Political prisoners struggle for medical care in Thailand

His case prompted public discussion on standards for inmates’ access to medical care

Originally published on Global Voices

This article was published by Prachatai, an independent news site in Thailand. An edited version has been republished by Global Voices under a content partnership agreement.

Ekachai Hongkangwan is an ordinary citizen who suddenly emerged as a “secret figure” on Thailand’s political scene after the 2006 coup, which not only reshaped the course of Thai politics but also irreversibly altered his life. Despite being detained several times and facing repeated death threats for his symbolic acts of resistance, Ekachai remained relentless in pursuing his activism.

His deteriorating health in custody highlights a broader issue: access to medical care — a fundamental human right — which too often remains out of reach for prisoners in Thailand. The issue is even more poignant for so-called “prisoners of conscience,” people who have been imprisoned merely for criticizing or challenging those in power.

Ekachai’s 20-year journey

After graduating from a private university, Ekachai made a living by selling online lottery tickets, but the 2006 coup turned his life upside down. His only source of income disappeared after the online lottery project was cancelled.

Previously uninterested in politics, Ekachai gradually became politically engaged and began learning about politics in both Thai and English.

He first came into the spotlight on March 11, 2011, after he was arrested during a protest organized by the “Daeng Siam” (the Red Shirts), a group led by disappeared Thai political critic Surachai Sae-dan.

This incident led to his first charge under Thailand’s draconian royal defamation law, which prohibits citizens from criticizing the royal family. The charge stemmed from two items he was selling at the protest: a DVD of a documentary by the Australian media outlet ABC discussing Thai politics, which included rumors about the then Crown Prince, currently King Vajiralongkorn, and a collection of WikiLeaks documents.

Ekachai revealed that his intention was merely to disseminate information from the perspective of foreign media to Thais so that they could understand how Thailand was perceived internationally. In addition, Thai society at the time was deeply polarized, and he believed that the Thai media was failing to fulfil its duty.

Ekachai spent two years fighting his first royal defamation case. He was granted provisional bail during the trial. However, on March 28, 2013, he was sentenced to two years and four months in prison. In 2015, the Supreme Court overturned the initial verdict and extended his sentence by four more months.

After his release, Ekachai remained active through his writing. His work ranged from historical research, a series of proposals for military reform, and memoirs about his life in prison.

He did not abandon activism, even as political suppression increased under the National Council for Peace and Order (NCPO), the military junta that ruled Thailand from May 2014 to July 2019, following the 2014 coup. For much of its reign, the NCPO implemented martial law and sought to silence critics and dissenters. During this period, Ekachai’s most prominent campaign was his relentless push for an investigation into the luxury wristwatch scandal involving Prawit Wongsuwan, former minister of defense and deputy chairman of the NCPO. His activism was carried out in his distinctive individual style.

Between 2017 and 2019, he was physically assaulted and threatened with death six times, and his car was set on fire twice. According to Thai Lawyers for Human Rights, Ekachai faced 30 cases, most of which were concluded. He has been sent to prison seven times.

He revealed in 2019 that his approach to activism differed from traditional protest movements. The old approach of mobilizing tens or hundreds of thousands of people ended with a violent crackdown. For him, large protests were difficult to control.

“So activism does not have to use solely rallies. The election results have already clearly shown that people no longer support large protests that shut down the streets. We have to find other ways. I prefer going alone and making the news,” said Ekachai.

His most recent arrest in 2020 exposed another significant issue. Ekachai faced a charge under Section 110 of the Criminal Code concerning an act of violence against the liberty of the Queen. Prosecutors hadn’t levied this charge against anyone for decades — it was “exercised for the first time in modern history,” according to Thai Lawyers for Human Rights (TLHR). It carries a severe penalty of up to life imprisonment or a prison term of 16–20 years, regardless of whether the offence was completed or merely attempted.

The case stemmed from a protest on October 14, 2020, when the mass pro-democracy protests, led by young people, erupted across the country. On that day, protesters gathered at Bangkok’s iconic Democracy Monument before marching toward Government House.

Some protesters arrived earlier and waited near the Government House. At the same time, the Queen’s royal motorcade passed through. They did not block the motorcade or throw objects at the passing vehicles, but they still faced the charge of violence against the liberty of the Queen.

According to police, the road used was not part of the royal motorcade’s usual route, but the motorcade chose it, despite being advised to use alternative roads as the protest was taking place near Government House.

No announcement was made. Awareness among officials across different agencies and operational levels varied significantly. A crowd control officer even testified that he was informed less than five minutes before the royal motorcade arrived.

On June 28, 2023, the Court of First Instance acquitted Ekachai and the other activists, concluding that the incident was a misunderstanding caused by the police. Two years later, however, the Appeal Court reversed the initial verdict, ruling that the demonstrators were aware that there would be a royal motorcade, and they intended to obstruct it.

Four defendants were sentenced to 16 years in prison, while Ekachai was sentenced to 21 years and four months due to his prior royal defamation conviction. Ekachai has now been detained for six months.

Ekachai’s health has deteriorated in prison. He suffers from an enlarged prostate and severe abdominal pain in the area where he had previously undergone surgery for a liver abscess. It is reported that he may require another major operation.

His lawyer requested his transfer to the Corrections Hospital, but the request was initially rejected. The Corrections Department said that he would be transferred on Wednesday, March 11.

Following the case, standards for inmates’ access to medical care in Thai prisons were widely questioned.

Last year, former Prime Minister Thaksin Shinawatra, who is serving a year-long jail sentence for abuse of power, was transferred to a hospital on his first night in prison due to a reportedly serious illness after returning from self-imposed exile.

He was later moved to the Police Hospital rather than being treated at the Corrections Hospital, where ordinary inmates are typically sent. The incident sparked a public backlash against Thaksin, as well as the judicial and correctional systems, amid widespread belief that he had received special treatment as part of a political deal with those in power. Some believed that Thaksin faked his illness to avoid detention in prison.

Ekachai’s life is now hanging by a thread. Two Thai “prisoners of conscience” have suffered death in custody after their health deteriorated while waiting for proper medical treatment.

His case now marks another serious challenge for the Corrections Department.