99. Furthermore, the case file records that the security system in the area of the Pre-Trial Detention Center consists of doors made of metal railings with their respective padlocks. From the main entrance of the area to the cell of the different inmates there are six doors with metal railings.160 It is an uncontested fact that, in mid-2006, the Director of Investigations, in charge of the area of the Pre-Trial Detention Center, ordered that “the cells should remain locked with padlocks from 10 p.m. to 7 a.m.” In this regard, Raúl Díaz Peña and Eligio Cedeño testified that the cells of those deprived of liberty remained locked from around 10 p.m. until 6 a.m. the next day.161 In this regard, the witness proposed by the State, Elvis Ramírez, Captain General, Investigations Coordinator as of August 2009 of the then DISIP, explained that there is a system with a bell that any detainee who has an emergency during the night can activate and, immediately, the officials on duty who are there 24 hours a day will go and attend the emergency.162 Nevertheless, Mr. Díaz Peña indicated that the said bell was put in place five years after he entered the Center.163 All in all, even though the Court does not have clear elements that would allow it to conclude when the bell was placed in corridor “B” of the Pre-Trial Detention Center, it is a proven fact that, at night and for more than three years, those deprived of liberty in the Pre-Trial Detention Center were subjected to long periods locked in their cells and that, since they had no sanitary installations in the cells, they had to call the officials who were guarding them in order to have access to the sanitary installations in each corridor.164 However, if they received no response to their calls, they had to use bags or waste paper baskets that each of them had in their cell and could only throw out the fecal matter the next day.165 Mr. Díaz Peña’s health situation and the medical treatment he received 100. With regard to the medical care and attention that Mr. Díaz Peña received while he was in the custody of the Venezuelan State, the evidence reveals that, on his entry into the Pre-Trial Detention Center on February 25, 2004, he underwent a physical examination and it was recorded that he was “generally in good condition.”166 101. Subsequently, in a brief presented on November 1, 2004, Mr. Díaz Peña’s defense counsel informed the judge of the case that, for more than three months, his client had been suffering from problems in his ears and that, approximately four years earlier, he had undergone surgery on his right ear,167 and his left ear had been drained. In addition, it was explained that the DISIP Medical hearing, Mr. Díaz Peña stated that “we had access to sunlight […] one hour every 15 days.” Cf. Testimony given by Raúl José Díaz Peña by electronic audiovisual means before the Inter-American Court of Human Rights during the public hearing held on December 1, 2011. 160 Cf. Report issued by the Director General of the General Directorate of Intelligence and Prevention Services on October 2, 2009 (evidence file, tome XXV, folio 17408). 161 Cf. Testimony given by Raúl José Díaz Peña by electronic audiovisual means before the Inter-American Court of Human Rights during the public hearing held on December 1, 2011, and Testimony given by Eligio Cedeño by affidavit on November 18, 2011 (evidence file, tome XXVII, affidavits, folio 17600). 162 Cf. Testimony given by Elvis Ramírez before the Inter-American Court of Human Rights during the public hearing held on December 1, 2011. 163 Cf. Testimony given by Raúl José Díaz Peña by electronic audiovisual means before the Inter-American Court of Human Rights during the public hearing held on December 1, 2011. 164 Testimony given by Elvis Ramírez before the Inter-American Court during the public hearing held on December 1, 2012, and Testimony given by José Díaz Peña before the Inter-American Court during the public hearing held on December 1, 2012. 165 Testimony of Eligio Cedeño given by affidavit on November 18, 2011 (evidence file, tome XXVII, affidavits, folios 17599 and 17600). 166 Cf. Medical report signed by Dr. Pedro Francis N. of February 25, 2004 (evidence file, tome X, folio 5662). 167 It is a proven fact that, on July 7, 1999, Raúl José Díaz Peña had a transmeatal tympanoplasty in the right ear because he had tympanic atelectasis and seromucous otitis, with a satisfactory evolution and recovery of hearing in the said 34