Gavin Foster
The Ugandans are here! Funded by the United Kingdom’s Department for International Development and the British Council, a delegation from the Uganda Prison Services is in Durban teaching South African Department of Correctional Services officials and prisoners how to handle HIV/Aids
What better place to push HIV/Aids education than in prison. You have a captive audience who see the effects of the disease every day and can’t just walk away. You have thoroughly educated students who’ll one day return to their communities and share their knowledge. Try telling free citizens about HIV/Aids and they’ll produce a very good excuse about the other things they have to do. Show them somebody with HIV/Aids and they’ll remember a very good reason for being elsewhere.
But in prison there is nowhere to go, and not much else to do. By the time you’ve finished with them, the prisoners will have a thorough grasp of the realities of the situation, rather than some half-baked ideas picked up in 30-minute cram sessions and, thanks to their work with patients, the Aids stigma will largely be gone.
“In the early 1990s the HIV rate in our prisons was over 30%,” says Mary Kaddu of the Uganda Prisons Medi- cal Services. “Then we started implementing strategies to fight the disease and the prison services programme got going. Today we’re down to 7% or 8%.”
Now Kaddu and her team are giving training to staff and inmates of Westville prison in Durban. The idea? To use this core of workers to train other South African prison officials and inmates in the prevention and control of HIV, and the care of those living with Aids.
What the Ugandans have achieved in their country isn’t a miracle. It’s an example of what teamwork can do.
“When people started dying in the outlying areas of our country in the early 1980s we knew something was happening, but it was blamed on witchcraft. Then the same symptoms started appearing in Kampala and we knew it was serious. Our president got involved and urged everybody to confront the problem. A national Aids programme was formulated, which extended to every government department, including the prison service, and we all worked closely together. When you find a snake in your house you don’t sit around discussing where it came from. You cut off its head!”
Because prisons are by nature not as accessible to health workers as other institutions, much of the work had to be done from within. Everybody in the prison services, from the national commissioner down, is involved in the department’s programme, with prisoners and warders working together on Aids control committees at the various prisons.
“We’ve trained many of our officers, and then we’ve trained the prisoners themselves to be counsellors quali- fied counsellors. We’ve had one case where a prisoner started his own training programme upon release, and he has so far educated hundreds and hundreds of people in the prevention and control of HIV and the care of Aids patients.”
Another benefit is that trained prisoners care for HIV-positive comrades during the hours that prison staff are largely off duty, which helps remove the stigma attached to Aids.
There are a number of differences between Ugandan and South African prisons and this affects the way things are done. Firstly, South Africa has a huge number of prisoners, while the entire prison population of Uganda could almost fit into Westville prison, so managing the project in that country is easier. Secondly, sodomy is uncommon in Ugandan culture in fact, it’s still punishable by 80 years imprisonment and, although practised in prisons, is nowhere near as prevalent as in South Africa. Thirdly, the gang culture rife in South African prisons is not a part of the Ugandan prison experience and prison rapes are virtually unheard of. And finally, compared to theirs, our prisons are hopelessly short of medical care workers.
But other problems are shared by prisons everywhere. Overcrowding is a problem in both countries and this also contributes to the Aids problem. Tensions rise, discipline is hard to enforce and standards of hygiene become more difficult to maintain. But in Uganda the close cooperation between the various government departments is bearing results.
“We’re all working together to reduce prison populations,” says Kaddu.
“Most of the overcrowding is caused by remands, so we’re trying to find out why there are so many. If the police say they have no transport to get the prisoners to court, then we may ask for the logistics. Or the courts say they don’t have the manpower to handle all the cases, and the prisons complain that they have no accommodation. Then we all sit together and see how best we can sort out these problems it’s a question of defining strategies and working together.”
Westville staff attending the course have been impressed with the quality of the syllabus and teaching, which has covered areas as diverse as proper condom use, pre- and post-testing counselling, risk assessment, management of diarrhoea and tuberculosis, palliative care and changing of behaviour patterns.
Once their initial two-week course is over, recommendations on the handling of HIV/Aids in prisons will be drawn up by the course leaders and delegates for presentation to the Department of Correctional Services and the minister. This will be followed by a course for 200 Westville inmates and prison warders. It is hoped the process will filter through to the rest of the country’s prisons.