chemotherapy on November 6, 2009, and on January 14, 2010, she was not taken to the subsequent follow-up appointments.388 239. Owing to the special position of guarantor that the State exercises over the person who is detained, and its consequent control of the evidence regarding their physical condition, detention conditions, and eventual medical care, it is the State that has the burden of proof to provide a satisfactory and convincing explanation of what happened and to disprove the arguments concerning its responsibility with valid probative elements. 389 The failure to submit evidence that clarifies the type of treatment that someone has received is particularly serious in cases that involve allegations relating to the right to health. In its position of guarantor, the State is responsible both for ensuring the rights of the individual in its custody, and for providing information and evidence on what happened to the detainee.390 In the instant case, the State has not demonstrated that Manuela’s failure to attend the hospital appointments could be attributed to the presumed victim; consequently, it must be presumed that the State was responsible for this omission. 240. The Court emphasizes that the medical services for persons deprived of liberty should be organized and coordinated with the general administration of the health care services, which means establishing expedite and adequate procedures for the diagnosis and treatment of patients, as well as for their transfer when their health situation requires special treatments in specialized prison establishments or in civil hospitals. To implement these obligations, health care protocols and agile and effective mechanisms for the transfer of prisoners are necessary, particularly in emergency situations and cases of serious illnesses. 391 In this case, Manuela was unable to attend one of her chemotherapy appointments in 2009; in 2010, the treatment was delayed by one month and, on at least two occasions, she was not taken to the hospital for follow-up medical appointments (supra para. 238). These deficiencies reveal that the State did not take the necessary measures to ensure that Manuela was transferred to the hospital to receive the medical treatment that she needed. 241. Additionally, the Court recalls that Article 5(2) of the Convention establishes that no one shall be subject to cruel, inhuman or degrading punishment, and that all persons deprived of their liberty must be treated with respect for the inherent dignity of the human person. In this case, Manuela’s detention prevented her from receiving satisfactory medical care, so that her punishment of imprisonment also became inhuman punishment, contrary to the Convention. Cf. Manuela’s medical record in the Rosales National Hospital. Entry for January 6, 2010 (evidence file, folio 2743), and Manuela’s medical record in the Rosales National Hospital. Entry for February 18, 2010 (evidence file, folio 2735). 388 Cf. Case of Bulacio v. Argentina. Merits, reparations and costs. Judgment of September 18, 2003. Series C No. 100, para. 138, and Case of Quispialaya Vilcapoma v. Peru. Preliminary objections, merits, reparations and costs. Judgment of November 23, 2015. Series C No. 308, para. 118. 389 Cf. Case of Bulacio v. Argentina, supra, para. 138, and Case of Chinchilla Sandoval et al. v. Guatemala, supra, para. 173. 390 Article 22 of the revised Standard Minimum Rules the Treatment of Prisoners. See also, Articles 25 and 26. The revised United Nations Standard Minimum Rules for the Treatment of Prisoners, also known as the “Mandela Rules,” were amended to reflect the global consensus on certain minimum standards for the medical care of persons deprived of liberty, and have established that every prison shall have in place a health-care service tasked with evaluating, promoting, protecting and improving the physical and mental health of prisoners, paying particular attention to prisoners with special health-care needs or with health issues that hamper their rehabilitation (Rule 25); and the need to maintain accurate, up-to-date and confidential individual medical files (Rule 26); that all prisons shall ensure prompt access to medical attention in urgent cases; that prisoners who require specialized treatment or surgery shall be transferred to specialized institutions or to civil hospitals; and that where a prison service has its own hospital facilities, they shall be adequately staffed and equipped to provide prisoners referred to them with appropriate treatment and care (Rule 27). This amendment to the United Nations Standard Minimum Rules for the Treatment of Prisoners was adopted by the United Nations General Assembly on December 17, 2015. Available at: https://www.unodc.org/documents/justice-and-prison-reform/Nelson_Mandela_Rules-E-ebook.pdf 391 68