Zahoor Afridi, a resident of the Sarband village outside Peshawar, has tears in his eyes as he remembers his first cousin, Muhammad Hayat.
Hayat, a taxi driver, was caught by the police and charged for possession under the Control of Narcotics Substances Act. He was sent to jail where he caught a contagious disease.
Hayat died in jail a few months after being imprisoned.
Afridi believes that his cousing did not get proper medical attention during his incarceration.
“If he had been treated properly, he would have been alive and with us,” Afridi said. “Poor people can do nothing except pray.”
Hayat’s demise and Afridi’s grief at his loss are unfortunately not unique or isolated incidents. Thousands of inmates in Pakistan’s prison systems are suffering from illnesses that might prove to be fatal. According to data supplied by the federal ministry of human rights to the Islamabad High Court, 30 out of every 1,000 prisoners have some form of a contagious disease.
In Khyber Pakhtunkhwa (KP) prisons, which already hold more inmates than their capacity, hundreds of prisoners are languishing with diseases such as hepatitis and tuberculosis.
Among the nearly 10,000 prisoners in KP, 1,151 are diagnosed with different illnesses, including 208 with hepatitis and 235 with mental disorders, according to human rights ministry report.
Many of those might be at risk of infection in prisons are probably not even convicted of crimes: 71 percent of the KP prison population is still under trial, according to the report.
The report acknowledged that “almost half of the sanctioned posts of medical staff remain vacant” at the prison hospitals. The situation is made worse by the fact that every jail does not have medical and dental equipment and very few prisons have functioning laboratories or paramedical staff, according to the report.
“The prisons authorities fail to provide ambulances to transfer prisoners to hospitals in case of emergencies,” the report stated.
Amanullah Pirzada, a Peshawar High Court lawyer, said the rules for the humane treatment of prisoners are not implemented. He said the Prisons Rules 1978 clearly direct that every prisoner must go through a medical screening within 24 hours of admission to jail. If found ill with a contagious disease, Pirzada said, the prisoner must be put in a separate cell. However, such facilities are not available in Khyber Pakhtunkhwa jails, he said.
Pirzada said Rule 143 of the Prisons Rules 1978 states that prisoners suffering from contagious diseases could be released on medical grounds. He has filed two writ petitions before the high court to seek action about the healthcare needs of the prisoners. Among his demands are medical screening and isolation of ill prisoners to stop the spread of infection among the inmate population.
The demand for the provision of health services to prisoners is in line with national and international obligations. Law and Justice Commission of Pakistan stated in 1997 that prisoners suffering from any disease must be thoroughly examined by the prison’s medical officer to determine treatment options. The rights of prisoners are also upheld in international law, including Article 10 of the International Covenant on Civil and Political Rights, which states that all persons deprived of their liberty should be treated with humanity and respect for their inherent dignity as human beings.
Masud Ur Rehman, the Inspector General of Prisons of Khyber Pakhtunkhwa, said every prisoner is medically examined within 24 hours of admission to a jail. He said the Chief Secretary has also directed health department to make arrangements for screening and the concerned authorities are following up on the directive.
“Every inmate diagnosed with HIV, Tuberculosis, Hepatitis C or any contagious disease gets free treatment as they get registration in the concerned centers for these diseases,” Rehman said. “Prisoners suffering from contagious disease are kept separate till it lasts.”
He said as per rules, if any inmate is suffering from any disease which is believed that it could not be treated while being imprisoned, the jail officials can write to court to consider that particular prisoner for bail. He also mentioned that a pro-bono lawyer is arranged to represent poor prisoners that seek reprieve on medical grounds. IG Prisons could not, however, how often such cases have come up in the past.
Director General Health Services of Khyber Pakhtunkhwa, Dr. Tahir Nadeem Pasha, said their hospitals in all jails are functional and staff is deployed there.
“Any patient referred there gets free treatment according to the chief secretary’s directions,” Dr. Pasha said. “We have enough funds for their treatment.”
Most people diagnosed with chronic Hepatitis B infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents from passing the infection to others as worldwide there is not proper cure for hepatitis B, Dr. Pasha said.
The Director of the KP AIDS programme Dr. Muhammad Saleem said that prisons do not fall within their programme’s ambit. But he said the health department provides support in treating sick prisoners and facilitates in training staff working at hospitals or medical centres at the jails. Dr. Saleem said the department has also requested UNICEF for one-time screening kits. If the kits materialise, he said, these could help the prisons directorate in the short term and help them plan for future screening with their own resources.
Cover image: Beds donated to the hospital at the Central Prison Haripur by a local college. Photo courtesy Khyber Pakhtunkhwa Prisons Department Facebook page