95 domestic riots, the suspension of constitutional guarantees and rights, domestic political instability, or any other public emergency or danger.179 223. Criminal punishment is an expression of the punitive power of the State and implies a detriment, deprivation or alteration of the rights of persons, as a consequence of an unlawful conduct.180 However, the injuries, pain or physical damage suffered by persons while deprived of their liberty may constitute a form of cruel treatment or punishment when, due to the detention conditions, there is a detriment of the physical, mental or moral integrity, which is strictly forbidden according to Article 5(2) of the Convention. The situations described above are contrary to the “essential aim” of imprisonment sanctions, as stated in Article 5(6), i.e. “the reform and social readaptation of the prisoners.” The Judicial authorities must take these circumstances into consideration at the time of applying or evaluating the punishment to be imposed.181 224. The United Nations Committee against Torture stated that the detention conditions at Yanamayo Prison, where Wilson García-Asto was detained, at over 3,800 meters above sea level, amounted to cruel and inhuman treatment and punishment. The Committee considered that the State should close said penitentiary.182 225. Furthermore, in its Report on Challapalca Prison, which is located at over 4,600 meters above sea level, the Inter-American Commission considered that Peru should immediately close such penitentiary and transfer the inmates detained therein to other penitentiary centers close to the places of residence of their next of kin.183 The isolation that Wilson García-Asto had to endure in said penitentiary, caused by the distance and difficulty to access such region, limited the possibility of receiving specialized medical assistance. This fact gave rise to the protective measures granted by the Commission to protect his health (supra para. 97(57)). Furthermore, the visits of his next of kin were restricted. 226. The Court has pointed out that the lack of adequate medical assistance does not meet the minimum material requirements for humane treatment under Article 5 of the American Convention. 227. The Court considers that, pursuant to Article 5 of the American Convention, the State has the duty to provide detainees with regular medical examinations, assistance, and adequate treatment whenever required. In turn, the State must provide for 179 Cf. Case of Caesar, supra note 177, para. 59; Case of Lori Berenson-Mejía, supra note 152, para. 100; and Case of De la Cruz-Flores, supra note 4, para. 125. 180 Cf. Case of Lori Berenson-Mejía, supra note 152, para. 101. 181 Cf. Case of Lori Berenson-Mejía, supra note 152, para. 101. 182 Cf. UN. Committee Against Torture. Inquiry under Article 20: Peru. 16/05/2001. A/56/44, paras. 144-193. (Inquiry under Article 20), paras. 183 and 184. 183 Cf. ICHR, Report on the situation of human rights at the Challapalca Penitentiary, Department of Tacna, Republic of Peru, OEA/Ser.L/V/II.118. Doc. 3, dated October 9, 2003 (case file of appendixes to the briefs of requests and arguments, Volume 1, appendix 5, page 1739).