199. In conclusion, it was not proven that the State kept a record or file on the health condition and treatment provided to the alleged victim since her admission to the COF, either at the prison or at the hospitals or health centers where she was treated. Nor was it proven that the State provided adequate food and medications on a regular basis. Faced with the progressive deterioration of her health, the doctors who examined her noted that there was a latent risk to her life and personal integrity, given that she suffered from a serious, chronic and ultimately fatal disease. However, in spite of her health condition, there is no record that the authorities ensured regular, adequate and systematic medical supervision aimed at treating her illnesses and her disability and preventing their deterioration, in particular through the provision of appropriate diets, rehabilitation and other necessary facilities. If the State could not guarantee such care and treatment within the prison, it was obliged to establish a prompt and effective mechanism or protocol to ensure that the medical supervision was timely and systematic, particularly in the event of an emergency. In this case, the procedures established for outpatient appointments at hospitals were not sufficiently flexible to allow for effective and timely medical treatment. 200. For the foregoing reasons, the Court considers that the State did not fulfill its international obligations to guarantee Mrs. Chinchilla’s rights to personal integrity and to life during her confinement at the COF. B.3 The State’s response to Mrs. Chinchilla’s disability 201. As stated previously, as consequence of the progression of her diabetes, from 2002 Mrs. Chinchilla progressively developed motor and visual disabilities, along with a number of health complications that significantly reduced her quality of life. These were associated with a number of social barriers existing in the prison, which made her increasingly dependent on other people as she required more specialized medical care. Thus, after several diagnoses of “decompensated diabetes,” the detection of ulcers on her feet and a foot wound that required constant cleaning, there was a progressive deterioration in her health. She developed physical and sensory disabilities caused by the progressive loss of her sight and the amputation of one of her legs,297 as a result of which she had to move around in a wheelchair. 202. It is not disputed that, as indicated by the State, after being confined to a wheelchair she was transferred to a cell in the prison´s maternal block, which had sufficient natural and artificial light and adequate ventilation, as well as a toilet and washbasin that were adapted to her needs. The dispute persists regarding the alleged lack of reasonable modifications to her cell and to facilitate her movement within the prison or her transfer to hospital for medical appointments, among other difficulties. Therefore, it is pertinent to determine whether the State is responsible for failing to respond adequately and effectively to the needs of the alleged victim, and thus, it is necessary to consider, more specifically, the State’s obligations toward persons with disabilities when they are deprived of liberty. 203. The Inter-American Court has emphasized that, from its beginnings and throughout its development, the Inter-American System has advocated for the rights of persons with disabilities.298 This issue was addressed in 1948 in the American Declaration of According to the World Health Organization, both blindness and the amputation of a limb are consequences of uncontrolled diabetes. See: World Health Organization, Diabetes. Fact Sheet No. 312. January 2015. Available at: http://www.who.int/mediacentre/factsheets/fs312/es/index.html 297 298 Cf. Case of Furlan and Family v. Argentina, supra, para. 128. 63