding lengthy sentences further contributes to the situation of overcrowding in the prisons.  Ghanaian law allows for only 10% remission of long sentences for good behavior.

The prison conditions were particularly poor for inmates on remand or those on death row. While there is a defacto moratorium on executions, the expert observed the “death row phenomenon” which refers to a combination of circumstances that produces severe mental trauma and physical suffering among prisoners serving death sentences, including anxiety created by the threat of death and hopelessness. There is also a lack of educational and recreational activities for these inmates and their living conditions are dismal.

“Family visits from children under 18 years old are not allowed in the Ghanaian prisons. I recommend the Government to reconsider this issue, which is not resource dependent and could go a long way to help the mental state of inmates” explained the independent expert “in particular of female prisoners with small children” he added.  Denial of visits by children constitutes cruel, inhuman and degrading treatment not only of the inmates but of the children as well.

“With regard to the treatment of prisoners by the prison staff, I note with satisfaction that in conducting my interviews I did not receive complaints”, said the expert. “However, I am concerned with regard to practices observed of violence by prisoners against prisoners, in particular in the prisons of Kumasi and Sekondi, where cellblock leaders are officially appointed by the prison authorities. These leaders exercise a high degree of authority within the prison population.  I documented one case of severe injury caused by beating with canes.”

The UN expert received numerous complaints regarding the quantity and, in particular, the quality of the food provided by the prison authorities. Overall, he observed an apparent repetition of meals served and very minimal level of nutrition.  The Special Rapporteur acknowledges that in 2012 the Government did increase the amount of money spent on food three fold – it is now 90 cents (USD) per inmate per day. However, the prison authorities openly acknowledged that this amount does not allow for sufficient nor balanced nutrition.

In all places visited there was an extremely poor standard of equipment, absence of qualified doctors, an apparent lack of medicine and limited medical screening. Many places of detention have not purchased new supplies of drugs since 2012– relying instead on donations.  The Special Rapporteur also notes the total absence of routine screening by qualified forensic medical doctors.

“Inmates told me they are dependent on their families to bring them medicines but many do not receive family visits nor do they have money to buy their own medicine” noted the expert.

The Government must guarantee essential medicines – which should include, among other things, pain treatment and psycho-therapy substances of the most recent generation– to be in line with minimum international obligations under the right to health, and the prohibition of torture and inhuman or degrading treatment.

“Family visits are an issue of survival in detention facilities throughout Ghana” said the expert, “If transferred to a prison far from the family inmates may not receive additional food or medicine.”

Mr. Méndez welcomes the fact that the new Ankaful Maximum Security Prison, operational in 2012, is in line with international standards, and can help address the issue of overcrowding in other prisons.

“Currently the maximum security prison is at less than 20% capacity.  I urge the Prison Service to prioritise the next steps needed to have it fully operational.  There is prison staff available from the surrounding prisons who could be relocated so that prisoner transfers can be accelerated in order to alleviate overcrowding and inhumane conditions in other prisons as soon as possible.”

The Government must ratify and implement the Optional Protocol to the Convention Against Torture (OPCAT) as a matter of national urgency. Among other things, this will allow a national system of regular prison monitoring by independent experts.

The Special Rapporteur also visited police stations and holding cells across several regions.  Overall, the conditions in the cells visited were generally very poor. The situation at the Nkawkaw police station (Eastern region) was intolerable. In addition to a high degree of overcrowding, the 32 detainees had no access to water, no bedding and limited ventilation in extreme heat. This situation amounted to cruel, inhuman and degrading treatment or even torture.
In Accra, the UN expert encountered and documented a clear case of caning used as a disciplinary measure against several youth at the Senior Correctional Centre, the only facility dedicated to juveniles.

“The physical signs were no older than 24 or 48 hours, and as these victims had been admitted months earlier, the abuse could only have happened at this facility” said Mr. Méndez. “I have urged the authorities to conduct an immediate independent and impartial inquiry to establish accountability for this serious act of torture against children”.

An aggravating factor to overcrowding is that the legal aid system is so severely limited that it barely exists in practice due to underfunding and low salaries. The right to a lawyer is available upon arrest but only appointed by the court in capital offences or crimes which that may result in life imprisonment.

“The result”, said the expert “is that for all other offences the police can interrogate a detainee without a lawyer if they cannot afford to pay for one.  I heard testimonies of alleged beating with hands or sticks by the police upon arrest or interrogation. My preliminary assessment is that police abuse does not appear to be widespread but the risk of torture or ill-treatment is elevated.

An additional problem is that even if a lawyer is appointed they do not always show up for trial so cases are often adjourned, resulting in months or years in remand custody.  The Legal Aid Board is inadequately resourced – there must be a right to effective counsel in all circumstances and without exception.

Visiting the Psychiatric Hospitals in Accra and Ankaful, the Special Rapporteur noted the lack of resources, the insufficient training and limited medication. He learned that there are currently only 12 psychiatrists operating in Ghana, covering a population of over 25 million people.  “The two psychiatrists who met with me were highly competent and committed to their mission,” said Mr. Méndez.

“Besides the lack of supplies, which leads to insufficient treatment of patients, I am particularly worried about the application of electro-shock therapy as practiced at the Psychiatric Hospital in Accra” said the independent expert. “It is administered without adequate anesthetics, not as a last resort, nor with free nor with free and informed consent.”

The Special Rapporteur also visited two prayer camps north of Cape Coast and acknowledged that a large percentage of the population turn to these community faith healing centres when trying to cope with a family member suffering with mental illness or other problems that they feel may require spiritual healing.

“I saw patients chained to the floor or walls of their cells or chained or tied to trees for prolonged periods of time.  The practice of shackling is alleged to be due to the risk of escape or the aggressive behavior of some patients.  Many of the patients say they have been shackled for extensive periods of time, from a number of months to several years.”

There is no therapeutic justification for the use of prolonged restraint of persons with disabilities and any use of restraints on persons with mental disabilities, for even a short period of time, may constitute torture or ill-treatment.  

 “I am deeply concerned about the practice of shackling and the application of forced fasting on persons with mental disabilities or in some cases with neurological problems, including children, in the prayer camps” said Mr. Méndez.

The State has an obligation to regulate, control and supervise health-care practices with a view to preventing maltreatment under any pretext and to address gaps in protection.  In this context, the Special Rapporteur welcomes the adoption of the new Mental Health Care Act in 2012, which is clearly an improvement over the old law.

“However, I am concerned that no further steps have been taken to implement the law. I urge the Ministry of Health to set up the Oversight Board and Visiting Committee and establish a precise timeline so that the provisions, including regulatory functions that will also extend to prayer camps, can become operational before the end of the year.

In closing, the Special Rapporteur again thanks the Government for the invitation and extends his gratitude to the high ranking officials with whom he met, including  representatives of the Ministry of Foreign Affairs, the Ministry of Interior, the Ministry of Justice,  the Ministry of Gender, Children and Women Social Protection, the Constitutional Review Implementation Committee and the Chief Psychiatrist of the Ministry of Health, the Ghana Police and Prison Services, the Military Legal Directorate, as well as representatives of the judiciary and of the National Commission of Human Rights and Administrative Justice. 

The Special Rapporteur also expresses his gratitude to representatives of the Ghanaian civil society, international and regional organizations, victims and their families for sharing with him their information and insight.

He will present a country report with his observations and recommendations to be presented at the next session of the Human Rights Council in March 2014.

Juan E. Méndez (Argentina) was appointed by the UN Human Rights Council as the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment on 1 November 2010. He is independent from any government and serves in his individual capacity. Mr. Méndez has dedicated his legal career to the defense of human rights, and has a long and distinguished record of advocacy throughout the Americas. He is currently a Professor of Law at the American University – Washington College of Law and Co-Chair of the Human Rights Institute of the International Bar Association. Mr. Méndez has previously served as the President of the International Center for Transitional Justice (ICTJ) until 2009, and was the UN Secretary-General Special Advisor on the Prevention of Genocide from 2004 to 2007, as well as an advisor on crime prevention to the Prosecutor, International Criminal Court, between 2009 and 2010. 

*Check the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment:http://www2.ohchr.org/english/law/cat.htm  

Learn more about the mandate and work of the Special Rapporteur:http://www2.ohchr.org/english/issues/torture/rapporteur/index.htm  

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