Disease in detention

For many in Pakistan, social distancing is simply not an option. For the poor and destitute living in congested quarters in urban slums, life is an endless struggle against hunger and failing health. In times of a pandemic such as this, the most vulnerable are the poor, the sick, the elderly, and the forgotten inmates of the many prisons in our country.

Pakistan has one of the largest prison populations in the world. Over 77,000 prisoners reside in prisons meant to house just over 57,000. In Punjab, 29 out of 41 prisons are overcrowded, whereas in Sindh, eight prisons are filled beyond capacity. There is no social distancing in these tiny, crowded cells, no place to hide.

Before Covid-10 struck, some 2,400 inmates were reported to be suffering from contagious diseases such as HIV and TB. In addition, 2,100 have physical ailments, while another 600 have some sort of mental illness. Approximately, 1,200 prisoners are over the age of 60. Their advanced age, coupled with limited disease prevention measures, makes their situation particularly dire. Lack of sufficient medical facilities and shortage of doctors further exacerbate these matters. Of the 193 posts of medical officers in jails of Pakistan, 108 remain vacant.

In congested places with poor ventilation, communal toilets and towels, where water and soap are uncommon luxuries, the transmission of Covid-19 will have devastating consequences for detainees, prison staff, visitors, and the general public alike.

The government of Pakistan is obligated under domestic and international law to protect the rights of prisoners during public health emergencies. Article 12 of the International Covenant on Economic, Social and Cultural Rights stipulates that states must “respect, protect and fulfil the right of everyone to the enjoyment of the highest attainable standard of physical and mental health including those who are imprisoned or detained”.

In 2019, a landmark judgment of the Islamabad High Court reaffirmed prisoners’ rights by stating that: “The status of a prisoner is similar to that of a ward of the state because he or she, as the case may be, is in its legal custody and care… The State, therefore, owes a duty of case to every prisoner regardless of his or her nature of imprisonment.”

Pakistan’s existing legal framework allows executive and judicial authorities the discretion to carry out exceptional measures such as immediate release, commutation and suspension of sentences, conditional early releases, and granting bail to under-trial prisoners. The Islamabad and Lahore high courts took strong decisions to ensure the release on bail of under-trial, juvenile and women prisoners where offences fall within the non-prohibitory clause and in cases which provided less than seven years of imprisonment. In Khyber Pakhtunkhwa, under the directives of the Peshawar High Court, 3,228 under-trial prisoners have been released since March 1, 2020. The Sindh and Balochistan governments have also issued similar directives.

But we can do more. Additional vulnerable categories of convicted prisoners need to be identified and considered for immediate release, subject to adequate screening protocols. This includes the elderly and the sick who are particularly at risk.

Cases in point are of Kanizan Bibi and Abdul Basit. Kanizan Bibi is a paranoid schizophrenic woman in her mid-forties who has been on death row for nearly 30 years. Diagnosed by several medical boards, she has not spoken a word in at least a decade. Abdul Basit, a former administrator at a medical college who has spent over a decade on death row, contracted tubercular meningitis while in jail. For 10 years, he has been lying paralyzed on the floor of his cell, suffering from fecal and urinary incontinence and completely dependent on the prison staff for his personal hygiene.

These are just two of Pakistan’s many mentally ill and disabled inmates whose cases need to be reviewed and granted presidential mercy under Article 45 of our constitution. Concomitantly, the intake of new prisoners must be strategically reduced. Prison data from Punjab suggests that between March 1 and 22 alone, 9,812 under-trial prisoners were admitted to jails in Punjab. This indicates a staggering statistical average of 500 new prisoners per day.

The Ministry of Human Rights is closely following the situation of prisoners in light of this pandemic. Information received from jail authorities reveal that most provinces have comprehensive prevention plans to combat Covid-19. These plans, by and large, align with WHO guidelines and include screening protocols, registry of people in and out of jail, ban on production of prisoners to court, restrictions on outside food, etc.

What is needed now are stronger contingency plans in the eventuality of a possible corona outbreak in prisons. Greater synergies with health authorities, development of containment strategies, and clear criteria for onsite treatment or transfer to hospitals need to be established. WHO guidelines provide for provision of adequate space between people, adequate air exchange, routine disinfection of the environment, as well as limiting contact of prisons by distributing food in rooms/cells instead of a common canteen.

Prisons authorities will have to work together with healthcare teams and follow protocols in accordance with the National Action Plan to fight the coronavirus. The spread of Covid-19 is an unprecedented global public health crisis. Only the most proactive and comprehensive strategies are needed to protect and care for our most vulnerable populations.

The writer is secretary, Ministry of Human Rights.