Dozens of prisoners have tested positive for several diseases, including acquired immunodeficiency syndrome (AIDS), in Khyber Pakhtunkhwa prisons due to overcrowding of inmates, reveal documents available with Aaj News.

“As many as 196 prisoners have contracted tuberculosis (TB), Hepatitis B and C, and AIDS in different jails of KP,” it showed. Aaj News obtained the documents from the KP Prisons Department under the Khyber Pakhtunkhwa Right to Information Act 2013.

Below is the breakdown of the total cases:

• Hepatitis C: 138
• Hepatitis B: 29
• AIDS: 25
• TB: 4

The Peshawar Central Prison has the highest number of infected prisoners with at least 34 of the inmates testing positive for Hepatitis C, seven for Hepatitis B, and six for AIDS.

It was revealed that prisons also lacked health facilities.

Bannu Central Jail with nine infected prisoners, Lakki Marwat District Jail with 12, Nowshera sub-jail with eight, Swabi sub-jail 13, Charsadda jail with 12, and Malakand sub-jail with four cases have no medical facilities.

One such case was of Peshawar taxi driver Muhammad Hayat. The 28-year-old was sentenced to jail for 25 years in a drugs case in 2015. He contracted AIDS and Hepatitis during his incarceration and died in 2020.

‘Nothing but prayers’

His cousin Zahoor Afridi told Aaj News that Hayat was completely healthy when he was sentenced. “He was kept in cramped cells that were shared by several people, who would sleep shoulder to shoulder. He got sick due to being in constant close proximity in the barrack to people exposed to infectious diseases. Then he died due to lack of adequate treatment in the jail.”

Cutting a forlorn picture, Afridi said those with limited means have no other hope but to pray for their loved ones at the mercy of the prison system.

SK* is an inmate at the Peshawar jail. At some point during his imprisonment, he contracted hepatitis but claims not to have recieved adequate care

SK said that when he was transferred to the jail, he underwent a medical examination on admission. But he was not examined later even though he informed the prison administration about the symtons and his worsening health. When he was finally examined, he tested positive.

“If someone has a disease, examination or treatment is not done automatically. The prisoner has to report it,” SK said. “But the health facilities at the prison are non-existent,” he said. SK added that government hospitals outside the prison don’t treat such as priority and their ake time even as the inmates’ condition deteriorates further.

The jail administration confirmed what SK had to say.

Prisoners have also rights

Advocate Ehsan Ullah Jan said there is an underlying assumption that prisoners, whether detained or incarcerated, have no rights. “However, this is not the case at all,” he said.

He cited the International Covenant on Civil and Political Rights, adopted by the United Nations in 1966 and ratified by Pakistan in 2010. Article 10 of the convenant states that inmates should be treated respectfully and humanely.

Prisoners belonging to the enemy camps also have rights related to health, Jan added.

“Prisoners of war must at all times be humanely treated. Any unlawful act or omission by the Detaining Power causing death or seriously endangering the health of a prisoner of war in its custody is prohibited, and will be regarded as a serious breach of the present Convention,” says Article 13 of the Geneva Convention pertaining to the treatment of prisoners of war.

“The Power detaining prisoners of war shall be bound to provide free of charge for their maintenance and for the medical attention required by their state of health,” says Article 15 of the same law.

Similarly, articles 30, 31, and 32 also stressed the need for ensuring the health of prisoners at all times.

What is the space in KP jails

The KP, with as many as six central, eight district, and 24 sub-jails, could house around over 13,000 prisoners.

• Available space for prisoners: 13,076

• Men: 12,621

• Women: 455

• Current number of prisoners: 14,321

• Men: 13,722

• Women: 181

• Children: 364 boys and four girls

The documents showed that only 2,897 prisoners have been sentenced by courts while 11,424 under-trial inmates were awaiting court decisions on cases, which makes up around 79% of the total prisoners right now.

Purpose of jails

Retribution or revenge, incapacitation, deterrence, and rehabilitation are four major purposes of jails, Peshawar High Court lawyer Abdul Wahab Tarkalani told Aaj News. The details explained by him are as follows:

• Retribution means punishment for crimes against society in which the offenders were deprived of their freedom which was a way of paying the debt of society.
• Incapacitate is aimed at removing criminals from society to protect innocent people from further harm.
• Deterrence is that criminals are sent to prison to stop others from breaking the law
• Rehabilitation means transforming the criminal into a law-abiding citizen.

“Contrary to the purpose of prisons, our prisons are more problematic and lacking in facilities and positive activities due to which crimes are increasing day by day,” Tarkalani said.

How do people get infected?

Infectious diseases were usually spread by direct transmission of bacteria, viruses, or other germs from one person to another, Dr Shams Wazir, the chairman of the Young Doctors Association Social Welfare Wing, told Aaj News.

It can happen when an infected person “touches, kisses, coughs or sneezes on another person” who was not infected.

“These germs can also be spread via sexual contact through the exchange of bodily fluids. An infected person may not have any symptoms of the disease. But maybe the person can just be a carrier,” Dr Wazir, who is also a medical specialist at the Khyber Teaching Hospital, said.

Medical experts believe that many germs could live on inanimate objects, including tables, doorknobs, or handles. For example, when a person touches a doorknob held by a person with a cold, they can pick up leftover germs.

“If you touch your eyes, mouth, or nose before washing your hands, you can get an infection,” said Dr Wazir.

Overcrowding

Overcrowding caused problems such as the spread of chronic diseases, unsanitary environment, lack of checks and balances, riots in prisons, and misclassification of prisoners, Raees Gul, a lecturer at the Islamia College University Peshawar, wrote in his research on overpopulated KP prisons.

He has pointed out that the delay in justice was the reason for overcrowding in prisons.

Laws in place, but ‘without implementation’

Amanullah Pirzada, who has worked for the rights of prisoners, said that laws for the rights of prisoners in jails were in place, but they were not being implemented because of which prisoners were deprived of their rights.

Medical screening is mandatory within 24 hours of every prisoner being brought into the jail and if any prisoner was suffering from a contagious disease, then that prisoner would be locked in a separate cell, according to Rule 18 of KP Prisoners Rule 2018. “However, this facility is often not available in prisons,” he said.

The activist said that overcrowded prisons with inadequate health facilities were the reason infectious diseases were spreading among prisoners.

“According to the rules, healthy prisoners can voluntarily donate blood three times during their imprisonment. In exchange for the blood donation, the prisoner gets 30 days amnesty each time. It not only reduces the burden on prisons due to early release of prisoners but also helps patients in need of blood ,” Pirzada said.

He had filed two different cases in the court for the implementation of laws pertaining to keeping prisoners suffering from diseases in separate cells and amnesty to prisoners who voluntarily donate blood. The court had ordered that the petition must be filed again for making any aggrieved person a petitioner.

Both applications would be re-prepared and filed in the court, Pirzada added.

Overcrowding—a ‘worldwide issue’

The problem of overcrowding in prisons is a global phenomenon, IG Prisons in the KP Saadat Hasan said while stressing the need for serious measures to control it. In a similar vein, he said the district jail in Hangu would soon be made functional and the under-construction jail in Swabi would soon be completed.

“Additional blocks and cells are being constructed in Peshawar, DI Khan, and Bannu jails,” Hasan said.

When asked about the under-trial prisoners, the IG Prisons said that the issue of being locked up in minor cases was being raised in the Justice Coordination Committee.

Every now and then, sessions and district court judges approves such cases for urgent hearing to expedite the process. He, however, added that the issue could not be resolved immediately because of legal complications.

“Screening of all sick prisoners is conducted after every two months. We provide the medical facilities that are required by the prisoner,” he said. Those who are seriously ill are referred to hospitals, he added.

Hasan admitted that there were problems due to a lack of resources and overcrowding, however, efforts were under way to overcome them by bringing amendments to the law, increasing the capacity and improving the competence of the department.

Contact with Health Department

The Department of Jail has its own health system, however, the Health Department provides support in case of staf fshortage, KP’s AIDS and Hepatitis Control Programme Project Director Dr Asghar Khan said.

Under the programme, screenings are conducted for diagnosis and sick prisoners are referred to Peshawar’s Lady Reading Hospital or Services Hospital where they get “absolutely free treatment”.

What legal experts have to say

Legal expert Uzma Sattar opined that the capacity of the prisons was decreasing due to an increase in crimes and delay in justice.

“Prisoners are also facing lack of sleeping space and bathrooms along with the spread of diseases,” she said. “It is a headache not only for the prisoners but also for the prison administration.”

Sattar said the onus lies with the prisons to provide better conditions for inmates, in terms of health facilities as well as assisting the inmate to reform. “This way the problems of the prisoners would be reduced as well.”

Many prisoners remain unaware of their rights, senior legal practitioner Saifullah Muhib Kakakhel warned that the number of such patients could double as many prisoners, like most people, shy away from diagnostic tests for Hepatitis and especially AIDS due to the stigma associated with it.

He added that the problem gets severe when such people do not inform the administration despite having symptoms.

Financial challenges

Jail officials say they are facing financial problems in addition to the outbreak of diseases. The budget document, available on the KP website, shows the following funds allocated for prisons:

• Budget: Rs3,795,911,000

If divided among the existing number of prisoners, 14, 321, each inmate would get Rs265,059 monthly and Rs726 per day.

The budget includes the salaries of employees, allowances, training, transport fares, food expenses, furniture costs, utility bills, and miscellaneous items.

“There may be a shortage of funds,” KP Finance Ministry spokesman Attaullah Khan said, adding that the decision on the annual budget and funds is taken after viewing all the expenses and details.

He added that for the budget of the next financial year, the expenses of the Prisons Department of the previous year and the current prices of the items would be taken into consideration. “The department will also consider the budget demand to meet the shortfall in funds,” Khan added.

“It is said that no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones,” said Nelson Mandela, who spent 27 years in jail before becoming South Africa’s first black president.

If Mandela had been in a KP prison, he would have been more worried about infections instead of apartheid.

An earlier version of the story erroneously spelt the following names: Ehsanullah Jan as Ahsanullah Jan and Saifullah Mehboob Kakakhel instead of Saifullah Muhib Kakakhel. The errors are regretted.