The government’s foot-dragging response to a Durban High Court order to provide anti-retroviral treatment to HIV-positive prisoners continued this week when it ignored a deadline to give the High Court proof of its treatment plan for inmates at Durban’s Westville Prison.
Instead, it applied for leave to appeal against the judgement — further drawing out a process that started in October last year.
This follows the death of one of the 15 prisoners who, with the Treatment Action Campaign (TAC), took the prison and departments of health and correctional services to court in April this year.
Prisoner MSM died on August 6 after, according to court papers, suffering with “bleeding piles, painful rash on both ears, fungal infections, tuberculosis, body rash, general itchiness, oral thrush, lesions, penile sores, mouth sores, septic sores on knees [and] painful feet”, between November 2004 and March this year. He had started ARV treatment only in July.
The TAC reacted by staging a sit-in protest at the Human Rights Commission’s offices in Cape Town on Wednesday, demanding that Minister of Health Manto Tshabalala-Msimang and Correctional Services Minister Ngconde Balfour be investigated for culpable homicide, for ignoring the “urgency” of prisoner MSM’s case.
The TAC has also called for a full judicial inquiry into the death.
TAC spokesperson Ralph Berold, who spent two days interviewing inmates at the prison this week, said conditions at its clinic were “shocking”, and that the government’s appeal could only exacerbate the plight of those infected with HIV/Aids.
“One [prisoner] has died already and nine are bedridden and in desperate need of medical attention. There is a shortage of basic resources and drugs, such as Fluconazole, which is used to treat oral thrush. Prisoners developing oral thrush cannot eat,” said Berold. He added that prisoners received only two meals a day and that this further compromised their health.
“There is also a problem with the prison clinic accessing TB medication, which means prisoners sometimes can’t get new drugs in time to continue their treatment.”
The battle for ARV treatment for Westville inmates started in October last year when the TAC tried to negotiate with prison authorities and the government for ARV treatment for prisoners with CD4 counts of less than 200 per cubic millimetre of blood.
The talks plodded on until March this year when, after new CD-4 counts showed a dramatic deterioration in prisoners’ health, the Aids Law Project — acting on behalf of the 15 inmates and the TAC — launched a court challenge to the national departments of health and correctional services, Westville Prison and the KwaZulu-Natal health Minister Peggy Nkonyeni.
In June Judge Thumba Pillay ruled in favour of the prisoners, ordering that HIV/Aids treatment be provided to the 13 applicants “and all similarly situated prisoners” at the prison with immediate effect. The judge gave the government and prison two weeks to come up with a plan for ARV delivery.
At the initial hearing, lawyers for the authorities asked Judge Pillay to recuse himself on grounds that his daughter, Sue Pillay, was correspondence attorney for the Aids Law Project.
He refused, but in late July gave the government leave to appeal against both this and the main order on ARV treatment. However, he also ruled that government had to comply with his initial ruling, setting August 15 as the deadline for the submission of an ARV plan. Instead, the government this week launched another application for leave to appeal and resurrected Judge Pillay’s refusal to recuse himself.
Adila Hassim, Aids Law Project attorney, said the government’s application for leave to appeal “defeats the purpose of the original judgement, which recognised the urgency of the matter and undermines the authority of the courts”. The TAC demanded that the “government withdraw their latest criminal delaying tactic to appeal the interim order and to smear Judge Pillay”.
While there are almost no statistics on how many of South Africa’s prisoners are infected with HIV, a recent study of 300 Westville Prison inmates indicated a 30% infection rate.
Death rates in South African prisons have increased by 500% since 1996, and death from “natural causes” in prisons has increased by 30% in the past three years. Many believe HIV/Aids and TB are responsible.