Sanitary facilities and personal hygiene

Sanitary facilities - toilets, showers and washbasins - are everyday features which are of great importance especially in situations where people are deprived of their liberty, when detainees find themselves in a situation of total dependence on the authorities. Regular access to clean facilities in good working condition is essential to maintain people’s dignity. When these conditions are not met, the everyday life of detainees is seriously adversely affected. Not taking into account these basic needs may constitute cruel, inhumane or degrading treatment, or even torture.

The cleanliness of the sanitary facilities is essential not only in order to respect people’s dignity but also to prevent the transmission of infectious diseases, as most diseases contracted in prisons are transmitted by the faecal-oral route. Lack of water and inadequate access to showers also affects personal hygiene and increases the risk of contracting diseases.

The condition of the pipes, drainage system, and of the sanitary facilities in general is important to guarantee good hygiene in the establishment and to prevent water wastage. Lack of water may be a consequence of damaged taps or pipework, insufficient pressure, or drought. It is essential that right from the design stage of places of detention, climatic factors (including seasonal changes), and access to the drainage system and needs in line with capacity are duly taken into account.

The water available must be able to be allocated in a rational way between the toilets, washbasins and showers in order to guarantee the personal hygiene of the detainees, but also between the kitchen, sick bay, waste disposal, garden watering (especially for the kitchen gardens, if there are any), and for the needs of the staff working in the establishment. When the living quarters of warders are adjacent to the place of detention, their need for water and their guarantee of hygiene must obviously be taken into account as well.

According to the minimum standards laid down by the ICRC, the amount of water necessary for survival is 3-5 litres per person per day, and 10-15 litres per person per day to cover all minimum needs and remain in good health, as long as the other services and facilities are also in good working order (ICRC and WHO).

Toilets and latrins

There may be different types of toilets or latrines in prison, but they are generally of two types according to the setting: dry latrines, if possible equipped with a ventilation system, or flushing toilets enabling excrement to be flushed away. The choice of one or other system depends on economic, climatic and sometimes cultural factors, but the dry latrine system generally makes it difficult to guarantee a satisfactory level of hygiene, especially in a large establishment. The system for removing waste and excrement must be efficient and capable of preventing the transmission of infectious diseases. Similarly, septic tanks must be in good working order and of suitable size for the capacity of the place of detention.

Whatever the system used, it is essential that access to it is easy and quick, in order to satisfy bodily needs when they arise, and that the facilities are clean, in order to maintain human dignity and prevent the transmission of infectious diseases. In certain prisons, the exercise yards are equipped with communal urinals, which must also meet minimum standards of hygiene.

Not every establishment provides toilets within the cell or dormitory, even if this is the best way to ensure that people have access to them whenever they need. When cells or dormitories do not have toilets or latrines, a system must be put in place to enable people to access them quickly both during the day and at night.

Sometimes, when there is no toilet in the cell or dormitory, buckets are used, especially at night. This practice makes it very difficult to guarantee the requirements of either privacy or hygiene, even if the buckets are emptied regularly, and the practice should be avoided (CPT).

Sanitary facilities are among the most used parts of the infrastructure, so it is to be expected that they quickly wear out, and they are also at risk of being damaged or vandalised. The authorities must therefore have available robust material that is easy to use and an adequate stock of spare parts, especially for the pipework. If the material is defective, there may be a risk of considerable water leakage and wastage which may threaten the supplies needed when there is a shortage or lack of water.

The number of latrines available should be of one for 25 detainees (WHO), the strict minimum acceptable one latrine for 50 detainees (ICRC). Situations of overpopulation present a strain on the capacity of the sanitary facilities and pose serious risks in terms of hygiene, the prevention of disease, and respect for the privacy of detainees.

When toilets are built into cells or dormitories, it is important that they are separated by a partition or door, in order to maintain the dignity of the detainees, especially in shared cells, and to maintain the hygiene of the living space. A sanitary annex which is only partially partitioned is not acceptable in a cell occupied by more than one detainee (CPT). Finally, there must be adequate space between the toilets and the detainees’ beds.

The toilets must be sufficiently ventilated to avoid bad smells in cells/dormitories. Openings of ventilation fans that are too noisy risk being obstructed by the detainees, thereby rendering them ineffective.

When the prison is equipped with a system of video surveillance, the toilets should not be in the field of vision, or should at least be blurred.

All toilets, whether individual or communal, must be equipped with a washbasin.
The quantity of water necessary for washing one’s hands after using the toilet, and thereby preventing the transmission of infectious diseases, must be at least one litre per person per day (ICRC). All toilets should be cleaned daily and disinfected once a week, and up to twice a day if there is an epidemic (ICRC). Detainees must have toilet paper available to them in sufficient quantity, or access to sufficient water according to the context and cultural considerations.

Isolation cells and disciplinary cells must be equipped with a toilet and a source of water, or at least it must be possible to satisfy bodily needs when they arise, in line with the standards in place for the other cells and dormitories. The same applies to access to showers. Disciplinary measures must not violate the dignity of the person.

Showers

As with toilets and latrines, showers must be sufficient in number, clean and in a good condition, and detainees must be able to use them as often as possible, at least once a week, taking account of the climate and the general hygiene norms. Hot water must be available in sufficient quantity and it must be possible to alter the water temperature according to the seasons and the climate.

It is important for all detainees to have equal access to the shower and for an equal amount of time. The authorities must ensure that the most vulnerable detainees, the weakest or those viewed most unfavourably for one reason or another must not be discriminated against in access to the showers, nor only be given access when there is no hot water left. When there is a limited amount of water and/or the rota for access to the showers involves the use of escorts, it may be important to limit the duration of the showers, and thereby the water use. As a minimum, this should be 2.5 litres per minute. 5 litres per person represents the minimum water necessary for washing oneself. Finally, there should be at least one shower for 50 detainees (ICRC).

The architecture of shared showers should guarantee a minimum amount of privacy to the detainees, and the showers should be separated from each other by partitions. The layout must also allow people to leave their clothes in the dry, on a bench or peg. As a communal space that is generally not much supervised, showers may present risks of violence and abuse, even rape, for the most vulnerable detainees. It is important that preventive measures are taken to reduce this type of risk as much as possible.

Personal hygiene

Detainees are responsible for their own personal hygiene, as well as for looking after their clothes and accommodation and keeping these clean. In order to do this, they must have available the necessary toiletries and in sufficient quantity, as well as cleaning equipment and household cleaning products. Personal hygiene is essential to safeguard community life in a situation of deprivation of liberty and to stop diseases occurring, especially skin problems, and it is also an essential component of personal dignity. Not being able to cater for essential needs in terms of personal hygiene may constitute a form of cruel, inhumane or degrading treatment.

The cleanliness of communal facilities must be ensured by the authorities, who must notably fight effectively against cockroaches, rodents, fleas, bed bugs lice and vermin in general. In order to do this, the establishment must be regularly disinfected, fumigated if necessary and regular checks must take place in the cells, dormitories, toilets and showers. These checks are essential to prevent diseases, especially skin problems.

As a minimum, detainees must regularly receive soap from the authorities (at least 100-150 grams per month according to the ICRC), toothpaste, toilet paper (if it is used) and cleaning products (if cleaning is not carried out by the establishment). Detainees must also receive products to look after their hair, and men must be able to shave regularly. Detainees must not have to rely on their families for these basic items or be obliged to buy them in the prison.

Groups in situations of vulnerability

The authorities are responsible for adequately meeting the needs of women and girls in detention, especially as far as their menstruation is concerned. They must therefore regularly receive free sanitary towels and basic toiletries. Women with young children must receive diapers free of charge and on a regular basis. A lack of such basic products may itself amount to degrading treatment. They must be guaranteed easy access to sanitary facilities that are clean and in good condition. 

Children in detention must receive free basic toiletries and have regular access to sanitary facilities that are clean and in good condition. Personal hygiene must be encouraged and the necessary means must be made available by the authorities.
Disabled people must have easy access to toilets and showers. If necessary, reasonable accommodations must be made by the authorities. The dimensions of the special cells must allow for access by wheelchair to the bathroom without taking away the door. When detainees with a disability are not able to take care of their personal hygiene, they must receive the support necessary from the staff. This help must not depend on the good will of co-detainees. 

Hygiene standards are sometimes related to cultural aspects or religious practices. It is important that ethnic, religious or indigenous minorities are able to follow, as far as possible, their own rules and customs. To do this, the authorities may, for example, provide easy access to sources of water at certain times for detainees who express such a need. 

LGBTI people who are deprived of their liberty may be exposed to the risk of not having access to showers due to discrimination. The authorities must guarantee fair and equal access for all the population in detention. They must also ensure that LGBTI people are not the victims of abuse when they use communal showers. The specific hygiene needs of transgender detainees must be duly taken into account by the authorities. 

Hygiene standards are sometimes related to cultural aspects or religious practices. It is important that ethnic, religious or indigenous minorities are able to follow, as far as possible, their own rules and customs. To do this, the authorities may, for example, provide easy access to sources of water at certain times for detainees who express such a need. 

United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules)

Rule 15

The sanitary installations shall be adequate to enable every prisoner to comply with the needs of nature when necessary and in a clean and decent manner.

Rule 16

Adequate bathing and shower installations shall be provided so that every prisoner can, and may be required to, have a bath or shower, at a temperature suitable to the climate, as frequently as necessary for general hygiene according to season and geographical region, but at least once a week in a temperate climate.

Rule 18

1. Prisoners shall be required to keep their persons clean, and to this end they shall be provided with water and with such toilet articles as are necessary for health and cleanliness.

2. In order that prisoners may maintain a good appearance compatible with their self-respect, facilities shall be provided for the proper care of the hair and beard, and men shall be able to shave regularly.

Rule 35.1

The physician or competent public health body shall regularly inspect and advise the prison director on:
[...]
(b) The hygiene and cleanliness of the institution and the prisoners;
(c) The sanitation, temperature, lighting and ventilation of the prison [...]

Rule 42

General living conditions addressed in these rules, including those related to light, ventilation, temperature, sanitation, nutrition, drinking water, access to open air and physical exercise, personal hygiene, health care and adequate personal space, shall apply to all prisoners without exception.

UN Rules for the Treatment of Women Prisoners and Non-Custodial Measures for Women Offenders (Bangkok Rules)

Rule 5. Personal hygiene

The accommodation of women prisoners shall have facilities and materials required to meet women's specific hygiene needs, including sanitary towels provided free of charge and a regular supply of water to be made available for the personal care of children and women, in particular women involved in cooking and those who are pregnant, breastfeeding or menstruating.

United Nations Rules for the Protection of Juveniles Deprived of their Liberty

Rule 34

Sanitary installations should be so located and of a sufficient standard to enable every juvenile to comply, as required, with their physical needs in privacy and in a clean and decent manner.

Report of the Special Rapporteur of the Human Rights Council on torture and other cruel, inhuman or degrading treatment or punishment, A/66/268, 5 August 2001

Paragraphe 51

Rules 12 and 13 of the Standard Minimum Rules stipulate that detention facilities should provide sufficient sanitary fixtures to allow for the personal hygiene of the detainee. Therefore, cells used for solitary confinement should contain a lavatory and wash-basin within the cell. In its 2006 report on Greece, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment observed that isolation cells in the Komotini Prison failed to meet the necessary minimum standard for sanitary fixtures because detainees were forced to use the toilet for a wash-basin as well. Other environmental factors, such as temperature, noise level, privacy, and soft materials for cell furnishings may also be implicated in the solitary confinement setting.

Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, A/HRC/31/57, 5 January 2016

Paragraph 70

With regard to women, girls, and lesbian, gay, bisexual and transgender persons in detention, the Special Rapporteur calls on all States to:

[...] (l) Ensure adequate sanitation standards and provide for facilities and materials that meet women’s specific hygiene needs, such as sanitary towels at no cost, and clean water, including during transport; [...]

Detention guidelines: guidelines on the applicable criteria and standards relating to detention of asylum-seekers and alternatives to detention

Guideline 8. 48

If detained, asylum-seekers are entitled to the following minimum conditions of detention:

(x) Basic necessities such as beds, climate-appropriate bedding, shower facilities, basic toiletries, and clean clothing, are to be provided to asylum-seekers in detention. They should have the right to wear their own clothes, and to enjoy privacy in showers and toilets, consistent with safe management of the facility.

European Prison Rules

Rule 19.3

Prisoners shall have ready access to sanitary facilities that are hygienic and respect privacy.

Rule 19.4

Adequate facilities shall be provided so that every prisoner may have a bath or shower, at a temperature suitable to the climate, if possible daily but at least twice a week (or more frequently if necessary) in the interest of general hygiene.

Rule 19.5

Prisoners shall keep their persons, clothing and sleeping accommodation clean and tidy. 

Rule 19.6

The prison authorities shall provide them with the means for doing so including toiletries and general cleaning implements and materials. 

Rule 19.7

Special provision shall be made for the sanitary needs of women. 

Principles and Best Practices on the Protection of Persons Deprived of Liberty in the Americas

Principle XII - 2. Hygiene

Persons deprived of liberty shall have access to clean and sufficient sanitary installations that ensure their privacy and dignity. They shall also have access to basic personal hygiene products and water for bathing or shower, according to the climatic conditions.

Principes XII - 2.Hygiene

Women and girls deprived of their liberty shall regularly be provided with those articles that are indispensable to the specific sanitary needs of their sex.

Extract from the 2nd General Report [CPT/Inf (92) 3] - Imprisonment

Paragraphe 49

Ready access to proper toilet facilities and the maintenance of good standards of hygiene are essential components of a humane environment.

In this connection, the CPT must state that it does not like the practice found in certain countries of prisoners discharging human waste in buckets in their cells (which are subsequently "slopped out" at appointed times). Either a toilet facility should be located in cellular accommodation (preferably in a sanitary annex) or means should exist enabling prisoners who need to use a toilet facility to be released from their cells without undue delay at all times (including at night).

Further, prisoners should have adequate access to shower or bathing facilities. It is also desirable for running water to be available within cellular accommodation.

Extract from the 9th General Report [CPT/Inf (99) 12]

Paragraphe 30

The CPT would add that, in certain establishments, it has observed a tendency to overlook the personal hygiene needs of female detainees, including juvenile girls. For this population in custody, ready access to sanitary and washing facilities as well as provision of hygiene items, such as sanitary towels, is of particular importance. The failure to provide such basic necessities can amount, in itself, to degrading treatment.

Extract from the 10th General Report [CPT/Inf (2000) 13]

Paragraphe 31

The specific hygiene needs of women should be addressed in an adequate manner. Ready access to sanitary and washing facilities, safe disposal arrangements for blood-stained articles, as well as provision of hygiene items, such as sanitary towels and tampons, are of particular importance. The failure to provide such basic necessities can amount, in itself, to degrading treatment.

24th General Report of the European Committee for the Prevention of Torture

Paragraph 105

Juveniles should have ready access to sanitary facilities that are hygienic and respect privacy. In particular, attention should be paid to ensuring that female juveniles are provided with ready access to sanitary and washing facilities as well as to hygiene items, such as sanitary towels.

Guidelines on the Conditions of Arrest, Police Custody and Pre-Trial Detention in Africa

32. Women

b. Safeguards for arrest and detention
If arrest, custody and pre-trial detention is absolutely necessary, women and girls shall:

v. Be provided with the facilities and materials required to meet their specific hygiene needs, and offered gender-specific health screening and care which accords with the rights to dignity and privacy, and the right to be seen by a female medical practitioner.

Report of the Special Rapporteur on the human right to safe drinking water and sanitation, A/HRC/33/49, 27 July 2016

Para. 4

Gender-based violence infringes the right to life, personal safety and freedom of movement. Gender non-conforming people often feel that they need to sign away their freedom of expression since segregation by gender — including in public toilets, detention centres, relief camps and school — poses a risk of exclusion, humiliation and violence.

Para. 48

Standards in regulations and building codes should include special needs for women and girls, and must be developed for schools, hospitals, the workplace, market places, places of detention and public transport hubs and public institutions, among other places. Standards should consider general menstrual hygiene needs, but also who the users are likely to be. Standards must subsequently be implemented, put in practice and accordingly be enforced at all levels. Everyone should be able to use the toilet corresponding to the person’s gender identity and States must pay attention to the special needs of more vulnerable persons, including those with disabilities and the elderly.

Para. 77

The Special Rapporteur recommends that States: (i) Ensure the gender-responsive water, sanitation and hygiene facilities are available in schools, hospitals, the workplace, market places, places of detention and public spaces like public transport hubs and public institutions, among other places. Laws and regulations must be developed, promoted and enforced and must serve to hold Governments and non-State actors to account.

Council of Europe, Recommendation CM/Rec(2012)12 of the Committee of Ministers to member States concerning foreign prisoners, October 2012

Hygiene

18.1. Facilities for sanitation and hygiene shall, as far as practicable, accommodate the cultural and religious preferences of foreign prisoners, while maintaining appropriate medical standards.

18.2. Rules that require prisoners to keep their appearance clean and tidy shall be interpreted in a manner that respects prisoners’ cultural and religious preferences, while maintaining appropriate medical standards.

What is the ratio of toilets and showers per detainee?

When the toilets are integrated into the cells/dormitories, are they separated by a door and/or a partition?

How is access to toilets guaranteed in the cells or dormitories if there aren’t any facilities inside?

Are the cells and dormitories without toilets provided with buckets? If so, how frequently are they changed or cleaned?

What is the general condition of cleanliness and maintenance of the sanitary facilities? Who is in charge of the cleaning? Are the detainees provided with cleaning products?

Are the sanitary facilities disinfected regularly?

What quantity of water is available to each detainee every day?

Is there a system of ventilation in the toilets and showers? If so, is it in good working order?

Is a sufficient quantity of hot water provided in the showers?

Do people in isolation have regular access to the showers and toilets?

Does the architecture of the showers allow the detainees to have a minimum amount of privacy?

Are there signs that access to the showers is not fair for all persons in detention? Are certain groups discriminated against?

Do women and girls receive regularly, in sufficient quantity and free of charge, the hygiene products they need, including sanitary napkins? 

Do children in detention receive the products they need for their hygiene? Is good hygiene encouraged by the authorities by awareness-raising initiatives?

Are adapted facilities provided for disabled people to have easy access to toilets and showers? Do they receive the help they need from the staff to ensure a decent level of hygiene?

Are adaptations provided for detainees with specific hygiene needs or needs for access to sources of water because of their culture or religion?

Are there signs that LGBTI people are discriminated against in access to the showers, or that they are the victims of abuse in the communal showers?

Do transgender people have access to specific hygiene products?