Disease burden in jails

The inordinately high positivity rate of hepatitis C reported among inmates in Punjab's jails is a wake-up call for urgent policy intervention. The statewide screening has thrown up alarming results. On an average, 27 per cent of the inmates have been found to be infected. A sub-jail in Patti, Tarn Taran, has recorded the shocking positivity rate of 67 per cent. Viral hepatitis is among the leading causes of the cirrhosis of the liver as well as liver cancer, and it is a major contributor to the burden of disease in India. Studies conducted at the national level have found prison inmates to be at the highest risk for contracting hepatitis. In some cases, the risk is nine times more than that for the general population.

The vulnerability of inmates to infectious diseases in jails is attributed to cohabitation in a closed environment for long periods of time and their exposure to other risk factors. Intravenous drug abuse, needle-sharing, deviant sexual behaviour and poor hygiene are among the reasons of them being more susceptible to acquired illnesses. After release from prison, they might act as a bridge to spread the disease in the community. Reports from across the country suggest a lack of adequate medical staff in prisons, an abysmally poor healthcare budget, absence of even rudimentary conveniences and a lack of awareness about preventive strategies. Regular screening for early detection, adequate health education, and orientation of the medical staff about infection control ought to be mandatory requirements in jails.

The congestion in prisons came into renewed focus during the Covid-19 pandemic. The release of incarcerated persons on bail or parole was among the steps taken to prevent the spread of the contagious virus in the jails. That should have reduced the number of prisoners, but the occupancy rate is still way higher than the capacity. Prison and penal reforms are crucial to resolving the problems affecting the prisons.

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