Lebanon: Sharp increase of deaths in custody must be a wake-up call for authorities

Lebanese authorities must urgently prioritize the health of prisoners as deaths in Ministry of Interior-run prisons nearly doubled in 2022 compared to 2018, the year before the ongoing acute economic crisis began, Amnesty International said today.

Judicial authorities must conduct prompt, impartial and effective investigations into all deaths in custody to determine to what extent prison officials’ misconduct or negligence may have contributed to these deaths and hold anyone found responsible to account. The authorities should also investigate to what extent the sharp increase in deaths is linked to structural factors such as overcrowding, lack of adequate resources and impunity for ill-treatment, all exacerbated by the economic crisis.

An Amnesty International investigation “Instead of Rehabilitation, He Found Death: Deaths in Custody Doubled Amidst Four-Year Economic Crisis” explores the reasons behind the sharp rise in deaths in Lebanon’s prisons. Ministry of Interior figures shared with the organization paint a stark picture of rising mortality rates as deaths increased from 14 in 2015 to 18 in 2018 and 34 in 2022.

“The sharp increase in custodial deaths must be a wake-up call to the Lebanese government that their prisons need urgent and drastic reform. They must decongest prisons, including through utilizing non-custodial measures as alternatives to pre-trial detention, and must commit additional resources to ensure people in prison are receiving adequate healthcare and have immediate access to emergency medical care,” said Aya Majzoub, Amnesty International’s Deputy Director for the Middle East and North Africa.

“The economic crisis is no excuse for prison authorities to deny prisoners access to medication, shift the cost of paying for hospitalisation to the families of prisoners or delay prisoners’ transfers to hospitals. The judiciary should promptly and impartially investigate every death in custody, and any shortcomings and neglect on the part of the authorities must be addressed, including, where appropriate, through prosecution of those responsible.”

The Ministry of Interior provided no explanation of the causes of these deaths in custody. Amnesty International’s investigation raises concerns that the marked increase in deaths in custody is linked to the economic crisis crippling the country, as well as shortcomings in prison and health authorities in the provision of adequate and timely medical care to people in custody, including in cases where emergency treatment was required.

Between September 2022 and April 2023, Amnesty International interviewed 16 people, including prisoners and family members of individuals who died in custody. It reviewed several medical reports as well as photos and videos taken by people in prison. Amnesty International wrote to the Ministry of Interior and the Ministry of Health with questions on deaths in custody. Both ministries responded, and their responses were incorporated into the investigation.

Reports of denial of timely medical care

While the authorities have blamed the economic crisis for the deterioration in the health of prisoners, in at least three cases of deaths in custody in 2022, families of the deceased told Amnesty International that prison officials dismissed the complaints and symptoms of those detainees prior to their death, delaying their treatment and transfer to hospitals and causing their conditions to worsen.

Khalil Taleb, 34, died in Roumieh prison on 21 August 2022. According to his brother, Khalil’s health started deteriorating upon his arrival. Even though his family provided funds to pay for his treatment, they told Amnesty International that the prison pharmacist dismissed his pains and the prison guards delayed his hospital transfer.

His brother said: “He either arrived [to the hospital] already dead or unconscious… Instead of rehabilitation, he found death.”

In accordance with the UN Minnesota Protocol on the Investigation of Potentially Unlawful Death, prison directors must report all deaths in custody to the ordinary judiciary, which is independent of the prison administration, to conduct prompt, impartial and effective investigations into the circumstances and causes of these deaths.

Prisons lack basic healthcare

Overcrowding in prisons has become particularly acute in recent years. Lebanese prisons are 323% over capacity, and around 80% of detainees are held pre-trial. The combination of overcrowding and dire detention conditions has led to the deterioration in the health of the prison population. Meanwhile, in light of depreciating currency and skyrocketing inflation, resources for the provision of healthcare have drastically decreased.

The real value of the Ministry of Interior’s budget for providing healthcare to people in prison decreased from 7.3 million US dollars in 2019 to around 628,000 US dollars in 2022.

As a result, prisons are not adequately staffed, and prison pharmacies lack basic medication such as painkillers and antibiotics.

Since the start of the economic crisis, the government has failed to pay hospitals bills related to the treatment of people in custody which has resulted in many hospitals refusing to admit patients from prison or requiring upfront payment, even in emergency treatment cases, which is a violation of Lebanese law. According to the figures shared by the Ministry of Interior with Amnesty International, 846 people in custody were hospitalised in 2018 and only 107 in 2022.

While Lebanese law specifies that the Ministry of Interior is responsible for providing healthcare to all individuals held in its custody, Amnesty International found that prison authorities were requiring families to pay for their relatives’ medical care, including in cases where emergency medical treatment was needed.

Amnesty International is cognizant of the impact of the broader economic crisis on the medical sector and on the resources of the prison authorities. But even governments struggling through an economic crisis have an obligation to ensure that they are not discriminating against the prison population in the provision of the right to health. Under both Lebanese and international law, the provision of healthcare for prisoners is a state responsibility and must be free of charge.

Amnesty urges the Lebanese government, with the support of the international community, to allocate additional resources to ensure that prison authorities can improve conditions and healthcare in prisons and other places of detention.

Ill-treatment

Amnesty International frequently documents torture and other ill-treatment in detention in Lebanon, including the case of one individual who died in custody in 2019 amid allegations of torture that were not adequately investigated.

The Ministry of Interior told Amnesty International that 14 members of the Internal Security Forces were internally disciplined for “beating and blackmailing” people in custody.