The problems in our prison systems are well documented. These include severe obstruction and excessive delays in the courts. Another issue is the lack of acute care for their health.
This is one reason for continued imprisonment because the overwhelming prison population is poor – there is no money to send money on bail up to the P500, and there are no resources to effectively advise and collect evidence in defense. This also means no financial capacity to pay attention to welfare situations. The first five diseases after imprisonment are upper respiratory tract infection, acute gastroenteritis, influenza and tension headache.
How bad is it? For people who have been sentenced to prison and enjoy the assumption of innocence, the Prison Administration and Criminal Bureau (BJMP) has fewer than 15 health officials who will join more than 200,000 people deprived of liberty.
This is translated to a medical officer for about 15,000 prisoners. If each officer checks 10 inmates a day for a calendar year, it will take 40 years to see them all. This assumes that only ordinary control and all medics have the necessary skills and training.
The drug allowance for detainees is less than P15 per day or P500 per month. Each year, the BJMP sues an increasing budget for the needs of prisoners and annually creates problems.
Given the congestion and inadequate support facilities and the fact that the majority of detainees are arrested for substance abuse, a particular issue that reaches the epidemic level is the transmission of human immunodeficiency virus (HIV) and other blood infections, including hepatitis. Prisoners for sharing needles for drug use.
High risk behaviors, such as male-male sex, without the use of condoms, combine the problem.
We have an HIV law that came into force in 2018 – the Philippine HIV and AIDS Policy Act (Republican Act No. 11166). Volunteer testing is encouraged. Mandatory testing is permitted where necessary to test a person accused of serious and minor physical injury, rape and simple seduction; or in the case of blood or organ donation.
HIV testing requires informed consent from prisoners. Some have religious beliefs that prevent them from participating in voluntary examinations. The stigma, fear and ignorance around HIV and AIDS are barriers to the need for openness and understanding of the HIV epidemic in the prison population. Open laws and policies and adequate tools supported by competent staff are essential for the health management of prisons.
Test results to protect the privacy of test results are confidential. Non-discrimination is hidden in the law, but low awareness of the causes of HIV that may cause AIDS. The public health dimension requires data on people infected with HIV / AIDS to provide general information about the prevalence of the disease.
The recent passing of the General Health Act is another pillar of support that may include packages for drug use and treatment use. The affordability of health services remains a key determinant for the protection of any cohort anywhere in its health.
In developed economies, no one dies of AIDS anymore. HIV and AIDS are treatable diseases that come with an official price tag. Early detection is important for referring infected persons to appropriate medical facilities for treatment and care. It's too late and there's a death sentence.
Prevention is still the best solution, but with the conditions in our prisons that do not follow the rules, the HIV epidemic appears to be joining the cluster with the dengue epidemic and the resurgence of polio.
Indeed, Dostoevsky's observation that “a society should be judged on how it treats its criminals, not on how it treats its elite citizens” is reinforced by how we treat innocent detainees who spend their days or nights wasting their lives. It may never come, especially for the sick.
Physical death can be a comfort. Mental illness can reduce pain. But suffering will not be justified by our inaction. Both of us should not be institutionalized in our systems that are called for treatment and rehabilitation, maintenance and reform.