PORT-AU-PRINCE, Haiti >> The emaciated inmate in black shorts lay on a thin mat in Haiti’s most notorious prison, isolated from other prisoners at Port-au-Prince’s National Penitentiary because of drug-resistant tuberculosis.

He slowly sat up to talk to a visiting reporter and more than 70 fellow tuberculosis patients gathered at the door of the neighboring cell to complain about their suffering while detained, many on minor charges like theft.

“We don’t have water!” one cried, while his fellow inmates said their food came late or not at all.

Haitian inmates are thirsty, starving and sleeping standing up because they don’t have enough enough room to lie down. The United Nations says 185 inmates died in Haiti last year — many of malnutrition-related diseases. This year, more than 20 have died so far. Human rights experts and attorneys expect the number to rise because gang violence has led to severe fuel and food shortages.

“I fear that a humanitarian catastrophe is coming,” said attorney Arnel Rémy, coordinator for Haiti’s Association of Lawyers for the Defense of Human Rights.

More than 80% of Haiti’s more than 11,400 inmates are being held in pre-trial detention. It could be years before they see a judge, if at all, according to human rights experts. Haitian law allows people to be held legally without charge for 48 hours but in Haiti, the law often isn’t followed.

Last year, Haiti’s government released more than 70 inmates convicted of minor offenses after several videos posted on social media showed emaciated prisoners. But such moves are rare and in the meantime, the health of inmates worsens, with some dying before they get to court.

In December, the University of Florida published a study that found that men in Haiti’s prisons were on a starvation-level diet, consuming fewer than 500 calories a day. Researchers studied more than 1,000 inmates at two prisons in Haiti, including the National Penitentiary. They also found that more than 75% were at risk for scurvy and beriberi — a lack of B1 vitamin — and noted that prisoners are not fed during lockdowns.

Some prisoners have friends or family who bring them food and drink every day, but that longstanding practice has dwindled amid a surge in gang violence that has shut down key roads and led to a scarcity of public transportation in some communities.

“No one brings me food,” said François Gausly, 50, adding that he has been in prison for four years after being accused of stealing a motorcycle, but has yet to see a judge. “I eat only once a day. Sometimes it’s rice. Sometimes, it’s grits.”

A U.S. State Department report noted that arbitrary arrests are common in Haiti and that authorities often detain people on unspecified charges.

The area around Haiti’s National Penitentiary — the country’s biggest with nearly 4,000 inmates, even though it was built for 800 — has grown more dangerous: gun shots from warring gangs ring out almost daily, and a correctional officer was shot in late May as he left the penitentiary.

Despite the risk, about a dozen women stood outside the prison on a recent weekday holding plastic bags of food scrawled with the names of their loved ones and their prison cell number.

One woman who brought rice scooped some of it up with her hand and ate it as a corrections officer observed her: Anyone bringing food or drink is forced to taste it to avoid attempts to poison someone inside.

Among those waiting to deliver food to an inmate was 52-year-old Fenise Jean-Pierre, whose son has been in prison for eight months. He has yet to see a judge after someone accused him of killing a police officer. He was arrested two years after the killing and maintains his innocence.

Jean-Pierre said her son, 33, has lost a lot of weight, is forced to share a bucket with cellmates to relieve himself and is nursing a swollen foot.

“He has to sleep standing because there is no room where he is,” she said.

That day, she brought him only one meal because it was all she could afford, and she worries about not being able to help him at all.

“The more unstable this country becomes, the less access I have to see him,” Jean-Pierre said.

Inside, a group of inmates responsible for delivering the food brought by friends and family distributed the items as a song from the popular group “Racine Mapou de Azor” played in the background.

“We’ve been here too long without seeing a judge. We want to be sentenced or freed!” yelled one inmate who wore sunglasses.

Health through Walls, a Florida-based nonprofit that provides medical care for inmates at the National Penitentiary and other prisons across the world, gives inmates in Haiti reinforced supplements and the occasional protein shake to stave off malnutrition.

“We know the food is bad,” said Dr. Edwin Prophète of the group.

Health through Walls has trained nearly 70 inmates to identify sick people within prison cells because medical staff are now barred from doing daily health rounds given the growing insecurity.

Wilfred Mexuy, the head cook at Haiti’s National Penitentiary, who is serving a 15-year sentence for murder, told the AP that he prepares one or two meals a day for prisoners, but that his work depends on things he can’t control.

“Sometimes we have food but no power,” he said, adding that the prison was once three months without electricity and that the generator broke down.

Attorney Arnel Rémy said a group of lawyers have started pooling together money to buy inmates food.

“What worries us is the absence of the government, and its refusal to act quickly,” he said.

Haiti’s Ministry of Justice, which oversees the country’s prisons, did not return a message seeking comment.

Among the newest inmates at Haiti’s National Penitentiary is well-known attorney Robinson Pierre-Louis, who was secretary general of Haiti’s Bar Association and was detained last year after being accused of trying to free two men implicated in a big arms-trafficking case.

Pierre-Louis, who told the AP he was innocent, described the prison conditions as “savage” and “disgraceful.”

“It’s an attack on human dignity,” he said. “Some are making it, but others can’t survive.”