How prisons in Bangladesh keep Covid-19 in check

Keeping Covid at bay in prisons -

• 68 prisons across the country have the capacity to hold 42,450 prisoners, but they have now around 80,000 
• With the breakout of pandemic in March 2020, all prisons sketched up new protocols to rein in the virus transmission
• Their measures include mandatory mask-wearing, 14-day quarantine for new inmates, setting up isolation and quarantine wards, not allowing prisoners' family visits but weekly talks over phone, access to hand sanitisers and others
  

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Shayaz (not his real name), who spent over one year in Keraniganj central jail after being charged with possessing illegal drugs, did not even hear of a single case of Covid-19 infection at the facility.

The jail authorities discreetly maintain positive cases so that no one panics – this explains how Shayaz had been kept out of the loop.

Obviously, there are reports of positive cases in Keraniganj jail but the number is very low.

"Only 19 prisoners and 39 prison staff have tested positive for coronavirus since March 2020," said Subash Kumar Ghosh, senior superintendent at Keraniganj central jail.

The question is – how jail inmates managed to keep Covid-19 infections low despite living in cramped prison cells that are to house more than double their capacity. 

The 68 prison facilities (central and district jails) across Bangladesh have the capacity to hold 42,450, where it is to accommodate around 80,000 prisoners.

Now, two-three persons stay in a cell and 20-25 in a ward of Keraniganj central jail, Subash said, adding the number in a ward used to be 30-40 in the pre-pandemic time.

When the pandemic made inroads into Bangladesh in March 2020, all prison authorities sketched up new protocols to rein in the virus transmission.

Their measures include mandatory mask-wearing, 14-day quarantine for incoming inmates, setting up isolation and quarantine wards, not allowing prisoners' family visits but weekly talks over phone, access to hand sanitisers and others.

According to Subash, when a staff member tests positive, they are immediately relieved of their duty and sent home. They join work only after testing negative. 

In the case of prisoners, they are sent to an isolation centre. Keraniganj central jail has a 70-bed isolation centre set up under the initiative of the International Committee of the Red Cross (ICRC).

The Sylhet central jail reported the first prisoner's death from coronavirus in May 2020. The deceased was 55 years old. The latest Covid-19 death was of a Chattogram jail inmate that took place in the Chattogram medical college hospital on 18 April this year. The deceased was 37 years old.

Shubroto Kumar Bala, senior prison superintendent at Rajshahi central jail, said, "We have had only a prisoner and a staff member who contracted Covid-19 during my six-month time here."

No prisoner has got infected in Rangpur central jail and only a staff member tested positive there so far. In Mymensingh central jail, no prisoner or staff member has tested positive in the last eight months, according to prison sources.

Assistant Prison Inspector General Md Mainuddin Bhuiya said when prisoners show symptoms they are likely to be moved to isolation centres inside respective prisons, from where a sample is collected from them for coronavirus tests. If the test result comes positive, a prisoner is sent to a hospital for treatment, depending on the severity of their health conditions.

However, three central jails - Keriniganj, Rajshahi and Chattagram - maintained that the prisoners who tested positive for coronavirus were first sent to hospitals for different health issues such as heart condition, diabetes, etc. At the hospitals, coronavirus tests were carried out. Sample collection did not take place in the prisons.

"Coronavirus is actually a mild fever and cold virus although new strains are more lethal. But still 80% of the infected either show no symptoms or mild to moderate signs, this especially occurs among young and hardworking people," Dr AM Zakir Hussain, former regional advisor of the World Health Organisation told The Business Standard.

"It is therefore improbable that prisoners did not or do not get infected by Covid-19, rather they might not suffer noticeably," he added.

Disagreeing with a low infection rate among jail inmates, Pritom (not real name), who served his nine-month time in Keraniganj central jail from February 2018, told TBS, "If prison staff reveal one positive case, it is safe to assume it is 40 as when someone was infected in wards, it would spread like wildfire."

Speaking from his experience of living in the overcrowded facility for nine months before the pandemic, he said even the process of getting to see a doctor is lengthy. One has to notify the ward in-charge, who passes the message to the medical gate, and then to the doctor who is available.

Currently, Keraniganj, where Pritom served his time, has over 9,000 prisoners with a capacity to accommodate 4,590. And, there are only three doctors and three medical assistants available for the prisoners, according to the jail superintendent.

In the wake of the pandemic, the ICRC increased its engagements in Bangladesh's prisons.

"The pandemic has increased challenges in prisons, given specific vulnerabilities of prisoners and difficulties in preventing and containing infectious diseases," Rayhan Sultana Toma, head of Public Communications Unit at the ICRC, told TBS.

"To limit the risk of virus transmission among prisoners and prison staff, the ICRC supported the authorities in implementing standard operating procedures in 68 prisons and shared recommendations for managing prisoners in the context of Covid-19," she added.

The ICRC also supported the prison authorities in setting up three Covid-19 isolation centres in selected prisons and a tent in the Old Dhaka central jail to enlarge the accommodation capacity for prison and support staff with technical advice, gave training on infection prevention and control measures and provided essential protective equipment and medical and non-medical items.

The ICRC Detention Doctor does not treat prisoners personally, but works on the systemic level by providing expert advice to the prison authorities and supporting prison health staff through practical recommendations on health-related issues. Volunteers of the Bangladesh Red Crescent Society enabled the ICRC in their operation inside Bangladesh prisons during the pandemic.

Taking the official numbers of coronavirus infections and deaths in Bangladesh prisons at a face value, it may be ascertained that Covid-19 management in prisons is a successful model to curb the spread of the virus in overcrowded facilities. 

There have been countless reports of coronavirus outbreaks in prisons around the world, such as in China, the United States, Haiti, Mexico, Pakistan, India, Italy, Canada, and Iran.

Most recently, Thailand and many more countries' prisons have fallen victim to the virus outbreak at some point since March 2020. Not only outbreaks but there had been reports of prisoners killed in riots, where prisoners protested the lack of Covid-19 safety measures.

In comparison to the rest of the world, Bangladesh is faring well in terms of Covid-19 management across its prisons by avoiding an outbreak, so far.