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ZAMBIA: Agencies step in to address HIV/AIDS in prisons

Prison walls have not insulated inmates from the effects of Zambia's HIV/AIDS pandemic, aid workers warn.

Prisoners are rendered vulnerable due to overcrowding, poor nutrition, limited access to healthcare, injecting drug use, unsafe sex and tattooing, according to government officials and NGOs.

According to the Zambia Prisons Service (ZPS), last year about 450 inmates in the 52 prisons across the country died from HIV/AIDS-related illnesses.

In response, government agencies and NGOs have been implementing programmes to prevent and address the HIV/AIDS pandemic and its most prevalent opportunistic disease, tuberculosis (TB).

ZPS deputy-director of international relations and corporate affairs, Doreen Ngoma, cited HIV/AIDS, which has claimed the lives of both officers and inmates, as one of the major problems the service has had to deal with in recent times.

She pointed out that some inmates were already infected with HIV at the time of their conviction and the service had to take responsibility for providing them with healthcare.

Having identified the challenges and problems posed by the pandemic, the ZPS was developing an HIV/AIDS policy with a range of prevention measures to address the pandemic among inmates, officers and their families, and working with a number of stakeholders to sensitise prisoners to the dangers of HIV/AIDS, Ngoma said.

A project run in collaboration with the Copperbelt University (CBU) clinic has paid some dividends: the 'In But Free' (IBF) programme, which implies that prisoners can be in jail but free from disease, provides inmates with information on how to protect themselves.

'In But Free' teaches prisoners to avoid contracting the disease by not sharing razor blades, and about the dangers of sexual intercourse. "They are also taught how to live positively if they are already infected," Ngoma noted.

Some officials have also been trained to provide psychosocial counseling, and inmates have enrolled as peer educators to disseminate information on HIV/AIDS.

The Community Responses to HIV/AIDS (CRAIDS), a component of the Zambia National Response to HIV/AIDS, recently launched a primary healthcare project for prisoners to tackle the pandemic at the Mukobeko Maximum Prisons in Kabwe, the administrative capital of Zambia's Central Province, about 150 km north of the capital, Lusaka.

CRAIDS has trained some prison officers and inmates in home-based care, and has recommended that prisoners should have access to HIV/AIDS education, care and treatment, and cleaning materials such as bleach.

Central province CRAIDS regional facilitator Julius Kampamba said, "Denying access to such measures for people in prisons places them at increased HIV infection, and those living with HIV/AIDS at increased risk of health decline and coinfection with TB, and death".

Kampamba observed that to effectively strengthen the health system and services in prisons, the government should identify more partners who could help with needed resources to fight HIV/AIDS.

The ZPS and CRAIDS welcomed the government's provision of free ARVs to the prisoners. Ngoma pointed out that although HIV-positive inmates were accessing ARVs from government hospitals and clinics, they would be able to get them through the prison system once the Prisons Health Care Service had been established and Prisons Act number 16 of 2004 had been amended.

Ngoma said the establishment of the healthcare service would enable the ZPS to employ its own medical staff to provide much-needed support.

The Prisons Fellowship of Zambia (PFZ), a prisoner rehabilitation programme operating in 40 jails in the country, recommended that ARVs be provided. "If we are to combat this scourge effectively, all sections of society must be targeted. This includes the prisons," PFZ executive director Bishop Enocent Silwamba said.

PFZ uses a community-based health approach in providing health information and medical services to inmates with the help of volunteer care groups, clinical officers and as peer educators.

The programme has been advocating the isolation of prisoners suffering from tuberculosis (TB) and the decongestion of penal institutions.

"So far there has been positive cooperation from prison authorities. Kamfinsa Prison [in Kitwe, Copperbelt Province,] is an example of this cooperation, where TB patients and those chronically ill are isolated," said Silwamba.

PFZ also conducts weekly mobile clinics in Copperbelt prisons and has formed support groups for positive living.

But the programme is against providing condoms to prisoners, to avoid promoting sodomy. According to Silwamba, "Condoms should be provided to those being released from prison, who are infected, so they do not transmit to their spouses."

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[This report does not necessarily reflect the views of the United Nations]

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