The provision of healthcare to the prisoners in Pakistan is just as muddied as other aspects of its criminal justice system. Despite being a state party to the United Nations Standard Minimum Rules for the Treatment of Prisoners (better known as Mandela rules after Nelson Mandela), the indifference and irreverence to these international commitments are appalling. The Mandela Rules call for humane treatment of the prisoners while setting minimum standards for their healthcare and emphasise the same standards for the inmates as those are available in the community. Let’s not forget that these are just minimum standards hence much less than the “model system of penal institutions.”
Health management in prisons needs a major shift of approach. There has been no accountability for neglect of the health of the prisoners. One fundamental step in this direction is to strictly keep a record of all prisoners who complain of any medical condition. Furthermore, the breach of this clause shall attract administrative action but this safeguard is absent at the moment. This record should also mention the treatment given and also any referrals if made. This would also help in ascertaining the cause of custodial deaths and preventing such deaths in future instead of regularly categorizing them as due to “natural causes.” Resultantly, the prison administration is routinely absolved of all responsibility.
There is understandably a shortage of medical staff in the prisons and generally, doctors are not willing to serve there unless compelled by a pressing personal reason. The doctors employed in the prisons lack motivation or drive to serve the prisoners and often appear lethargic, listless and cold as if they too are serving some sentence. In the absence of diligent and dutiful doctors, the existing medical care may be augmented with volunteer doctors or by developing linkages with philanthropic organisations. There are non-official visitors designated by the home departments to involve the community. Volunteer doctors can also be designated similarly. Another quick and cost-effective solution is to transfer the healthcare function of prisons to one of the wards of the nearest secondary or tertiary care hospital
Unnecessary arrests and archaic laws governing bail have swelled the prison population beyond capacity.
Overcrowded prisons are directly linked to poor healthcare. Unnecessary arrests and archaic laws governing bail have swelled the prison population beyond the capacity for decent management. Superior Courts have restricted the unfettered use of the power of arrest through several judgments and the latest being Sughran Bibi vs The State (PLD 2018 SC 595), where it is once again reiterated that the mere registration of an FIR does not merit an arrest. It has been underlined in several cases that the arrest shall be made in the cases where the suspect may abscond; temper the record; or influence the investigation; recovery has to be made from him; not cooperate in the investigation or a threat to public safety or tranquillity. A survey of the under-trial prisoners’ records should be made by the judiciary on the standards set by itself in several cases and set those free on bail who are languishing in jails just as a matter of procedure.
The decision of bail on health grounds should not appear whimsical or inconsistent. Admittedly, such bails should be granted judiciously but also not turned down on mere suspicion of faking disease by an overcautious judge. There are cases where an under-trial prisoner died of the same disease or infirmity which he pleaded in his application for bail on health grounds. By the time the acquittal or release is made of such an appellant, his health incurably deteriorates. Ascertaining the genuineness or gravity of disease shall not be a matter to be guessed over by a judge but a well-advised medical opinion shall be the rule unless proved otherwise by a contending party.
Concerted effort and action by all three, legislature, judiciary and executive are required to ameliorate the condition of those who are confined and thus incapacitated to look after themselves. The prisoners deserve concern and compassion from society in place of of the present neglect and abandonment.
The writer specializes in gender and human rights and tweets @SaimaAhad3