LAW and order go hand in hand to ensure justice and well-being of society, to maintain a balance of power, to limit excessive authority that infringes on others’ basic freedom and to uphold basic rights for the vulnerable. While the law includes punishment by suspending certain fundamental human rights of prisoners to serve the greater purpose, it is never acceptable to eliminate the same rights that every human being is entitled to, one of such fundamental human rights being health care.
Accessing healthcare facilities is a basic human right and there are no exceptions to this rule. The state should ensure that all people, including prisoners, receive proper healthcare. The Geneva Convention, particularly Convention (III) relating to the Treatment of Prisoners of War, guarantees that all prisoners receive proper hygiene and medical care, mandating provisions for medical attention, treatment and regular medical check-ups by the detaining authorities. Detaining authorities are obliged to uphold these standards, which include the provision of hospitals and trained medical professionals to address serious illnesses or injuries.
Bangladesh has ratified numerous international treaties and conventions that affirm the right to access medical care for all individuals without discrimination based on factors such as race, sex, nationality, ethnicity, language, religion, or any other status. These include the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, the International Covenant on Civil and Political Rights and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. All of these treaties focus on ensuring a right to life with dignity and securing people from cruel or degrading treatment, necessitating the access to health care as a core element of a decent lifestyle.
Moreover, the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules) provide detailed guidelines on the treatment of prisoners, emphasising access to health care. Rules 25 to 35 specifically address healthcare access, stating that all prisoners should receive healthcare at a level equivalent to that available in the community, regardless of their legal status. This underscores the obligation to provide medical care to prisoners consistent with international human rights standards.
In our context, Article 32 of the Constitution of Bangladesh outlines the right to life and Article 35, which addresses protection in relation to trial and punishment, explicitly states that no person shall be subjected to torture or to cruel, inhuman, or degrading punishment or treatment. Both articles ensure a broad spectrum of protections, implicitly including healthcare protection for prisoners. In addition, the jail code and the Prison Act, 1894, mandate provisions for ensuring prisoners’ health care by regular medical checkups, hygiene and access to reasonable medical services.
Although these international standards and national legislation have structured a skeleton to ensure health care for prisoners by ensuring their access to medical assistance and treatment, the administrative approach and management sometimes fail to reflect the obligation of the detaining authorities to provide necessary assistance concerning these. For prisoners in Bangladesh, this right remains a distant promise as they grapple with a severe healthcare crisis within the country’s prison system. The ratio between appointed doctors and prisoners makes it difficult for doctors to provide proper treatment.
A recent study has shown that there are only 16 doctors against 77 posts, serving approximately 90,000 inmates. Hospital facilities are available in only 12 prisons, leaving others without essential healthcare services such as ambulances and emergency care. The scarcity of doctors and healthcare facilities affects not only the general prisoners but everyone in the prison system. Reports to the court in November 2019 indicated that there were only 10 doctors serving in 68 prisons, out of 141 available positions. By 2021, 112 doctors had been appointed across the country’s prisons, still leaving vacancies.
Despite clear guidelines outlined in the Jail Code regarding health care for prisoners, authorities in Bangladesh have failed to adhere to these standards. Lawyers and rights activists note that deaths, particularly from cardiac diseases, occur due to the inability of prison medical centres to provide immediate life-saving care. Medical centres in district jails often operate without physicians. Families of prisoners lament the arduous process of obtaining medical care, often resorting to bribery to navigate bureaucratic hurdles. In June 2019, the High Court, in response to a writ petition, urged jail authorities to expedite the recruitment of physicians. However, prison officials cited that physicians are often hesitant to join the prison health system due to financial and professional concerns.
Bangladesh, like many other countries, struggles with overcrowded prisons and limited resources. However, the situation is exacerbated by inadequate healthcare services, leaving prisoners with limited access to essential medical treatment and facilities. Reports from human rights organisations paint a grim picture of neglect, with instances of preventable deaths and untreated illnesses haunting the system.
One of the primary challenges facing the prison healthcare system is the shortage of medical personnel and facilities. With a high inmate-to-doctor ratio, many prisoners do not receive time for medical attention, leading to the worsening of conditions and increased suffering.
In response to mounting pressure, the government has pledged to improve healthcare services within the prisons. Initiatives such as increasing the number of medical staff, enhancing infrastructure and providing specialised care for vulnerable populations have been proposed. However, the effectiveness of these measures remains to be seen, as implementation and accountability remain key challenges.
As Bangladesh struggles with this humanitarian crisis within its prison system, urgent action is needed to uphold the rights and dignity of all individuals, including those behind bars. Only through concerted efforts to address the root causes of the healthcare crisis can meaningful change be achieved, ensuring that no prisoner is left to suffer in silence.
Barrister Tasmiah Zaman is senior associate at Mahbub & Company and Somaiya Islam is an associate at Mahbub & Company.
