Last year, I entered a prison cell in Brazil seemingly designed to breed tuberculosis. Sixty men shared only six cement bunks. Most slept on the bare floor, some in a tangle of hammocks. The intense heat and humidity made the stench of sweat, feces, and mold overwhelming.
Some of the inmates had been in that cell for two years, let out for at most two hours a week. You can view the video I recorded the day I visited here.
The cell is part of the Curado prison complex, in the state of Pernambuco, whose facilities pack in more than three inmates for every official space, as Human Rights Watch documented in a recent report.
Tuberculosis is spread through coughing and sneezing. Inhaling only a few germs is enough to become infected. Overcrowded conditions with poor ventilation and little access to the outside facilitate the spread of the disease. According to the latest official data, Brazil’s prisons have nearly 1,000 cases of tuberculosis per 100,000 people detained, a rate almost 40 percent higher than in the general population.
The director of a prison, Professor Barreto Campelo, also in Pernambuco, told me that so many new inmates arrive each week that personnel cannot screen them all for tuberculosis. They are only tested after symptoms appear, the director said, by which time the disease has likely spread. “Overcrowding makes it impossible to eliminate the disease,” he conceded.
Despite making great strides in combating tuberculosis in the last two decades, Brazil remains among the 20 countries with the highest number of new cases every year, according to the World Health Organization (WHO). On World Tuberculosis Day, commemorated on March 24, the WHO is asking countries for renewed commitment to eradicate the disease.
Prisons are not isolated from the rest of the world. Detainees have contact with their families, prison personnel, lawyers, and human rights researchers like me. And of course, inmates are eventually released and can bring tuberculosis to their communities.
If Brazil is to continue making progress against tuberculosis, it needs to improve conditions in prisons, screen detainees properly, and provide adequate medical care to inmates – not only because health is a basic human right, but also because good care will improve the health of those who are both inside and outside the prison walls.