Pretrial holding facilities, which include police lock-ups not designed for large numbers or extended stays, often force detainees to live in filthy, overcrowded conditions without access to fresh air, minimal sanitation facilities, health services, or adequate food. In the worst cases, detainees die from the conditions and associated disease, and surviving detainees sleep with the corpses. In some cases, pretrial detention centers are so bad that innocent people plead guilty just to be transferred to prisons where the conditions might be better.
In prisons and other post-conviction detention centers, incoming prisoners may be screened for disease, get health care, and/or have access to methadone therapy and condom distribution. But with rare exceptions, none of this is available in pretrial detention. Instead, arrestees are brought in, locked up in a pretrial detention center where they are exposed to disease, and then in many cases released into society to spread the illnesses they have contracted. This is also a danger for prison guards and other employees. In 2001 in Tomsk, Russia, the local detention center had a shocking TB infection rate of 7,000 cases per 100,000 inmates. Outside the prison gates, the rate was not much better: 4,000 cases per 100,000 residents.