Institute for Justice and Democracy in Haiti

Injustices of Cholera: Reflections from the Saint Marc Prison

By Beatrice Lindstrom, Lawyers’ Earthquake Response Network Fellow

We’re led through the courtyard past the cell where the women are held, the sun beating down around us.  I catch glimpses of people sitting on turned-over buckets, the only “furniture” in the cells, peering back at us through thick metal bars.  I don’t yet know what proper prison etiquette is: do I greet them with a smile to acknowledge their humanity, or does this disregard the horror of their situation?

The cells are brutally overcrowded: this one holds 18 prisoners in a space 8 ft by 10 ft, a worst-case scenario for rapid spread of cholera.  It’s not until I get home that I let my mind ponder the details of the every-day reality of living in indefinite confinement with 17 other people in a space the size of my small kitchen.

80 percent of prisoners in Haiti have never been convicted of a crime, and I wonder what set of misfortunes caused these women to end up here.

There are 411 prisoners in the Saint Marc prison, living in about 20 cells. Cholera was first reported here last week, and now there are 24 suspected cases.

A prison officer shows us the makeshift cholera ward, where those who have fallen ill are kept in quarantine in the far corner of the prison.  The first cell holds those who are under observation.  They are separated from those with full-blown symptoms, who lie in a different cell on beds with holes cut out of them and buckets underneath.  They look tired, exhausted, lifeless.  IV rehydration bags provided by Partners in Health are suspended from the ceiling, and a nurse, another inmate who volunteered to look after the sick, sits at the front of the room.  I don’t know if she has professional training, but at least she’s there.

As one of its key cholera strategies, Haiti’s Ministère de la Santé Publique et de la Population (MSPP) has developed a communication campaign that includes a series of posters that demonstrate various ways to prevent cholera.  Colorful cartoons illustrate the importance of washing fruits and vegetables with treated water and disposing of fecal matter and vomit in latrines.  These posters hang on the walls of the prison courtyard, but it’s hard to see what purpose they serve here other than to emphasize the stark gap between that which is needed to prevent cholera, and the government’s neglect to provide it.

Here, prisoners are forced to defecate in buckets in their cells.  I wonder if these are the same buckets that serve as their chairs.

The prison officer explains to us that they have no clean water.  The water that is pumped up in the courtyard comes from the Artibonite River, the source of the cholera virus.  They use purification tablets to treat it, which makes it clean enough to bathe in without getting skin rashes, but not safe enough to drink.

Clean water and sanitation are the two fairly simple measures that prevent cholera; in Haitian prisons, neither is available.

In the prison office, which smells unmistakably of chlorine, an old blackboard displays the prison inventory.  There are 379 men and 18 women.  192 of the men and 6 of the women are serving out their sentences.  The other half of these people are held in pre-trial detention and have never been convicted of a crime.

White scratchy letters at the bottom of the board tells us there has been one death.  They tell us he fell sick from cholera and allegedly refused treatment.  His pre-trial detention turned into a death sentence.

Within the walls of the prison, the government’s complete disregard for human life is undeniable and inexcusable.  Whatever magnitude and resource challenges may excuse the failure to contain cholera outside the prison are obsolete here, in this confined space under complete state control.

In the oppressive heat, my anger simmers.  The state, that took these people into its custody without due process or a means to challenge their detention, has a heightened responsibility to ensure their health and safety.  But instead, prisoners are fed contaminated water at the hands of the state, and no investments have been made into even the most basic infrastructure that ensures sanitation and protects the dignity of those imprisoned.  As of November 20, 19 prisoners have died of cholera in four prisons around Haiti.  Many of them had never had a trial, and cholera is the only sentence they have received.

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