Brazil’s prisons are a human-rights disaster. Detainees—even those who have not been convicted of a crime—are routinely held in overcrowded, violent, and disease-ridden cells. Overcrowding in the prisons of the northeastern state of Pernambuco is especially dire. The prisons hold more than three times as many inmates as their official capacity in conditions that are dangerous, unhealthy, and inhumane.

During visits to Pernambuco’s prisons in 2015, a researcher from Human Rights Watch entered a windowless cell without beds, in which 37 men slept on sheets on the floor. Another, which had six cement bunks for 60 men, lacked even enough floor space. A tangle of makeshift hammocks made it difficult to cross the room, and one man was sleeping sitting up, tying himself to the bars of the door so that he wouldn’t slump over onto other men. In that cell, the stench of sweat, feces and mold was overpowering.

Poor sanitation and ventilation, combined with overcrowding and lack of adequate medical care, allow disease to spread among inmates. The prevalence of HIV infection in Pernambuco’s prisons is 42 times that of the general population; the prevalence of tuberculosis is almost 100 times that of the general population. Prison clinics are understaffed, medication is scarce, and ill detainees are often not taken to hospitals for lack of police escort.

The prisons in Pernambuco are severely short-staffed, with fewer than one guard for every 30 prisoners, the worst ratio in Brazil, where the average ratio is one for every eight, according to official data. Brazil’s Ministry of Justice considers appropriate a ratio of one guard to every five prisoners. At one prison in Pernambuco that holds 2,300 inmates—a “semi-open” facility where some inmates are allowed to come and go for work—only four guards are on duty during each shift, its director told Human Rights Watch.

The extreme overcrowding and lack of sufficient staff make it impossible for prison authorities to exercise adequate official control within the prison grounds. In response, they have adopted a practice of delegating authority to a single inmate within each pavilion—fenced-in areas within the prison walls that usually contain multiple cell blocks and more than 100 inmates. The chosen inmates are commonly referred to as “keyholders” because they are given the keys to the pavilion and the cells within, and tasked with maintaining order inside. Prison staff retain control only outside the pavilions.

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