7 iii) it appreciates the efforts made by the State in order to provide medical attention to the detainees, but the proportion between physicians and detainees is still deficient, and iv) it considers that the State actions to strengthen the judicial system are positive, but “it expects further information on the effects of the mutirão […] so as to be able to ascertain the impact that such an [action] could entail to the specific provisional measures.” 10. That the State has the general obligation to respect and guarantee the total enjoyment and exercise of the rights of all the persons under its jurisdiction, duties which are imposed not only with respect to the power of the State but also with respect to the actions of individual third parties. Special duties derive from these general obligations, ascertainable on the basis of the special needs of protection of the legal person, either by his/her personal situation or by the specific situation in which he/she may be4, as in the case of detention. The Court has pointed out the special position of guarantor that the State acquires with respect to the detainees, originated in the special subjection relation existing between the inmate and the State. In such a situation, the State general duty to respect and guarantee rights has a particular nuance which forces the State to provide inmates the minimum conditions compatible with their dignity while they are confined in detention centers, with the purpose to protect and guarantee their right to life and physical integrity.5 11. That the Court appreciates the efforts of the State with the purpose to improve the detention conditions at the Penitentiary, among which overcrowding reduction and redevelopment of the premises outstand. The Court further appreciates the fact that the State itself has declared the following at the public hearing: a) overcrowding at Urso Branco appears as the greatest problem of the unit, from which practically all the other problems derive; b) there are problems in the supply of personal hygiene items and mattresses; and c) it is necessary to adopt measures in order to improve social work and health services for the beneficiaries, as well as the adequacy of the structure of some of the cells (supra Considering clause No. 7.iii and iv). 12. That this Court again states that the improvement and correction of the Urso Branco Prison is a process which shall require the adoption of short, medium and long term measures on the part of the State in order to face the structural problems which affect those confined thereat. The duty to adopt such measures derives from the general obligation of respect and guarantee of rights, assumed by the State when it ratified the American Convention on Human Rights.6 4 Cf. Case of the Mapiripán Massacre v. Colombia. Merits, Reparations and Costs. Judgment of September 15, 2005. Series C No. 134, pars. 111 and 113; Case of Anzualdo-Castro v. Peru. Preliminary Objection, Merits, Reparations and Costs. Judgment of September 22, 2009. Series C No. 202, par. 37, and Case of Perozo et al. v. Venezuela. Preliminary Objections, Merits, Reparations and Costs. Judgment of January 28, 2009. Series C No. 195, par. 298. 5 Cf. Case of “Juvenile Reeducation Institute” v. Paraguay. Preliminary Objections, Merits, Reparations and Costs. Judgment of September 2, 2004. Series C No. 112, par. 159; Case of the children deprived of liberty in FEBEM. Provisional Measures regarding Brazil. Order of the Inter-American Court of Human Rights of November 25, 2008, Considering clause No. twelve, and Matter of the Urso Branco Prison. Provisional Measures regarding Brazil. Order of the Inter-American Court of Human Rights of May 2, 2008, Considering clause No. nineteen. 6 Cf. Matter of the Urso Branco Prison, supra note 5, Considering clause No. twenty.