As if prison life itself were not punishment enough, some inmates find themselves in the double predicament of incarceration and sickness. As WEZZIE GAUSI writes, tuberculosis (TB) is one of the ailments making prisons hell on earth for some inmates.
Thirsty-five-year-old Uze Hamisa is a Likuni, Lilongwe,- based ex-prisoner who spent 10 years behind bars at Maula Prison after being convicted of theft in 2015.
Like anyone else, Hamisa did not imagine that, one day, he would end up in prison.
“I was going about my business as taxi driver when, unknowingly, I transported customers who, I later learned, were thieves. The State claimed that I was an accomplice and the courts sided with it. The truth is that I was innocent and ever have been in relation to that issue,” he said.
That is how he embraced prison life that set him on the path to catching TB.
“Of course, the moment I stepped in prison, inmates warned me that I would soon shed off my body and become prisoner-like. They also advised me to be seeking medical attention for every ailment.
“They made it clear that, apart from expecting anything thrown at me while in prison, I needed to brace for diseases, notably tuberculosis, which they said was common in the country’s prisons,” he said.
Not long after, he realised why he was given that piece of advice.
“There were 289 inmates in our section. All of us were using one toilet and one bathroom. We were compacted in one place and the way we slept was uncomfortable. They say people go to the prison to change but that is not the case with Malawi’s prisons. The only thing that one gets within the walls of prison is anguish, persistent hunger and diseases that see no limits,” Hamisa said.
Under such circumstances, he does not understand why it took him so long to catch TB.
However, slightly over two years into his incarceration, the expected happened; he was diagnosed with TB in 2018.
It was not just him that tested positive for Mycobacterium tuberculosis, the bacterium that causes TB.
Five others tested positive, too.
Mycobacterium tuberculosis attacks any part of the body such as the kidney, spine and brain.
However, according to the World Health Organisation, not everyone infected with TB bacteria becomes sick.
At first, Hamisa thought everything would be fine as he was aware of prisoners that had been cured from TB during the time he had been in prison.
He was in for a surprise.
“My heart sunk when doctors told me and the other inmates that were diagnosed with TB that we had Multi Drug Resistant (MDR) TB, which was relatively new in this country. I got depressed by the news. The whole Maula Prison learned about the news. Prison warders soon removed everyone from the cell I was in, leaving me alone. They feared that I could transmit the disease to other prisoners.
“They instructed everyone not to get close to me. I felt like I was dying any minute from that moment. There was no one who could come near me to give me food or anything; I was starving. As time passed, doctors came and took me to Bwaila Hospital for treatment,” he said.
On getting to the hospital, he claimed that they were isolated and stigmatised.
“To make matters worse, they kept us in a building that used to house people with mental challenges. It was double punishment; being a prisoner and sick,” he said.
Since MDR was a new kind of TB, the six inmates were used as case studies for testing drugs.
“Come to think of it; we could get an injection and 21 tablets of drugs a day. Whenever we were given the medication, we could lose consciousness immediately.
“I don’t know how we survived that procedure. I don’t even know what kind of medication I was receiving but all I know is that we were given the injection early in the morning. After receiving the injection, everyone could fall unconscious until around 5 in the afternoon— meaning we were doing everything, in terms of answering to the call of nature, where we were sleeping.
“And, as prisoners, we were chained all the time as they thought we would flee from the facility. But, then, the state we were in, we could not even think of running away. Health personnel could also stigmatise us; they could give us food and check on us while standing metres away,” Hamisa said.
Anthony Masitala, 36, also went through hell when he, as a prisoner, was diagnosed with MDR TB.
He is now out of prison.
“My skin complexion became darker than before because of the medical processes he went through when they were experimenting on me and others at Bwaila Hospital in Lilongwe. I suspect that, for the two years I spent at the hospital, I received tablets equivalent to three buckets of 50 litres of water and about 200 injections.
“The experiment that was conducted on us was very bad. We went through stigma and discrimination as our relatives were not allowed to come closer to us. We were chained all the time until Centre for Human Rights Education Advice and Assistance (CHREAA) came to our rescue,” Masitala said.
CHREAA Executive Director Victor Mhango said it is true inmates that have been diagnosed with TB are facing challenges in prisons.
He said, for those that have TB, the challenges are many as they have to sleep in rooms with other inmates with no social distancing.
“We have spoken, time without number, that our prisons are not a safe place for keeping people. They eat once a day, they stay in congested rooms, superseding the initial number of inmates that could be accommodated.
“The Malawi Government really needs to think of ways of decongesting prisons. As things stand, TB will continue to spread as wild fire among inmates if nothing positive happens,” Mhango said.
However, Malawi Prisons Service spokesperson Chimwemwe Shaba dismissed reports that prisoners with TB are mixed with those without TB.
He said he was not in the know about such practices because inmates with Covid, for example, are isolated from.
“As such, we cannot fail to isolate those with TB.
“We, as prison, put lives of inmates first; so, it is strange to insinuate that inmates with TB are kept in same facilities with those without it. Of course, we have had issues of space but, of late, we have seen organisations like Chreaa facilitating the release of some inmates so that we decongest prisons,” Shaba said.
Centre for Human Rights and Rehabilitation Executive Director Michael Kaiyatsa said prisoners have rights, including the right to seek medical help when they fall sick.
“It is important that prisoners that are suffering from TB are isolated and taken care of. We all know that TB requires a good diet as the medication is strong. As such, prisons should be in a position to provide good care to prisoners despite them being prisoners,” Kaiyatsa said.
The report on the inspection of prisons and police cells conducted by the Malawi Inspectorate of Prisons in February, May, August 2020 and February 2021 indicates that TB is prevalent in prisons.
Almost all prisons had numbers of inmates receiving TB treatment at the time of inspection. In most of the prisons, there is admittedly no consistent screening of TB on admission.
The report further shows that prisons were found to be overcrowded by 278 percent beyond the designed capacity during the period of inspection of the official capacity, which amounts to a violation of the right to freedom from torture, cruel and inhuman treatment.