TO SERVE WITHOUT HEALTH? Inadequate Nutrition and Health Care in the Russian Armed Forces
EXECUTIVE SUMMARY AND RECOMMENDATIONS
Conscript soldiers in Russia performing their first year of compulsory military service are routinely denied adequate food and access to medical care, in violation of their human rights. As a result, many go hungry or develop serious health problems, including pneumonia and festering sores, as minor health concerns remain untreated. In several dramatic cases, this treatment has led to the death of conscripts or permanently damaged their health.
Human Rights Watch documented cases of denial of adequate food and medical care to first-year conscripts from more than fifty military units throughout Russia. Taken together with long-standing reports by Russian nongovernmental organizations devoted to conscripts' rights, this research indicates that conscripts throughout Russia have endured these privations for years. Their diet falls short of the Russian military's nutritional standard for soldiers, as it often lacks meat or green vegetables. The food conscripts do receive is often of poor quality, rotten, or bug-infested. The abusive and violent hazing of first-year conscripts that has made Russia's military notorious extends to the mess hall: senior conscripts prevent junior conscripts from eating enough food, and forcibly confiscate younger conscripts' most desirable food.
Internal army standards require careful monitoring of the health of conscripts and adequate access to medical care. But in practice, monitoring mechanisms are often simply ignored or are ineffective. The hazing system prevents many first-year conscripts from seeking medical care for minor health problems, as they fear repercussions from senior conscripts. In some cases senior soldiers harass and beat conscripts after they seek medical care. In others, conscripts' commanding officers and even doctors deny conscripts' requests for medical care. Conscripts who overcome these obstacles and seek medical treatment at on-base sick bays often complain the care they receive is substandard. Conscripts frequently fall ill with pneumonia repeatedly during their service. For many others, infected small cuts become festering sores. These major health problems are entirely preventable, if adequate and timely health care is provided.
In some cases we documented, the denial of adequate food and medical care had grave consequences. Viacheslav Turov, a nineteen-year-old conscript from the Siberian city of Novokuznetsk, died in 2001 from complications of double pneumonia after only three and a half months in the military. Early in his service, he had complained in a letter to his parents about losing seven kilograms in just a few weeks because of an inadequate diet. The post-mortem report identified malnutrition as having contributed to his death. Later, an officer received a two-year suspended prison sentence in relation to Turov's death.
Violent hazing continues in many on-base sickbays and in some military hospitals, where senior soldiers beat or otherwise ill-treat first-years, or force them under threat of abuse to perform a variety of humiliating chores. In at least one case, the victim committed suicide after a night of particularly cruel treatment. The systematic nature of the hazing signifies a widespread dereliction of the obligation of officers to protect conscripts against ill-treatment. Violent hazing is a separate topic of Human Rights Watch research.
Although these problems have plagued Russia's military for years, the government does not appear to have taken any measures to address them. The Russian Ministry of Defense and its Military Medical Commissionrefused to meet with Human Rights Watch to discuss our findings. In a written response to Human Rights Watch's request for a meeting to gain information about soldiers' diets, the Ministry of Defense flatly denied harassment and hazing in canteens, acknowledging only that occasionally food disappears as a result of a dereliction of duty by "individual officials."
The Russian government's failure to provide adequate food and medical care to conscripts violates its obligations under domestic regulations and under the International Covenant on Economic, Social and Cultural Rights (ICESCR). The government should take real steps to stop these abuses. It should work to restore the effectiveness of enforcement mechanisms set out in the Code of Military Conduct aimed at ensuring that soldiers receive an adequate diet, monitoring their health, and ensuring effective access to health services when necessary. These steps should include:
·Investigations by the general staff of the armed forces and an independent outside body, such as Russia's ombudsman, should examine the reasons why existing enforcement mechanisms are not effective. These investigations should draw up steps to change the shortcomings identified and suggest additional mechanisms that can effectively prevent violations of the rights of soldiers.
·The armed forces and military procuracy (office of the prosecutor) should institute mechanisms to ensure the protection of soldiers' rights; they should hold accountable all officers and lower ranking personnel who infringe upon any soldier's right to adequate food or health care, or who interfere with state and military mechanisms to protect and enforce those rights.
·The government should establish a permanent monitoring mechanism, possibly by creating an ombudsman for military servicemen, to ensure the existing standards are consistently and appropriately implemented.
·The government should promptly ratify the European Social Charter.
·The Council of Europe should encourage Russia to ratify the Charter at the earliest possible date and should provide training on its provisions.
·The U.N. Committee on Economic, Social and Cultural Rights should carefully examine the violations of rights of Russian soldiers to adequate food and health care when it considers Russia's fourth periodic report on the implementation of the U.N. Covenant on Economic, Social and Cultural Rights in November 2003.
·The international community should help advance the recommendations put forward in this report by raising them during appropriate bilateral and multilateral dialogues with the Russian government.
·The U.S. government, the European Union and its member states, and other donors should provide adequate assistance to the work of soldiers' rights organizations in Russia, which are providing life-saving services in Russia.
This is the second in a series of Human Rights Watch reports on human rights abuses in the Russian military. To research it, Human Rights Watch conducted more than hundred interviews with conscripts, their parents, officials, lawyers, NGO experts, and former military servicemen in 2001 and 2002. The interviews were done in Cheliabinsk, Moscow, Novokuznetsk, Novosibirsk, St. Petersburg, Vladivostok, and Volgograd. The conscripts served on more than one fifty bases in more than twenty-five of Russia's eighty-nine provinces.We also extensively studied the archive files of several soldiers' rights groups.
The majority of the men interviewed for this report did not serve their full two-year term of military service. Many ran away from their units during their first year of service because of violent hazing; others were discharged in their first year for health or other reasons. This report therefore relates primarily to the right to adequate food and medical care for conscripts in their first year of service.
Modern Russia has had a conscription army since 1918. In recent years, approximately 400,000 young men between the ages ofeighteen and twenty-seven are drafted each year for two years of service in the regular army, the Ministry of Internal Affairs forces, border troops, or other branches of Russia's vast armed forces. Violent hazing and other abuses of conscripts are endemic and have resulted in thousands of young men fleeing their units every year. Persistent reports of hazing, malnutrition, and poor medical care cause massive draft evasion, especially in the more affluent parts of Russia. As young men approach conscription age, they and their parents become anxious about the perils of military service, and begin looking for ways, both legal and illegal, to avoid it. Abuse in the military has also given rise to immense public antipathy toward conscription. Recent opinion polls show that most Russians support the abolishment of the conscription system and prefer a fully professional army. The Russian government's plans for military reform envisage a reduction in the number of men to be drafted and in the length of service, but retain conscription for the foreseeable future.
Russia's Health Crisis
Since the collapse of the Soviet Union, a profound public health crisis has plagued Russia. General health in all parts of the population has deteriorated and life expectancy in Russia lags far behind that in Western Europe. A recent countrywide pediatric health study found that 67 percent of 31.6 million Russians eighteen years old and under suffer from health problems, with bronchial and respiratory illnesses being particularly common. Another study found that half the country's expectant mothers are undernourished and two-thirds of Russian babies are born with health problems.
Violations of the rights to adequate nutrition and medical care in the Russian armed forces must be seen in this context. The privations many conscripts suffer may exacerbate the fragile health they were in when they entered the military. Commenting on the poor health of Russia's conscripts and their social background, a top Russian general said at an April 2003 press conference, "the military contingent [the conscripts] that we have reflects the condition of our society." In fact, the general's grim statement may have been overly optimistic: the approximately 400,000 young men drafted into Russia's armed forces each year generally come from the least affluent parts of society, as many young men from middle or upper class families successfully find ways to avoid the highly unpopular military service. Many of those drafted also have a history of alcohol and drug abuse.
Medical commissions that determine whether candidate conscripts are fit for military service typically declare more than 30 percent of those examined unfit. Yet, in a crunch to fulfill draft quotas, each year the commissions also declare many young men fit for service despite health problems that, under Russian law, should disqualify them. Human Rights Watch research in the archives of soldiers' rights organizations in Moscow, St. Petersburg, Volgograd and other Russian cities found numerous cases of young men who were discharged from the armed forces for health conditions that predated their draft order. In interviews, dozens of conscripts told Human Rights Watch that the medical examinations they underwent had been superficial and that physicians had failed to pay due attention to their health problems.
The violent hazing of first-year conscripts that is endemic in many units of Russia's armed forces further ruins the health of conscript soldiers. Numerous conscripts described to Human Rights Watch how senior conscript soldiers, known as dedy, systematically bullied them in their first year of service, making them perform degrading chores and physical exercises, and demanding money, alcohol, food, and cigarettes from them. Refusal to comply led to beatings, which most said were routine throughout their first year of service. Many conscript soldiers also said that, at times, they faced far more serious ill-treatment or even torture, both in retribution and gratuitously, including beatings with heavy objects, beatings while they were suspended in painful positions, scorching of skin with lit cigarettes, and sexual abuse.
Human Rights and the Armed Forces
Under international law, everyone has a right to adequate food and to the highest attainable standard of health. The United Nations Committee on Economic, Social, and Cultural Rights, the body that monitors states parties' compliance with the International Covenant of Economic, Social and Cultural Rights, has affirmed that a positive obligation for states exists with regard to certain groups that are "unable, for reasons beyond their control," to enjoy the right to adequate food or medical care by the means at their disposal. Conscripts fit this criterion, as they live in custodial circumstances-they are not allowed to leave their base without prior permission from their commander and may be administratively or criminally punished should they do so-and generally do not have access to alternative sources of food or medical care.
From the perspective of international human rights law, military conscripts are an exceptional group. The special mission of the armed forces may justify restrictions on their rights that far exceed those that may be placed on almost any other group. For example, ordering a prisoner to crawl through the mud for several hours would almost certainly constitute degrading treatment. Such an order from a military commander to conscripts during field training would be a legitimate part of a soldier's preparation for battlefield conditions. Similarly, temporary deprivation of food can also be a legitimate part of a conscript soldier's training.
International human rights law includes standards for minimum treatment of persons in state custody or otherwise deprived of their liberty, for example prisoners or people detained because of mental disabilities. These standards set limits on such restrictions, and impose on states positive obligations to provide for the well-being of those in state custody. No such standards exist for conscripts. However, in its case-law, the European Court of Human Rights has consistently held that, while certain restrictions placed on specific rights of military servicemen may be necessary to ensure the proper functioning of the army, these may not serve to altogether negate a basic right.
From this principle, Human Rights Watch has derived three criteria for determining the lawfulness of restrictions on conscripts' rights:
1. Restrictions of conscripts' rights should have a legitimate purpose related to the specific mission of the armed forces;
2. They must be shown to have been planned, and may not be arbitrary;
3. They may not unjustifiably threaten the health or well being of the conscript.
Our research found that the denial of food and medical care to Russian conscripts did not meet these criteria. This treatment is driven not by military necessity but by arbitrary cruelty and negligence.
THE RIGHT TO ADEQUATE FOOD
One of the main responsibilities of commanders in enhancing the conditions of service is to ensure timely and full provision of the prescribed norms of nutrition to every serviceman.
For the first month of his military service, Vasilii S.'s typical meal consisted of water-based millet porridge with fish, mashed potato, some bread, butter, and a cup of steaming tea. In the three meals per day he got, there was no meat, vegetables, or eggs, all required by internal military regulations. Frequently, the eighteen-year-old and his fellow conscripts were forced to gulp the hot food and tea down in a matter of minutes. That was all the time senior conscripts gave them to eat, leaving them the choice between "swallowing boiling food" and "collapsing under the severe physical strain [of military service]." Often, senior conscripts also confiscated the butter. The food itself was of inferior quality, as Vasilii S. soon discovered. The mashed potato was made of expired, and sometimes moldy, instant potato mix and water. Vasilii S. avoided it whenever he could because it gave him heartburn. One day, when he had kitchen duty, Vasilii S. was asked to prepare the fish for the porridge. As he cut up the pike and catfish, he discovered that they were worm-infested. He stopped eating the fish after that but could not bring himself to tell his fellow soldiers.
Vasilii S.'s diet clearly fell short of the Russian military's internal regulations that prescribe a detailed daily diet for soldiers, but his experience was not exceptional. In 2002, Human Rights Watch interviewed thirty-one conscripts from military bases across Russia about their diet in military service. Nineteen of the young men told Human Rights Watch that they were badly fed throughout their first year of military service. Repeated claims by these and other conscripts of weight loss during military service appeared to confirm that the meals these men received were nutritionally insufficient. Ten conscripts, who all served on more than one military base, said they had mixed experiences. Only three young men said they had been fed well throughout their military service. Interviews with experts at conscripts' rights organizations in regions across Russia, and extensive research in their case records strongly suggest that malnourishment is a problem at military bases throughout the country, and has been for years. The diet generally described does not appear to meet nutritional standards and the food is often inferior or pest-infested. Worse still, younger conscripts often have too little time to consume their meal as senior conscripts impose rules on first-year conscripts that force them to practically inhale their (sometimes hot) food or leave half their meals behind. Senior conscripts also frequently compel first-year recruits to hand over choice food items to them.
Two retired military officials identified corruption as another reason why the quantity and quality of food items that reach the conscripts' plate do not meet the official standard. They said corrupt officers at warehouses and kitchens sell off food products for their own profit, sometimes replacing the food items with inferior products. According to a retired colonel, now the head of the St. Petersburg-based NGO For Military Reform, large quantities of food are lost in the regiments. He said officers in charge of regimental warehouses, the heads of the canteens, and the cooks, routinely steal food to sell it on the market or for their own consumption. A former military procurator confirmed the existence of these corrupt processes and said that "everyone is complicit" (in Russian: Ruka ruku moet) making the official mechanism to check the quality and quantity of the food conscripts get an empty formality. In a letter to Human Rights Watch, the Russian Ministry of Defense stated that it exercises "strict control" over all levels of the provisions service. It stated that, as a result, "individual facts of losses and failure to deliver material funds are uncovered, which are the result of ill-faith of individual officials to their official duties."
For most conscripts, the lack of adequate food results in hunger; in the words of one conscript we interviewed, "a feeling of hunger haunted us all the time." Undoubtedly, inadequate food intake among many conscripts also makes them more susceptible to illnesses, including nutritional deficiency disorders. In some cases, complications related to malnourishment led to the premature death of conscripts.
Russian official standards are consistent with the government's international obligation to provide adequate food to conscripts. A Ministry of Defense order on rations and the Military Code of Conduct (in Russian: Ustav vnutrennei sluzhby vooruzhennykh sil Rossiiskoi Federatsii) provide a detailed legal framework for the diet of soldiers. The order, which is legally binding, establishes standard daily rations for all troops, including conscripts. It contains a list of foods that conscripts should receive every day, and specifies required amounts per product in grams. These include, among others, white and dark bread, cereals, pasta, meat, fish, milk, butter, sugar, and vegetables (see Graph 1 for the full general ration). This official diet appears to be close to international dietary recommendations and to national recommendations in, for example, the United States, with respect to energy and protein content. It is not possible, however, to evaluate the dietary recommendations completely without more information about the content of the recommended daily vitamin supplement and about the assumptions behind the recommendations on the quality of the grains and meat for which specific quantities are suggested.
The Military Code of Conduct, which regulates the rights and obligations of soldiers, stipulates that conscripts are entitled to three warm meals per day. It encourages variety in the diet and states that when officers determine the menu they should take into consideration not only the type of combat preparation the troops are engaged in and availability of food supplies but also the wishes of the troops themselves. The Code further states that, before every meal, officers must check the quality of the food, the quantity of individual portions, and sanitary conditions in the canteen and kitchen.
The International Covenant on Economic, Social and Cultural Rights requires governments to "progressively achieve the full realization of the right to adequate food." The U.N. Committee on Economic, Social, and Cultural Rights has indicated that diets should include "a mix of nutrients for physical and mental growth, development and maintenance, and physical activity that are in compliance with human physiological needs at all stages throughout the life cycle and according to gender and occupation."
While the Military Code of Conduct does not reference the ICESCR, its nutritional standard should be seen as interpretive of the standards contained in the ICESCR. The government is therefore obliged, from the perspective of international law, to take all reasonable steps to ensure observance of these standards. Digression from the standard without well-founded reasons thus constitutes a violation of the right to adequate food. Human Rights Watch also believes that regular digressions from the official standard risk rendering the diet insufficient in calories, protein, and other nutrients as Russia's nutritional standard appears adequate but by no means generous. This is particularly true considering the level of physical activity that can be expected from conscripts in the armed forces and the physiological needs of the age group most conscripts belong to.
The actual diet of conscripts generally falls well short of these detailed rules. Conscripts generally described a persistent lack of meat and vegetables, poor quality of the food served to them, and a steady, monotonous diet of macaroni or potato and cabbage. They also said officers generally reduce the official procedure to check the food's quality and quantity to a pointless formality, when they observed it at all.
Several conscripts told Human Rights Watch that meals were not checked for quality and quantity in their units at all, others said the procedure was performed regularly but was reduced to a formality. Anton S. told Human Rights Watch: "They would serve one plate with everything we were supposed to get, and put it on display. However, the plates we got looked nothing like it."
Foods most frequently missing from conscripts' diets were meat, eggs, green vegetables (except cabbage), and sometimes fish. Many conscripts complained about a lack of sugar, although it was unclear whether the quantities of sugar they received in their tea matched the official norm. The fact that certain food items are routinely absent from conscripts' diet risks rendering it insufficient in nutritional value. Conscripts also frequently described their diet as monotonous, saying they received almost the exact same diet every day. This contravenes the spirit of the official standard, which prescribes and encourages variety, and the international standard as interpreted by the U.N. Committee on Social, Economic and Cultural Rights. For example, Dmitrii Kosov said he and his fellow conscripts mainly ate macaroni: "Macaroni with macaroni, macaroni with bread, macaroni in the soup... They apparently had a lot of it." Many other conscripts said they constantly ate potatos and never saw any pasta. Another conscript said: "They fed us cabbage, cabbage and more cabbage…"
Concerns about Quality and Hygiene
Many conscripts complained that the quality of the food they received was poor, or about apparently unsanitary conditions in kitchens or canteens. These complaints primarily concerned the following issues:
·Insects and other pests in food. A number of conscripts complained of worms, larvae, ants, and other insects in their soup, bread, meat, fish, and porridge. For example, Alexander Kaiankin said: "The bread was of low quality. If you'd cut it open, ants would sometimes crawl around inside." Another conscript said, "we had worms in our porridge… Once I found a cockroach in my compote." Yet another mentioned "white worms" in his porridge.
·Spoiled foods. Several conscripts were fed spoiled foods, including bread, potatoes, fish, meat, and eggs. One said: "I peeled potatoes when I had kitchen duty. They were all squashy…" Another conscript said he received mashed potato made of expired potato mix: "It was old. On the labels on the bags you could see they were expired, maybe by six months. Some of it had already gone bad." Ilia B. said that he and his peers were frequently given rotten fish for lunch: "[We could tell that the fish was bad] both by smell and color. Nobody ate it, except for the pigs."
·Lack of hygiene. Many conscripts reported unsanitary conditions in kitchens or canteens at their bases. Several said they had found cockroaches in their food or drinks. One conscript said the salted pork rind (in Russian: salo) he and his fellow soldiers received was regularly full of hair. Another said he regularly found sand in his soup.
·Low quality meat. The conscripts who did receive meat in their diet often complained that the meat was in fact fat or mostly gristle, and was inedible. Vladimir Z. told Human Rights Watch: "[It's the kind of] meat that when you can pull it out of your mouth and let go of it, it snaps back. It's impossible to chew it." Several other conscripts said they were given meat from the strategic reserves that had been frozen for several decades. In the words of one of them, "the meat was older than I am." Many conscripts also said they received tinned stewed meat, or tushenka-widely recognized as inferior to meat but not necessarily so in nutritional value. A retired colonel told Human Rights Watch that substituting tushenka for fresh meat to fulfill the military's dietary requirements for meat is a widespread and "old army specialty." The retired colonel also confirmed that officers frequently take meat out of the strategic reserve when they do not have fresh meat in their warehouses.
Hazing and the Right to Food
Hazing prevents conscripts from receiving a diet that meets official standards and causes conscripts to go hungry. In canteens in military units across Russia, senior conscripts routinely take food from junior conscripts or severely restrict the amount of time for eating. Officers are not present during mealtimes to maintain order in canteens.
Too Little Time to Eat
Informally, senior conscripts have the authority to determine when meals are over; when they finish, they order everyone else to stop eating as well. Almost half the conscripts interviewed for this report complained that for part or all of their military service senior conscripts routinely gave them so little time to eat-by most descriptions between one-and-a-half and five minutes-that they were forced to either practically inhale their food or leave half of it uneaten. Senior conscripts physically abuse or humiliate junior conscripts who take uneaten food with them. In some cases, senior conscripts were served first and started eating while first-year conscripts were waiting to get their food. In other cases, senior soldiers skipped soup and went straight to seconds. In both scenarios, the senior soldiers ordered everyone to stop eating as soon as they were done. Training conscripts to consume food quickly may be a legitimate element of field training. But this was clearly not the purpose in the numerous cases examined by Human Rights Watch.
Senior conscripts generally enter the canteen and are served first while junior conscripts wait for their food. Vladimir P. told Human Rights Watch:
The dedy started eating first. As soon as the dedy finish eating they go out and make us get up. They don't care if you finished eating or not. There were times when the last person to sit down had just filled his plate and had about half a minute left… There were times when we remained hungry.
Describing another scenario, a conscript told Human Rights Watch: "The dedy don't eat soup, only second course, and we would eat soup and then time was up. During lunch, we didn't have enough time to eat the second course." In Maksim Komlev's words, "when they only took the second course, they quickly ate it and said: 'Company, lunch is over!'"
While some said they learned to eat quickly, others said no matter how hard they tried, they were unable to finish their meals. For example, Ilia B. described the scene in his canteen:
They gave us (ten junior conscripts) 1.5 minutes to eat our first and second course. Nobody ate the soup because it was too hot. We immediately ate the seconds. As we entered the canteen, a sergeant stood by the entrance and looked at his stopwatch and yelled: "Your minute has ended! Carry out the plates."
Conscripts said that they were sometimes tempted to put bread or other food in their pockets after senior soldiers had declared mealtime over. One said that a "feeling of hunger was there all the time, twenty-four hours a day…. There were problems because of it. People took bread with them, although you're not supposed to." Those who were caught carrying food out of the canteen faced disciplinary punishment. One conscript recounted:
You sometimes could not finish your food. And if you take something with you, [ you're in trouble]. Once, they caught one of us, he had a piece of bread in his pocket. They smeared a thick layer of toothpaste on the bread and forced him to eat it. He didn't brush his teeth for the next two months, couldn't bear the sight of it, but he finished the piece. What else could he do?
Another conscript said that when someone in his unit was caught bringing bread out of the canteen, senior soldiers brought a lot of bread to the barracks that evening: "They said: 'Now you're going to eat.' So you eat one, two, three loaves, until you feel really awful."
Every fourth conscript interviewed about their diet in the military stated that senior soldiers had confiscated their food during mealtime, mostly white bread, butter, and meat. Aleksei Dryganov told Human Rights Watch:
We gave our tea to the senior conscripts, as well as our bread and butter, leaving us only 100 grams of potato and a piece of black bread. In the evening, the same story. The meat was taken right away. You wouldn't even get to the table before they take it from you.
Another conscript said: "They gave us buns and [the dedy] took them away from someone. If a ded felt like having a second bun, he'd just walk up and take it. Nobody would tell him anything." In some units senior conscripts systematically confiscated food, in others the practice was less common. One conscript said: "The dedy sometimes took the butter. If you managed to put it on your bread they left it to you but if you weren't quick enough you'd say goodbye to your butter." Another said: "They only took our butter, sometimes also an egg. They would give us two, one they took. But that was rare."
Two conscripts who fled the same unit together said in separate interviews that the senior soldiers forced them to save their pieces of white bread and hand them over later. They described the punishment that was imposed if a conscript ate the bread himself:
Sometimes when you are hungry, you eat the piece of white bread, which you're supposed to give away. And you pay for that. If you don't bring it, they say: "Go to the drying room." And there you get [beaten]. Several guys went to hospital because of it."
The other conscript expanded: "God forbid that anyone sees you eat a piece of white bread. They wake you up at night, and they make you do knee bends and pushups, and you get beaten over the head with a stool, or an iron rod."
The Government's Response
Poor nutrition and arbitrary denial of food has plagued first-year conscripts for years. Yet, the Russian government does not acknowledge these problems and has apparently not taken any steps to address them. In response to repeated requests from Human Rights Watch for a meeting to discuss these issues, Deputy Minister of Defense V. Isakov sent a three-page letter to Human Rights Watch denying the existence of both problems. In his letter, the deputy minister describes the control procedures provided for in the Military Code of Conduct and states that "with such functional control over the provision of food in military units, such a problem as senior conscripts confiscating food from junior conscripts does not exist." In an apparent denial of the practice of senior conscripts limiting the eating time of junior ones, the deputy minister stated that "the eating time in each military unit is determined by its commander." The deputy minister also apologized for the "impossibility to have a meeting in the near future."
THE RIGHT TO ADEQUATE MEDICAL CARE
One of the main duties of a commander in his work is to ensure permanent battle-readiness of his (sub)unit is to care for the health of his subordinates.
Safeguarding the health of conscripts is a major priority for the Russian armed forces-at least, in theory. Internal army regulations contain detailed provisions for monitoring the health of soldiers and addressing problems when they arise. However, in reality these provisions are routinely ignored. Monitoring of soldiers' health is often superficial or non-existent, and access to health care is severely impeded. Hazing prevents many conscripts from seeking medical care for their health problems. Those who overcome their fear and seek medical at on-base sickbays often receive substandard help and subsequently face repercussions from senior conscripts. Hazing even continues in some military hospitals.
Background on Living Conditions
The Military Code of Conduct attaches great importance to creating living conditions in the armed forces that are conducive to good health. It defines ensuring strict observance of sanitary rules, appropriate shelter, and adequate food as among the "main aspects" of a military commander's work. The poor living conditions of conscripts discussed in this report indicate that officers are failing in this duty. Many conscripts interviewed for this report attributed the health problems they developed during their service to poor living conditions. With striking uniformity, they linked stomach problems to their poor diet and festering sores to poor personal hygiene and drafty and damp living quarters. Personal hygiene was a major problem for many on their military bases. Several said they were given too little time to wash properly during the weekly shower they are entitled to. One conscript who suffered from festering blisters said he was afraid to go to the bathroom to wash in the evenings:
You fear going to the bathroom in the evening because the dedy sit there and smoke. You can be sure that they will harass you [if you go in] and that you'll get [beaten]. It's better to just go to sleep and not go to the bathroom.
Others said they were not given changes of underwear for extended periods of time. Many conscripts and their mothers said that because of these conditions their clothing became infested with lice.One mother said: "There was also the following detail. His underwear, but also his uniform generally, were alive from the lice." Another mother said: "When he came home on a leave of absence, I washed his uniform and [discovered] lice-lice and larvae in his underwear. As his leave was less than twenty-four hours, I washed, dried and ironed at night."
These living conditions, which, no doubt, contribute to the health problems of conscripts, contravene the Russian army's internal regulations.
Access to Medical Care
The Military Code of Conduct contains explicit and unequivocal language on access to medical care: A military serviceman may not hide an illness and is obliged to promptly report any illness to his immediate superior. In cases requiring immediate attention, the superior is supposed to grant the serviceman permission to go to the sickbay right away. If a condition is not urgent, the superior registers the health complaint in a registry and the conscript can go to the sickbay at the regular visiting hour. Additionally, the code requires commanding officers to monitor the health conditions of all staff during battle training and everyday life, prescribes weekly superficial physical examinations of all conscripts, as well as semi-annual, extensive examinations. These provisions, in theory, set out a level of access to health care that is consistent with the right to health as defined in the International Covenant on Economic Social and Cultural Rights.
Yet, these norms are often ignored in practice. Several conscripts told Human Rights Watch that they only underwent in-depth examinations when transferred from one unit to another but not after every six months of service. One conscript told Human Rights Watch that superficial examinations were conducted every week while he was in a special training unit. He said he and his fellow conscripts had to undress to their underwear, after which the commander of his company and the medical doctor checked them for bruises and health problems. Once he was moved to a regular unit, these body checks ceased.
Another conscript told Human Rights Watch: "In our unit, they checked our pockets for sharp objects every day but we never had any body checks. In the early months, I walked around with several large bruises…" Access problems exist at several levels. In some cases, conscripts did not seek medical care because senior soldiers pressured them not to or had tremendous fear of repercussions before seeking help. In others, some conscripts said that superiors whom they approached denied them permission to go to the sickbay. Still others said doctors turned them back without paying due attention to their health concerns when they sought medical help. This, in turn, has resulted in a widespread perception amongst recruits that it is pointless to seek medical care.
Human Rights Watch research shows that the practices described below have existed for a considerable number of years, and that the Russian government has apparently taken no effective steps to remove these obstacles to access to health care. Despite repeated requests, the government has refused to meet with Human Rights Watch to discuss this issue. The failure of the Russian government to ensure effective access to health care for conscript soldiers violates its obligations under the right to health.
Pressure Not to Seek Medical Care and Repercussions
If you were sick, you were at fault.
Conscripts from military bases across the country uniformly described a presumption that those who seek medical care do so to avoid the hardships of military service. Because of this presumption, both junior and senior conscripts pressure their peers not to seek medical care. Conscripts who ignore the pressure often face repercussions, including harassment, beatings, and extortion. As a result, many conscripts try to cure minor health problems themselves, rather than risk abuse by seeking professional care.
Alexander Kaiankin told Human Rights Watch that conscripts regard with suspicion peers who go to the sickbay:
In our unit it was considered disgraceful to go to the sickbay, for example to complain about a blister or a painful festering sore. [Seeking medical care] was bad and was stopped. [The dedy would say] "you're dodging [your duties]…" Other junior conscripts start to despise you, and the senior ones encourage that.
Another conscript, who said he frequently had bruises from beatings, confirmed the pressure dedy put on conscripts to avoid medical care: "It was undesirable to go to the sickbay. If you go to the sickbay, you make things worse for yourself… They told us: 'If you go to the sickbay, we'll kill you.' They threatened us." Aleksei K. summed the situation up: "Honestly, if you weren't too ill, it was too much of a problem to go to the sickbay. Nothing good was to be expected–they immediately started picking on you …"
Several conscripts told Human Rights Watch about the repercussions they faced after hospitalization. Igor K.'s story is illustrative:
K., from Novgorod province, began serving on the Liabiazhe military base outside St. Petersburg in late 2000. He told Human Rights Watch that a poor diet during the first six months of training exacerbated stomach problems he had had prior to his military service. After moving to a regular regiment, K. sought medical care and was hospitalized with an acute stomach condition. K. was put on a special diet and received medication for one month, which relieved his stomach problem but did not fully cure it. K. told Human Rights Watch: "After my release from the hospital, the attitude toward me in the regiment had changed. Other conscripts and sergeants began to humiliate and mistreat me."
Two months later, K. was hospitalized again with another bout of stomach problems. He spent another month in the hospital. When released, the attitude toward him had worsened. "A number of soldiers began to beat me and pick fights with me." In October 2001, K. was beaten so badly that he was hospitalized with an internal injury that required surgical intervention. Upon return to the unit, the harassment and ill-treatment started again. After yet another hospitalization and renewed beatings, K. fled his unit.
Superiors Refusing Access to Medical Care
Several conscripts told Human Rights Watch that they sought permission from their superiors to report to the sickbay but were denied. For example, Vladimir O., who served in an Interior Ministry forces unit in Kirov Province, said that when he developed a cough, he tried to see a doctor. His superior told him that he could not go to the sickbay and had to continue to perform guard duty. O. told Human Rights Watch he has a long history of bronchial problems. After this incident, he fled his unit and returned home where he received treatment and was cured. Another conscript, Ilia B., asked permission from his sergeant to report to the sickbay when he experienced chest pains and generally felt sickbut was denied. B. told Human Rights Watch he went to the sickbay anyway and was yelled at when the sergeant found out.
Apparent Inadequacy of Sick Bays
Conscripts overwhelmingly told Human Rights Watch that seeking medical care at on-base sick bays is pointless, in particular for minor health problems. Most said that they drew this conclusion after they or their peers sought care at sickbays but received none. For example, Vladimir Z. said he went to the sickbay because a stinging pain in his chest kept him from sleeping: "[The doctor] looked at me and said: 'You're all right, you're healthy. Go back to duty.'" Another conscript said he tried to see a doctor after being beaten in the kidney area. According to the conscript, the doctor came outside at the regular visiting hour and apparently:"Who's dying? Nobody. Ok." He then left without so much as examining the conscript. Conscripts who at the time realized that they required professional medical attention told us they did not go to the sickbay because it was "pointless." One conscript said that in his unit's sickbay there was only a nurse "who loved to drink and only applies disinfectant." Another said that "seeking medical care was useless because they only gave [nondescript] tablets and nothing else." Reflecting remarks by a number of other conscripts interviewed for this report, Pavel P. said: "We cured ourselves. I wrote to my mother because they never had medication in the sickbay…"
Physical Abuse and Harassment at Sickbays and Hospitals
Violent hazing, an endemic phenomenon on many military bases throughout Russia, often does not stop at the doors of sickbays and military hospitals, and therefore interferes with conscripts' right to adequate medical care. Human Rights Watch interviewed several dozen conscripts who said senior soldiers physically ill-treated them and forced them to perform a variety of chores for them in sickbays and military hospitals. These abuses took place primarily in the evenings and at night, after medical personnel and officers had departed senior conscripts in charge. In one case we documented, the victim committed suicide after a night of particularly cruel treatment.
International law prohibits governments from treating persons in an inhuman or degrading manner under any circumstances. This prohibition also applies to conscripts, although considering the special mission of the armed forces the threshold for inhuman and degrading treatment may be higher for conscript soldiers than for other groups in custodial situations, such as prisoners and persons committed to mental institutions. International law does not prohibit the performance of chores and other work by conscripts while they are in hospitals. Yet, Human Rights Watch believes that, in determining whether and what work can be assigned to hospitalized conscripts, the primary concern should be the health condition of the patient. Assignment of work that interferes with their recovery would violate the right to the highest attainable level of health.
Abuse at Sickbays
Most conscripts who had spent time in sickbays told Human Rights Watch that harassment and hazing continues there. Human Rights Watch documented, among others, the following cases:
·Aleksei Dryganov, who served in a unit outside St. Petersburg in early 2002, was admitted to the sickbay when his temperature spiked to 39 or 40 degrees Celsius (102.2 to 104 Fahrenheit), after a senior conscript beat him over the head with a stool. He recounted that two senior soldiers accompanied him to the sickbay and, after getting drunk in the evening, "forced me to serve them: take away plates, prepare soups for them. Once, they forced me to clean up even though I was on an I.V." Commenting on another stay in the sickbay, Dryganov said: "I was there for three days. They didn't letme sleep until 4:00 a.m. All the time I had to prepare tea, prepare soup, and clean their rooms." After three days, Dryganov fled his military base.
·Vitalii K., who served in unit 45935 St. Petersburg in 2002, landed in the sickbay with a high fever on his third day of military service. He said medical personnel there took his temperature but did not give him any medication to bring down the fever. Instead, he said, he was asked to mop the floor. When he said that he could not do it anymore, he was told that if he stopped he would regret it. He continued to mop. The next day, he was put to work again, this time carrying bricks from the sickbay to a location outside the military base. That same day, soldiers at the entrance of the base told K.'s sister, who did not know her brother was in the sickbay and had come to see him be sworn in, that her brother was too ill for her to see him. Minutes later, K. and another patient from the sickbay walked out of the base carrying a load of bricks.
·Alexander O. told Human Rights Watch he landed in the sickbay of his base near Volgograd after senior soldiers severely beat him. Yet, even there, he was not safe from his tormentors: "In the evening, the sergeants from my regiment came to the sickbay to harass and abuse sick soldiers. They forced us to steal things from the sickbay for them. This happened at the end of the day when the officers and medical doctors had gone home." It was made clear to O. and other sick soldiers that refusal to comply would lead to further beatings.
Physical and Other Abuse in Military Hospitals
Harassment and hazing also occurs in some military hospitals. While most young men interviewed for this report said they were treated well in military hospitals, about a dozen conscripts said they faced harassment, humiliation and sometimes ill-treatment in them. Conscripts particularly singled out military hospital 442 in St. Petersburg, although we also received allegations of abusive treatment in military hospitals in Novocherkassk and Kislovodsk. Several interviewees stressed that the abuses occurred primarily in the evening and night, after senior medical personnel left the hospital.
Military Hospital 442
Five conscripts described various types of inappropriate treatment of patients in military hospital 442. Several told Human Rights Watch that senior soldiers there forced them to work or do chores for them during the day and got drunk and became abusive at night. Dmitrii Kosov, who was in the hospital in early 2001 for several weeks, said:
They…chased us out into the freezing cold in the morning to shovel snow, in our pajamas, without even winter boots [in Russian: valenki], in slippers. We had kitchen duty, washed dishes, carried heavy milk cans. It was pointless to explain that your whole body hurts. They don't care: "You're not in a resort, go, work." Hospitalized senior soldiers would have drinking parties at night. They sent the young ones to get vodka… Sometimes people were beaten. It was all rather unpleasant.
In a separate interview with Human Rights Watch, Roman Davydov, who was in the hospital at the same time as Kosov, confirmed Kosov's testimony.
Vitalii K., another conscript, told Human Rights Watch that the dedy in the military hospital frequently got drunk at night and became abusive. They forced him and other junior conscripts to leave the military base to get alcoholic drinks for them. They also regularly put them all in a row in the night and forced them to do physical exercises. K. noted that these abuses always took place in the evening, when the doctors and other officers had left for the day.
Human Rights Watch received similar reports from other conscripts who fled the same hospital. The mother of one said her son, hospitalized for an ear infection,told her that "it is impossible here, worse than in the regiment." She said second year soldiers got drunk at night and became abusive, forcing them with "shoves and kicks" to run errands for them. Her son eventually ran away from the hospital. So did Anatolii T., who was getting treatment for heart problems and festering foot sores. He told Human Rights Watch that the senior soldiers in his ward found out that he had previously gone absent without leave and started harassing him:
The guy with whom I arrived told them I had ran away. It immediately started. They don't like people who run. They forced me to do all sorts of things. They didn't beat me but forced me to work. Cleaning the corridor, steps… There were also two guys who'd been in Chechnya. They immediately said: "You have to give us 500 rubles otherwise your life here is going to be very unpleasant."
One interviewee observed that conscripts who were sent directly from military bases to the hospital, rather than through a soldiers' rights group, were particularly vulnerable to abuse. He said:
I was fine in the hospital… I was lucky compared to some others. There were some slaves, victims. Those who were sent there from the units, not from the Soldiers' Mothers. There was this guy Lyosha there, he loved humiliating them, he was abnormal… He beat them on the spinal cord after they had a spinal tap.
Other Military Hospitals
Human Rights Watch also received reports of harassment and abuse in several other military hospitals, although it was unclear whether the abuses there are as widespread as in military hospital 442. We documented, among others, the following cases:
·In February 2001, nineteen-year-old Aleksei Andriushenko landed in a military hospital at Kamenka military base in Leningrad Province with pneumonia-the second time in three months of military service. A few days later, Andriushenko was dead. A military court later concluded that Andriushenko had committed suicide after other conscripts severely humiliated him on several consecutive nights. The court found that on several occasions, conscripts had forced Andriushenko and another conscript to get out of bed late in the evening and sing songs for them. The senior conscripts regularly punched their victims in the chest when they forgot the words. In the night from February 16 to 17, 2001, the humiliation became much more severe. According to the court,
…after that [forcing them to sing songs], Poluianov forced Andriushenko to bare his torso and imitate an athlete. Then Poluianov and Karmashov began to play cards. The loser repeatedly forced the ill servicemen, including Andriushenko, to hit each other on the forehead. The person being hit had to fold his hands over the forehead. Andriushenko received no fewer than five such blows.
At 2:00 a.m. that night in the same ward, junior sergeant Magomedov ..forced… Vasilkov and Andriushenko to lie down on the floor and imitate sexual intercourse, making all relevant noises and kissing one another, for a half hour.
That same night and in the same place, between 3:00 a.m. and 6:00 a.m., Poluianov and Kormashov…repeatedly hit and kicked each [of them] in different places of their bodies, causing bruises and abrasions. After that, they forced them to do pushups until they collapsed: do knee bends; stand with knees and elbows on the legs of a stool that had been turned up side down; hang above a bed, with the hands and legs placed on the head and foot boards of the bed; stand with the legs half-bent, holding a stool in front of them with stretched out arms. Only after that…they allowed Andriushenko and Vasilkov to rest, but forced them to lie together in one bed.
The court found the perpetrators guilty of humiliation of their fellow servicemen causing serious consequences, and sentenced them to prison terms ranging from a year and a half and four years.
·Stanislav U. and Evgenii G. spent time in military hospitals in Novocherkassk and Kislovodsk respectively. Both said violent hazing continued in the hospitals but commented that it was "not as bad as in the military unit." U. said harassment and beatings took place at night only, when doctors and officers had gone home and only the nurses remained. He said the nurses were unable to exercise any control over the senior soldiers.
Jane Buchanan, researcher in the Europe and Central Asia division of Human Rights Watch, Diederik Lohman, senior researcher of the Europe and Central Asia Division of Human Rights Watch, Anna Neistat and Alexander Petrov, respectively director and deputy director of the Moscow office of Human Rights Watch conducted research for this report in the cities of Cheliabinsk, Moscow, Novokuznetsk, Novosibirsk, St. Petersburg, and Volgograd. Diederik Lohman is the author of the report, which was edited by Rachel Denber, acting executive director of the Europe and Central Asia Division of Human Rights Watch, Veronika Leila Szente Goldston, advocacy director of the Europe and Central Asia Division of Human Rights Watch, James Ross, senior legal advisor at Human Rights Watch, and Iain Levine, program director at Human Rights Watch. Invaluable assistance was provided by Anna Sinelnikova, Emily Letts, and Ludmila Belova, all associates at the Europe and Central Asia division of Human Rights Watch; Joanne Csete, director of the HIV/AIDS program; and Nikolai Mitrokhin, Yana Chervona, and Angelika Bykadorova, all interns with the Europe and Central Asia division of Human Rights Watch.
This report would not have been possible without the many young men who shared their, often traumatic, experiences in Russia's armed forces with us. Thank you for your courage to be so frank with us. We also extend our warmest gratitude to the phenomenal staff of the Association of Soldiers' Mothers of Cheliabinsk Province, the Soldiers' Mothers Committee in Novosibirsk, the Committee for the Protection of the Rights of Military Servicemen in Novokuznetsk, the Moscow-based Union of Committees of Soldiers' Mothers of Russia, the Soldiers' Mothers of St. Petersburg, and the Right of the Mother in Volgograd and Uriupinsk, who generously shared their unique knowledge of Russia's armed forces; helped us organize dozens of interviews with conscripts, officials, and others; and gave us access to their, often extensive, archives.
 In the course of its research, Human Rights Watch received anecdotal evidence indicating that the quality of health care provided in on-base sickbays and military hospitals is generally poor. However, due to our lack of access to sickbays, military hospitals, military medical staff and medical files, we are not able to draw general conclusions on the quality of the health services provided in these institutions.
 The conscripts interviewed for this report, many of whom served on more than one base, served on bases in, among others: the Republic of North Ossetia, the Republic of Dagestan, the Republic of Komi, Amur Province, Astrakhan Province, Cheliabinsk Province, Chita Province, Kemerovo Province, Leningrad Province, Moscow Province, Murmansk Province, Novosibirsk Province, Orenburg Province, Pskov Province, Rostov Province, Samara Province, Sverdlovsk Province, Tiumen Province, Volgograd Province, Khabarovsk Region, Krasnodar Region, Krasnoyarsk Region, Primorsk Region, Stavropol Region, Moscow, St. Petersburg, and others.
 Conscript and professional soldiers make up rank-and-file soldiers and sergeants in the Russian armed forces; in peacetime, conscript soldiers far outnumber professional (contract) soldiers. Higher ranks are made up of professional soldiers.
 Article 2 of the Law on the Conscription Obligation and Military Service of March 28, 1998 contains a full list of all branches where conscripts may serve:
Military service is a special kind of federal state service, which citizens perform in the Armed Forces of the Russian Federation, as well as in the border troops of the Russian Federation, the interior troops of the Ministry of Interior of the Russian Federation, the railway troops of the Russian Federation, troops of the federal agency for government communication and information under the president of the Russian Federation, civil defense troops (hereinafter–other troops), engineering-technical and road construction military formations of federal executive organs (hereinafter–military formations), the foreign intelligence service of the Russian Federation, the organs of the Federal Security Service of the Russian Federation, the organs of the Federal Border Service of the Russian Federation, the federal organs for government communication and information, the federal organs of state security (in Russian: gosudarstvennoi okhrany), the federal organ for ensuring mobilization preparedness of the organs of state power of the Russian Federation (hereinafter–the organs) and in special formations created for time of war.
 Throughout Russia it is overwhelmingly the mothers of recruitment-age males who actively seek to prevent their conscription.
 According to a report of the Center for Strategic and International Studies, 60 percent of Russians support a transition to a professional army (See: Theodore P. Gerber and Sarah E. Mendelson, "Strong Public Support for Military Reform in Russia," PONARS Policy Memo 288, May 2003 at http://www.csis.org/ruseura/ponars/policymemos/pm_index.htm (accessed September 25, 2003)).
 A government plan adopted in July 2003 envisages decreasing the number of young men drafted each year by about 50 percent and cutting the length of mandatory military service from two years to one year by 2008.
 Between 1990-99, life expectancy for men and women was well below the average in Western European countries or the United States. In Russia, a man could expect to live to sixty-one (as compared to seventy-four in Germany and seventy-three in the United States) and a woman to seventy-three (as compared to eighty in Germany and the United States).
 The report was cited in: "33% of Kids Healthy," Associated Press, March 11, 2003.
 The report was cited in: Steven Eke, "Survey: 60% of Russian children unhealthy," British Broadcasting Corporation, December 16, 2002.
 "Top general laments quality of conscripts," Associated Press, April 9, 2003
 Human Rights Watch, "Conscription through Detention in Russia's Armed Forces," A Human Rights Watch Short Report, Vol. 14, No. 8 (D), November 2002.
 A Ministry of Defense official told a press conference in April 2002 that in 2001, doctors on draft boards found no less than 54 percent of the young men tested unfit for military service (see: www.utro.ru/articles/2002040216595170289.shtml (accessed on September 3, 2002). Another official said that for the 400,000 young men drafted some 600,000 young men are declared unfit each year (see:"More than half of Russians unfit to serve in army: general," Agence France-Presse, November 29, 2001). Russian law contains a long list of medical grounds that exempt an individual from performing military service temporarily or permanently. The law on military service establishes five categories of fitness of conscript candidates: A – fully fit for military service; B – fit for military service with minor restrictions; C – partially fit for military service; D – temporarily unfit for military service; and E – unfit for military service. Conscript candidates who are classified in category A and B are considered fit for military service, although category B excludes service in certain types of units. People classified in category C do not have to serve in peacetime but may be drafted in time of war. The fitness of conscript candidates in category D is re-examined within a year (Article 24 (1a) of the law on military service). Those placed in category E cannot be drafted even in time of war. An appendix to the Regulation on the Military Medical Examination (confirmed by Decision No. 390 of the government of the Russian Federation of April 20, 1995) contains a list of medical conditions and the relevant categories. The appendix can be found at: http://www.hro.org/docs/rlex/milexp/index.htm (accessed on August 23, 2002).
 Hazing in the armed forces is popularly known in Russia as "dedovshina." The term "ded," a short form for "dedushka," or grandfather, refers to senior conscripts.
 See the International Covenant for Economic, Social and Cultural Rights, G.A. res. 2200A (XXI), 21 U.N. GAOR Supp. (No. 16) at 49, U.N. Doc. A/6316 (1966), 993 U.N.T.S. 3, entered into force Jan. 3, 1976.articles 11 &12. Russia, then the Soviet Union, ratified the covenant in 1973.
General Comment 12. The Right to Adequate Food, Committee on Economic, Social and Cultural Rights, 20th sess., 1999, para. 15. See: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.1999.5,+CESCR+General+comment+12.En?OpenDocument (accessed on October 24, 2003). The Committee on Economic, Social and Cultural Rights provides authoritative interpretations of the International Covenant for Economic, Social and Cultural Rights though the periodic issuance of General Comments.
 Conscripts depend almost entirely on the government to provide them with food. Conscripts are supposed to receive a small stipend for cigarettes each month. However, most conscripts Human Rights Watch interviewed said they never received the money or said senior soldiers immediately confiscated it. Many soldiers also told Human Rights Watch that senior soldiers also confiscated any food they received through parcels and from visiting relatives.
 See International Covenant on Civil and Political Rights (ICCPR) , G.A. res. 2200A (XXI), 21 U.N. GAOR Supp. (No. 16) at 52, U.N. Doc. A/6316 (1966), 999 U.N.T.S. 171, entered into force Mar. 23, 1976, article 10 ("All persons deprived of their liberty shall be treated with humanity and respect for the inherent dignity of the human person"). General Comment 21 of the Human Rights Committee states that article 10 "applies to any one deprived of liberty under the laws and authority of the State who is held in prisons, hospitals - particularly psychiatric hospitals – detention camps or correctional institutions or elsewhere. States parties should ensure that the principle stipulated therein is observed in all institutions and establishments within their jurisdiction where persons are being held. Human Rights Committee, General Comment 21, Article 10 (Forty-fourth session, 1992), para. 2,
The rights of prisoners are set out in various international instruments, including the U.N. Standard Minimum Rules for the Treatment of Prisoners, approved by the Economic and Social Council by its resolutions 663 C (XXIV) of July 31, 1957 and 2076 (LXII) of May 13, 1977, and the European Prison Rules, adopted by the Council of Europe's Committee of Ministers in its recommendation No. R(87)3 of February 12, 1987. The rights of people in mental institutions are delineated in the UN Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care, adopted by the General Assembly Resolution number 46/119 of February 18, 1992, and by the Council of Europe's Committee of Minister's Recommendation No. R(83)2 "Concerning the Legal Protection of Persons Suffering from Mental Disorder Placed as Involuntary Patients."
 The Parliamentary Assembly of the Council of Europe (PACE) has recognized the need for guidelines on the application of the European Convention on Human Rights to the special circumstances of conscripts in military service. In 1998, PACE recommended that the Committee of Ministers formulate such guidelines. See resolution 1166(1998), Parliamentary Assembly of the Council of Europe, adopted September 22, 1998.
 In Engel and others v. the Netherlands case (Judgment of June 8, 1976), the European Court of Human Rights laid down a general rule on the applicability of the European Convention on Human Rights to military servicemen. It held that:
The Convention applies in principle to members of the armed forces and not only to civilians. It specifies in Articles 1 and 14 (art. 1, art. 14) that "everyone within (the) jurisdiction" of the Contracting States is to enjoy "without discrimination" the rights and freedoms set out in Section I. Article 4 para. 3 (b) (art. 4-3-b), which exempts military service from the prohibition against forced or compulsory labour, further confirms that as a general rule the guarantees of the Convention extend to servicemen. The same is true of Article 11 para. 2 (art. 11-2) in fine, which permits the States to introduce special restrictions on the exercise of the freedoms of assembly and association by members of the armed forces.
Nevertheless, when interpreting and applying the rules of the Convention in the present case, the Court must bear in mind the particular characteristics of military life and its effects on the situation of individual members of the armed forces (para. 54).
Applying this general rule to the concrete circumstances of the Engel case, in which the applicants alleged that the measures of military discipline they were subjected to violated their right to liberty, the Court held that "the bounds that Article 5 (art. 5) requires the State not to exceed are not identical for servicemen and civilians. A disciplinary penalty or measure which on analysis would unquestionably be deemed a deprivation of liberty were it to be applied to a civilian may not possess this character when imposed upon a serviceman. Nevertheless, such penalty or measure does not escape the terms of Article 5 (art. 5) when it takes the form of restrictions that clearly deviate from the normal conditions of life within the armed forces of the Contracting State" (para. 59).
The Court has also ruled that a state's right to impose restrictions on the rights to respect for the private life and freedom of expression of servicemen due to the particular characteristics of military life is not unlimited. In the Lustig-Prean case (Judgment of September 27, 1999), the applicants complained that the authorities had investigated their sexual orientation and dismissed them from the armed forces on account of their homosexuality. They alleged that both the investigation and the dismissal violated their right to respect for their private lives. The Court held that "it is open to the State to impose restrictions on an individual's right to respect for his private life where there is a real threat to the armed forces' operational effectiveness, as the proper functioning of an army is hardly imaginable without legal rules designed to prevent service personnel from undermining it. However, the national authorities cannot rely on such rules to frustrate the exercise by individual members of the armed forces of their right to respect for their private lives, which right applies to service personnel as it does to others within the jurisdiction of the State" (para. 82)
In the Vereinigung Demokratischer Soldaten Österreichs und Gubi v Austria case (Judgment of December 19, 1994), the applicants alleged that the decision by the Austrian Ministry of Defense not to distribute a magazine about the armed forces to servicemen while distributing all other such magazines constituted a violation of freedom of expression. The government argued that the magazine presented a "threat to discipline and to the effectiveness of the army" and this justified its decision not to distribute it. The Court held that "none of the issues of der Igel [name of the publication] submitted in evidence recommend disobedience or violence, or even question the usefulness of the army. Admittedly, most of the issues set out complaints, put forward proposals for reforms or encourage readers to institute legal complaints or appeals proceedings. However, despite their often polemical tenor, it does not appear that they overstepped the bounds of what is permissible in the context of a mere discussion of ideas, which must be tolerated in the army of a democratic State just as it must be in the society that such an army serves" (para. 38).
 Article 329 of the Military Code of Conduct. See: Obshchevoinskie ustavy vooruzhennykh sil Rossiiskoi Federatsii (Codes of Conduct for the armed forces of the Russian Federation), (Rostov-na-Donu, Feniks, 2002).
 Human Rights Watch interview with Vasilii S., October 4, 2002, Uriupinsk, Volgograd Province. S. served in unit 2062 in the city of Kaspiisk, Republic of Dagestan. Vasilii S. is a pseudonym.
 In fact, Vasilii S. was lucky; after a month he was transferred to a different military base, where he was fed slightly better.
 Human Rights Watch interview with Sergei Podolskii, November 28, 2001, St. Petersburg
 Human Rights Watch interview,July 31, 2003, undisclosed location. The former military procurator requested to remain anonymous.
 Letter from V. Isakov, deputy minister of defense, to A. Neistat, director of the Moscow office of Human Rights Watch, dated June 25, 2003, No. 163/VNK/292.
 Human Rights Watch interview with Denis Ivanov, April 17, 2002, St. Petersburg. Ivanov served in units 3526 (Lebiazhe, Leningrad Province) and 6717 (St. Petersburg) of the Ministry of Interior's troops.
 Supplement No. 1 to the Regulation on Ensuring Rations to the Armed Forces of the Russian Federation in Peacetime, signed by then- Minister of Defense Igor Sergeev in Decree 400 of July 22, 2000. The ration lists vary for the different types of troops and different kinds of situation, including for special rations for air and sea borne troops, for troops on submarines, as well as for hospitalized military servicemen. In this report, we compare conscripts' actual diets to the general ration (in Russian: obshchevoiskovoi paek).
 See, e.g., United Nations Food and Agricultural Organization/World Health Organization, Handbook on Human Nutrient Requirements (Rome: United Nations, 2001), and National Research Council, Recommended Dietary Allowances: 10th Edition (Report of the Subcommittee on the Tenth Edition of the Recommended Dietary Allowances, Food and Nutrition Board, Commission on Life Sciences, National Research Council), Washington, D.C. United States Department of Agriculture.If, however, soldiers receive only cooked cabbage, bread and grain porridges for days at a time with no supplements, fresh fruits or vegetables, eggs or meat, as indicated by some of the men interviewed by Human Rights Watch, their diets would be likely to be deficient in protein, vitamins and minerals and possibly energy.
 See article 227 of the Code of Military Conduct. See also: V.N. Dubrovin and Yu.I. Migachev, "Materialnoe obespechenie I sotsialnaia zashchita voennosluzhashchikh, grazhdan, uvolennykh s voennoi sluzhby, chlenov ikh semei" (Material Provision and Social Protection of Servicemen, Retired Servicemen, and their Families), Moscow, 2000, page 65.
 See V.N. Dubrovin and Yu.I. Migachev, page 65.
 The Code states in article 240:
Before the food is distributed, the medical doctor (or his assistant), together with the regiment's duty officer, are required to check the quality of the food, weigh the individual portions, and check the sanitary conditions of the canteen, the plates and dishes and kitchen ware. After a conclusion by the doctor (or his assistant), the commander of the regiment or, at his instruction, one of his deputies) tries the food.
The results of the check are recorded into the book of record on control of the quality of prepared food.
General Comment 12. The Right to Adequate Food, Committee on Economic, Social and Cultural Rights, para. 9.
 Human Rights Watch interview with Anton S., July 31, 2003, St. Petersburg. S. served in unit 6716 (Lembolovo, Leningrad Province) of the Ministry of Interior's troops. Anton S. is a pseudonym.
 For example, internal regulations state: "In order to ensure variation of the diet it is permitted to replace certain food items with others in accordance with relevant rules…" (V.N. Dubrovin and Yu.I. Migachev, page 65).
 Human Rights Watch interview with Dmitrii Kosov, April 11, 2002, St. Petersburg. Kosov served in the Ministry of Defense's unit 12744 in Osinovoe Roshche, Leningrad Province.
 Human Rights Watch interview with Aleksei K., October 4, 2002, Volgograd. K. served in units 37115 (Krasnodar Region) and 61918 (Totskoe, Orenburg Province). Aleksei K. is a pseudonym.
 Serving low quality food prepared in unsanitary conditions may violate the requirement that food provided be "free from adverse substances" (General Comment 12. The Right to Adequate Food, Economic and Social Council, para. 10).
 A number of conscripts also complained that they received porridge made of the chaff of rice (in Russian: сечка) and ground chaff of grains (in Russian: droblenka). While chaff may not please the taste buds, it does contain numerous nutrients.
 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province. Kaiankin served in the Ministry of Defense's unit 22336 in Volgograd Province.
 Human Rights Watch interview with Roman Davydov, April 13, 2002, St. Petersburg. Davydov served in two Ministry of Defense units in the Russian Far East, among them unit 52594.
 Human Rights Watch interview with Egor Z., October 5, 2002, Volgograd. Z. served in unit 6688 in the Northern Caucasus. Egor Z. is a pseudonym.
 Human Rights Watch interview with Alexander Sukhanov, April 17, 2002, St. Petersburg. Sukhanov served in the Ministry of Defense's construction unit 32087 in St. Petersburg.
 Human Rights Watch interview with Vasilii S., October 4, 2002, Uriupinsk, Volgograd Province. Several other conscripts also said they ate mashed potato made out of potato mix.
 Human Rights Watch interview with Ilia B., October 29, 2002, Novokuznetsk. B. served in a Ministry of Defense unit eastern Siberia. Ilia B. is a pseudonym.
 Human Rights Watch interview with Vasilii B. , October 17, 2002, Novosibirsk. B. served in a training unit in Pereslavl-Zalesskii, Yaroslavl Province, and in a rocket troops unit in Uzhur, Krasnoyarsk Region.
 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province.
 Human Rights Watch interview with Vladimir Z., November 4, 2002, Cheliabinsk. Z. served in unit 69771 in Sverdlovsk Province and in an unknown unit in Shadrinsk, Cheliabinsk Province. Vladimir Z. is a pseudonym.
 During the Cold War, the Soviet armed forces maintained a food supply for the eventuality of war. These supplies are popularly known as "strategic reserves."
 The effects of long-term freezing of food items are not well known. Most of nutrition experts seem to agree that freezing up to one year should not affect most foods if they are properly wrapped and protected from the more deteriorating effect of air. In the case of fruits and vegetables, there seems to be a consensus that the kind of freezing now done in Western industrialized countries actually preserves nutrients very well compared to other means of storage. See, e.g., the main dietary guidance document of the U.S. government, which notes that most frozen foods are rich in nutrient content: U.S. Department of Agriculture and U.S. Department of Health and Human Services, "Nutrition and Your Health: Dietary Guidelines for Americans--Fifth Edition," (Washington, DC: Government Printing Office, 2000), online at http://www.health.gov/dietaryguidelines/dga2000/document/frontcover.htm (retrieved October 10, 2003).
 Human Rights Watch interview with Roman Davydov, April 13, 2002, St. Petersburg.
 Human Rights Watch interview with Sergei Podolskii, a retired colonel and head of the nongovernmental organization For Military Reform, November 28, 2001.
 Article 240 of the Military Code of Conduct, see also footnote 25.
 Conscripts described two different eating arrangements: In some cases, pots and dishes were put on tables and conscripts served themselves, in others conscripts stood in line to receive a plate in a cafeteria style arrangement.
 Human Rights Watch interview with Vladimir P., September 30, 2002, Volgograd. P. served in unit 47084 in Vladikavkaz. Vladimir Z. is a pseudonym.
 Human Rights Watch interview with Anatolii Z. , November 7, 2002, Cheliabinsk. Z. served in units 54076 in Novoaltaisk and 25626 in Cheliabinsk of the railroad troops. Anatolii Z. is a pseudonym.
 Human Rights Watch interview with Ilia B., October 29, 2002, Novokuznetsk.
 Human Rights Watch interview with Denis Ivanov, April 17, 2002, St. Petersburg.
 Human Rights Watch interview with Aleksei K., October 4, 2002, Uriupinsk, Volgograd Province.
 Human Rights Watch interview with Vasilii B. , October 17, 2002, Novosibirsk.
 Human Rights Watch interview with Aleksei Dryganov, April 10, 2002, St. Petersburg.
 Human Rights Watch interview with Andrei D., November 3, 2002, Cheliabinsk. D. served in unknown units in Chebarkul (Cheliabinsk Province) and Verkhnaia Pyshma (Sverdlovsk Province). Andrei D. is a pseudonym.
 Human Rights Watch interview with Vladimir Z., November 4, 2002, Cheliabinsk.
 Human Rights Watch interview with Aleksei Koshelev, April 12, 2002, St. Petersburg. Koshelev served in units 6716 (Lembolovo, Leningrad Province) and 6718 of the Ministry of Interior's troops.
 Human Rights Watch interview with Anton A., April 18, 2002, St. Petersburg. A. served in unit 51046 of the railroad troops in Mga, Leningrad Province. Anton A. is a pseudonym.
 Human Rights Watch interview with Stepan M., April 18, 2002, St. Petersburg. M. served in unit 51046 of the railroad troops in Mga, Leningrad Province. Stepan M. is a pseudonym.
 Letter from V. Isakov, deputy minister of defense, to A. Neistat, director of the Moscow office of Human Rights Watch, dated June 25, 2003, No. 163/VNK/292.
 Article 326 of the Military Code of Conduct.
 Article 329 of the Military Code of Conduct state that military commanders must strive to "enhance the conditions of service and life of military servicemen" by requiring "strict observance of the sanitary norms and demands of the military regulations for housing military servicemen, organizing their nutrition, provision of water..." They also should ensure "timely and full provision for every military serviceman the prescribed norm of nutrition."
 Soldiers themselves face a similar duty: "maintaining and strengthening the health…of military servicemen is an important and integral part of their preparation for fulfilling their soldier's duty" (Article 326 of the Military Code of Conduct). Article 334 further states that: "Every military serviceman has to take care of maintaining his health, may not hide illnesses and must strictly observe rules for personal and community hygiene…" These provisions reflect the position of theCommittee on Economic Social and Cultural Rights, which has explained the right to health as "an inclusive right extending not only to timely and appropriate health care but also to the underlying determinants of health, such as access to safe and potable water and adequate sanitation, an adequate supply of safe food, nutrition and housing…" (General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights, 22nd sess., 2000, para. 11, see: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4,+CESCR+General+comment+14.En?OpenDocument (accessed October 24, 2003).
 One conscript said fifty conscripts had ten minutes to bathe in a bathroom with only four showerheads. Article 335 of the Military Code of Conduct stipulates that conscripts must wash their full bodies once a week in the bathhouse. It also requires them "to wash their hands and face in the morning and brush their teeth; wash their hands before meals; wash their hands and face, brush their teeth, and wash their legs before sleep; shave regularly, and cut hair and nails in a timely fashion; and to change underwear, bed sheets, foot bindings, and socks once per week on bath day.
 Human Rights Watch interview with Vladimir Z., November 4, 2002, Cheliabinsk. Human Rights Watch's research into violent hazing found that abusive soldiers frequently use bathrooms or other closed off locations to harass and ill-treat their junior colleagues, in an apparent attempt to avoid being seen.
 Another conscript said he and his peers were not given a change of underwear for a full month, while the Military Code of Conduct clearly states that underwear has to be changed once a week.
 Human Rights Watch interview with Nina S., mother of Egor T., April 13, 2002, St. Petersburg. T. served in units 6716 (Lembolovo, Leningrad Province) and 6717 (St. Petersburg) of the Ministry of Interior's troops. Nina S. and Egor T. are pseudonyms.
 Human Rights Watch interview with Olga and Nikolai Grushko, parents of Evgenii Grushko, April 18, 2002, St. Petersburg.
 Article 349 of the Military Code of Conduct.
 Articles 341 and 342 of the Military Code of Conduct.
 The Committee on Economic, Social and Cultural Rights considers access to health services one of the essential elements of the right to health. This includes "equal and timely access to basic preventive, curative, rehabilitative health services and health education; regular screening programmes; appropriate treatment of prevalent diseases, illnesses, injuries and disabilities…" (General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights, para. 17).
 Human Rights Watch interview with Petr K., July 31, 2003, St. Petersburg. K. served in the Ministry of Defense's unit 67616 in Kamenka, Leningrad Province. Petr K. is a pseudonym.
 Human Rights Watch interview with Anton S., July 31, 2003, St. Petersburg.
 In November 2002, Human Rights Watch contacted the Central Military Medical Commission of the Ministry of Defense to seek a meeting to discuss some of the findings of our research. After initial telephone contact, on November 21, 2002, we sent a letter to General-Major Valerii Kulikov, head of the Central Military Medical Commission, in which we set out the purpose of our research and outlined a series of issues for discussion. However, our request for a meeting was denied.
 States have a positive obligation to provide conscripts with adequate health care as they are "unable, for reasons beyond their control, to realize the right themselves by means at their disposal." General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights. para. 37. Russia has formulated rules for access to health care for conscripts that are consistent with that obligation. Russia is bound, by the requirement of progressive realization, to ensure proper implementation of these rules. Russia's failure to do so constitutes an act of omission, as defined in para. 49 of General Comment 14.
 Human Rights Watch interview with Maksim Komlev, April 8, 2002, St. Petersburg.
 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad province.
 Human Rights Watch interview with Anton A., April 18, 2002, St. Petersburg.
 Human Rights Watch interview with Aleksei K., October 4, 2002, Uriupinsk, Volgograd Province.
 Human Rights Watch interview with Igor K., April 13, 2002, St. Petersburg. K. served in unit 3526 of the Ministry of Interior's troops in Lebiazhe, Leningrad Province. Igor K. is a pseudonym.
 Sickbays are areas on military bases where a small medical team provides basic medical care to soldiers who have been injured or have fallen ill. Soldiers who require more than basic care are sent to military hospitals.
 Human Rights Watch interview with Dmitrii Kosov, April 11, 2002, St. Petersburg.
 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province.
 Human Rights Watch interview with Igor K., April 13, 2002, St. Petersburg.
 Human Rights Watch interview with Pavel P., April 19, 2002, St. Petersburg. P. served in unit 01375 of the railroad troops in Mga, Leningrad Province. Pavel P. is a pseudonym.
 See, e.g. ICCPR, article 7 ("No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment"). Article 7 is not subject to derogation (article 4).
 For example, initiation rites that border on degrading treatment may be acceptable in the armed forces as a means of building the kind of group solidarity that is the backbone of any army. They may not be acceptable in other situations. However, such initiation rites should have a legitimate goal, may not be arbitrary, and may not unjustifiably threaten the health of the conscripts.
 Human Rights Watch interview with Aleksei Dryganov, April 10, 2002, St. Petersburg.
 Human Rights Watch interview with Vitalii K., October 2, 2002, Volgograd and a letter from K.'s mother to the soldiers' rights organization Right of the Mother in Volgograd, dated July 23, 2002. K. served in the Ministry of Defense's unit 45935 in St. Petersburg. Vitalii K. is a pseudonym.
 Human Rights Watch interview with Alexander O., October 2, 2002, Volgograd. O. served in unit 42091 in Krasnodar Region. Alexander O. is a pseudonym.
 Human Rights Watch interview with Dmitrii Kosov, April 11, 2002, St. Petersburg.
 Human Rights Watch interview with Roman Davydov, April 13, 2002, St. Petersburg.
 Human Rights Watch interview with Vitalii K., October 2, 2002, Volgograd.
 Human Rights Watch interview with Galina K., mother of Alexander K., April 18, 2002, St. Petersburg. K. served in military construction unit 31502. Galina K. and Alexander K. are pseudonyms.
 Human Rights Watch interview with Anatolii T., April 13, 2002, St. Petersburg. T. served in unit 6716 of the Ministry of Interior's troops in Lembolovo, Leningrad Province. Anatolii T. is a pseudonym.
 Soldiers' rights groups often arrange for conscripts who flee their units to be hospitalized for a reassessment of their fitness for military service. The parents of these soldiers and soldiers' rights groups closely monitor their treatment while in the hospital.
 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province.
 Andriushenko's father bitterly disputes this conclusion. He believes the senior soldiers not only humiliated his son but eventually also murdered him.
 Verdict of the Vyborg Garrison Military Court of January 18, 2002.
 Human Rights Watch interview with Stanislav U., October 4, 2002, Uriupinsk, Volgograd Province; and Human Rights Watch interview with Evgenii G., October 4, 2002, Uriupinsk, Volgograd Province. U. served in units 6794 (Astrakhan Province) and 3033 (Persianovka, Rostov Province) of the Ministry of Interior's troops. G. served in unit 2062 in Kaspiisk, Dagestan. Stanislav U. and Evgenii G. are pseudonyms.