Medication Shortages and Inadequate Treatment in Armenian Prisons

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“Don’t mention the name of the medical service, I’m terribly dissatisfied. Because of them, I’ve been labeled a liar,” said 35-year-old Arthur (name changed), who is now in his third year of detention. 

Arthur is serving a ten-year sentence for one criminal conviction and is also a defendant in another case currently on trial. He is periodically transported to court for hearings. During a recent session, he began to feel unwell:

“The nurse came in and said, ‘What’s wrong with you? Are you even eating?’ My blood pressure was low, they couldn’t hear my heartbeat at all, and she immediately ordered an electrocardiogram. Now they’ve come to take me again, but I said, ‘I’m in no condition to travel. Do you want me to faint in the vehicle and be left on the side of the road?’”

Arthur said he ultimately did not attend the hearing that day. The court, unaware of his condition, ordered his forced appearance, as no medical certificate had been submitted. When one was eventually issued, it stated he had seen a doctor not on the day of the missed hearing, but several days earlier.

“Your Tooth Might Hurt and There Might Be No Medicine”

Arthur’s difficulties with the prison healthcare system extend beyond his most serious medical concerns; at times, he struggles to obtain even basic medications, like painkillers for a toothache.

“You tell the doctor you need painkillers, and he says, ‘I don’t have any—I haven’t received any.’ You call the person in charge of distributing medication, and they say, ‘I already gave it to the nurses.’ Then you call the nurse, and she says, ‘I didn’t get any.’ Now try figuring out who’s telling the truth.”

Fifty-year-old Norik (name changed), another inmate, refuses to rely on the prison’s medical service at all. “I don’t take anything from them—nothing. I buy all my medication myself,” he said. Norik suffers from multiple chronic conditions, including arrhythmia, stomach and kidney ulcers, and a benign lung tumor.

“I’m supposed to take four or five different medications. They might give me a week’s supply of one, and only five days’ worth of another. When I tell them I’ve run out, they say, ‘I’ll report it tomorrow, get it, and bring it to you.’ But arrhythmia requires uninterrupted treatment. If I skip my meds, my blood pressure shoots up to 260.”

Norik also described being offered substitute medications when the prescribed drugs were unavailable, raising further concerns about the adequacy and consistency of treatment.

“They ask, ‘Do you want us to give you a substitute?’ I say, ‘I don’t know—I’m not a doctor.’ Then, for two months, there’s no substitute available, so they offer a substitute for the substitute, and then another substitute for that one… Eventually, the cardiologist came and asked, ‘What medications are you taking?’ I said, ‘Whatever they give me.’ He replied, ‘That’s why your blood pressure isn’t going down.’”

According to Norik, the doctor later admitted that he had been given unnecessary medication.

The Human Rights Defender’s (HRD) office has documented issues of medication supply in penitentiaries. The annual report highlights cases where inmates received prescribed treatment and medication months after prescription, and only after the HRD’s intervention.

“Failure to provide necessary medication to inmates may constitute a breach of the state’s obligation to ensure proper medical care and treatment for those under its custody,” the report states.

Laura Gasparyan, Head of the Department for the Prevention of Torture and Ill-Treatment at the Human Rights Defender’s Office, partly attributes the issue to delays in the state procurement process. She explains that the process can take up to a month, and in some cases, medications cannot be procured at all because no suppliers submit price offers.

Although official reports state that prescribed medications may be substituted with alternatives containing the same active ingredients, even these substitutes are not always available at the Penitentiary Medicine Center’s pharmacy, a state non-commercial organization (SNCO).

The Penitentiary Medicine Center was established in March 2018 under the Ministry of Justice and since April 28, 2023, it has operated under the Ministry of Health.  Its mandate is to safeguard and improve the health of detainees and convicts by providing access to comprehensive medical services within penitentiary institutions.

Medications Without Medical Care

According to the Human Rights Defender’s (HRD) report, detainees often have to rely on personal or family funds to access prescribed medications. Once delivered, the medicines are inspected by the Penitentiary Medicine Center’s staff—sometimes even X-rayed—before being approved for use.

But getting medication into the facility is only part of the struggle.

“They bring the medicines, but there’s no doctor—sometimes for hours,” said Norik, a 50-year-old inmate. He explained that the sound of raised voices from downstairs often signals that relatives have arrived with medicine. “These days, a relative has to take a number, wait five hours just to hand over the items, then another two hours to get the medicine approved, and finally wait again to retrieve their passport. It takes a full day.”

The HRD recorded one case last year in which a detainee was transferred to a facility on a Friday evening without access to his essential, continuous-use medication. Staff refused to accept the medicine from his family due to non-working hours and administrative barriers. He went without treatment for three days, and his condition worsened significantly.

Norik also described restrictions on even the most basic medical items: inmates are not allowed to keep iodine or thermometers and must request a doctor to access them—assuming a doctor is available.

“We used to have a thermometer,” Norik said. “No one hurt themselves with it, but now it’s not allowed. It’s all based on a stereotype that someone might self-harm. Sure, there are people who do that—but that comes from internal issues, and the lack of medical response only makes things worse.”

He added, “If I get agitated, I might act out too. I’ve been trying to see the chief doctor for two months. No one responds. When you finally get examined, they just do an X-ray and say, ‘See? Nothing’s wrong, right?’”

Hunger Strikes as a Last Resort for Medical Attention

According to former inmate and practicing lawyer Arman Sargsyan, prisoners often have to resort to desperate measures—such as hunger strikes—just to access the medical care they need.

“They stop eating, and within three days the issue gets resolved,” Sargsyan said. “Before I was released, another hunger strike took place just so people could get treatment—sometimes only after physical altercations. One man’s entire body was inflamed. We fought for months to get him to a hospital, but officials refused, saying there was no state funding.”

These issues have also been documented by a public oversight group monitoring Armenia’s penitentiary institutions. According to Zaruhi Hovhannisyan, a member of the group, neglect of urgent medical needs is among the most frequent complaints they receive.

“Many cases of self-harm stem from frustration over delayed or denied medical care,” she explained. “People suffer from chronic conditions without adequate treatment. Even when doctors prescribe something, it’s often delayed or ignored entirely.”

Hovhannisyan noted that the causes of these delays are systemic: too few medical personnel, combined with the logistical challenges of escorting inmates to outside medical facilities.

Inmate Arthur said he submitted a written request six months ago asking to see an ear, nose, and throat specialist at his own expense—but has yet to receive a reply.

“We have a guy here who’s clearly losing his hearing,” he said. “A doctor came once and said his condition required immediate treatment and that he’d be provided with a hearing aid. That was months ago. Nothing has happened since. He’s still waiting. And this isn’t an isolated case.”

Laura Gasparyan from the Human Rights Defender’s office confirmed that hunger strikes have become a common tactic in response to poor medical care. The HRD’s 2023 annual report found that many prescribed medical examinations were delayed for months, with most only taking place after the HRD’s direct intervention.

Fear of Punishment for Complaining

Arman Sargsyan recalled a case involving a medical worker who showed bias against inmates, specifically refusing to provide proper medical care to a patient because he had been convicted of murder.

According to Sargsyan, detainees often hesitate to file complaints. They fear that if the medical worker receives only a reprimand but keeps their position, they might face retaliation, such as being given inappropriate medication.

Zaruhi Hovhannisyan confirmed that her group has received similar complaints and has formally appealed to the authorities to take action. However, in conversations with staff from the Penitentiary Medicine Center, she was told that chronic understaffing remains a major obstacle. Despite the offer of higher salaries, the difficult working conditions make it hard to attract and retain medical personnel.

“As the medical workers themselves put it, ‘It feels like we’re imprisoned too,’” she said.

“I Refuse to Arrange an Interview” 

Staff at the Penitentiary Medicine Center initially expressed willingness to be interviewed about detainee healthcare and related concerns—but only with approval from the Ministry of Health.

When contacted by phone, Ministry spokesperson Mariam Tsatryan declined to arrange the interview, citing the format: since the resulting material would be published in writing rather than as a video, she insisted that all inquiries be submitted in writing.

However, this article is based on interviews with current and former inmates, as well as experts in penitentiary justice, who described a broad spectrum of medical care issues. The request for an interview was made to clarify these accounts and to give the Ministry the opportunity to provide its position—not at the Ministry’s prompting, but in the spirit of journalistic balance and due diligence.

It is worth noting that, under Article 3 of Armenia’s Law on Freedom of Information, formal written requests are typically used to obtain factual data held or generated by a public body—not to solicit commentary or clarification.

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