READ: Part 1 | Duterte’s drug war pushes prisons to a breaking point

Longtime activist Joseph Canlas was 59 years old when he was arrested in successive Holy Week police raids in March 2021, at the height of the COVID-19 pandemic. After 42 days in jail, he died.

Canlas had comorbidities, including high blood pressure and diabetes, according to his family who sued the officials of the Angeles City Jail for negligence. According to documents filed before the Ombudsman, Canlas was not tested for COVID-19 upon his transfer to the city jail from the custodial center of Camp Olivas.

On his 15th day of detention, the family wanted to arrange for a COVID-19 test for Canlas but they were told he was already being checked at the hospital. On the same day, April 15, they were told he tested negative and was moved back to the city jail but had to be quarantined.

“[The quarantine] was packed, together with 90 to 100 detainees,” said the family, but they were still being told Canlas was well. If they could bring paracetamol and cough syrup, that would be best, the family was told. Canlas was able to call his family on May 7, informing them he had been released from quarantine. 

On May 8, the family got a message from Canlas’ fellow detainee, saying that the activist had been unresponsive and was taken to a hospital. The detainee told the family that since release from quarantine, Canlas was barely able to walk, breathe, or even feed himself.

He tested positive for COVID-19 and died on May 11. The cause of death was “Acute Respiratory Failure secondary to COVID-19 Pneumonia Critical.” The Office of the Ombudsman found simple neglect of duty and sanctioned three jail officials, including the nurse, with one month suspension.

The family is appealing for heavier sanctions, telling the Ombudsman that “such incompetence and inefficiency” caused Canlas’ death.

‘Silent tragedy’

Around the world, deaths in custody are happening at an unacceptable rate. Global estimates peg that prisoner deaths occur 50% more than in the outside community. During the 53rd session of the United Nations Human Rights Council in June 2023, Special Rapporteur on arbitrary killings Morris Tidball-Binz presented a report on the “silent global tragedy” of people dying inside prisons.

“[It’s] to raise awareness about an invisible, albeit largely preventable, tragedy of global dimensions, often resulting from a failure in the duty of States to respect and protect the fundamental right to life of those deprived of liberty,” said Binz’s report.

Since 2019, or even before the pandemic hit, deaths in custody of pre-trial detainees or those who are still awaiting judgment, have been higher than the national death rate, except in 2021. This indicates an abnormality about the deaths in custody, that it can’t just be chalked up to the oversimplified logic of “people die.”

In 2019, deaths in custody doubled to 983 total deaths, or an equivalent of 7.3 deaths for every 1,000 Persons Deprived of Liberty (PDLs). In 2020, or when the pandemic hit, 1,005 PDLs died, equivalent to 7.58 PDLs dying per every 1,000. 

The years 2022 and 2023 have been higher in crude death rate, because while the actual number of death for 2023 is lower, at 973, the population is also lower, which means the ratio of people dying is higher.

The causes of death have to be established to come up with precise solutions. There’s just a problem: the Philippines has been recording its data vaguely, charging many deaths to “cardiopulmonary arrest.” 

“Based on studies, you can’t put that under there because all causes of death are cardiopulmonary arrest. There has to be underlying factors why they had a cardiopulmonary arrest,” Dr. John Paul Borlongan, medical division chief of the Bureau of Jail Management and Penology (BJMP), told Rappler.

BJMP started in 2020 to “fix our system of reporting” where cardiopulmonary arrest can’t just be accepted as a cause of death. “We need to know what the root cause is,” said Borlongan.

That’s the reason why beginning 2020, there was a sudden drop in deaths due to cardiopulmonary arrest. “Before 2020, we weren’t digitized so we were doing it manually. But now, with the support of an NGO, we have a health information system, so now we can start to give more accurate and reliable data,” said Borlongan. 

Shortage of health professionals

Dennis, not his real name, 52 years old, had been throwing up blood and had been confined in the clinic of the Manila City Jail male dormitory when Rappler visited mid-April. Rodel, 69 years old, was newly arrested for slander, penalized with only a six-month maximum imprisonment. Still, the detention makes him anxious because “I am old, and I am sick.” Rodel was also at the clinic when Rappler visited.

Based on statistics, it’s dangerous for Dennis and Rodel to be sick at their age inside the Manila City Jail male dormitory, because the facility has been chalking up the second highest number of deaths nationwide since 2021. 

Metro Manila is also the region with the highest incidents of deaths in custody in the country. (Quezon City male dormitory is the consistent highest, but there was an ongoing decongestion and transfer operation that restricted our team from filming.) 

Even if the Manila City Jail male dorm is 260% congested, there are no doctors based in the facility, only a nurse.

BJMP has 22 doctors only for all 478 facilities across the country, and three of them are primarily engaged in administrative tasks. This leaves 127,031 PDLs across the country in the hands of 19 doctors. To manage the overwhelming number of patients, these doctors are roving and jumping from one jail to another. 

“The BJMP desperately needs doctors, but nobody’s applying. It’s so hard to recruit because the base pay of our doctor is P40,000 to P49,000, or P50,000. So that’s their base pay versus what you can get from other jobs,” Jail Chief Inspector Jayrex Bustinera, BJMP spokesperson, told Rappler.

BJMP’s current ratio is 1 doctor to every 6,685 PDLs. Because of the scarcity of doctors, Borlongan said they rely mostly on their nurses. Data shows that BJMP has 1,746 nurses, but according to Borlongan, only around 800 of them function as a health aide.

Aside from physicians, the BJMP also faces a shortage of other healthcare professionals, with only eight psychologists, 60 medical technologists, 36 pharmacists, 35 dentists, and 22 nutritionists serving 127,031 PDLs.

Living space

At the Dasmariñas City Jail female dormitory in Cavite, the most congested jail in the Philippines, 312 people are crammed into spaces meant for only 11. Divided among three cells, the inmates endure the cramped quarters of three-tiered lofts.

Most of the day, PDLs sit on the floor with their legs crossed. They couldn’t freely walk or stand because of the limited space. At night, they sleep side by side. This has been their routine.

This overcrowding not only strips them of personal space, but also severely restricts their possessions. Each person is only allowed what can fit in a small box – typically seven shirts and some underwear. Any items that exceed this limited capacity are considered contraband.

Access to basic necessities like water is a privilege for PDLs in Dasmariñas due to its scarcity. 

They resort to makeshift pipes to collect every drop from their faucets. Containers catch the water, which is then stored in drums. This is what they use for drinking and bathing. 

The female PDLs also do not have a clinic. During our visit, there were two PDLs in “isolation” due to suspected tuberculosis, but isolation means they are wearing masks and sitting on a bench with a plastic cover curtain. 

The bench doubles as their bunk bed, with one sleeping on the floor while the other occupies the top. They take turns deciding who sleeps where. 

The condition in the Manila City Jail is no different. Constructed in 1847 during the Spanish colonial period, the capital’s city jail was originally designed for 1,182 detainees only. Now, it’s home to 3,429 PDLs. 

Food and medicine

These pressing concerns about living conditions are compounded by the inadequate provision of food and medicine within these facilities.

Every day, a budget of P70 is stretched to cover the three meals of each PDL – P25 for breakfast, P25 for lunch, and P20 for dinner.

To ensure that meals are nutritious, the National Nutrition Council estimated that a family of five requires a daily budget of at least P1,212.650. This translates to each person needing P242.40 per day to meet the council’s standards.

The mandated subsistence allowance of P70 is only 28.9% of the needed budget.

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Despite adhering to a meal plan provided by nutritionists from their respective regional offices, the quality of food remains questionable. 

For Ron, not his real name, who is in the Manila City Jail,  the food can occasionally be decent. However, he often finds it “almost inedible” that “even a cat wouldn’t eat it.” 

At least, he said, the jail never fails to bring them food three times a day. “‘Yun naman ang importante, may laman ang sikmura,” he said. (That’s what’s important, that the stomach isn’t completely empty.)

Even jail officers accept it’s not enough. “That budget is too low. Any of us outside prison will say P70 is not enough, sometimes it’s just for snacks, or not even sufficient for a snack but for us here in BJMP, we allot P70 for three meals for PDLs so we’re asking if PDLs can be allotted more budget for food,” said Manila City Jail spokesperson Elmar Jacobe. 

Bustinera said they have to work with what is available and what fits within the budget allotted by Congress. The last time the budget for food and medicine for PDLs was adjusted was in 2019, five years ago, increasing from P60 to P70 for food and from P10 to P15 for medicine.

In life, there are three basic necessities – food, clothing, and shelter. In jail, these necessities become lifelines that are often frayed and insufficient. 

Given these deplorable conditions, awaiting trial behind bars becomes a sentence in itself. – Rappler.com