Pretrial detainees in North Korea regularly experience torture, sexual abuse and other harmful treatment under leader Kim Jong Un’s regime, according to a report released Monday by Human Rights Watch (HRW).

The report, "Worth Less Than An Animal: Abuses And Due Process Violations In Pretrial Detention In North Korea,” describes the harsh conditions and politicized nature of the country’s criminal justice system.

“North Korea’s pretrial detention and investigation system is arbitrary, violent, cruel, and degrading,” said Brad Adams, HRW’s Asia director. “North Koreans say they live in constant fear of being caught in a system where official procedures are usually irrelevant, guilt is presumed, and the only way out is through bribes and connections.”

HRW interviewed 22 North Koreans who had previously been held in detention and interrogation facilities to compile the report. Former government officials told HRW that detainees are referred to by their numbers, rather than their names and are considered to be subhuman by authorities.

“If we moved, we were punished by standing and sitting, doing push-ups, abdominals, or holding onto the metal bars,” said a former soldier who fled North Korea in 2017. He had been detained multiple times for his attempts to flee to South Korea and said detainees are frequently beaten by guards.

The HRW report describes how detainees are given little food, insufficient space to sleep and little opportunity to bathe. Detainees have also been covered with lice, fleas and bedbugs.

North Korea’s detention system drew major controversy in 2017, after American detainee Otto Warmbier returned to the U.S. in a coma in June of that year. Warmbier, a college student, was held captive by North Korean authorities for 17 months after being accused of stealing a propaganda poster from a hotel in Pyongyang.

Warmbier had entered North Korea as part of a guided tour group. When he returned to the U.S., scars were found on his body and his teeth were crooked, suggesting that he may have been tortured. North Korea has denied torturing Warmbier, who died shortly after he was repatriated to U.S.

President Donald Trump has said Kim Jong Un is not to blame for Warmbier’s death.

Human rights watchdog Freedom House has rated North Korea as “not free.” “North Korea is a one-party state led by a dynastic totalitarian dictatorship. Surveillance is pervasive, arbitrary arrests and detention are common, and punishments for political offenses are severe,” it says on Freedom House’s website.

North Korea has been ruled by the Kim Dynasty since its founding in 1948. Kim Jong Un, the grandson of North Korea founder Kim Il Sung, has led the country since 2011.

In 2018, the Trump administration estimated that between 80,000 to 120,000 political prisoners in North Korea are held in internment camps.