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Healthcare For Prisoners

Written by: Madhu Tyagi, 5th Year Law Amity Law School
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People believe that prisoners are sent to prison as punishment, and not for punishment. This implies that the loss of an individuals right to liberty is enforced by containment in a closed environment. Thus keeping the individual in the custody of the state, should not, however, have a deleterious effect on him. But this is, unfortunately, the case to some degree or another in many of the worlds prisons. Is it possible then to define what is healthy environment in a prison? Let alone, talking about a prisoners right to health services that are to be provided to him by the prison authorities?

The answer to this question is that prisoners have unalienable rights conferred upon them by international treaties and covenants, they have a right to health care, and most certainly have a right not to contract diseases in prison. Prison jurisprudence recognizes that prisoners should not lose all their rights because of imprisonment. Yet, there is a loss of rights within custodial institutions, which continue to occur. Public health policies are meant to ensure the best possible living conditions for all members of society, so that everyone can be healthy. Prisoners are often forgotten in this equation. They are in constant contact with all kinds of people who come in and out of prison every day. This constant movement in and out of prison makes it all the more important to control any contagious disease within the prison so that it does not spread into the outside community.

In India, overcrowding has aggravated the problem of hygiene. In many jails, conditions are appalling. At the tehsil level jails, even rudimentary conveniences are not provided. Prisoners in India are not even tested for specific infectious diseases, although all prisoners undergo a medical examination when they begin serving their sentence. No studies of the prevalence of viral infections among prison inmates have been done at a national level. India's prison manuals provide for
segregation of prisoners suspected of having contagious diseases. A few jails have established informal contacts with medical and social organizations for counseling of inmates to prevent the spread of infections.

Violence in prison settings has many causes. Clashes may have ethnic causes, or rivalries between clans or gangs. The closed, often vastly overcrowded, living conditions also lead to hostilities between inmates. The tedious prison environment, lack of occupation of mind and body and just plain boredom, lead to accumulated frustration and tension. This environment leads the way to high-risk activities, such as use of drugs and sex between men. Some indulge in these activities to combat boredom. Others, however, are forced to engage in them, in a coercive play for power or monetary gain. Risky lifestyles can lead to the transmission of diseases from one prisoner to other prisoners, and pose a serious public health risk if unchecked. Contracting any disease in prison is not part of a prisoners sentence. This fact becomes even more significant when the disease is potentially fatal, as is the case with HIV/AIDS.

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 he is an innocent person or a criminal liable to punishment under the law. With specific reference to health, the right to conditions, adequate for the health and well-being of all was already recognized in the Universal Declaration of Human Rights. The International Covenant on Economic, Social and Cultural Rights ( ICESR) furthermore states that prisoners have a right to the highest attainable standard of physical and mental health.

The minimum standard rules for prisoners regulate the provision of health care for them. Apart from the civil and political rights, the so-called second generation economic and social human rights, as set down in the ICESCR, also apply to prisoners. The right to the highest attainable standard of health should also apply to prison health conditions and health care. This right to health care and a healthy environment is clearly linked, particularly in the case of HIV, to other first generation rights, such as non-discrimination, privacy and confidentiality. Prisoners cannot fend for themselves in their situation of detention, and it is the responsibility of the state to provide for health services and a healthy environment.

Human rights instruments call for prisoners to receive health care at least equivalent to that available for the outside population. On one hand, equivalence rather than equity has been called for because a prison is a closed institution with a custodial role that does not always allow for the same provision of care available outside. Prisoners are more likely to already be in a bad state of health when they enter prison, and the unfavorable conditions therein worsen the health situation. Hence the need for health care and treatments will often be greater in a prison than in an outside community. However, providing even basic health care to prisoners has proved extremely difficult in India, as the health system is chronically insufficient.

In prisons, the human environment is often one of violence and high-risk lifestyles, either engaged in voluntarily by those prisoners with positions of power, or forced upon the weaker prisoners. Prisoners have a right to live in conditions where their individual safety is guaranteed. It is paramount for the prison administration to have a thorough knowledge of how HIV is likely to be transmitted in a given prison. If sexual coercion and/or violence are the main issue, better surveillance and timely intervention to protect targeted prisoners must be enforced. HIV-positive inmates should not be denied access to recreation, education or access to the outside world.

From a strictly medical point of view, there is no justification for segregation as long as the prisoner is healthy. Solitary confinement of HIV-positive inmates should be forbidden. Any restrictions should be exceptional, such as mandatory testing for particularly risky situations, such as prisoners working as medical orderlies in hospitals or dental clinics. There may also be considerations of personal security where, for example, prisoners known to be HIV-positive request to be kept in a secure unit as they fear for their own safety.

Both prison reform and penal reform are crucial elements if the many problems affecting the Indian prisons are to be resolved. Diminishing the overall prison population will allow improvements of the physical and working conditions of the prisons, and help to ensure the security of all individuals in custody. Obviously, financial resources will have to be allotted to the prison systems as well. One effective way to curb the rise in prison populations would be to offer alternatives to imprisonment for non-violent and civil offenders.

Also Read
Prison Reforms In Indian Prison System:
All men are born equal and are endowed by their creator with some basic rights. These rights are mainly right to life and liberty, but if any person doesn’t comply with ethics of the society then that person is deprived of these rights with proper punishment.

Status of Jails In Punjab:
Goal or Jail or prison, the two forms of the word are due to the parallel dual forms in old Central and Norman respectively, ‘jaiole’ or ‘jaole’, and ‘gaiole’ or ‘gayole’. The spelling ‘jail’ is used in American prisons, were first used in England for punishment during sixteenth century.

Overcrowding of Civil Jails:
According to the Code of Civil Procedure, Section 51 empowers the court to order execution of a decree by arrest and detention in prison of the judgement debtor in appropriate cases for the period specified in section 58, CPC. No order of detention of the judgement debtor in civil prison is to be made where the total amount of the decree does not exceed five hundred rupees.

Role of Judiciary in Protecting the Rights of Prisoners:
Judiciary in every country has an obligation and a Constitutional role to protect Human Rights of citizens. As per the mandate of the Constitution of India, this function is assigned to the superior judiciary namely the Supreme Court of India and High courts.

The Problems of Undertrials:
Criminal Law of India is a replica of colonial times. It is hostile to the poor and the weaker sections of society.

Taking Prisoners Rights Seriously:
In the case of Hussainara Khatoon v. State of Bihar , a shocking state of affairs in regard to the administration of justice came forward. An alarmingly large number of men and women, including children are behind prison bars for years awaiting trial in the court of law.

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