THE RIGHT TO HEALTH IN PRISON: RESULTS OF A NATIONWIDE SURVEY AND REPORT buckets or portable units in their cells during lock up, generally after dinner. In the morning, the prisoners have to then empty their buckets into the main septic tank. 4.125 The Commission wishes to highlight that prisoners complained that they are required to eat, sleep and defecate in the same area and accordingly reiterates its recommendation to the Prisons Department to consider remodelling or rebuilding affected prisons to ensure that every cell has its own toilet facility. 4.126 The Commission explains that the European Court of Human Rights considers the act of discharging human waste in a confined space used as a living area to be degrading.160 (vi) Exercise and Sport 4.127 Outdoor exercise is crucial for the mental and physical well-being of prisoners as part of a balanced regime of activities in prison. This is especially so, given that many prisoners spend most of their time in their cells with limited access to sunlight and fresh air. International standards specify that prisoners should have at minimum one hour in the open air per day as time outside can also provide prisoners with the opportunity to socialise or take part in recreational activities. 4.128 The Commission explains that outdoor activities are an important and integral part of healthcare delivery in prisons to ensure a healthy physical and mental health status of prisoners. Suitable facilities must be provided, which are large enough, safe and properly equipped, in order to provide the opportunity for genuine exercise and recreation as well as to benefit prisoners with chronic illnesses, like hypertension, heart disease, and diabetes who require regular exercise. Unfortunately, the Commission observed that Malaysian prisons lack such facilities. 4.129 Although this is justified on disciplinary or security grounds, for example, those serving life sentences with limited or no time for outdoor exercise, the Commission is of the view that the prison administration must take measures to ensure that all prisoners have access to the minimum of one hour outdoor exercise per day, including those under segregation, isolation or punishment. This can be achieved with proper prison management and 160 Napier v The Scottish Ministers [2004] S.L.T. 555 92