‘Grave concern’  - Tuberculosis cases raise human rights, health worries in detention centres 

Tuberculosis has been linked to the deaths of two inmates at the Hunts Bay Police Station lockup in St Andrew between August 2024 and April 2026. Over the same period, more than 30 other cases were registered in state detention facilities.

Also called TB, the bacterial disease primarily affects the lungs and spreads easily through the air via coughing, sneezing, singing and talking. It causes severe damage to the lungs and other organs. Active TB is curable with a six month course of special antibiotics. It is highly fatal without proper medication, with up to two-thirds of untreated cases resulting in death.

Several detainees at Hunts Bay are currently undergoing treatment for the disease.

The Ministry of Health and Wellness said the first case at the facility was identified in August 2024. By December that year, 10 cases were recorded. Between February and September 2025, another 14 cases were identified, including one death. From January to April this year, 11 more cases were confirmed, along with a second death.

According to the health ministry, Jamaica is a low-burden TB country with an incidence of fewer than 10 cases per 100,000 population per year. The 30 high-burden TB countries, as defined by the World Health Organization, account for approximately 90 per cent of all global TB cases, with incidence rates in these regions often exceeding 150 to more than 400 cases per 100,000 population annually.

In 2024, two cases were identified at the Horizon Adult Remand Centre and one at the Tower Street Adult Correctional Centre in Kingston.

In 2025, two cases were identified at the Denham Town Police Station lockup in St Andrew, one at the Greater Portmore (‘100 Man’) Police Station in St Catherine, three more at Horizon Adult Remand Centre, one at the St Catherine Adult Correctional Centre, and one at Tower Street.

So far in 2026, another case has been confirmed at Horizon, three at Greater Portmore, and one at Denham Town.

According to the health ministry, it remains unclear in some cases whether inmates contracted tuberculosis while in custody or had already been infected before incarceration.

Health and Wellness Minister Dr Christopher Tufton said the issue was one of national security, public health, and institutional management. The ministry also described the Hunts Bay facility as being of grave concern.

“Hunts Bay remains the facility of greatest concern,” the ministry said in response to questions from The Sunday Gleaner.

“Once an inmate is identified by the officers as being unwell, the person is taken for medical care and, if suspected of having TB, would usually be admitted to the National Chest Hospital for care,” it added.

“The risk of spread is then heightened due to the close proximity of persons in the cells and frequency of contact, also the delay at times in getting inmates who are not feeling well to medical attention,” it said further.

Tufton said if the illness is confirmed, “screening of those persons who would have been in contact with the inmate diagnosed as having TB then takes place”.

Dr Romayne Edwards, consultant emergency medicine physician at the University Hospital of the West Indies, said antibiotics are used to treat tuberculosis and noted that emergency physicians are often the first point of contact in the diagnosis and treatment process.

 “Tuberculosis is caused by a bacterium called mycobacterium tuberculosis and persons with active TB disease in the lungs can spread the disease when speaking, singing, talking and laughing. A person becomes infected after inhaling the droplets when the germs enter the lungs. Symptoms include a persistent cough, fever, poor appetite and weight loss,” she told The Sunday Gleaner.

She said reporting suspected cases was mandatory.

Citing the Public Health Class 1 Notifiable Disease Order of 2003, Dr Edwards said healthcare workers, including those in emergency departments and primary healthcare facilities, are required to report suspected or confirmed cases within 24 hours.

“The aim is for the public health officials to trigger surveillance investigations and control measures to prevent spread. Tuberculosis is multi-systemic and it affects the lungs and other areas of the body (extra pulmonary). All patients are admitted and isolated once there is suspicion of active disease. Treatment is by administering an antibiotic therapy regimen based on local protocols and resistance patterns,” Edwards explained.

Patients can remain admitted for months while receiving treatment. However, individuals may carry TB bacteria without displaying symptoms because the disease can remain dormant in the body. When inactive, it cannot be spread, but weakened immune systems can cause it to become active.

Latent TB is detected through the Mantoux test or by blood testing.

For doctors, personal protective equipment, including N95 masks similar to those used during the COVID-19 pandemic, is recommended. Inmates, however, have no such protection inside cells which, according to police sources, are often overcrowded beyond their intended capacity.

An attorney who recently visited a client at the National Chest Hospital told The Sunday Gleaner that an estimated 20 handcuffed patients were receiving treatment there.

“While this was concerning, it is, unfortunately, not surprising, given the deplorable conditions of detention, including severe overcrowding and a lack of proper ventilation,” the lawyer said.

The Police Civilian Oversight Authority (PCOA) said inspections conducted on February 10 and 12 this year confirmed one TB case at the Hunts Bay lockup.

“Evidence of this was found in the medical journal at the station, which indicated that a physician had already administered treatment and collected samples from five other prisoners in custody for TB testing. Lockup staff, however, informed the team that an additional 10 prisoners in custody were suspected of being infected,” the PCOA said in a statement earlier this year.

Although no confirmed TB cases were identified at the Greater Portmore lockup during inspections, the PCOA said records showed one inmate had been treated for TB-like symptoms pending confirmation. The health ministry later confirmed that case.

The oversight body also reported that five individuals were being treated for scabies, a contagious skin condition that causes severe itching and pimple-like rashes.

According to the PCOA, an audit of protective measures for staff found that officers at the Hunts Bay facility, which also had a chickenpox outbreak last December, had access to adequate PPE, including masks, gloves and sanitisers. The authority also noted that both Hunts Bay and Greater Portmore were holding more prisoners than their approved capacity.

Attorney-at-law Tamika Harris, president of the Advocates Association of Jamaica (AAJ), said the spread of the disease in overcrowded and unsanitary lockups is a serious matter.

“These conditions raise serious public health and human rights concerns. I am calling for an urgent investigation into the circumstances at the station, as well as the implementation of meaningful and sustained measures to address overcrowding and improve the conditions under which detainees are held. The current situation is untenable and requires immediate attention,” Harris told The Sunday Gleaner.

Maria Carla Gullotta, of the non-governmental organisation Stand Up Jamaica, warned that police officers and correctional staff were also at risk when inmates carried communicable diseases.

She said she was not surprised tuberculosis had emerged in the lockups because of the filthy conditions and constant movement of detainees in and out of facilities.

“The police personnel at the facilities are also at risk of contracting the disease. Their families are also at risk because they go home from work. Every three, four, or five days, you have people coming in and going out. So the spread of anything which can be contagious is a very risky business,” she posited.

Gullotta described the state of many cells as deplorable.

“It is something which everybody knows. Every attorney, every person who enters a lockup is horrified. What’s more dangerous, however, is that most families are unaware that their loved ones are sick while in the lockups, and ... many only become aware when other detainees advise them,” she said, adding that there is a gap between when persons are suspected of being ill and when they are taken for medical examination.

“And I repeat myself saying that there are at least 15 or 16 lockups which are so famous for being absolutely unhuman and nobody has been doing anything much. I acknowledge that some improvements have been implemented in the prison, but I didn't hear anything done in the lockups, which are, by the way, the [worst] place because, as you mentioned before, somebody can be in the lockup for three days, go home, and pass it to somebody else. But while in a prison, it might be that you stay 10 years, so it remains there,” Gullotta told The Sunday Gleaner.

Gullotta said families of inmates who died should seek legal advice to determine whether grounds existed for legal action.

Meanwhile, the Independent Commission of Investigations did not respond to queries on whether it has investigated reports of deaths of inmates in police custody due to tuberculosis or what were the outcomes of any such probes.

erica.virtue@gleanerjm.com