HEALTHCARE IN PRISONS IN INDIA

Owing to increasing crime rates, rise in population, and a more authoritative judicial system (leading
to higher conviction rates), there is severe overcrowding and exhaustion of prison facilities in India.
This makes the prison environment rather unhealthy and it serves as “hot-spots” for infectious
disease transmission. The walls of the prison however cannot prevent disease transmission –
thereby making prison health a very significant part of public health. Most prisoners are imprisoned
for only very short periods of time. More than one third of prisoners are imprisoned for less than 3
months in India. Thus, there is a great deal of interaction between the two communities on either
side of prison walls. The continuum with society is also ensured via the prison staff. Even if prisoners
are not released there is significant interaction within the prison-system itself – prisoners being
circulated in different cells, different prisons, between judiciary systems and jails and even between
prisons and health centres.

Prisoners are known to be at a high risk for diseases like sexually transmitted infections (STIs), HIV-
AIDS, hepatitis B and hepatitis C. A study published in 2007 reported that in 20 countries, HIV
prevalence was more than 10% within prison populations. Evidence regarding the high burden of
HIV/STIs in Indian prisoners is available but scarce. A study on the prevalence of HIV in Indian prisons
revealed that 1.7% of male and 9.5% of female inmates were HIV positive. This is significantly higher
than the national HIV prevalence of 0.32% in males and 0.22% in females.

Various factors have been implicated for this including intravenous drug abuse and frequent
visitations to sex workers. The report on “Prevention of spread of HIV amongst vulnerable groups in
South Asia” from United Nations office on drug and crimes revealed that 63% of prisoners in India
had a history of drug abuse. The prevalence of drug abuse varies between 8% to 63% among Indian
prisoners. Continuance of high risk behaviours such as unprotected sex and substance abuse after
release from prison is also very common. Lack of conjugal life in prisons has also led to prisoners
engaging in male-to-male sexual acts. A study conducted in a North Indian jail revealed that 28.8%
were homosexual or bi-sexual, 68% had multiple partners and 80.6% engaged in unprotected sex.
Intravenous drug abusers generally have criminal history (mostly for minor crimes), and they too
avoid utilizing health services for fear of persecution, ostracism and discrimination.

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 counselling of inmates to prevent the
spread of infections.

Recent Case Laws

The Hon’ble supreme court of India in the case of Rama Murthy v State of Karnataka1 specified 9
problems that the Indian prisons are afflicted with recognising the lack of proper healthcare as one
of the major problems. They being: –

 80% prisoners are under trials

 Delay in trial.
 Even though bail is granted, prisoners are not released.
 Lack or insufficient provision of medical aid to prisoners
 Callous and insensitive attitude of jail authorities
 Punishment carried out by jail authorities not coherent with punishment given by court.
 Harsh mental and physical torture
 Lack of proper legal aid
 Corruption and other malpractices

The Supreme Court of India in its landmark judgment in Parmanand Katara vs Union of India
2
(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 need for prison reforms has come into focus during the last few decades. The Supreme Court
and the High Courts have commented upon the deplorable conditions prevailing inside the prisons,
resulting in violation of prisoner’s rights. The problem of prison administration has been examined
by numerous expert bodies set up by the Government of India. The most comprehensive
examination was done by the All India Jail reforms Committee of 1980-83, popularly known as the
Mulla Committee. The National and the State Human Rights Commission have also, in their annual
reports, drawn attention to the appalling conditions in the prisons and urged governments to
introduce reforms

Mandate on Government & Prison Authorities for Protection of Prisoners

The State is under an obligation for protecting the human rights of its citizens as well as to protect
the society at large, and is authorized to do so. To protect the citizens from any possible abuse of
this authority, they are given certain basic privileges recognized by the Constitution of India as
Rights. Elevation of such claims to the status of Rights, gives the citizens the capacity to evoke the
power of the Judiciary to protect themselves against violation of such rights, as well as to seek
redressal for their restitution. The Supreme Court of India, by interpreting Article 21 of the
Constitution, has developed human rights jurisprudence for the preservation and protection of

1
(1997) 2 SCC 642
2 1989 AIR 2039, 1989 SCR (3) 997
prisoner’s rights to maintain human dignity.3 Prison jurisprudence since the late ‘60s recognizes that
prisoners do not lose all their rights because of imprisonment. , there is a loss of rights within
custodial institutions that continue to occur.

The Indian State is also a signatory to various international instruments of human rights, like the
Universal Declaration of Human Rights which states that: “No one shall be subject to torture or
cruel, inhuman or degrading treatment of punishment”4. Also important is the United Nations
Covenant on Civil and Political Rights which states in part: “All persons deprived of their liberty shall
be treated with humanity and with respect for the inherent dignity of the human person”5.
Therefore, both under national as well as international human rights law, the state is obliged to
uphold and ensure observances of basic human rights.

3 Rights of prisoners and convicts under the criminal justice administraton by Justice T.S.Sivagnanam Judge, High Court,
Madras, National Judicial Academy Regional Judicial Conference, Organised by High Court, Madras, Tamil Nadu State
Judicial Academy and The National Judicial Academy, 24.02.2012 to 26.02.2012
4
Universal Declaration of human Rights, Article 5.
5 United Nations International Covenant on Civil and Political Rights, Article 10