the State’s alleged failure to comply with the obligation to adapt domestic law to the American Convention, contained in Article 2 thereof (supra para. 254). It also points out that the Commission’s recommendation relates to the violation of judicial guarantees and judicial protection declared in relation to the actions of the enforcement judge. Consequently, the Court considers that the Commission has not justified its request, particularly in terms of the characteristics that such a remedy should have. C.4 Access to medical care in the COF and in other prisons 287. In its merits report, the Commission recommended guarantees of timely access to adequate medical treatment at the Women’s Orientation Center. 288. For their part, the representatives requested that the State “establish health services in prisons, in accordance with international standards on the rights of persons deprived of liberty. In particular, they requested: a) The provision, throughout the prison, of medical and paramedic staff duly trained to treat sick persons and, in particular, to attend to medical emergencies, with health care protocols and adequate equipment; b) That prisons be provided with medicines and adequate medical facilities to attend emergencies, as well as chronic illnesses, such as diabetes, acquired immunodeficiency syndrome -AIDS-, chronic kidney disease; it is considered important that women’s prisons be provided with special facilities to treat illnesses specific to women, gynecologists and specialized staff in these areas of health; c) The establishment of effective medical record systems for each person deprived of liberty, available to doctors and prison staff, so that they have accurate knowledge of the inmates’ health condition, their treatments, medical history and all pertinent information to ensure adequate treatment; [and] d) Guarantee that persons deprived of liberty are taken punctually to their ambulatory appointments at specialized health centers, when necessary, and ensure adequate mechanisms for transport and attendance at those appointments”. 289. Furthermore, in “matters of protection and monitoring of the rights of persons deprived of liberty,” the representatives asked the Court to order the State to: a) “Establish prison monitoring and control systems that are effective for the protection of individual rights and, in particular, order the State to adopt appropriate mechanisms so that judges and other agents of the State comply with international quality standards of medical care and protect the right to health of detainees. b) Strengthen the system for the protection of the rights of persons deprived of liberty, through the appointment of enforcement judges, in sufficient number and with adequate training for the defense of the human rights of persons deprived of liberty in all places where prisons exist. c) Order the State of Guatemala to reduce prison overcrowding, given that in women’s prisons the current rate overcrowding is 300%, and take all necessary steps in that regard, including the use of non-custodial measures for less serious crimes and, where applicable, the effective adaptation of prisons with special facilities for disabled persons. d) Strengthen the Justice system in matters of implementation, with additional human and technological resources to guarantee a prompt and effective response to the needs of persons deprived of liberty. - Increase the number of doctors that treat the prison population, considering that the conditions of those deprived of liberty increase the risk of epidemics, contagion, etc. - Provide specialized gynecological care to all women deprived of liberty. 290. The State argued that persons deprived of liberty in the COF are guaranteed access to regular, timely medical attention, free of charge, and that it “has mechanisms and procedures to guarantee medical access for persons deprived of liberty at the Women´s Orientation Center. It specified that inmates are examined upon admission to the COF, and during the time they serve their sentence in the COF; this includes the required assistance 89

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