Healthcare facility is an intrinsic and indispensable part for every prisoner irrespective of the gravity of crime for which he/she has been convicted. Though the prisoners are contained in a closed environment, they are entitled to their basic Fundamental and Human Rights. The prisoners are sent to prison as punishment but it should not have an inimical effect on them. Public health policies are supposed to clinch the best feasible living condition for all the members of the society with no exception to the prisoners. The nasty and overcrowded prisons take a toll on the health of the prisoners leading to a spiteful life. The pathetic condition and environment in the prison not only affect the physical health of the prisoners but also exceptionally deteriorate their mental health. The conditions of the jails in India are mostly appalling and, in some places, the primary and basic healthcare facilities also are not provided to them. The prisoners are very prone to infectious diseases as they regularly come across various people who are constantly in and out of the prison. And in most of the prisons the basic tests for detecting dreadful infectious diseases do not take place.
Table of Contents
Need of Healthcare for Prisoners
Health is one of the prime components for human development which directly affect the socio-economic development of a nation. Healthcare is a fundamental right guaranteed to us under Article 21 of the Indian Constitution. However, this healthcare facility is not accessible to the prisoners to the full extent. The prisoners become vulnerable both physically and mentally. There are numerous reasons which affects the mental health of the prisoners, which in most of the cases takes a toll on their physical health. There is no privacy for the prisoners, moreover the prisons are cram-full, violence in prison, lack of physical or mental activity in the prison, and many other factors affects the health of the inmates. The prisoners are in dire need of healthcare facilities in order to restrict their lives from becoming worse. The Supreme Court in the case of Pt. Parmanand Katara v. Union of India & Ors  has vehemently observed that whoever is in charge of a particular community is under the obligation to preserve the life of innocent people as well as of criminals. Moreover, every doctor is under a professional obligation to extend their service in protecting the lives of people. The prisoners are sent to prisons as punishment and for their rehabilitation. So, the inmates must be provided with the basic requirements to live their life with dignity. Proper hygiene, sanitation, food facility and medical treatments must be made accessible to the prisoners who are already undergoing a hostile phase in their life.
Factors affecting Prisoner’s Health
There are quite a few factors that negatively affect the physical as well as the mental health of the prisoners. The factors including and not limited to are as follows:
As per the data of the 2019 Report of the National Crime Records Bureau, on the population and Occupancy rate or prisoners in the country, the average occupancy rate of the jails in the country is 118.5% . Overcrowding of the prison proves to be very problematic for maintaining proper hygiene, sanitation and healthcare. This excessive cram-full condition of the prisons causes appalling problems for the inmates making themselves prone to several physical and mental illnesses.
Poor hygiene conditions in the prisons increase the susceptibility of the prisoners to infectious diseases. Proper hygiene helps to maintain a control over the same, thus decreasing the rate of spread. But the already congested prisons face immense difficulty in maintaining basic hygiene in order to prevent the spread of dreadful diseases and transmissible infections. Exiguous hygiene conditions make the prison environment filthy which concomitantly affects the mental health of a person thus making their life more miserable.
Sanitation is a basic public health condition that helps in providing a clean environment thus restricting the transmission of any kind of disease. Sanitation includes the availability of an adequate amount of clean drinking water, proper disposal of sewage and human excreta. Unavailability of soaps, washbasins, sanitary napkins, disinfectants and other cleansing and sanitizing agents are the major hindrances in maintaining proper sanitation of the prison. Thus, the inmates become more vulnerable towards infection and diseases.
Violence in Prison
Violence is very much prevalent in prisons. The root of this violence may be due to ethnic or religious clash or for any other personal reason among some inmates. The constant violence in the prison has a pernicious effect on the mental and physical health of the prisoners. Moreover, sometimes violence among the inmates leads to bloodshed. Blood contamination can led to menacing diseases such as Brucellosis, AIDS, Hepatitis B etc.
In many instances, it has been observed that the inmates engage themselves in uninterrupted drug abuse.it is observed that the majority of the prisoners have been engaged in illicit drug abuse at some point of their life. 
A bulk of people who have the experience of incarceration have a history of alcohol consumption, tobacco intake and/or illicit drug use. 
Constant engagement in drug abuse causes paranoia , anxiety and other mental disorders among the inmates.
Right to Healthcare for Prisoners
The prisoners like every other individual are entitled to the basic fundamental rights. The Supreme Court in D. Bhuvan Mohan Patnaik & Ors v. State of Andhra Pradesh & ors ardently held that the convicts are not deprived of all the fundamental rights which they would otherwise possess merely because of their conviction. 
Some of the legal provisions safeguarding the right to health of the prisoners are as follows.
Universal Declaration of Human Rights
Under Article 25(1) of UDHR (Universal Declaration of Human Rights), everyone has the right to medical care and a standard of living adequate for health and wellbeing. 
International Covenant on Economic, Social and Cultural Rights
Under Article 12 of the ICESCR (International Covenant on Economic, Social and Cultural Rights) everyone has the right to enjoy the attainable physical as well as mental health. 
In the case of Bandhua Mukti Morcha v. Union of India & Ors it was observed that the life and breath of article 21 is derived from the provision of Article 39(e) thereby protecting the health of every individual and recognizing Right to Health as a Fundamental Right. 
Everyone has a right to live with human dignity which includes the protection of one’s health which is a minimum and a basic need for survival.
The State is under obligation in directing its policy towards securing that the health and strength individuals are not abused.
Model Prison Manual 2016
As per Model Prison Manual 2016 released by the Ministry of Home Affairs, the prisoners have the right to basic minimum needs which includes health and medical care among other requirements.
Moreover, under this manual extensive screening will be made available for women prisoners including tests to detect presence of Sexually Transmitted diseases, drug dependency, mental health problems.
Furthermore, mental health assessment must be made for death row prisoners and physical and mental health reports of such prisoners must be made to certify that they are fit both mentally and physically 
The Prisons Act
The name of the prisoners, who desires to see a medical subordinate or who ever is out of proper physical or mental health, must be reported to the jailer by the officer in immediate charge of the prison.
A hospital or a proper place for the reception of the sick prisoners shall be made available to the prisoners in every prison.
No punishment of penal diet must be given to the prisoners. Furthermore, the Medical officer must certify what extent of punishment the prisoner can undergo without any kind of injury to his health. 
Healthcare Facilities under Model Prison Manual,2016.
The Supreme Court of India has directed the States to take into consideration the Model Prison Manual of 2016 for implementing rehabilitation and reformative programs. Under this Manual, the facilities available to the prisoners are as follows
- Hospital accommodation must be provided to the Prisoners.
- The Chief Medical Officer of the Medical officer in charge shall examine the sick prisoners every day and for aged patients special care must be taken, especially in terms of ophthalmological care, dental care, physio-therapy etc.
- Special de-addiction program is to be organized for the prisoners who are identified as drug addicts.
- Following clinics such as Dental clinics, Ophthalmological Clinics, Clinical Laboratory, Minor operation theatre, Psychiatric Unit etc. to be available to the prisoners.
- The diet of all the prisoner’s is shall be entirely under the control and supervision of the chief medical officer.
- Any Patient suffering from any kind of Illness or disease must be sent for immediate treatment either as an outdoor patient or as an indoor patient.
- There must be a proper place for washing clothes, and overall cleanliness of the hospital must be maintained and the patients who are not too ill shall be required to bathe every day.
- Special care must be taken for the prisoners for prisoners who are losing weight or whose physique has become poor upon admission in the prison.
- All the prisoners are to be vaccinated on admission in the prison.
- Prisoners with cases of dysentery and diarrhea must be segregated and kept in separate ward
- Prisoners with pulmonary tuberculosis to be segregated in separate wards
- Prisoners with minor infectious disease such as mumps, measles, scabies etc. on no account must be ignored and neglected.
- In the cases where the prisoners are showing signs of lunacy and if they are noisy or filthy must be kept in separate cells.
The overall condition in most of the prisons is not at all up to the mark. Though the Model Prison Manual, 2016 has thrown light on the healthcare facility of the prisoners but the guidelines are yet to be implemented in the prisons. Overcrowding of prisons proves to be very problematic for the inmates thereby creating a hindrance in giving proper healthcare facility to the prisoners. The concerned authority must adhere to the strict implementation of all the facilities under the Model Prison Manual, 2016. The main purpose of sending prisoners to prison as punishment is for their overall rehabilitation. But if the proper healthcare or well-being of the inmates are not considered then the rehabilitation of the prisoners will not be possible. Deficient mental health is a fertile ground for increasing criminal behavior. The mental health problems of the prisoners must be properly addressed and for that special attention should be given in order to enable the prisoners for re-settlement in life.  Thus, both physical as well as mental health of the inmates must be taken care of. Prisoners must be made aware of their fundamental right to health care. It is hoped that with the due implementation of the Model Prison Manual,2016 the condition of the prisons will get better and the prisoners will be provided with adequate healthcare facilities.
 AIR 1989 SC 2039.
 National Crime Records Bureau, “Capacity, Inmate Population and Occupancy Rate of Jails”, (20 December,2019), available at : https://ncrb.gov.in/sites/default/files/psi_table_and_chapter_report/TABLE-1.2_2019.pdf (Last Visited February 7, 2021).
 Luis Royuela, Linda Montanari, Mirlam Rosa, Julian Vicente, “Drug Use in Prison: Assessment Report” (3 February, 2014) available at : https://www.emcdda.europa.eu/system/files/publications/784/Drug_use_in_prison_assessment_report_462763.pdf (Last Visited February 7, 2021).
 Stuart A, Kinner, et al(eds), Drug Use in Prisoners: Epidemiology, Implications, and Responses (Oxford University Press, March 2018), available at: https://oxfordmedicine.com/view/10.1093/med/9780199374847.001.0001/med-9780199374847 (Last Visited February 7, 2021).
 AIR 1974 SC 2092.
 Universal Declaration of Human Rights,1948 art. 25(1).
 International Covenant on Economic, Social and Cultural rights, 1966, art.12.
 AIR 1984 SC 802
 Model Prison Manual, 2016.
 The Prisons Act, 1894.
 Ms. Sumana Majumdar & Dr. Arpita Acharya, “Mental Health Problem among prison population, Udaipur, Tripura” 6 Indian Journal of Applied Research 300 (2016).
BY TIYASA LODH | LLOYD LAW COLLEGE