If you are poor and in jail for some reason and you happen to be seriously ill, you are probably out of luck. But if you are a rich inmate or have political clout, you do not even need to be sick to have extended holidays at the country's leading government hospitals. 

Only four of the country's 68 jails have doctors. While the state “manages” health services inside jails with just six doctors and 112 doctors' posts vacant, it creates a serious problem for inmates with limited means.

The prisoners who are affluent and have muscle power and political clouts can bribe their way to better medical care outside the jails, even when they are not seriously sick, while the poor simply suffer and in some cases die.  

There are numerous examples but we are citing a few here to drive the point home.

Abul Kalam, a rickshaw puller in his mid-30s, had been suffering from a rectal infection since he landed in jail for murder in August 2015. As his condition worsened in the jail hospital, his repeated pleas for better treatment at a hospital outside the jail went unheeded. 

After 20 agonising months, Kalam was finally moved to Dhaka Medical College Hospital (DMCH) from Kashimpur Central Jail-1 on March 13 this year and that too after he had threatened to commit suicide, his wife Fahima alleged.

Doctors immediately performed a surgery on his rectum that had already developed gangrene. Kalam survived the surgery but died three days later.

Family members of inmate Tara Miah, 45, who died at the same hospital on April 21 this year also raised serious allegation of poor treatment. He was arrested in Comilla's Daudkandi and had become sick. Tara was moved to the DMCH six months after his arrest but it proved to be too late for him.

His son Sumon now laments that if they had arranged some money for corrupt jail staffers, his father would have been moved to the hospital much sooner and probably he would not have died. 

When poor inmates like Kalam and Tara have to stay in jails without proper treatment, managing a VIP cabin in a hospital outside the jails and staying there without any apparent illness is no big deal for many. They know what it takes to get such undue privileges.

Many top criminals, drug barons, political leaders, and graft-case convicts have records of mastering the craft of staying in hospital without actually being sick.

Sources said that what they need to do is just bribe people, including some corrupt jail guards and jail hospital staffers. A portion of the money also goes to the pockets of doctors, they claimed.

Nur Mohammad's case is an example that was exposed by a ministry probe recently.

Nur, accused in a sensational cocaine smuggling case, was admitted to Chittagong Medical College Hospital (CMCH) without any major physical problems. The hospital authorities allowed him to stay in a cabin.

The health ministry probe revealed that the accused was admitted to the CMCH cabin unnecessarily. Several CMCH officials and doctors were served show-cause notices and the ministry asked the CMCH director to file a criminal case against its former assistant director Sheikh Mohammad Jamal Mostofa Chowdhury for allowing Nur to stay in the hospital illegally.

The ministry also wrote to senior secretary to the public administration ministry to request the Armed Forces Division to withdraw CMCH Director Brig Gen Md Jalal Uddin and take action against him for his alleged involvement in the matter.

Even though the health ministry asked for taking departmental action on July10, Brig Gen Jalal is still the director of CMCH.

About the allegations, Brig Gen Jalal told The Daily Star yesterday evening that the home ministry was investigating the allegations.

“The probe was at the final stage and the enquiry report would reveal whether I was involved in the matter. Whatever happens in the hospital, the responsibility lies with me as I am its chief,” he said.

Nur's case was not one off.

Influential prisoners, including convicts, are staying in hospitals instead of jails by bribing a section of doctors and jail officials, claimed the sources.

According to them, the prisoners stay in hospitals to avoid jail and cite simple physical problems like neck pains, back pains and chest pains.

“The bribe ranges from Tk 10,000 to several lakh depending on the status of the inmates,” said a jail source wishing anonymity. The “system” (of bribery) is relaxed for political leaders and those who have political influence.

Besides, the inmates have to pay additional sums for hospital staffers and on-duty jail guards during their stay in hospital.

At least 30 percent of the inmates who get admitted to hospitals outside jails make the transaction through corrupt jail and jail hospital staffers and doctors reportedly get a slice of the pie, jail sources alleged.

This is not a victimless crime. The culture of bribing to go to hospitals outside jails leaves poor inmates with serious health issues neglected.

Officials at the Dhaka Medical College morgue and jail sources said nearly 50 inmates die every year while undergoing treatment at DMCH. They said the majority of them are brought in too late.

The Daily Star went through the DMC morgue's ledger for May and June and found that 11 inmates died during the two months alone.

Biplob Kanti Biswas, a doctor at Dhaka Central Jail, refuted the allegations.

He, however, said they have to consider some inmates for sending them to hospitals outside the jails under pressure from political leaders.

He claimed that they try to ensure facilities for all inmates but security issues and lack of vehicles are often obstacles as force deployment is necessary when inmates take treatment in hospitals outside the jails.

It sometimes takes two to three hours to complete all formalities and send an inmate to a hospital outside, said Biplob, adding, “We often have to deal with requests from higher authorities, including some political leaders, for sending inmates to hospitals outside.”

Take the case of Amin Huda. He was awarded 79 years of imprisonment but passed 18 months in Birdem Hospital's VIP cabin, reportedly managing the jail authorities.

Following media reports, Huda was finally moved back to the jail on May 7 this year.

Rumour has it that Huda paid Tk 50 lakh bribe for his stay in Birdem Hospital but this paper could not independently verify that.

Like Huda, top criminal Tofail Ahmed Joseph, sentenced to life imprisonment, stayed in BSMMU for over a month. He was released from the hospital yesterday and taken back to jail. Before this, Joseph was taken back to jail on May 7 this year after a 20-month stay in hospital.

Tangail's ruling Awami League lawmaker Amanur Rahman Khan Rana, accused in the freedom fighter Farukh Ahmed murder case, is now undergoing treatment at the DMCH AC cabin. He was admitted last month, according to jail officials.

Following a three-month stay in hospital, he had been taken back to jail on May 9 this year after the media reported that he was staying there without being sick.

Destiny Group Managing Director Rafiqul Amin has been at a BSMMU cabin for the last one month.

Sources alleged that they were able to stay in the hospital as they had money and political power.

Jail sources said at least 30 to 35 inmates remain admitted to different government hospitals of Dhaka, and eight jail guards or policemen are deployed for each of them.

While making several visits to the DMCH last month, The Daily Star correspondents found that prisoners talk over mobile phones and meet relatives and family unabated, violating jail rules.

Inspector General (IG) of Prisons Brig Gen Syed Iftekhar Uddin refuted the allegation of providing “hospital service” for money. He, however, acknowledged that they failed to provide proper treatment to all inmates due to shortage of doctors.

He said they were trying to improve the situation and sought help from the ministry concerned for recruiting more doctors.

Besides, a number of VIP and political inmates come to jail with instructions from court regarding their “blood pressure issues”, “heart diseases”, “diabetes” and “urinal problems”, he said.

“In these cases, we have to ensure treatment whenever they become sick and have to send them to hospitals outside as we have a manpower shortage … .”

When inmates are sent to hospitals outside, the doctors there decide when they would be released, he told The Daily Star.

“If we want to bring someone back to jail then the hospital asks for an undertaking [a document that says the patient was taken from hospital against doctors' advice to stay],” said the prison chief.

“Generally, upon checking psychological status, jail doctors decide on inmates' hospital stay. But it is also not being practised because of manpower shortage.”

The IG prisons said they now write to hospital authorities and the ministry every month if anyone stays in hospital for a long time.

Contacted, DMCH Director Brig Gen Mizanur Rahman said doctors decide on who would stay in the hospital. “We generally do not interfere in doctors' decisions.”

Responding to a home ministry letter, the jail authorities informed the ministry in early August that 111 prisoners of seven divisions were in different hospitals.

Of them 11 were from Dhaka Central Jail, 18 from Narayanganj Jail, five from Faridpur, seven from Mymensingh, two from Natore, 10 from Bogra, 14 from Chittagong, three from Cox's Bazar, seven from Comilla, six from Sylhet, two from Habiganj, 13 from Jessore, four from Barisal and one each from Bagerhat and Narail jails.

At different times, Narayanganj seven-murder convict Tarek Sayeed, graft accused Basic Bank Managing Director Joynal Abedin Chowdhury and arms case accused Mizanur Rahman have stayed in hospitals even though they were not seriously ill.

Over 7,000 prisoners are in Dhaka Central Jail in Keraniganj and there are two doctors for them. There are two doctors in Kashimpur jails, and Chittagong, and Sylhet jails have one doctor each.

Apart from Dhaka Central Jail, all jails have hospitals in them. They are served by 106 nurses. Fourteen of the jails have ambulances.