Five of them grabbed Martín, tied his ankles and hung him upside down. Immediately, his own blood reddened the red rope that tore his skin. It was only the beginning. For an hour he was the punching bag of the thugs who controlled the Tacumbú prison, the largest in Paraguay.
— They broke my ribs, teeth... They left me there for about an hour...
This is how Martín tells it, thin and calm, leaning against the wall of the visiting courtyard of this prison, a group of old buildings and pavilions with metal roofs, so overcrowded that they look like anything but a boring prison. Behind its thick walls, the movement of people seems like a central market at rush hour, a casino at night or several churches in full mass. Also a landfill with hundreds of recyclers sleeping among the garbage or a crack den. All at the same time.
Martín is wearing a cap, a striped shirt and jeans that when he walks reveal a little of the scar that surrounds his ankles, a burn that reaches to the bones. He is 28 years old and entered this prison two years ago, which was planned for 1,000 people, but which at that time held almost 4,000. Like him, 70% without seeing a judge, according to official data, and probably already serving more than his fair share of sentences.
Like everyone inside, Martín dreams of the outside. He says that he imagines himself sitting watching TV at home with his family:
—Free and working, that's all I want to be like.
What he does not imagine, like almost no one else in this labyrinth of gray walls and faded red bars, is that inside he has a hundred times more chance of contracting tuberculosis than outside.
And he does not even know that it is spread through the respiratory tract, when an infected person coughs, sneezes or spits, or the symptoms of this disease - chronic and bloody cough, fever, night sweats and weight loss -; which destroys the lungs and can spread to other organs. Nor that before, in Europe, it was known as consumption or white plague. Nor does he know that smoking makes it worse quickly.
A problem that would be minuscule outside, where Paraguayan public health provides free antibiotic treatment that eliminates the disease in six months, if treated in time. But deadly inside, where if an inmate dares to leave the depths of a pavilion to the infirmary, located near the main door, he must pay several tolls in cash. Sometimes to guards, other times to inmates. Each barred door you manage to cross will cost you more and more.
— Now there is a ward for them, but there are sick people in all the wards, says Martín.
Although becoming infected with the bacteria that causes tuberculosis does not necessarily mean developing the disease, in Tacumbú, the rate of people who develop it reaches a stratospheric proportion. It is one hundred times higher inside than outside, according to a recent study published in the scientific journal
The Lancet
by doctors from Paraguay and one from Spain.
“All the prisons are exploding with tuberculosis. Not only do they lose their freedom, they are condemned to get sick,” one of the study's researchers, Paraguayan epidemiologist Guillermo Sequera, explains to América Futura. He and his team analyze the impact of tuberculosis in Paraguayan prisons and how the same bacillus is spreading outside, according to this other study from last year published in
Nature
.
After eight years of follow-up, the researchers demonstrate the “alarming risk of tuberculosis associated with prison environments in Paraguay, and how this risk persists for years after incarceration.” They also highlight that more effective tuberculosis control measures are necessary “to protect people's health during and after incarceration.” While 45 out of every 100,000 people have tuberculosis in Paraguay, the proportion within is 4,500 per 100,000.
A historic punishment
“Ordering” was a fundamental part of Western criminal law until the 19th century. The guilty party had to be “the herald of his own condemnation,” as the French philosopher and historian Michele Foucault wrote in his book
Discipline and Punish
. The condemned man was paraded and tortured through the streets, shackled, with signs on his back, head or chest, to remember his sentence.
Foucault, a student of prison systems, detailed how the humanist ideas of the European Enlightenment left behind more than twenty centuries of “tortures” and changed the object of punishment: from punishing the body to punishing the soul. Prisons were born, and States as we know them today, where, supposedly for the good of all, a few, from high towers, watch over many and prison sentences are adjusted, supposedly, in proportion to the crime.
Its purpose: to curtail freedom, not the hands or other parts of the body, and to “reform” the individual with work and education to make him “useful,” that is, productive for the dominant class of the capitalist system, the bourgeoisie, explains Foucault.
Something that seems not to have happened in Paraguay, where people in custody do not have access to comprehensive health or education and still face direct physical punishment, such as beatings or not having a safe place to sleep, bathe or defecate. And also indirect, such as becoming seriously ill or dying due to poor and minimal health care, as reported year after year by the reports of the state institution National Mechanism for the Prevention of Torture, independent of the Government.
"In addition, what happens with tuberculosis is applicable to other infectious health problems such as HIV, hepatitis, influenza... Mortality after leaving prison is very high," highlights Sequera.
Just one hour before dawn on December 18, a platoon of 2,000 police and soldiers surrounded Tacumbú. A few minutes later they break down the front door. The prison lights go out. They receive and send thousands of shots that cut off the flames of fire. Inside, some armed inmates, most of them mere witnesses, see their months-long mutiny fall and the criminal organization that ruled the prison, the Rotela Clan, fall. Grenades explode, shots rain down.
Martín remembers being there, crouched, pressed against a wall in the central courtyard, leaning on a friend's shoulder when, in the blink of an eye, among the smoke and explosions, one of the bullets coming out of the helicopter flying over the prison lands on his friend's face.
Martín is left in shock, covered in blood again, but unharmed. He ends up, like 700 other inmates, naked in the same courtyard where he played dead for hours before being handcuffed so as not to be part of the list of 12 inert bodies left by the operation. Javier Rotela, leader of the mafia group dedicated to drug trafficking that governed the prison, was arrested alive when he threatened a pregnant woman with a knife.
Thus ends the reign of the Rotela Clan in Tacumbú and that of his group of thugs who tortured Martín. And thus the Paraguayan State regains control of the prison, lost decades ago in the hands of a group of local and international criminal organizations that fight for control such as the PCC of Brazil, which still manages some pavilions of the other prisons in Paraguay.
A successful operation for the Government, but it has not changed one bit the absence of the State that allows the development of mafias and impedes health care. Tuberculosis is still rampant in Tacumbú. How is this situation fixed?
A danger that extends to the entire population
Spanish evangelical missionary pastor Pedro Pastora has been working in Tacumbú for 16 years. He usually enters the prison with other volunteers to bring food to inmates without money or beds, known as “passilleros.” They live in inhuman conditions that, because they are so everyday, are exhibited even in the light of day and the cameras of the journalists who visit them.
Pastor compares living in the halls of prison with hell itself and calls the pavilion run by her church paradise, where the rules are strict and, if you don't comply, they throw you out: no drugs, music and cigarettes. Fixed times for eating and sleeping. Fixed times to pray and pray. A quiet place, surrounded by chaos, but in any case, and in Christian terms, it seems more like purgatory than paradise.
To make matters worse, the police operation destroyed everything good there was: the newly built bathrooms, the electrical installation, the supermarket, the hardware store, the work workshops, some 300 mattresses and even a chapel:
—And so we are. Sleeping on the floor and covering bullet holes and yes, it was a war. A few from Rotela fell, but the rest were internal. They caught everyone. Nothing mattered.
Pastora confirms that the Government offers anti-tuberculosis medication inside the prison, but remembers that people barely have water or electricity and that the precariousness is such that they cook with plastics for lack of firewood.
—There are so many who do not know how to read or write and so many who do not take the disease seriously. Timely medical assistance is not enough.
Paraguay has been governed by the same right-wing and neoliberal party for almost 75 years. The Colorado Party has controlled the country in the form of a dictatorship between 1954 and 1989, and in the form of an alleged democracy since 1992. However, until today, it dominates the three powers of the State.
Its rulers and parliamentarians have been reducing and corrupting public institutions for decades. And its judges and prosecutors have been sending so many people to prison without judging for three decades that the prison population has doubled in the last ten years. Stealing a chicken can lead to prison in Paraguay and murder cannot, depending on the money that the accused and the accuser can “invest” in the judges and prosecutors.
Currently, the Paraguayan prison system guards 17,000 people deprived of liberty, of which more than 11,000 are in preventive detention, Sonia Von Lepel, a lawyer who works in the National Mechanism for the Prevention of Torture, tells América Futura.
“As there is no good support from the program in prisons, people become infected again, and are more likely to have complications or develop serious and permanent lung problems,” adds Von Lepel.
The abuse of preventive detention and the almost non-existent presence of the State in the form of health and education are the causes of overcrowding that forces inmates to pay for a cell or a bed or to build their own wooden rooms within spaces that they do not have. They were rooms, the lawyer points out.
“The greatest contagion occurs due to the overcrowding in which they live. People do not sleep because they fear being assaulted, raped and because of poor nutrition. It is a permanent stress,” details Sequera.
Both professionals agree that, although the prison population doubled, the same did not happen with health resources. “It is not a problem of the prisoners or the Ministry of Justice. It is a Public Health problem and it must be treated as such,” adds the epidemiologist, who recommends that the Ministry of Health be in charge of prisons and not the Ministry of Justice.
“Prisons are everyone's responsibility and what happens there affects us all. Most people get infected inside, but get sick when they go out, he adds. Tuberculosis can manifest itself up to three years later, depending on the defenses of each person. “It is a matter of public health and, as such, it must be carried out by health specialists. It was solved 30 years ago in other countries by changing the health governance of prisons,” summarizes the Paraguayan doctor.
The average to see a judge in Paraguay, and know if one is declared guilty or not, is between three and six years. Martín has at least one left. Whether he comes out quickly or not, chances are he won't be able to wake up one day coughing up blood.