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Overcrowding fuels TB in prisons

At a Queson Institute ward in the Philippines, patients with drug resistant tuberculosis receive treatment for free but must pay for costly additional antibiotics and vitamins. Leah Mae Damazo/IRIN
Humanitarian agencies and rights groups are concerned about overcrowding in Philippine prisons, where tuberculosis (TB) is now taking a toll.

At the Manila city jail, every available space has been appropriated. Men and youths angrily jostle each other, while some sleep standing up as a medical worker walks the corridors to check on their condition.

The oppressive heat creates a nauseating smell of humanity, but there is a bigger problem - TB - an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs.

Otherwise treatable, the disease is spreading rapidly through the prison population, officials say.

"We have seen that the overcrowding of jails and prisons has serious consequences for detainees," Jean-Daniel Tauxe, the International Committee of the Red Cross (ICRC) head of delegation in Manila, told reporters recently after numerous prison visits across the Philippines.

"Access to safe water, sanitation, healthcare, and acceptable living conditions are a major problem in overcrowded detention facilities," he said, adding that the steady spread of tuberculosis had become "a serious concern".

Built in the 1940s, the Manila City Jail was designed to accommodate about 1,000 inmates. It currently houses more than 5,000 prisoners, adult men mixing with teenage boys awaiting trial, on trial or awaiting transfer to a penal colony after conviction.

The women's section is equally grim.

According to the Bureau of Jail and Management Penology (BJMP), which has administrative control over all the country's 1,132 city, district and municipal jails, the total inmate population has doubled to nearly 70,000 from about 35,000 a decade ago.

In Metro Manila, some 22,000 inmates are now registered, over an actual capacity of 16,000, the same agency reports.

And with cases, including petty offences, taking years to resolve in backlogged, understaffed courts, the number of inmates will likely rise to more than 115,000 this year, the penology bureau says.

Tauxe said concern over tuberculosis spreading in Philippine jails had prompted his group to support local authorities to implement a national programme to help combat the disease, a pilot project involving some 30,000 inmates in seven prisons.

"Legal and procedural problems, which delay the processing of cases, are the root causes of overcrowding," Tauxe said.

"Criminal neglect"

In one highly publicized case in 2008, Melvic Lupe, a factory worker jailed with 18 others in a labour dispute, died due to tuberculosis.

One of the surviving 18 meanwhile died in September last year, although the cause of death remained unclear, according to the Asian Human Rights Commission, which was following the case.

"It is appalling that anyone should die of tuberculosis today. It is no longer the dreaded affliction that has killed millions of people over the past decade," the commission said in its letter to the BJMP last year.

"It has been for many years now a treatable disease and the fact that prisoners have died of it while in custody speaks of the criminal neglect of the prison authorities."

Lawyer Rita Arce Alfaro, in a study for Manila's Far Eastern University on the problems facing inmates, said the situation had become so dire that inmates "fall easy prey to outbreaks of skin diseases such as boils, infections and various allergies.

"Tuberculosis proliferates inside prison walls," she said, stressing that the Philippine government allots less than US$1 a day per prisoner to cover three meals and water. This harsh reality contravenes the UN's Standard Minimum Rules for the Treatment of Prisoners, she wrote.

"The main thrust of the present-day prison system has not evolved from the time of the guillotine. But if urgent needs are to be addressed, reform in the prison system is a must," she said.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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