In the golden era of global health, prisons have long occupied a hidden parallel world, a big dirty secret, so to speak, where in cells so overcrowded that inmates sleep standing, diseases are inescapable, medical care and nutrition are far beyond reach, sanitation is nonexistent and justice is a dream.
“Most people know little if anything about what goes on inside foreign prisons,” a statement from Sen. Patrick Leahy (D-VT) last week said, “and many would prefer not to know.”
The bill Leahy and Sen. James Inhofe (R-OK) reintroduced last week would change that, making unsafe, inhumane and unjust prison conditions worldwide a matter for diplomats and donors to document and address. The Foreign Prison Conditions Improvement Act would set standards for humane conditions, require the Secretary of State to report on prison conditions in at least 30 countries receiving U.S. assistance or under U.S. sanctions, engage governments in recognizing and remedying human rights abuses behind bars and open the door to foreign aid to assist in bringing improvements.
Leahy and Inhofe introduced the bill last year, while Rep. Chris Smith (R-NJ) introduced a parallel bill in the House of Representatives, but the session ended before legislators acted on it. The bill cites studies estimating HIV infection rates in prisons in developing countries to be as much as 50 times higher than outside prison walls, and tuberculosis infection rates to be as much as 20 times higher. Senator Leahy, who last month visited Haiti’s Prison Civile in Port au Prince, cited the filth, overcrowding, and sickness he saw there, as well as the efforts of the nonprofits Health through Walls and the Rural Justice Center to bring access to medical care and justice behind its walls, in his statement.
Health through Walls, which only began to receive USAID funding in the last few years, has promoted medical screening and treatment, as well as improved nutrition and sanitation at the Haiti prison and other prisons in the Caribbean and Africa for more than a decade, successfully addressing outbreaks of infectious diseases and malnutrition. In 2007, its director and co-founder Dr. John May noted what appeared to be a return of malnutrition symptoms, when he began to see patients with swollen feet and legs. With the prison by then overcrowded to more than four times its capacity, he learned, the swelling resulted from prisoners who had no room to sit or lie, standing, 24 hours a day. With funding, the organization systematized healthcare at the facility, including bringing needed equipment and medicine to diagnose and treat HIV and tuberculosis. A USAID-supplied GeneXpert machine, to diagnose tuberculosis, including drug-resistant strains, and among HIV-infected prisoners is on the way.
“They are examples of how modest funding can save lives,” Leahy said. Many in the penitentiary he saw in Haiti, as well as around the world, he said, have not been convicted of crimes, but are imprisoned while awaiting trial, or after “woefully unfair trials including for nothing more than peacefully expressing political or religious beliefs or defending human rights.”
In his statement accompanying announcement of the resubmitted bill, Inhofe said he has made more than 100 visits to African countries in the last three decades. He added, “I believe that given the chance the majority of Africa’s leaders will welcome the opportunity to interact with our embassy and consulate personnel and adopt the best practices for achieving the elimination of unhealthy and unsafe conditions in their prisons and other detention facilities.”
Inhofe’s statement closed with a biblical quote: “Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.”