Prisoners’ right to healthcare
The past few decades have seen extraordinary changes in the health of average citizens and the prison inmates are no exception. The multitude of problems accelerated due to constant decay of urban spaces, setting-up of unplanned urban dwellings, lack of civic amenities, widespread illicit drug use and expanding poverty-associated epidemics, has had a devastating impact on the well-being of both urban population and incarcerated Pakistanis.
Prisoners now arrive at lock-up sicker than at any time since the independence of Pakistan. Not surprisingly, prison medical services have been transformed into beleaguered outposts struggling to cope with near impossible demands. The prison authorities’ longstanding failure to ensure hygienic and humane conditions in prison and other detention facilities is amplifying the threat posed by pandemic diseases.
We have to acknowledge that detained people have the same right to health as the non-incarcerated population and are entitled to the same standards of prevention and treatment. The detained population along with general population have a compelling interest in knowing the prison authorities’ plans for handling the sick and ill inmates and how they are prepared to handle the pandemic behind the closed gates.
Prisons are, in fact, a growth industry. It is critical to note that over the past few decades, the worldwide prison population has significantly increased and the situation in not different even in Pakistan. The trend has placed an enormous financial burden upon already depleting financial resources. Imprisonment has become a near automatic response to crime, rather than a last resort. Prison systems in our country is no longer aimed at reformation and social rehabilitation, but rather are focused on punishment through deprivation of liberty.
In November 2019, there were approximately 77275 prisoners including pre-trial detainees/remand prisoners in 98 establishments across Pakistan, while the official capacity of all prisons is 57 742. It is quite interesting that this population consist a major part of pre-trial detainees/remand prisoners as 62.1%. While female prisoners constitute only 1.6% of total prison population. This brings the occupancy level to 133.8% of official capacity of prison system, obviously our prisons are overburdened and have a potential to yield all kind of health risk posed not only to inmates but to the rest of the society.
Throughout the country, the prisons and detention centers’ conditions are generally characterized by structural deprivation and non-fulfillment of rights necessary for a humane and dignified existence. This has resulted to a systematic practice of inhuman or degrading treatment or punishment. Since the prison systems are underfunded, this cannot be used as an excuse for not refurbishing detention facilities, purchasing and issuing basic supplies, or providing food and medical treatment.
More specifically, situations that lead to cruel, inhuman, or degrading treatment or punishment, and even to torture, result from overcrowding, lack of ventilation, poor sanitary conditions, prolonged isolation, holding suspects incommunicado, non-separation of different categories of prisoners, especially the prison structure is insensitive to women and children and holding persons with disabilities in environments that include areas inaccessible to them.
The list of unacceptable conditions is, of course, not exhaustive. To ensure the safety of prisoners and to prevent physical, sexual, or emotional abuse, it is a high time to allocate adequate financial resources to improve the ever-deteriorating conditions of our prisons, including proper training of authorities and staff. There must be a proper mechanism to oversee and to ensure that the health professionals appointed in the prison systems are appropriately coordinating with public health departments and communicate openly with staff and people in custody. Provide appropriate hygiene training and supplies and ensure that all areas susceptible to harboring the diseases and accessible to prisoners, prison staff, and visitors are disinfected regularly, consistent with accepted best practices
Medical care is a minimum and indispensable requirement for ensuring humane treatment of prisoners. Medical care and treatment, including examinations, must be carried out promptly, independently, and consensually. Medical examinations should be administered upon a person’s admission to a place of detention and after every transfer between facilities, then thereafter upon a routine basis. Regular medical examinations constitute a basic safeguard against ill-treatment during the period of imprisonment.
Furthermore, provision of basic supplies and medical treatment directly relates to the fundamental and universal rule mandating that persons deprived of liberty must be treated with respect for their dignity. Rules 24 through 35 of the Nelson Mandela Rules specifically address health services with regard to prisoners and ensure prisoners should enjoy the same standards of health care that are available in the communities and that care must be free of charge. Too, in cases of emergency, prisoners should have access to prompt medical attention and be transferred to specialized institutions to receive proper care.