It Is Time To Decongest Our Prisons - A Message From The Past And Present

Around 11.5 million people were in custody worldwide as of 31st December 2021 with India having 488,511  people in prison. This included people who were awaiting trial and had not been proven guilty yet. In India, 35 of every 1 lakh people were in jail in 2021. 

There are 1306 prisons in India with an occupancy ratio of 118% which means on average a prison in India has 18% extra prisoners than it can accommodate. This, however, varied from state to state. Uttar Pradesh and Delhi had prison occupancy of 174% and 154%, respectively. Only 18 states and union territories had fewer inmates than they could accommodate. But, how does an overpopulated prison threaten public health?

Prisons as disease epicenters

In 1862, an illness rapidly spread among the inmates of the Agra Central Prison. Dr C Plank, the administrator of the prison, identified it as a cholera outbreak but was helpless despite his best efforts as the treatment available during those days for cholera was ineffective. He tried ‘isolating’ prisoners in a crowded prison, and restricting interaction between different prison work gangs as it was believed back then that cholera spread through the air.

Fifteen years later, in 1877, another cholera outbreak in a crowded prison in Myanmar (then, Burma), killed nearly 80 inmates. Lack of adequate space and clean drinking water made cholera lethal which led to a fourfold increase in deaths as compared to the previous year.

India under the Britishers saw many more deaths due to disease outbreaks in prisons. Instead of reforming public health and prison standards, the Britishers blamed the prisoners’ habits for their increased risk of disease and death. Prisoners, however, were used as study subjects to understand cholera better. 

‘The inmates of a large prison, such as the one under notice, are so placed as to offer peculiar advantages in the study of epidemic disease,’ wrote  Dr C Plank, Administrator of the Agra Central Prison in his report.

Nearly 150 years later, in 2020, Uttar Pradesh saw a steep rise in COVID-19 cases. The prison which was running at nearly double its capacity was an ideal place for a disease like COVID to spread. Cases and deaths were rising and so the Supreme Court of India directed the state government to release prisoners awaiting trial. Unsuccessful efforts from the government however led to even further overcrowding of the prison. During the second wave in 2021, nearly 30,000 inmates and prison staff tested positive and reportedly 25 succumbed to the illness. 

COVID-19-related increased deaths in prisons were noticed worldwide and not just in India. With prison not being looked at as a place for reformation but as punishment, is it justified to strip off the rights of people when they are imprisoned?  

Do prisoners have the right to health?

The Supreme Court of India in its landmark judgment in Parmanand Katara vs Union of India (1989) and others ruled that the state has an obligation to preserve life whether the person is innocent or a criminal liable to punishment under the law.

‘Social laws do not contemplate death by negligence to tantamount to legal punishment.’ - Supreme Court Judgment in 1989.

The Prisons Act, 1984, gives each prisoner in India the Right to Health. It is the duty of the jailer to get the prisoner medical attention without delay if any prisoner desires it, for physical or mental health issues, and effectively follow the instructions of the medical personnel. The law also directs that each prison should have a hospital or a similar facility to take care of sick inmates.

Role of prison health in public health

It is important to maintain the health of the prisoners mainly for two reasons. Firstly, the prison population is at high risk of contracting serious infections like tuberculosis (TB), HIV, and hepatitis, to name a few. Sooner or later, when these prisoners are released they become a threat to public health as they can spread these untreated diseases and increase the disease burden in the community. Thus, treating such diseases early and effectively in prison is imperative.

Secondly, prison health plays an important role in social justice. As most prisoners come from underprivileged backgrounds, prison health helps in reducing health inequalities to some extent. 

Indian prisons have been criticized globally. From unhygienic conditions to barely edible food, prisoners are at risk of a plethora of conditions, ranging from communicable diseases to mental health disorders. In a country that is fighting a constant battle against tuberculosis, overcrowded and undernourished prisoners living in unhygienic conditions are at the highest risk of developing the disease and going undiagnosed and untreated. A study done in India in 2017 found that 19% of the inmates screened had TB symptoms and nearly 8% were diagnosed with TB on microscopy.

Should we decongest our prisons?

As of 2021, three in four prisoners were under trial or awaiting trial, meaning that only one-fourth of the entire Indian prison population had been proven guilty of a punishable offense. Most of these accused inmates, who were often just waiting for years for a hearing date, were found to be young, barely literate, accused of minor violations, and too poor to afford the bail fee. 

Prisoners can’t fend for themselves and their health is the responsibility of the state. Considering the state of public health and the rate at which it is improving in the country, expecting prison health to improve anytime soon is impractical. With a majority of prisons overcrowded with possibly innocent people, it is important either to speed up the legal process or release the ones who were imprisoned for minor violations. 

The past and the present have taught us the same lesson, prisoners’ health is a major component of public health. It will be impossible to control any pandemic if prison health is not improved, not just in India but worldwide. Pandemics are said to shape the human race. I hope the recent pandemic leads us to a better and healthier future.

Edited by Radhikaa Sharma.

This article was first published in August 2022.

Photo by Ye Jinghan on Unsplash