exercise her right to health through adequate and regular medical care, the lack of
treatment for her ailments which aggravated her health condition, putting at her at risk of
suffering a serious, chronic and ultimately fatal51 disease, led to a physical impairment that
translated into a disability. Thus, in some circumstances, the attitudinal and physical
barriers faced by a person deprived of liberty can expose him or her to a situation of
disability.
III. RIGHT TO HEALTH OF PERSONS WITH DISABILITIES DEPRIVED OF THEIR
LIBERTY: ACCESSIBILITY AND REASONABLE ACCOMODATION IN PRISON
CONTEXTS
41.
In the case of Mrs. Chinchilla, the Medical Services Coordinator of the General
Directorate of the Prison System reported that the prison had medication to treat infectious
problems, as well as oral medications to treat diabetes, osteomyelitis and arterial
hypertension. However, the Coordinator added that Mrs. Chinchilla required subcutaneous
insulin for her diabetes, which was the cause of all the metabolic problems that she suffered,
including chronic renal insufficiency, for which the prison did not have adequate equipment
to provide care. For example, on November 28, 2003, Mrs. Chinchilla requested permission
to attend a medical appointment, but the judge decided on December 1, 2003, that she
should receive medical treatment for her diabetes symptoms within the prison.
Consequently, as a result of the evolution of her diabetic disease from 2002, Mrs. Chinchilla
had to have a leg amputated, which impaired her mobility. This created a situation of
disability resulting from various complications that considerably diminished her quality of
life, since she faced a number of barriers in the prison, given that she had to move around
in a wheelchair.52 It should also be recalled that, as a result of the poor treatment of her
diabetes, Mrs. Chinchilla gradually lost her sight.
42.
Regarding the practical facilities and procedures that Mrs. Chinchilla had to follow to
be allowed to leave the COF to attend medical appointments in hospitals, the Judgment
noted numerous difficulties in terms of the accessibility and availability of the means of
transportation and the time available to the policemen who guarded her. For example, it
was necessary for the COF guards to carry her and lift her with some difficulty into a “pick
up” truck, which did not have facilities to transport a person in a wheelchair. Moreover, after
the amputation of her leg, instead of making this procedure more flexible, the judge insisted
that in future all requests to attend appointments should be submitted at least eight days
in advance, otherwise they would be denied. It is clear, then, that the procedures
established for outpatient appointments in hospitals were not sufficiently flexible to permit
effective and timely medical treatment, particularly in cases of emergency. 53
Cf. Case Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment
of February 29, 2016, Series C No. 312, para. 199.
51
Cf. Case of Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs.
Judgment of February 29, 2016, Series C No. 312, paras. 87, 140 and 201.
52
Cf. Case of Chinchilla Sandoval v. Guatemala. Preliminary objection, merits, reparations and costs.
Judgment of February 29, 2016, Series C No. 312, paras. 82, 197, 199, 218 and 240.
53
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