Coronavirus has completely changed the daily lives of all people, invading even the daily life of those who are often most forgotten: people deprived of liberty. As the media have shown, the contagious virus has had great consequences on the prison population in the world, with thousands of deaths, leaks, quarrels and riots, affecting the criminal population and those around it, officials and family members.
Indeed, between these walls, contagious diseases such as coronavirus are a country issue. Prisons have long been shown to have increased risk of contagion and incidence rate of infectious diseases such as influenza, tuberculosis, HIV, hepatitis B and C, among others (WHO, 2014)[1]. For example, the TB rate is usually 5 to 80 times higher in prisons than in the non-private population of freedom (WHO, 2014). HIV, on the other hand, has been observed to be up to 50 times more among the criminal population than in the general (WHO, 2014). Finally, other diseases such as hepatitis C also have alarming figures, from 6 times more likely to be suffered among the criminal population in prisons in Brazil, 10 times more in Taiwan, and between 21-39% in Australia, in contrast to the general population (How, Kumar, Taylor, Sumantera, Rich, 2003)[2].
These figures, despite being alarming, are long-breathed and present in virtually every prison in the world. It is therefore striking how little progress has been made in preventing these cases. The causes, moreover, are also clear, identifying poor prison conditions, overcrowding, lack of toilet spaces and drinking water, and limited access to vaccines or health treatment as the main factors (Biswanger, Blatchford, Forsyth, Stern, Kinner, 2016)[3], (WHO, 2014).
Contextualizing the scenario in our country, the national prison reality generates optimal conditions for the internal expansion of the coronavirus. We have a rate of 228 inmates per 100,000 inhabitants (Prison 2019), with excessive overpopulation rates such as CDP Limache that exceeds almost double its capacity (189%). There are also prisons without access to safe drinking water, with poor electrical facilities, no clean toilets, and a widespread lack of specialized medical care, or even nursing. Even more, today, only one prison has a hospital (LEASUR, 2018[4]).
Worse still, considering that the “high-risk population” stipulated in the country’s protocols, i.e. older adults, pregnant women, children and adolescents and people with chronic diseases, are also present in prisons. By way of example, the older adult population (aged 60 years and older) in prisons represents 2.7% of the total prison population, corresponding to 1,122 detainees. Of these, 11% are women and 89% male, and one-fifth (25%) is deprived of freedom as impeuted (GENCHI, 2018[5]). In turn, in addition to the thousands of children and adolescents in SENAME, as of October 2019, prisons had 75 pregnant women, 104 women with nursing children under 2 years of age, and 106 children under 2 years of age in the country’s prisons.[6] Of these cases, there has not yet been a government pronouncement. Finally, according to a study carried out in Chilean prisons in 2012, 45% of the penal population presents at least one formally diagnosed pathology, the second most common pathology being those affecting the respiratory system, predominating asthma (Osses-Paredes and Riquelme-Pereira., 2013)[7]
The solution? There is no written recipe, but we can learn from the mistakes or strategies of other countries. The following measures are humbly proposed:
Do not restrict visitors in a sharp way, for this has caused riots, anger, and mass chaos. The cases of Italy and Brazil account for this. It should be considered that, without much background or information, they are restricted from visits, which in turn implies a blockage of income of food and other goods that require them to live. It should be remembered that coronavirus impacts not only health, but also social and mental well-being. For this reason, it intends to inform the penal population correctly, reassure, and raise awareness. In this way, they are more likely to request to suspend visits, to protect themselves and their loved ones, as has been observed in Bolivia and Argentina.
Use, as far as possible, alternative measures to deprivation of liberty. The government has shown progress on this for the older adult population, with the exception of those who have committed serious crimes such as humanity, however, it can also be applied to the more than 14,000 people in pre-trial detention or to women with lactating children. We see in Iran an example of this.
Maintain a vaccine system for detainees, civil servants and their families. In turn, in case of suspicion or contagion, apply isolation protocols, safeguarding decent treatment to people. This should also be applied to civil servants, since, for example, in Spain, through a kindergarten worker in a prison, there are at least 1 woman and 3 children in the maternity modules of the prison under observation.
Finally, and above all, it is necessary to change the cultural mindset of an entire country that considers the use of prison to be the solution for everything, and that the criminal population is not relevant. In a context of global health crises like today, it is clearer than ever that “prisons are built to maximize control and supervision, but not to minimize transmission of a virus or to provide access to effective health” (Bick, 2007[8]).
In these times of cholera, or rather, coronavirus, can reflect not only public health problems in different countries, but also the precariousness of prison. Let us remember, “prisoners also cough” (Ariza and Ciprian, 2020)[9].
[1] World Health Organization (2014). Prisons and Health. Edited by: Stefan Enggist, Lars Muller, Gauden Galea and Caroline Udesen.
[2] Macalino, G. ., Hou, J. ., Kumar, M. ., Taylor, L. ., Sumantera, I. ., & Rich, J. . (2004). Hepatitis C infection and incarcerated populations. International Journal of Drug Policy, 15(2), 103–114. doi:10.1016/j.drugpo.2003.10.006
[3] Binswanger, I.A., Blatchford, P. J., Forsyth, S. J., Stern, M. F., & Kinner, S.A. (2016). Epidemiology of Infectious Disease-Related Death After Release from Prison, Washington State, United States, and Queensland, Australia: A Cohort Study. Public health reports (Washington, D.C.: 1974), 131(4), 574–582. https://doi.org/10.1177/0033354916662216
[4] LEASUR ONG (2018). Prison Conditions Report. Situation of prisons in Chile.
[5] Gendarmerie of Chile (2018) Statistical Penitentiary Compendium 2018.
[6] Gendarmerie of Chile (2019) Statistical Bulletin
[7] Osses-Paredes, C., & Riquelme-Pereira, N.. (2013). Health situation of inmates in a prison compliance centre, Chile. Spanish Journal of Prison Health, 15(3), 98-104. Retrieved 18 March 2020, http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1575-06202013000300003&lng=es&tlng=es.
[8] Joseph A. Bick, Infection Control in Jails and Prisons, Clinical Infectious Diseases, Volume 45, Issue 8, 15 October 2007, Pages 1047–1055, https://doi.org/10.1086/521910
[9] https://cerosetenta.uniandes.edu.co/los-presos-tambien-tosen/
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