Bangladesh’s prisons are holding more than twice the number of people they were designed for, while just 10 regular doctors and 23 ambulances serve around 100,000 prisoners across 68 facilities, putting emergency healthcare under severe strain.
The country’s prisons have a combined capacity of around 45,000, but the population had climbed to approximately 100,000 as of September 8, according to prison authorities.
Against that population, there are 151 sanctioned posts for prison doctors, but only 10 regular doctors are currently working.
The entire prison system also has just 23 ambulances, meaning most facilities do not have one of their own.
The shortages become particularly critical when a prisoner develops chest pain, breathing difficulties, stroke symptoms or another medical emergency requiring specialised treatment outside prison.
Before reaching a hospital, the prisoner must pass through the prison medical and referral process, while an ambulance and necessary security arrangements must also be secured.
Those concerned say the process can cost crucial time, particularly at night.
Human rights activist Nur Khan Liton said inadequate nighttime medical services and delays in transferring seriously ill prisoners to outside hospitals were longstanding problems.
“The shortage of doctors in prisons has existed for a long time. Medical services are particularly inadequate at night,” he told Bangla Tribune.
“If a prisoner becomes seriously ill, there is also a delay in sending them to an outside hospital for advanced treatment. The ambulance shortage adds to this and makes the situation even more complicated.”
Death figures raise concern
Deaths in custody have meanwhile raised further questions over healthcare conditions.
Ain o Salish Kendra recorded 97 prisoner deaths between January and August this year, compared with 61 during the corresponding period last year.
Human Rights Support Society, based on reports published by several media outlets, documented 73 deaths during the first eight months.
The Department of Prisons, however, recorded around 300 deaths between January and August, compared with 390 throughout last year.
The substantial differences between the figures reflect the organisations’ different sources and methods of documentation, but the official count puts the scale of deaths considerably higher than those captured by rights groups.
Ijazul Islam of HRSS said overcrowding, delayed transfers to hospitals, inadequate management of chronic diseases and shortages of doctors, nurses and medicines were interconnected problems.
Mental stress and suicide risks also needed greater attention, he said.
“The freedom of a person in prison may be limited, but their right to life, dignity and healthcare cannot be taken away,” Ijazul said.
He called for health screening when prisoners enter facilities, 24-hour emergency medical care, adequate doctors, nurses and ambulances, and independent investigations into every death.
‘Administrative problems naturally arise’
Acting Inspector General of Prisons Colonel Mohammad Mostafa Kamal acknowledged that overcrowding was making healthcare more difficult.
“The prisons have the capacity to accommodate around 45,000 prisoners. If there are around 100,000 prisoners there, some administrative problems naturally arise. It also becomes difficult to provide proper medical services,” he said.
Around half of the prison population is aged 45 or above, according to prison authorities, while around 30% are drug users or people incarcerated in connection with drug-related offences, factors that can add to healthcare requirements.
Kamal said the department was trying to provide treatment despite its limited resources and that prisoners were referred to government hospitals when necessary on doctors’ advice.
“Any death is undesirable,” he said.
“There are currently more than 100,000 prisoners in the prisons. In proportion to that, the number of deaths does not seem very high. However, we do not want any undesirable deaths.”