may entail a violation of articles 4(1) and 5(1) of the American Convention. 323 In a subsequent section the Commission will refer to protection for the right to health under Article 26 of the Convention. 228. In the instant matter, the Commission notes that 22 victims324 survived the accidents related to underwater diving. Of that group of persons, the IACHR notes that Timoteo Lemus died one year after the accident, Onasis Cooper died three years after the accident, Carlos Castellano died six years after the accident, and Ex Dereck Claro died in 2017. The petitioners alleged that to date the victims have not received health care from the State, and that the four victims mentioned died as a result of that omission by the State. 229. The Commission observes that according to the document prepared by PAHO already mentioned in this report, the treatment that should be followed in the case of Miskito divers who go to great depths is to be taken immediately to a hyperbaric chamber. This is to counter the decompression syndrome produced by the high levels of carbon dioxide in the body of the person affected. PAHO also noted that in addition to the use of the hyperbaric chamber, the person affected should receive rehabilitation services to recover. 230. Based on this information, from the description of the issue in many reports, it turns out that the Miskito divers did not receive timely or adequate medical assistance by their employers. The Commission has considered it proven that most of the fishing vessels in the zone did not have the means to provide medical care in emergencies. 231. Accordingly, as appears from the descriptions given of the accidents suffered by many of the surviving victims, after they surfaced after being submerged at great depths, and complaining of nausea or loss of mobility in the extremities, the captain of the boat did not adopt immediate measures to prioritize medical care. In many cases days went by before they were taken to the coast. In addition, in some cases they were taken to a medical center, where they had to cover the costs of their treatment and medicines and, with a few exceptions, did not have access to a hyperbaric chamber. Indeed, the IACHR notes that there was only one hyperbaric chamber in a private hospital in the city of Roatán. 232. The Commission takes note that in 2002 the Secretariat of Labor and Social Security and the Secretariat of Interior and justice held a meeting with the AMHBLI. At that meeting the members of the AMHBLI set forth the issues described above, related to the lack of prompt medical care in the case of deep submersions. Moreover, the minutes of the meeting referred to the need for the State to place an ambulance boat in the Mosquitia region with a hyperbaric chamber. 233. Nonetheless, the IACHR observes that according to the documentation provided by the parties, the State did not effectively implement the ambulance boat. The Commission considers that establishing that mechanism would have been an important measure for preventing the possible death of and negative health impacts on the divers who descended to great deaths. The European Court, in the case of Vilnes and others v. Norway, attributed international responsibility to the State for failing to ensure that the vessels have the elements needed to provide care for divers who suffer decompression, and that such information had to be made known to the divers.325 234. The IACHR observes that in the claims for compensation presented by the surviving victims reference was made to the victims’ health situation, in addition to the lack of adequate care. In addition to generally taking stock of the State’s omissions referred to in the preceding paragraphs, the Commission observes that through these claims the State took cognizance of the victims’ specific health situations. Nor did this trigger any action by the State to provide the health care that each surviving victim needed. The European I/A Court HR. Case of Gonzales Lluy et al. v. Ecuador. Preliminary Objections, Merits, Reparations and Costs. Judgment of September 1, 2015. Series C No. 298, para. 171; and Case of Suárez Peralta v. Ecuador. Preliminary Objections, Merits, Reparations and Costs. Judgment of May 21, 2013. Series C No. 261, para. 130. 324 Timoteo Lemus Pisatty, Onasis Cooper Brwon, Flaviano Martínez López, Carcoth Padmoe Millar, Amistero Bans Valeriano, Rolando Monico Thomas, Ralph Valderramos Álvarez, Ex Dereck Claro, Leonel Saty Méndez, David Esteban Bradley, Evecleto Londres Yumida, Arpin Robles Tayaton, Daniel Flores Reyes, Fredy Federico Salazar, Cooper Crescencio Jems, Félix Osorio Presby, Efraín Rosales Kirington, Melecio Pamistan Maick, Willy Gómez Pastor, Roberto Flores Esteban, Daniel Dereck Thomas, and Carlos Castellón Cárdenas. 325 ECHR, Case of Vilnes and others v. Norway. Judgment of March 24, 2014, para. 238. 323 40