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HEALTHCARE IN PRISON

INTRODUCTION

A few years back, the treatment of the convicts was nothing less than atrocious and inhumane. Acceptance of the notion of universal human rights, for those who have been found guilty, has been a long battle, and there is still a long way to go until it is accepted by the masses and the state. Individuals in jail in India face an astoundingly high disease burden. Although Indian law guarantees inmates the right to health and healthcare, conditions in the prisons in India flout this provision. Moreover, those who are incarcerated predominantly come from the vulnerable and marginalized sections of the community and have little to no knowledge of basic healthcare, making it essential to throw light on this pressing issue.

JUDICIAL RIGHTS OF THE PRISONERS

The constitution of India does not recognize the right to health as a fundamental right, the Apex court of the country has acknowledged that Article 21 (right to life) incorporates this identical interest. In the case of State of Punjab & Ors v Mohinder Singh Chawla, the court held that the “right to health is integral to right to life. The Government has a constitutional obligation to provide the health facilities” making it very clear that healthcare forms the basis of human right for all, irrespective of the felony committed by an individual. Parmanand Katara v Union of India, 1989 is a landmark judgement that upholds the principles of Article 21 i.e., the right to life. The court held that “The patient, whether he be an innocent person or a criminal liable to punishment under the laws of the society, it is the obligation of those who are in charge of the health of the community to preserve life so that the innocent may be protected and the guilty may be punished.” Time and again the Supreme court has emphasized the improvement of healthcare facilities provided at the ground level.

The Supreme Court in order to “Re-Inhuman Conditions in 1382 prisons” passed several guidelines in 2016 to ensure the mental and physical well-being of the prisoners. In Rasikbhai Ramsingh Rana v the State of Gujarat, 1994 the Gujarat High Court convicted the officers in charge of failing to provide timely medical treatment to the prisoners.

PRISON CONDITIONS IN INDIA

Human rights activists have consistently criticized Indian prisons for their appalling conditions, quoting the lack of toilets and urinals, dirty drinking water, a lack of nutritious or hygienic food, a lack of sanitary napkins, and usually unsanitary living quarters. Each of these factors negatively impacts the physical and mental well-being of the prisoners. These conditions along with overcrowding have made Indian prisons extremely vulnerable to the dissemination of infectious diseases, like tuberculosis & COVID-19 as well as STDs (sexually transmitted diseases) such as hepatitis B, hepatitis C, and HIV-AIDS. The preceding discussion makes it very clear that the prisons in India lack the fundamental necessities of daily life such as sanitation.

Varavara Rao’s latest petition to get a “permanent medical bail” highlighted the Taloja Jail in Maharashtra’s lack of basic healthcare facilities. The Bombay High Court directed the Inspector General Prisons of Maharashtra to provide timely medical aid to prisoners following the provisions of The Maharashtra Prison (Prison Hospital) Rules, 1970 (“Prison Hospital Rules”). Activist Teesta Setalvad shared her opinion on the healthcare in prison after being granted bail on an interim basis, “The result is an unhealthy clutch of power held by the jail authorities and bureaucracy over the prison space that inept medico-legal professionals [doctors at hospitals meant to oversee and report health and other conditions] fail to breach. Conditions in several of India’s prisons are pathetic with zero or next to zero monitoring by committees statutorily required to do this job.”

ACCESS TO HEALTHCARE

The prisons in the country are severely understaffed and not well equipped with trained staff, leading to a lower standard of medical care available to the inmates. Additionally, the prisoners need to be accompanied by police escorts who take them to the nearest civil hospital. These escorts are often unavailable leading to a delay in treatment which in turn causes the health status of the inmate to deteriorate. Furthermore, the patients can only be taken to nearby civil hospitals and not municipal hospitals leading to a situation of overburdening

According to the data released by NCRB in 2021, the sanctioned strength of Medical Staff was 3,497 while the actual strength was 2,080. Whereas the occupancy rate of the prison during this period was at an all-time high of 130.2%. Moreover, the number of deaths in judicial custody rose from a total of 1,887 in 2020 to a whopping 2,116 in 2021. 

The rise can also be attributed to the pandemic which painted a clearer picture of the medical assistance available in the prison during the time of a global epidemic. However, the NCRB report does not include any data relating to the prisoners who contracted COVID-19 and the ones who recovered showing the deep-rooted troubles with the administration of the medical records in jails. Reports suggest that “India does not even spend 100/- per day on a prisoner” as compared to other developing nations this figure is significantly lower and is even decreasing at a rapid rate due to the difference in the allotment of budget to the civil city jails. 

On September 2, the Supreme Court issued a notice in a plea seeking to establish adequate mental healthcare facilities in all prisons of the country. “As per the petition, the lack of mental health establishments in prisons is a blatant derogation of the mandate of Section 103(6) of the Mental Health Act of 2017 which requires the establishment of a Mental Health Establishment in the medical wing of at least one prison in the state.” The prisoners form a section of society who are at large vulnerable to mental illnesses due to the overcrowding of prisons, isolation from family and society, loss of livelihood, etc. Not having the infrastructure to deal with such illnesses in the prisons itself poses a great threat to the integrity of the system. 

CONCLUSION

Several commissions and committees have already been formed to overlook the progress in implementing the rules and regulations set in place for better healthcare at the prisons. However, constant resource overburdening and personnel understaffing have hampered the implementation of these provisions. India has increased the allocation of public spending in the recent budgets however the amount which will be spent on improving the medical infrastructure in the prison remains unknown.

To prevent further violations of prisoners’ right to health, all sanctioned posts for medical officers in all prisons should be filled as per the Prisons Manual’s qualifications. The state’s prison hospital rules should be amended to allow for the admission of prisoners to municipal hospitals, and weekly mobile medical testing and vaccination units should be introduced in prisons as an alternative to escorting prisoners to hospitals

Author(s) Name: Sanya Dua (Symbiosis Law School, Pune)