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Siyayinqoba Beat It! 2005 Episode 17 –
Prisons and HIV
There are about 160 000 people in South Africa’s prisons. Current estimates are that over half of South Africa’s prison population is HIV positive. Yet condoms are not easily available in prisons and the Department of Correctional Services does not offer antiretroviral (ARV) treatment. The Siyayinqoba team asked: What effect does this have on the rate of HIV infection inside and outside prison? What about the right of prison inmates living with HIV and AIDS to receive the treatment they need?
Jason Wessenaar: Kgotsong re ya le amohela mona ho Siyayinqoba Beat It! Support Group. {Sesotho} [Hello and welcome to the Siyayinqoba Beat It! Support Group.] My name is Jason. In the Siyayinqoba Support Group we are all living positively with HIV. Each week we get together to talk about issues that affects our lives with HIV; from positive living to promoting antiretroviral access in rural areas. U-Siyayinqoba wuhlelo lwakho lokuphila kangcono ne-HIV. Uma uphila ne-HIV {isiZulu} [Siyayinqoba is your guide to living positively with HIV. If you are living with HIV] or you have a friend, a family member or a partner who is HIV positive this program is for you. Kuleliviki sikhuluma ngezinkinga kumajele ethu. {isiZulu} [This week we are discussing the HIV problem facing our prisons.] It is estimated that over half of the prison population may be HIV positive and yet the Department of Correctional Services does not offer ARVs to inmates who are living with HIV/AIDS and condoms are not easily available in our prisons. Surely, this must be unconstitutional. What happens inside our prisons affects what happens on the outside. And what happens on the outside affects what happens inside; our problems. Over 160 000 people are in prison at any given time and over 25 000 are released from our prisons each month. Those released go back to their families, wives, partners and girlfriends. To help us discuss this topic we are joined by Umesh Raga the investigating officer with the Inspectorate of Prisons. Welcome Umesh. Beat It! spoke to Sifiso Zulu an inmate living with HIV who gives us more insight to the conditions in prisons.
Living with HIV inside prison
Durban, KwaZulu Natal
Sifiso Zulu: Mina ngingu-Sifiso Zulu, Io oboshelwe la eWestville prison e-Medium B. Okwamanje ngidonsa isigwebo esingu-fifteen years. Ja, into eyenzekile ngahlatshwa yikugula, ngagula ngaze ngayiswa esibhedlela, ngithe mangisesibhedlela nga-approacha ngomunye usister, usister Dladla wangitshela ukuthi udokotela uncome ukuthi ngihlole igazi ukuthi ngizazi ukuthi ngimekuphi nge-status sami kwi-HIV/AIDS. Ngase ngivuma ukuthi ahlole igazi lami, kwaphela isikhashana bese abuya ama-results nemiphumela bese wabuya wangitshela ukuthi ngiphila negciwane. {isiZulu} [My name is Sifiso Zulu and I’m an inmate at the Westville Prison in Medium B. At the moment I’m serving a fifteen year sentence. I started getting really ill and then I was referred to the hospital here. I met sister Dladla who told me that the doctor suggests I test for HIV. I agreed to the blood test and after a short while I got my results that I’m living with HIV.
Gustav Wilson (Department of Correctional Services): Condoms are provided in private places such as in the toilets as well as at accessible areas. If offenders are for instance visiting our healthcare facilities it is accessible there as well.
Sifiso Zulu: We don’t get condoms in prison; you find them in toilets, visiting areas or anywhere else. In order to get condoms you have to go to the hospital and ask a medical member for the condoms. You find them in a box in a corner, in a toilet or anywhere.
Nicholas Nxumalo (Nurse – Medium B Hospital, Westville Prison): Mostly guys who are admitted here they are suffering from AIDS, I should say AIDS. All the patients who are admitted here at the healthcare unit are mostly in need of ARVs, but unfortunately there are no ARVs at the moment.
Sifiso Zulu: Ama-condom lapha ngaphakhathi awukwazi ukuwathola, abasibona ivanzi, awasabalele ukuthi uwathole noma use-toilet, noma visiting kuphi kuphi. Uma uwafuna ama-condom ufanele ubheke esibhedlela ukhulume ne-medical member. Kube yiwena oyitshelayo ukuthi ngincela ukuthi ningisize ngama-condom. Ngeke ukwazi ukuwathole ebhokisini mhlambe asekoneni noma e-toilet noma kuphi kuphi. {isiZulu} [When you experience an opportunistic infection, you are referred to a doctor. The doctor will prescribe medication and sometimes there are problems, because there are delays in getting the medication. I think management should look into that, because if I experience any opportunistic infection I can be referred to a clinic and get my pills fast.]
Gustav Wilson (Department of Correctional Services): In South African prisons or correctional centres we do not provide antiretroviral therapies. We refer our offenders who are allegeable for ARV treatment to the nearest public health facilities which is accredited according to criteria set by the National Health Department.
Sifiso Zulu: Kwenziyo izinto ke kuma-opportunistic infections, uma akuvela, into eyenzekalayo la ekhaya urefera kudokotela. Udokotela uma efika besa aku-odela i-medication yilapho ngibona khona ukuthi kuba nama-delays, uthole ukuthi umuthi wakho uhamba isikhashana ethanda ukuthi gxagxa. Uma, singajabula kakhulu uma i-management ingaku bhekisisa lokhu, uma ngivela yisifo esithile ngifika ngisi-reporte la ekhaya ekliniki mese kusheshwe kuspeedwe i-process yokuthi i-medication yami ngiyithole. {isiZulu} [As an HIV positive inmate, I am very disappointed, because when I watch television, I hear organisations such as TAC saying that ARVs are effective in keeping people with HIV alive. So I would be very happy if the roll out of ARVs was also happening here at Westville Prison.]
Support Group
Ricardo Moses(former inmate): I was the first one to disclose my status at that prison and I was one of the lucky guys, which I can say whereby we had a support group in there which they called it Group of Hope. Several prisons in South Africa also have those support groups in prison and those guys really assist, that is what inmates do in there.
Busisiwe Maqungo: Were you tested in prison?
Ricardo Moses (former inmate): Ja. I went to prison in 2002, when my wife was pregnant and the request came from the doctor from Tygerberg that I need to be tested and there on that time when my test came out at that Riebieek West Prison I want to attempted suicide. So they transferred me from that to Malmesbury.
Anthony Fernandes: You won’t very clear on kind of why you were suicidal. I mean or why you know, wanted to escape the situation. I mean it could be one of many things, I’m sure you will tell us or don’t. For me the question is really, do you get treated differently if you HIV positive? I mean stigma is one thing but I mean don’t you think that authorities will think now you HIV positive now you must get special treatment and therefore you different from other prisoners?
Ricardo Moses (former inmate): From my experience is the reason why want to suicide was that the situation which I was in at that time it was in big rooms 24 to 25, not a big room it’s a small room but there’s 24 to 40 people sleeping in that one room. And for me it was, I couldn’t control the situation on that point because I wasn’t uhm...what can I say, prison material on that time because about 14, 15 days in my sentence over five years. So being here with guys which I don’t know, tested HIV positive, which I know and so on that point I knew my wife is knowing on the outside because the request came from outside.
Anthony Fernandes: So it was lack of emotional support. It is fear of being sexually harrased, it is over crowded, not space for yourself, your own thoughts. It’s a couple of things not just one thing.
Ricardo Moses (former inmate): And on the end of the day when I moved to another prison the situation was much better. Where I slept in a, it’s like a small room, but its only compatible for two people to sleep in that room.
Jason Wessenaar: It is a bit difficult I think in prison to address issues of stigma.
Anthony Fernandes: ’Cause it could be a good thing or a bad thing, but it could be to your advantage.
Jason Wessenaar: If you start giving inmates who are living with AIDS special attention, as in giving them extra things, you are depriving people of other things and then people wonder why are those given.
Anthony Fernandes: Or you might give people the idea that they should get HIV because they get better treatment. And that I see as more problematic.
Jason Wessenaar: And one of the other things that happened in Jo’burg Prison this is many years ago, I think 1995. They put all the inmates who were living with HIV in isolated cells and this was to protect them, this was to make sure also that they get, you know, the treatment that they want. They get a fruit everyday, they get peanuts they get other stuff. But that created a lot of problems because people knew that if you are in cell B, you know singles, you are infected with HIV. And what happened is that a lot of the people who were in there their wives left them, their girlfriends left them, their families knew about their status because you can’t keep secrets in prison.
Lihle Dlamini: If uya for i-VCT ejele wena Ricardo {isiZulu} [When VCT programmes are held in prison], is there confidentiality?
Ricardo Moses: There’s no secret in prison. Even if you want to stab somebody or even if you want to rape somebody, there’s no secret in prison. So it’s not 100% that we have confidentiality that only the medical staff will know that you are HIV positive.
Lihle Dlamini: Uthola ukuthi ama-superior ase- prison asho another thing and ama-inmates asho another. Sibonile lapha i-superior lapha uthi condoms are freely available in every toilet, but I prisoner ithi there are no condoms ema-toilet and then I think if kusenama-issues ukuthi ama-condom a-distributwa kanjani but if basekwi-denial yokuthi sex does happen in prison and rape does take place ngeke kuze kubelula ukuthi kubekhona ama-provision yama-ARVs. Because as much as umuntu ereyshiwe in prison angeke akhone ukuyo-reporta i-case because immediately aphuma ukuyo-reporta i-case bazamu-stabber or anything else kuze uyabona usabela impilo yake so kunzima a-reporte leyo case. {IsiZulu} The prison officials say one thing and the inmates say another. As we saw, the superior says condoms are freely available in toilets but the prisoners says there are no condoms in the toilets. There are still problems in the distribution of condoms. If there is still denial about sexual activities and rape in prisons, it won’t make it easy for the provision of ARVs. Because when a person is raped in prison he is unlikely to report the case, because they are afraid of being stabbed so they fear for their lives.
Jason Wessenaar: The authorities need to acknowledge that it is happening. The fact is they want it to happen, but it is happening. People get raped, people get infected with HIV while they are in prison.
Anthony Fernandes: You know how I understand it is people are not allowed to have sex in prison. You know that it is sort of not allowed at all and it’s against the law. But I do think that people have the right to protect themselves. And I think we need to sort of look at that kind of stand point, that condoms are not available for sex but they are there to protect yourself if you need to. And that for me is the biggest way to protecting rather than the sex bit.
Ricardo Moses: At Malmesbury you’ll get, it’s a big prison, they have about seven to eight different prisons they call it units, but they have condoms in there. And I personally was related to a guy who was raped at some other prison but was transferred there. And there was also sex involved with some other inmates who is personally sure which happened in showers. So yes, it is happening there. And there is sometimes where the inmates is going to report it to the warder or to the supervisor or even report to the head of the prison but nothing happen.
Jason Wessenaar: Sizophinda zibuye emva kwe-break. {isiXhosa} [We will be back after this break.] Stay tuned.
Jason Wessenaar: Mmuhi re ya ho amohela hape mona ho Siyayinqoba Beat It support group {Sesotho} [Welcome back to Siyayinqoba Beat It! Support Group] – the program for everyone infected and affected by HIV. We are talking about people living with HIV in prison, where there is no treatment and only limited access to condoms. But first the Beat It! team spoke to Clement Ntuli from Honeyville near Pietermaritzburg, an HIV positive ex-prisoner who is now out on parole. Clement’s story shows us the problem of the lack of treatment in prisons.
Living with HIV on medical parole
Durban, KwaZulu Natal
Clement Ntuli (HIV positive prisoner on medical parole): Ngi-HIV positive since 1996. Bengi sejele lase-Westville from 1998 until 2003. Kwaze kwathatha isikhathi ukuthi ngize ngigule, ngaphambi ukungincede isigwebo sami. Yebo ngeke ngiphike ukuthi abantu bayalalana ejele, kodwa ngoko abaphathi bafisa ngathi leloqiniso ngeke livele, ngoba uba ngabe ukuthi liyavela and then kuzonxaza ukuthi bona abenzi okufanele ukuthi balungise izimilo zethu, kodwa into enjalo iyayenzeka. {isiZulu} [I’ve been HIV positive since 1996. I was an inmate at Westville Prison from 1998 until 2003. I got ill before I could complete my sentence. Some inmates do have sex with other inmates in jail. But authorities ignore that fact because they are afraid of being accused of not doing their job properly in terms of providing safety measures.]
Zodwa Dlamini (Regional HIV Co-ordinator Department of Correctional Services): Ukuba ngaba sikhuluma ngendaba yocantsi olwezakalayo emajele, ngeke ngisho ukuthi sineqiniso kwalokho onkwenzakalayo. Siyakuzwa khona kuyakhulunya kodwa ke thina nje ngabaphathi, phela thina silindele umuntu mase bamuhlukumezile ngekocantsi abe eza kuthina azosho ukuthi ngiyalivula icala ngoba lo ungihlukumezile ngokoncansi. Manje asinawo amabajwa aphumela obala azothi thina sihlukumeziwe ngalolohlobo ke ngifuna ukuvula icala. {isiZulu} [In terms of sex between the inmates in jail, we don’t have proof that it’s happening. We hear people talking about it but as the authorities we expect people to report cases of rape if they are sexually abused. We haven’t had inmates coming to us to report cases of rape.]
Chloe Hardy (AIDS Law Project): We feel that there needs to be more done to prevent HIV infections in prison. It’s all very well to have a policy of no consensual sex in prisons, but we know that both consensual sex and assault are happening all the time. There is rape in prisons, there is a gang culture in prison that promotes HIV transmission. And so there are a lot of problems around HIV and it’s very critical for Correctional Services to address them.
Petros (HIV positive prisoner on medical parole): Ejele ngiye ngendaba yokubulala ne-robbery and I was sentence to life in prison. Ngilokho ngihamba isibhedlela sangaphandle ke. Kwathi ngo-2000 ngalesikhathi babona ukuthi isimo sami sempilo asikho kahle kakhulu. Kwathi 2004, bangenzela i-medical parole udokotela wasejele ukuthi bangiyeke ngiye ngaphandle. But i-department yabo ngoku failure kwayo yabona ukuthi angi-qualifayi ukuthi ngiphume, bathi ngisa philile ngisa kwazi ukuhamba. And ngabuza ukuthi fanele ukuthi ngiphume ngihamba njani, bathi fanele uphume sowulele embhedeni. Ngancabanga ukuthi kugcono ukuthi ngibayise e-court ngoba ngincabanga ukuthi i-court yiyo enganginceda. Ngathi uma ngifika e-court, i-court ya-favour mina kugcono ngikhishwe yiyo. {isiZulu} [I went to jail as a result of murder and robbery], and I was sentenced to life in prison. [I found out that I’m HIV positive whilst I was in jail. In 2000, they saw that my health was deteriorating a lot. In 2004 I was given a medical parole by our prison doctor, to be let free. The Department disagreed and said I didn’t qualify to be released. They said I was healthy and able enough to walk. I asked them what condition was I meant to be in. They said I can only be released if I’m bed ridden. I decided to take the matter to court hoping they would be able to help me. The court ruled in my favour and ordered that I be released.]
Clement Ntuli (HIV positive prisoner on medical parole): Ngaleso s’khathi sengiqala ukugula kwathi noma ngi-applaya ngicela ukuthi banginikeze i-medical parole. Kwabalula kumina ngoba bakungubuso abaziyo kakhulu. {isiZulu} [When I got very ill I applied for a medical parole. It was very easy because people saw my condition.]
Chloe Hardy (AIDS Law Project): Being HIV positive is not a get out of jail free card. But if someone recovers whilst they are on medical parole, they should have parole officers that are then monitoring them. And if they are now in good health, they should be returned to prison to serve the remainder of their sentence.
Clement Ntuli (HIV positive prisoner on medical parole): Ama-ARVs njengamanje awa offerishwa yinze ke njengase-Westville lapho kuye kwabakhona isitelekha ukuthi iziboshwa kade zizama khona ukuthi sinekweze ama-ARVs. {isiZulu} [ARVs are not provided and in Westville Prison there was a strike where inmates were campaigning for the provision of ARVs.]
Chloe Hardy (AIDS Law Project): Now that the ARV roll-out is progressing in the public sector, outside of prisons, it’s a requirement that the prisoners also have access to ARVs.
Clement Ntuli (HIV positive prisoner on medical parole): Nanka amapilisi wami ama-ARVs. Lena yisi-Stocrin ngiyiphuza ebusuku, lena yi-Lamuvidine, lena yi-3TC Lawa ngama vitamin ngiwaphuza zonke izintsuku. Ngiqale ukuwaphuza ngo-September 2004 ngonyaka odlule ngesikhathi i-CD4 count yami iyi-102, njengamanje i-CD4 count yami seyinyuke 236. Angikaze ngibhekane nenkinga kuze kubemanje. {isiZulu} [These are my ARV pills. This is Stockrin, which I take every night, this one is Lamuvidine, this is 3TC, and these are vitamins which I take everyday. Since September 2004, when I started taking ARVs, my CD4 count was 102, but now it went up to 236. I haven’t experienced any problems so far.]
Support Group
Jason Wessenaar: Ricardo, maybe let me start with you. In what ways can you relate to Clement’s situation?
Ricardo Moses: How can I say? Well I was at two different prisons time, whereby at the one prison it was horrible. There was no counseling when you are tested HIV positive. There’s no medication available, nothing like that. So I was later on, later stage I was moved to Malmesbury prison. And there I did get full support even from the warders.
Prudence Mabele: When do they decide now that you are ill and you can go home and either survive or die peacefully?
Umesh Raga (Judicial Inspectorate of Prisons): One can only be considered for medical release if you’re in the final phase of a terminal illness. The final phase of a terminal illness hasn’t been defined yet. In the view of the Judicial Inspectorate of Prisons for which I work, that too few prisoners are released on a medical parole.
Lihle Dlamini: I have seen abantu abadedelwa esibhedlela in the morning and in the afternoon they are dead. And they are also people abadedelwa i-prison because ba-HIV positive and they are in an AIDS stage. And then baphumela ngaphandle and then bathole ama-ARVs. What happens uma ngabe labantu babangcono {isiZulu} [I’ve heard of prisoners who were rushed to hospital in the morning and in the afternoon they are dead. And there are HIV positive prisoners who are released from prison because they are in the last stage which is AIDS. When they access ARVs and they are better, what happens?]
Umesh Raga (Judicial Inspectorate of Prisons): When one is released on medical grounds, it’s a conditional release, that the trigger for your release is your health status. That the prison is not the right place for you to receive treatment or you might be terminally ill and we’d like you to die a consolatery death in your community or family, but if your situation improves, unfortunately one of the consequences of that is that you have to complete the sentence that the court imposed.
Prudence Mabele: How many people are HIV positive? The statistics in prison, roughly, you know.
Umesh Raga (Judicial Inspectorate of Prisons): There was an average of 7571 AIDS and HIV cases in custody during the year 2004. That’s the figure that the Department has quoted. I do know also that for the same reasons that we never certain about the prevalence rate because of confidentiality and all of those other things. There is going to be a study by the Department of Health on HIV prevalence.
Jason Wessenaar: Umesh the report that you talking about states that there’s about 7571 people living with HIV in the prisons and as far as I know only people that have been tested, they are the statistics that are known, plus it seems only people in stage two or stage three have been tested. Those are the statistics that the Department of Correctional Services knows about. But for me it seems there is more which could be, the statistics could be twice, three times higher than they actually are. Given the number of deaths that are happening in the prisons, and given the number of people that are currently in the prison. Re bua hape ka HIV le ditjhankane ha re kgutla mabenkeleng. {Sesotho} [We talk more about HIV and prisons when we come back from the break.] Stay tuned.
Jason Wessenaar: Mmuhi re ya ho amohela hape mona ho Siyayinqoba Beat It Support Group {Sesotho} [Welcome back to Siyayinqoba Beat It! Support Group] – the program for everyone infected and affected by HIV. We are talking about people living with HIV in prison. What have you as an organisation done to address the issue of human resourses? Because I’m sure that it’s something that will address some of the issues of counselling and support? When I worked in the prison as an NGO that came from outside we did everything basically. We did the counselling, we did the support group, we did you know upon entry, we did the awareness during the inmates staying in prison we did the awareness. When they were going on pre-release we did, there was a program on pre-release we did basically everything.
Umesh Raga (Judicial Inspectorate of Prisons): Staffing is a problem in the Department of Correctional Services. Proffesional staffing is a problem and it’s a challenge which the department would have to meet. Our core function is to monitor the treatment and conditions of prisoners and to ensure that their treatment is aligned to human dignity. Now you also have obligations rather than only accessing rights.
Vuyani Jacobs: The department’s obligation should not be too much or too little, than the NGOs .What I’ve seen here, which everyone has been saying all the experiences we have in prison, is that NGOs have taken much of the bulk of the responsibility of the Department of Correctional Services. And what I’m saying is no, the NGOs must not take that responsibility the Department of Correctional Services must lead it. NGOs can be there to help.
Jason Wessenaar: Siyabonga Umesh, the support group nani babukheli ekhaya. Zinyaka zonke iziboshwa izingu 25 000 zibuyela emphakathini. Uma sezithelekile nge-HIV ngaphakathi kwejele ngingathethela njongusehlosweni amakhosikazi kanye nabalingani babo. Uhlelo ulugcwele lakarhulumeni lokho hlangebezana ne-HIV kumele lisebenze ngokugcwele emajele. Ukufundisa nge HIV kanye nokuphilisana nama-condom kumele kubekhona emajele. Ngaphezulu kwakonke ukulwashwa kanye nama-ARVs kumele abekhona kwabantu abane-HIV ne-AIDS emajele. {isiZulu} [Thanks to Umesh, the support group and the viewers at home. Every year, about 25 000 prisoners are released. If they are infected with HIV they can also infect their wives or partners. Government’s programmes in fighting HIV should also be effective in prisons. Condoms and education on HIV should be available in prisons. Above everything else, treatment and ARVs should be available to HIV positive prisoners, when they need them.] Siyayinqoba receives a lot of letters from the prisons. This is one of the letters. We do as much as we possibly can to reply to the letters. It says:
I was arrested in 2000 September, taken to Boksburg Prison for robbery. On arrival I was raped and forced to put on a tattoo of this notorious gangster 28. While I was in prison I noticed rape and sodomy happening. I’ve since tested positive for HIV and have had a lot of problems, in terms of getting access to treatment, counselling and care.
So this is obviously one of the letters that we receive, we will try to respond to as many letters as we possibly can. So please continue writing to us, we will try to help you where we can. We hope that you enjoyed the show and that you are feeling the Siyayinqoba Spirit. If you have any questions, comments or views about the show please contact us on the numbers below. Till then, stay healthy, stay positive.
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