Overcrowding, tuberculosis, and violence: the lethal cocktail hitting Ecuador’s prisons

Ecuador.– The Ecuadorian prison system is going through one of its most serious crises, marked by extreme overcrowding, an out-of-control tuberculosis epidemic, and constant acts of violence, a combination that has caused dozens of deaths in recent months and keeps families, doctors, and human rights organizations on alert. On November 9th, at least 30 people deprived of their liberty died in a prison in the country due to alleged asphyxiation. Just a month later, in that same penitentiary center, another 13 deaths were recorded after the explosion of a device outside the prison, without it having been clarified whether both events are related. Added to these episodes are numerous deaths from tuberculosis, especially in the Penitenciaría del Litoral, the most populated prison in Ecuador. The most recent case occurred last weekend, when 15 inmates died in the Penitenciaría del Litoral, located on the outskirts of Guayaquil. The Government of Ecuador confirmed the deaths through the Service for the Attention of Persons Deprived of Liberty (SNAI), which indicated that “the events are under the corresponding protocols” and that they would be linked to the health status of the inmates.

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Meanwhile, relatives of the inmates gather daily outside the prison in search of information, denouncing abandonment, lack of medication, and inhumane conditions.

“The inmates are dying of hunger and diseases like tuberculosis. There are no medicines. The fact that they have made a mistake is not a reason to treat them worse than an animal,” said Isabel Mancero, a relative of an inmate, to the newspaper El Universo.

Violence and disease: a ticking time bomb

Deaths are not only related to illnesses. Intra-prison violence continues to claim lives in different parts of the country. At the beginning of this month, the SNAI reported the death of 13 inmates in the Machala prison; in November, another 31 died in that same center; in September, 17 died in the Esmeraldas prison. Neither the states of exception nor the declaration of “internal armed conflict” have managed to stop the crisis. “The situation escalated much more than we had imagined. This is already a humanitarian problem”, warned Fernando Bastias, lawyer and member of the Permanent Committee on Human Rights of Guayaquil. According to his explanation, inspections carried out by the organization in the Penitenciaría del Litoral revealed serious deficiencies: food distributed irregularly, precarious hygiene conditions, and inmates who do not get enough to eat. On November 19, SNAI acknowledged that tuberculosis is highly contagious in contexts of confinement and poor ventilation, and that some cases evolve severely, which would explain the recent deaths. The institution indicated that the highest incidence is recorded in the province of Guayas and that priority attention has been activated to mitigate the contagion.

Extreme overcrowding and health risk

Ecuadorian prisons house between 31,000 and 37,000 inmates, with an estimated overcrowding of 38%, according to official data. This scenario favors the spread of respiratory diseases such as tuberculosis, warned infectious disease doctor Washington Alemán, professor at the Universidad Espíritu Santo de Guayaquil. “The public health risk is serious. The disease can be transmitted to prison staff, families, and eventually, the general population”, he warned. The specialist emphasized that overcrowding prevents isolating the sick and increases the risk of drug-resistant strains. According to figures from the National Institute of Statistics and Censuses, between six and ten inmates can coexist in a cell, although in practice that figure triples. An example is the Ibarra prison, which has a capacity for 302 people, but currently houses more than 600. More deaths from tuberculosis than from violence Data provided by SNAI to the Ombudsman indicates that in 2024, 324 inmate deaths were recorded from undetermined causes. In the first three months of 2025 alone, an additional 121 deaths were recorded. The Permanent Committee on Human Rights warns that these figures exceed those of previous years and even equal or surpass the mortality levels recorded during the prison massacres of 2021. Bastias estimates that, if the current trend continues, about 700 inmates could die in 2025 from tuberculosis, a figure higher than the total number of deaths from intra-prison violence since 2021.

“The way they die is traumatic; many reach a cadaverous state. This cannot be normalized,” he denounced.

The SNAI assured that it is working in a coordinated manner with the Ministry of Public Health to contain the tuberculosis outbreak, through medical brigades, transfers and relocations. However, national and international organizations, including the Inter-American Commission on Human Rights (IACHR), have reiterated their urgent call to the Ecuadorian State to adopt effective measures to guarantee the life, health and integrity of persons deprived of liberty.