In Bilibid, dozens die of unclear causes without being tested for coronavirus
AT A GLANCE
- In the past 8 months, an average of 60 convicts die per month inside Bilibid. The Bureau of Corrections (BuCor) says the death toll is normal for a 28,000 prison population.
- There were no clear causes of death for dozens of convicts who died during the pandemic. They were not tested for the coronavirus.
- The Commission on Human Rights says this may result in underreporting of actual coronavirus cases inside Bilibid which has a 335% congestion rate.
- Of the 28,000 inmates there, BuCor has reported only 40 who have tested positive for the coronavirus, and only one has died from it.
MANILA, Philippines – Inside the country's national penitentiary, convicts who are dying without clear causes are not being properly accounted for – making it hard to get a full and accurate picture of just how bad the coronavirus outbreak could be.
The Commission on Human Rights (CHR) fears this may result in underreporting of coronavirus cases, especially inside a very congested prison where the virus can be easily transmitted from one inmate to another.
The New Bilibid Prison (NBP) can hold only 6,435 inmates but as of the latest report, it has around 28,000 inmates – 335% over the NBP's actual holding capacity.
Documents obtained by Rappler show that dozens of persons deprived of liberty (PDLs) died in April with unclear causes of death, with varying labels such as "dead on arrival (DOA)" and "to consider COVID."
In May, a dozen convicts died with unclear causes of death, too, either classified as "DOA for autopsy" or "DOA to consider COVID."
There were a dozen other convicts who died in the same month whose causes of death were listed as either "to consider pneumonia" or "to consider myocardial infraction."
After a month of following up with the Bureau of Corrections (BuCor), Rappler reached Spokesperson Gabriel Chaclag and spoke with him on May 15. He said he would not be able to confirm specific details in the document, only that there have indeed been deaths of undetermined causes. He also said they were "not counting" them as COVID suspects.
"There are many cases like that, those who suffer [heart] attacks while playing, if they are taken to the hospital, because their death is sudden, they need to be autopsied. But because there is no autopsy during this lockdown, it cannot be determined, their cause of death becomes undetermined," Chaclag said in a mix of English and Filipino.
The Department of Justice (DOJ) said it continues to verify this data with BuCor. Justice Undersecretary Markk Perete confirmed at least one inmate who died on April 23 and whose death was listed as "pneumonia to consider Covid." He was never tested.
Human Rights Commissioner Karen Gomez-Dumpit said if these undetermined deaths are not fully accounted for, the government will not be able to properly assess the outbreak situation inside Bilibid.
"It is important that those persons deprived of liberty who died due to unknown reasons should have been tested for COVID to ascertain the cause of death...and to measure the gravity of COVID infection inside the prisons. [This way]...government can take appropriate steps to address the outbreak in prisons," Dumpit told Rappler.
So far, there are 40 Bilibid convicts who have tested positive for the coronavirus and at least one has been confirmed to have died from it.
Tests for the living, not the dead
Following the Department of Health (DOH) guideline, a death of undetermined cause has to be treated like a coronavirus patient, meaning handlers of the corpse must observe strict safety protocols.
In Bilibid, Chaclag said these corpses are tagged as "COVID remains." He emphasized that this does not automatically mean they were coronavirus suspects.
But no one will ever know for sure if they had the virus because BuCor does not test the dead convicts.
Given limited resources and a limited number of test kits available, prison officials are forced to make tough choices. Chaclag said they "would rather use the test kits on the living" inmates.
In fact, Health Undersecretary Maria Rosario Vergeire said this is also the DOH recommendation.
"Given the low sensitivity or yield, DOH currently does not recommend postmortem testing for COVID-19. Nevertheless there is room for clinical judgment of the attending physician if he or she determines the need for postmortem testing," Vergeire told Rappler in response to our question on the prison situation.
Chaclag said they do not count the deaths of undetermined causes as coronavirus suspects because they were "not required to count them" as such.
"Please ask the DOH if they include in their tally people who died who are treated the way the remains of COVID patients are treated. People who died inside their houses and the causes are unknown, does the DOH include those as COVID deaths?" Chaclag said in a mix of English and Filipino
He makes a point on the death count, especially if the DOH itself does not include such cases in its own tally of COVID deaths. But Dumpit said BuCor still has the obligation to keep and report separate data for the undetermined deaths. (READ: 'Takot na Takot Kami:' While government stalls, coronavirus breaks into PH jails)
"Any death in custody must be fully explained as this is the state’s obligation under existing treaties, particularly the International Covenant on Civil and Political Rights and the Convention against Torture, Cruel, Inhuman or Degrading Treatment or Punishment," said Dumpit.
Chaclag maintained that BuCor is on top of the situation, with an isolation facility approved by both the DOH and the International Committee of the Red Cross (ICRC).
He admitted the NBP hospital is understaffed and underequipped.
"Kulang talaga ang staffing, mga 8, or more or less 10 doctors, ang nurses konti din lang 'yun. Hindi nga sila puwedeng mag-operate dun, kapag hindi na nila kaya, ang protocol ay may mga partner hospital," said Chaclag.
(We are understaffed, we have only 8, or more or less 10 doctors, we have few nurses. They can't even operate there, if they can't handle it anymore, the protocol is to go to our partner hospitals.)
Prioritize prisoners for tests
Dumpit said there should have been at least some lead time before death when the convicts were tested for the coronavirus – again to fully account for cases, and make it easier for officials to do contact tracing.
"It also appears to show that prisoners do not have equal access to appropriate COVID testing," she said.
Because some convicts just drop dead from heart attacks – some even die in their sleep – according to Chaclag, there's all the more reason, according to Dumpit, to prioritize prisoners, sick or not, for coronavirus tests.
"Prisoners should be given the priority as the astronomical congestion rates will not be kind at all to those in detention as jails and prisons have proven to be incubators for disease even under ‘normal’ detention conditions," said Dumpit.
Inside Bilibid, fears are growing. Inmates hear about deaths of undetermined causes and they hear about the pandemic that continues to claim thousands of lives.
Rappler talked to inmates who said they would rather endure the heat of their cells than go out in the complex.
Jessa (not her real name), a mother of one of them, agreed to speak with Rappler on condition of anonymity.
"Talagang natakot sila kasi sabi nga nila, ibang klaseng war o ibang klaseng kalaban ito, ayaw na nga raw nila lumabas sa selda kasi takot na takot sila, kahit init na init na sila," Jessa said.
(They're really scared, as they said this is a different kind of war, they do not want to go out of their cells because they're so scared, even though it's so hot inside.)
Jessa added: "Andun 'yung pangamba na anytime puwedeng tamaan sila dun, sabi nga ng anak ko parang manok sila na mapepeste dun." (I'm worried that anytime they can contract the virus, my son told me they are like chickens there waiting to get infested.)
Normal death toll?
Since the beginning of the coronavirus lockdown, 60 convicts died in March and another 60 in April, Chaclag confirmed. Data for May was still unavailable, he said.
Rappler's documents matched Chaclag's numbers for March and April. Our documents show that from May 1 to May 19, at least 86 inmates have died.
Chaclag said this number was "normal," adding that in 2019, 61 died in October, 55 in November, and 53 in December. In January 2020, there were 47 deaths, and in February, 55.
"That is normal sa population nila dito. Saan ka ba nakakuha ng isang bayan na walang namamatay sa population na 20,000-plus?" said Chaclag. (That is normal for our population here. Is there a town with a population of more than 20,000 with no deaths?)
Based on the latest data of the Philippine Statistics Authority (PSA), the national crude death rate is 6 deaths per 1,000 population per year in 2018.
Rappler's own calculation based on BuCor's monthly death records since October 2019 shows that in the last 8 months, Bilibid's death rate has been 26 deaths per 1,000 population per year. This is more than 4 times the national crude death rate.
But to Chaclag, what is important is that "hindi po natin sila pinapatay (we are not killing them), they die of natural causes."
Jessa, the mother, would not be appeased. "The fact na merong pandemic, ang makakapag-satisfy lang sa akin ay sabihin ng BuCor na walang namamatay na COVID-related, pero meron nang namatay eh."
(The fact that there is a pandemic, the only thing that would satisfy me is for BuCor to say no one died from something related to COVID, but somebody has died already.)
Kept in the dark
The anxiety among inmates and their families is compounded by the lack of information coming from BuCor.
Jessa's son is still able to communicate from Bilibid, but all he asks her are about updates on the prison.
"May TV sila so alam nila nangyayari sa outside world, pero sa Bilibid mismo hindi. Para nga raw na may gag order sila dun, bawal pag-usapan ang anumang COVID-related," Jessa told Rappler.
(They have TV so they know what's happening in the outside world, but they don't know what's happening within Bilibid. It's like they have a gag order there, you can't talk about anything COVID-related.)
Rappler earlier reported that the sight of dead bodies being carried out from prison has caused concern among the inmates.
Relatives of some inmates whose names appeared on the documents told Rappler they learned of their kins' deaths only through unofficial channels.
Chaclag said they try to get in touch with all the families, but if the numbers on their database don't work, there's no other way to reach them.
Families are also having difficulty claiming the corpses of their relatives from the funeral home in Muntinlupa, but Chaclag said this is a matter best coordinated with the local government, rather than BuCor.
Transparency from BuCor, according to Dumpit, is key to ensuring that human rights of prisoners are indeed upheld.
"Let us just say that we continue to seek specific information on the situation of PDLs especially on this issue of the deaths in custody...We need accurate data about infections and deaths," she said.
Dumpit stressed that the CHR stands by its earlier calls to release low-risk and vulnerable prisoners to save them from the pandemic.
Given fears about the pandemic, families could only wish it would move faster. – Rappler.com
TOP PHOTO: PANDEMIC IN BILIBID. BuCor chief Gerald Bantag leads the disinfection of the New Bilibid Prison on March 19, 2020. Photo from BuCor