Chapter 4 – Observations The purpose of this Chapter is to provide a balanced examination of the survey and analysis, vis-à-vis the observations of the Commission. The observations were made during the Commission’s visits to selected prisons during the national survey. The issues observed relate to staff health care; medical services; vulnerable groups in prison; conditions of confinement; exercise and sport; adequate food and dietary requirements; remand prisoners; and prison staff. Chapter 5 – Recommendations This Chapter offers recommendations for enhancing the health care delivery in prison in accordance with universally accepted norms. The recommendations are also based on the Commission’s observations during the nationwide survey and are categorised according to the relevant stakeholders: 1. Recommendations to the Ministry of Health Malaysia (MOH): i. Medical Staffing ii. Clinical Governance in Prison Health Care iii. Specialised Training iv. Guidelines for Control of Tuberculosis (TB) v. Treatment of Prisoners at MOH facilities 2. Recommendations to the Ministry of Home Affairs Malaysia (MOHA): i. Budget ii. Staff Resources 3. Recommendations to the Prisons Department of Malaysia: i. Health Policies ii. Physical and Mental Health Screening iii. Protective Gear and Immunisation iv. Nutrition in Prison v. Dental Health vi. Female Prisoners vii. Vulnerable Groups 4. Recommendations to the Attorney-General’s Chambers of Malaysia (AGC) 5. Recommendation to the Ministry Of Works Malaysia (JKR) x