66. Section 3(1) of the LDA prescribes circumstances under which mentally disabled persons can be received into a place of detention and they are: • On submission of 2 certificates by persons referred to under the LDA as "duly qualified medical practitioners"; • Upon an order being made by and signed by judge of the Supreme Court, a Magistrate or any two Justices of the Peace. 67. A "duly qualified medical practitioner" under the LDA has been defined as "every person possessed of a qualification entitling him to be registered and practice medicine in The Gambia" 14 . 68. By these provisions, the LDA authorises the detention of persons believed to be mentally ill or disabled on the basis of opinions of general medical practitioners. Although the LDA does not lay out fixed periods of detention for persons found to be mentally disabled, the Respondent State has submitted that in practice the length of time spent by patients in the unit ranges from two to four weeks and that it is only in exceptional circumstances that patients may be detained longer than this period. These exceptional circumstances apply to mainly schizophrenics, and vagrant psychotics without any family support and known addresses. The African Commission takes note of the fact that such general medical practitioners may not be actual experts in the field of mental health care and as such there is a possibility that they could make a wrong diagnosis upon which certain persons may be institutionalised. Additionally, because the LDA does not provide for review or appeal procedures, persons institutionalised under such circumstances would not be able to challenge their institutionalisation in the event of an error or wrong diagnosis being made. Although this situation falls short of international standards and norms 15 , the African Commission is of the view that it does not violate the provisions of 6 of the African Charter because Article 6 of the African Charter was not intended to cater for situations where persons in need of medical assistance or help are institutionalised. 69. The Complainants also allege that institutionalisation of detainees under the LDA who are not afforded any opportunity of being heard or represented prior to or after their detention violates Articles 7(1)(a) and 7(1)(c) of the African Charter. 70. Articles 7(1)(a) and 7(1)(c) of the African Charter provides: "1. Every individual shall have the right to have his cause heard. This comprises: (a) The right to an appeal to competent national organs against acts of violating his fundamental rights as recognised and guaranteed by conventions, laws, regulations and customs in force; (c) The right to defence, including the right to be defended by counsel of his choice." 71. It is evident that the LDA does not contain any provisions for the review or appeal against an order of detention or any remedy for detention made in error or wrong diagnosis or treatment. Neither do the patients have the legal right to challenge the two separate medical certificates, which constitute the legal basis of their detention. These omissions in the LDA clearly violate Articles 7(1)(a) and 7(1)(c) of the African Charter. 72. The guarantees in Article 7(1) extend beyond hearings in the normal context of judicial determinations or proceedings. Thus Article 7(1) necessitates that in circumstances where persons are to be detained, such persons should at the very least be presented with the opportunity to challenge the matter of their detention before the competent jurisdictions that should have ruled on their detention. 16 The entitlement of persons with mental illness or persons being treated as such to be heard and to be represented by Counsel in determinations affecting their lives, livelihood, liberty, property or status, is particularly recognised in Principles 16, 17 and 18 of the UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Care. 73. The Complainants submit that the failure of the Respondent State to provide for and enable the detainees under the LDA to exercise their civic rights and obligations, including the right to vote, violates Article 13(1) of the African Charter which provides: "Every citizen shall have the right to participate freely in the government of his country, either directly or through freely chosen representatives in accordance with the provisions of the law." 74. In its earlier submissions, the Respondent State admits that persons detained at Campama are not allowed to vote because they believe that allowing mental health patients to vote would open the country's democratic elections to much controversy as to the mental ability of these patients to make an informed choice as to which candidate to vote for. Subsequently, the Respondent State in its more recent submissions suggests that there are limited rights for some mentally disabled persons to vote; however this has not been clearly explained. 6