VIVEKANANDA INSTITUTE OF PROFESSIONAL STUDIES

VIVEKANANDA INSTITUTE OF LAW AND LEGAL STUDIES

HUMAN RIGHTS LAW

PSDA

TOPIC
CUSTODIAL DEATHS : POOR MEDICAL CARE FOR PRISONERS

Submitted by - Submitted to -
Name : Jasmine Suri Dr. Navjeet Sidhu Kundal
Semester and Section : 7L Assistant Professor, VSLLS
Enrollment number : 06417703520

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 INTRODUCTION

Custodial death can be interpreted as the death of an accused during pre-trial or after
conviction. The death is caused by the direct or indirect action of police during
custody. It includes death occurring not only in jail but also on medical or private
premises, or in police or another vehicle. Custodial deaths can be classified into three
types:

1. The death occurred in police custody.

2. The death occurred in judicial custody.

3. The death occurred in the custody of army or paramilitary forces.

Custodial death can occur due to some natural reasons, where there is no involvement
of any other person or any kind of foul play by the police, for illustration - instances
when a convict or an accused die of an illness. But the problem arises when the law
enforcement authority is involved in the death of an individual while he or she is in
their custody.

LACK OF PROPER MEDICAL FACILITIES : WHAT THE DATA

TELLS US

As per The National Crime Records Bureau (NCRB) prisons statistics for 2018, of
the total deaths, as many as 1,639 persons died of “natural causes”, while 149 were
categorised as “unnatural deaths”. Another 57 deaths were for “unknown reasons”, as
some states have not furnished the required information.

The report neatly lays down the categories of deaths under two columns – natural and
unnatural. But a close look at the causes of death under the “natural death” category
and the illnesses listed indicates that there is nothing natural about these deaths. The
unnatural deaths category also evades judicial and state responsibility of providing
proper mental health care and security to those dead due to suicide, attacks and other
accidents while in judicial custody.

Among the natural deaths, data shows us that a majority of the deaths were reported
under heart-related ailments (411), lung-related ailments (231), tuberculosis (103),
cancer (80), liver- related ailments (72), brain haemorrhage (59), kidney-related
ailments (58) and HIV (46), among others. Prisoners’ rights activists, scholars and
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government hospital doctors say that most of these deaths could have been avoided if
proper medical facility was made available on time.

Prisons, as per the 2018 data, are working at almost half of the sanctioned medical
staff capacity. A total of 1,914 medical staff were actually posted in Indian jails
against sanctioned strength of 3,220 at the end of the year 2018. Uttar Pradesh has
reported the highest number of vacant medical staff posts at 240, followed by Bihar
with 217 vacant posts and Jharkhand at 153.

And these are just the sanctioned posts. Most prisons in India are overcrowded, and
so automatically the need for medical staff is higher. For the year 2017-18, Rs 6,068.7
crore was sanctioned for the prisons department across India. Of that, only 4.3% was
spent on the medical needs of those incarcerated.

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 CASE STUDY

Death of Jagannath Paoji Ingule, failure on the part of the Medical Officer
to diagnose at an appropriate time : Maharashtra (Case No. 16102/96-97/
NHRC)

The undertrial prisoner, Jagannath Paoji Ingule, aged 44 years, was in Nasik Road
Prison. After nearly one-and-a-half years of under-trial custody, he complained of a
swelling in the abdomen and general weakness following which he was admitted in
the Prison Hospital on the same day and from there he was referred to the Civil
Hospital for expert opinion. Later, he was again admitted in the Prison Hospital with
amoebic dysentery and severe anaemia and was referred to the Civil Hospital, Nasik
for further treatment. On 3 February 1997, he succumbed to death in the Civil
Hospital, Nasik.

The inquest report could not arrive at any conclusion on the cause of death. The post-
mortem report revealed that the prisoner was suffering from an advanced stage of
pulmonary and abdominal tuberculosis. The post-mortem report stated the probable
cause of death as cardio- respiratory arrest due to ‘pulmonary tuberculosis and plural
effusion’ and ‘abdominal tuberculosis and ascites and anaemia.’

The National Human Rights Commission considered it unfortunate that the disease
was not diagnosed even though the under-trial prisoner was in custody for more than
one-and-a-half years. He was being treated for amoebic dysentery while he was
actually suffering from an advanced stage of tuberculosis – pulmonary as well as
intestinal – a fact which was revealed in the post-mortem and which could have been
easily diagnosed with due diligence and care before the illness reached serious
proportions. The Commission held that access to adequate, timely and proper medical
diagnosis and treatment is an inherent right of prisoners whose freedom to seek and
have access to medical aid outside of the prison and on their own is curtailed by law.
It was further observed that diagnosis and treatment of tuberculosis is no more a
sophisticated area of medicine. With the large-scale manifestation of this infectious
ailment in the jails, any jail medical staff should reasonably be expected to know, or
ought to know, what was the diagnosis of the case that had been admitted.

While holding that there was negligence in the protection of the prisoner’s human
right to life and that the dependants of the victim were entitled to immediate interim
relief under Section 18(3) of the Protection of Human Rights Act, 1993, the
Commission recommended that -
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(i) an immediate interim relief of Rs.1 lakh to be paid by the State Government to
the dependants of the deceased; and

(ii) that the State Government should make a comprehensive appraisal for the control
of the spread of tuberculosis and other infectious diseases in the prisons and to
install, wherever lacking, adequate diagnostic facilities.

COMMENTS :

In the case of 1Shri D.K. Basu vs. State of West Bengal, detailed instructions were
given by the Supreme Court on the procedures to be followed by the police in cases
of arrest or detention. These instructions, inter-alia, include

• The arrestee should, when he so requests, be medically examined at the time of

arrest and major and minor injuries, if any, as are present on his or her body, must
be recorded in a memo. The inspection memo should be signed both by the
arrestee and by the police officer concerned, and a copy should be given to the
arrestee.

• The arrestee should undergo a medical examination by a trained doctor every

forty- eight hours of his detention in custody.

• The Supreme Court of India imparted a new dimension to the enforceability of

these directions by attaching the sanction of commitment for contempt for breach
or violation of these requirements. Article 10(1) of the ICCPR requires the State
party to ensure that all persons deprived of their liberty shall be treated with
humanity and respect for the inherent dignity of the human person. Article 11 of
the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment
or Punishment stipulates that each State Party shall keep under systematic review
interrogation rules, instructions, methods and practices as well as arrangements for
the custody and treatment of persons subjected to any form of arrest, detention or
imprisonment in any Territory under its jurisdiction, with a view to preventing any
cases of Torture.

1 (AIR 1997 SC 610)

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Death of Sibu – delay in the provision of timely medical aid: Kerala (Case
No.136/11/2000- 2001-ACD)

Then Commission received a complaint dated 24 June 2000 from Shri Unnikrishnan
Namboodiri, a resident of Palakkad, Kerala alleging that Sibu alias Sreekuttan died in
the sub- jail, Kottayam while in judicial custody. The petition alleged that Sibu
suffered from pain in his chest but the prison superintendent and a police constable on
duty delayed his admission in hospital, which eventually led to his death.

In response to a notice issued by the commission to the Director General of Police,

Kerala, the SDM, Kottayam submitted a magisterial inquiry report dated 22 April
2000 which stated that the deceased was arrested in connection with crime
No.41/2000 and was remanded to the sub- jail, Kottayam on 6 April 2000. The
condition of the deceased worsened on 9 April 2000 but timely action was not taken
to extend medical care to him consequently He died during the night of 9 April 2000.
The Superintendent, sub-jail, Kottayam was responsible for not taking the proper
steps and not issuing directions to the staff to provide immediate medical assistance
to the under-trial’s prisoners. In its proceedings of 20 November 2000, the
Commission held that Sibu appeared to have died because of the denial of timely
medical aid, which showed gross negligence on the part of the jail prison
superintendent.

The Commission, therefore, directed the Government of Kerala to initiate

departmental proceedings against the Jail Superintendent for dereliction of duty and
also issued notice to the Chief Secretary, Government of Kerala to show cause as to
why immediate interim compensation of Rs.50,000/- be not paid to the next of kin of
the deceased. The Government of Kerala in its reply dated 26 June 2001 indicated
that the mother of the deceased had filed a Writ Petition before the Kerala High Court
which had directed CBI investigation into the case. The Government, therefore,
submitted that it would be premature to consider the payment of any compensation as
any laxity on the part of the jail authorities in giving timely treatment could be
established only after getting the report of the CBI. The Commission was, therefore,
requested to defer its decision on the show cause notice until a final decision was
arrived at on the basis of the inquiry report to be submitted by the CBI before the
court, as directed by the High Court of Kerala. The Commission considered the stand
taken by the Government of Kerala and held that the law relating to immediate
interim relief is laid down under Section 18 (3) of the Protection of Human Rights

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Act, 1993. Immediate interim relief under Section 18 (3) has to be co-related to the
injury or loss which the victim or the members of the family suffered owing to the
violation of human rights by public servants. The Commission took the view that the
award of immediate interim relief is not dependent upon proof of criminal liability
beyond reasonable doubt or the result of the investigation being conducted by the
CBI etc. Accordingly, by its proceedings dated 14 June 2002, the Commission
directed the Government of Kerala to pay a sum of Rs.50,000/- as interim relief to the
next of kin of the deceased.

In compliance, the Government of Kerala submitted a report dated 16 October 2002

enclosing a copy of the sanction issued for the payment of Rs.50,000 to the next of
kin of the deceased.

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 INTERNATIONAL LAWS DEALING WITH HUMAN RIGHTS AND
RIGHTS OF PRISONERS

The provisions relating to the rights and treatment of the prisoners are contained in
various international instruments like the Universal Declaration of Human Rights, the
International Covenant on Civil and Political Rights, the United Nations Standard
Minimum Rules for the Treatment of Prisoners, the European Convention for the
Prevention of Torture and Inhuman or Degrading Treatment or Punishment and the
United Nations Basic Principles for the Treatment of Prisoners etc.

- The Universal Declaration of Human Rights (UDHR)

The General Assembly of the United Nations (UN) adopted the Universal Declaration
of Human Rights (UDHR) on December 10, 1948 to promote the human rights in the
world. It has been stated under Article 1 of the UDHR that all human beings are born
free and equal in dignity and rights. Article 2 of the UDHR provides that everyone is
entitled to all the rights and freedoms set forth in this Declaration, without distinction
of any kind, such as race, colour, sex, language, religion, political or other opinion,
national or social origin, property, birth or other status. It is clear that the term “all
human beings” used in Article 1 and the term “everyone” used in Article 2 also
includes prisoners.

Article 3 of the UDHR states that everyone has the right to life, liberty and security of
person. Right to life is one of the basic human rights and is available to both either to
prisoner or to freemen. It is be clear from the language of the Article 5 of the UDHR
which states that no one shall be subjected to torture or to cruel, inhuman or
degrading treatment or punishment.

- The International Covenant on Civil and Political Rights (ICCPR)

Regarding the treatment of prisoner’s provisions are made in the International
Covenant on Civil and Political Rights (ICCPR) which has been adopted by the
General Assembly of the United Nations adopted on December 16, 1966 and came
into force on March 23, 1976. Article 6(1) of the ICCPR grants every human being
whether prisoner or freemen inherent right to life. This right shall be protected by law
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and no one shall be arbitrarily deprived of his life. It has been further provided under
Article 7 of the ICCPR that no one shall be subjected to torture or to cruel, inhuman
or degrading treatment or punishment.

Article 10 of the ICCPR which is most important Article in respect of treatment of

prisoners. It provides that all persons deprived of their liberty shall be treated with
humanity and with respect for the 2inherent dignity of the human person.

- The United Nations Standard Minimum Rules for the Treatment of Prisoners
It has been adopted by the First United Nations Congress on the Prevention of Crime
and the Treatment of Offenders, held at Geneva in 1955, and approved by the
Economic and Social Council by its resolutions 663 C (XXIV) of 31 July 1957 and
2076 (LXII) of 13 May 1977. The United Nations Standard Minimum Rules for the
Treatment of Prisoners contains many rules regarding the rights and treatment of
prisoners. Some of them are as follows: -

• Provisions relating to the separation of categories of prisoners.[14]

• Provisions relating to the accommodation.[15]
• 3Provisions relating to the clothing and bedding
• 4Provisions relating to the food
• 5Provisions relating to the exercise and sport
• 6Provisions relating to the medical services
• 7Provisions relating to the protection of prisoners against double jeopardy

2 The International Covenant on Civil and Political Rights, Article 10, Paragraph 1.
3 The UN Standard Maximum Rules for the Treatment of Prisoners, Rules 17 to 19.
4 Ibid Rule 20
5 Ibid Rule 21
6 Ibid Rule 22 to 26
7 Ibid Rule 30
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• 8Provisions relating to the prohibition of corporeal punishment, punishment by
placing in dark cell, and all cruel, inhuman or degrading punishment.

• 9Provisions relating to the information to and complaints by prisoners.

• 10Provisions relating to the rights of prisoners to contact with their family and
reputable friends.

Apart from these rules the United Nations Standard Minimum Rules for the
Treatment of Prisoners also made rules regarding the treatment of prisoners under
sentence, insane and mentally abnormal prisoners, prisoners under arrest or awaiting
trial, civil prisoners and persons arrested or detained without charge in a detailed
manner.

8 Ibid Rule 31
9 Ibid Rules 35 to 36
10 Ibid Rules 37 to 39
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 SUGGESTIONS AND CONCLUSION

When the state takes away a person’s liberty, it assumes full responsibility for
protecting their human rights. The most fundamental of these is the right to life. Each
year, however, many people die in custody. Though majority of these deaths are due
to natural causes, but improper medical facilities could be an important aggravating
factor. Providing healthcare facilities, equivalent to that available in the community is
one of the most important remedial measures. The provision of adequate treatment
for HIV, communicable diseases, drug and alcohol addiction in detention is essential
in order to protect the rights to life. Proper awareness among jail authorities and
prisoners in such cases can prevent further spread of infection among the inmates.

Developing good practice standards on training; reviewing recommendations from

NHRC, and monitoring progress in their implementation are some of the steps in a
positive direction. Systemic measures to improve prison conditions, collecting and
sharing information on deaths in custody; and commissioning research and
implementation of the recommendations by the Government, should be undertaken.
The views of the Commission for better maintenance and running of prisons, better
trained and more dedicated staff, including medical staff, and de- crowding of prisons
are few of the important suggestions to be followed.

Factors such as timely medical diagnosis and treatment, facilities for quarantine in
communicable diseases are few of the important issues relating to the healthcare of
the individuals in custody. Strictly following guidelines & slight modification in the
already laid down procedures, as well as compliance among jail authorities will go a
long way reducing the morbidity and mortality among prisoners.

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