Moses Magadza

HARARE - A call has been made for judicial officers to revisit custodial sentences and use alternative, non-custodial penalties for petty crimes amid growing concern over a ballooning prison population jinxing efforts to provide equitable healthcare to people in incarceration.

The officer in charge of Harare Central Prison, Chief Superintendent Crashwell Mandave, made the call when his facility received an opportunistic infections antiretroviral therapy (ART) clinic from the United Nations Office on Drugs and Crime (UNODC) recently. 

Signe Rotberga, UNODC Regional Coordinator for Southern Africa, officially handed over the clinic, which was set up with financial support from the Swedish International Development Agency (SIDA).

Unfit for purpose
Mandave revealed that the prison, which was established in 1 910 with a carrying capacity of 1 470 inmates, was squirming under a population of 2 062 inmates, nearly 500 more than it was designed to accommodate. 

“Our prison is old with dilapidated infrastructure which is no longer serviceable. Cooking meals for inmates is a challenge because our electrical cooking pots are often not functional. Out of six pots in our kitchen, two are functioning but below capacity,” Mandave told Deputy Commissioner General responsible for administration, health, procurement and logistics, Dr Alford Dube, who represented the Commissioner General of the Zimbabwe Prisons and Correctional Service (ZPCS), retired Major-General Paradzai Zimondi, during the handover.

Water, other woes
He said when push comes to shove, as often happened, prison officials use a makeshift kitchen that uses firewood and work throughout the night to cook food for inmates.

He added: “Water supply from Harare City Council is very erratic and we can go for up to a week without water which compromises the health of inmates and officers.”
Although the prison has a borehole, Mandave said the water table was very low and the borehole was unable to cope with growing demand.

He said although the food situation at the prison was “generally fair”, special diet requirements of deserving inmates were often not met due to non-availability of prescribed rations.

Additionally, Mandave said his facility was struggling to meet demand for inmates’ clothing, blankets and sleeping mats while frequent power cuts by the Zimbabwe Electricity Supply Authority (ZESA) and a shortage of vehicles were other challenges. “We, therefore, recommend passing of non-custodial sentences by the judiciary for trivial cases such as shoplifting and possession of twists of dagga to reduce overcrowding,” he said. He suggested, also, that amnesty and presidential pardons for deserving inmates be explored to “decongest the already suffocating prison population”. 
He called for water and a standby generator able to power the whole prison.

UNODC support
In 2012, UNODC supported a healthcare facility assessment in Zimbabwean prisons in collaboration with the Zimbabwe Prisons and Correctional Service (ZPCS), the Ministry of Health and Child Care (MOHCC) and the National AIDS Council (NAC). 

The assessment evaluated equipment and infrastructure in identified prison health facilities that respond to HIV and AIDS as well as tuberculosis (TB). 

It found that some of the prisons had old buildings, inadequate health facilities, insufficient medical equipment and poorly trained staff. It showed, also, that there was poor nutrition for inmates, poor monitoring and evaluation systems and erratic supplies of medicines. In response, UNODC constructed the three-roomed OI and ART clinic at Harare Central Prison.  Work is at an advanced stage to finish the refurbishment of an old kitchen at the same prison and turn it into a laboratory to support the OI and ART Clinic. 

Nicholas Nyamapfeni, UNODC National Project Coordinator in Zimbabwe, told delegates that setting up the clinic had not been easy, but resilience had paid off.

“We started in 2017. Initially, we procured building materials and ZPCS provided labour. Unfortunately, there was an underestimation on the bill of quantities and because of the economic situation in the country, we were not able to procure the outstanding building materials using the UN procurement guidelines. We then hired a contractor to finish off the work,” he said.

Partnership power
UNODC in Zimbabwe and ZPCS have a long-running partnership and have collaborated on capacity building of human resources for health in prison settings. 

In 2014 a Partnership Forum was set up for stakeholders working on HIV and SRH for joint planning, coordination and monitoring of HIV and SRH activities in prisons.

UNODC conducted the first ever HIV prevalence study in Zimbabwean prisons in 2011. It found that HIV prevalence among prison inmates was at 28 percent with female inmates having a prevalence of 39 percent.  

That study informed the development of the ZPCS’ first ever HIV and AIDS Strategic Plan (2012-2015).  In 2017 UNODC conducted the first ever TB prevalence study in Zimbabwean prisons.  The study showed that the TB burden in prisons was one and half times higher than the general population. UNODC supports Member States including Zimbabwe and Namibia to implement the United Nations Standard Minimum Rules for the Treatment of Prisoners. 

The rules stress the right of prisoners to health care, including HIV and AIDS prevention, treatment, care and support without discrimination.

Training of trainers on peer education was conducted in May 2014 to equip ZPCS trainers with knowledge and skills in facilitating training on HIV and AIDS prevention, treatment, care and support interventions on TB, sexually transmitted infections (STIs) and other risky behaviours in prison settings. 
In June 2015, 24 prison health officers were trained in TB Case Management and Multiple Drug Resistant TB Management. 

Those trained include nurses, doctors, laboratory technicians and pharmacist technicians. In 2018, 32 ZPCS officers were trained in Monitoring and Evaluation of HIV and AIDS Programmes.  In February 2018, 28 ZPCS nurses were trained in Rapid HIV Testing while in March 2018, 40 ZPCS Officers were trained on Sexual Reproductive Health (SRH) and HIV Linkages. 
An additional 90 ZPCS Officers were trained in November 2018.

Gratitude and hope
Dr Owen Mugurungi, the National Director, HIV and TB Programme in the MOHCC, hailed the growing partnership between UNODC and ZPCS. 
He said the collaboration had emboldened Zimbabwe to set targets higher than those set by UNAIDS in ending AIDS.

He said whereas the world has agreed on 90-90-90 targets (by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression), “we are now talking of 95-95-95”. Chief Correctional Officer Thembikile Tsilili, who heads the new clinic as matron, said it could not have come at a more appropriate time given that approximately 500 of the inmates are on ART and need close monitoring.

“It will serve more than inmates. Our dependents will also use it. It will go a long way as it will be shared by other facilities including the Remand Prison. It will serve quite a big population,” Tsilili said.

She said one of the rooms in the clinic would be used to medically assessing officers and offer a full range of HIV testing services that include: counselling (pre-test information and post-test counselling); linkage to appropriate HIV prevention, treatment and care services; ART initiation; management of opportunistic infections; management of co-morbidities; adherence counselling and monthly review of all clients. A second room will be used as a consultation and counselling room for inmates while a third room will serve as an individual HIV testing room for officers and inmates. Nurses will use it to carry out investigations and send samples to outside laboratories. The room will be used to store test kits.

Impact
Dube thanked UNODC for supporting the prison. He said the new clinic would take quality health services closer to prisoners, who often sit at the bottom of priority lists in most countries. 
“We no longer have to refer officers and prisoners to other hospitals. This clinic will help us cut costs on transport, escorting prisoners and time.” On congestion, he revealed that plans were afoot to build a modern, bigger prison in Marodera.

Earlier, a prisoner had implored Dube to provide a vehicle so that prisoners could look for firewood to prepare meals.

Masango told him: “We have depleted our forests. We are looking at renewable energy – solar and gas. We have tried biogas, in vain.”

*Moses Magadza is Communications Officer at UNODC Regional Office for Southern Africa.