HEALTH-ZAMBIA: HIV-Positive Prisoners Find Freedom a Mixed Blessing

LUSAKA, Oct 21, 2004 (IPS) - The HIV pandemic has proved a divisive force in several African countries, not least Zambia.

As IPS reported last month, the question of whether to make HIV tests mandatory has sparked fierce debate in the country. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) Zambia currently has a 19 percent HIV prevalence rate.

However, another controversy is also afoot about the wisdom of releasing prisoners in the advanced stages of AIDS.

Since late 2001, more than 300 sick inmates have been freed by President Levy Mwanawasa on compassionate grounds.

Commissioner of Prisons Jethro Mumbuwa says Zambia's jails simply lack the resources to look after convicts who are seriously ill.

"The prisons are under-resourced both financially and (in terms of) human resources. Besides, we think that when people are terminally ill they are better off spending their last days with their families," he noted.

With many of the former inmates having been given life sentences for serious infractions, protests from the victims of their crimes might have been expected.

But surprisingly, some of the strongest opposition to the releases has come from the prisoners' families.

"Why, why give me this shell?" asks the wife of HIV-positive ex-prisoner Samson Nkumba (not his real name).

"They (the government) must keep him, because I cannot do what they have failed to do. I cannot afford ARVs (anti-retroviral drugs). It is traumatic for the children to see their father in this way," she adds.

These words are echoed by Clement Mfuzi, chairman of the Network of Zambian People Living with HIV/AIDS (NZP+). "Zambians are poor. (If) you lock up the bread earner, where do you expect families to get money to look after a sick relative?" he asks.

An instance where release worked to good effect was that of Jack Chiti, who was jailed for attempting to topple former president Frederick Chiluba in October 1997. Chiti's relatives petitioned for his release, and he subsequently died in the care of his family.

NZP+ believes that government is entrenching the stigma surrounding HIV-positive persons by washing its hands of prisoners with AIDS-related diseases.

While prison authorities claim inmates are counselled about their condition before being released, NZP+ also queries whether this process is adequate - and whether the convicts' families are being properly advised on how to care for them.

"You just do not unleash people with HIV onto an unsuspecting public. What if the convicts themselves are in denial (about their HIV status) and continue to have unprotected sex with their.spouses?" asks Mfuzi.

Prison often hardens convicts rather than rehabilitating them, he adds. This might encourage reckless behaviour on the part of former inmates - which makes the need for prison and home-based counselling still more urgent.

Says Nkumba, "They removed us from society because they said we were a danger to the public. They now throw us back to the same society when we are even more dangerous than before."

"Neither myself or my family were counselled, and I had not heard of any of my colleagues who were in the same situation being counselled. We are just told we are being released - that's it," he adds.

At present, Zambian courts do not take HIV status into consideration when sentencing felons. There are no voluntary counselling and testing facilities in prisons, and HIV tests are only conducted when a convict falls ill repeatedly.

Nonetheless, the dirt, congestion and poor nutrition that prevail in many prisons all but ensure that those HIV-positive prisoners at risk of developing AIDS-related diseases do so. Unprotected sex between male inmates also fuels the spread of HIV.

"The convicts cannot be forced or coerced into testing for HIV because of the human rights issue. But, I see a time when this will be a necessity because HIV is flourishing in the prisons," says Leslie Phiri, a lawyer based in the capital - Lusaka.

Zambia's Permanent Human Rights Commission insists that no prisoner should be forced to test for HIV, however.

Instead, it recommends that prisons be reformed to ensure that HIV-positive inmates receive the treatment needed to keep them alive.

Elsewhere in the region, officials are also grappling with the effects of HIV on prisons.

According to a 2003 study conducted by the Pretoria-based Institute for Security Studies, the HIV policies that South Africa's Department of Correctional Services has introduced are "excellent" in certain respects.

It notes, however, that the distribution of condoms in prisons - something advocated by UNAIDS and the World Health Organisation - ".would be considerably improved if it were to include the discreet provision of condoms in common areas rather than requiring prisoners to request condoms face to face with a member of the health staff."

The study, entitled 'HIV/AIDS in Prison: Problems, Policies, and Potential', goes on to state that "the provision of water-based lubricant in a similarly accessible manner" would help to reduce condom breakage and damage to the rectum during anal sex. Breakages and rectal damage facilitate the transmission of HIV.

Malawi, with its Banja la Mtsogolo (Family of the Future) programme, aims to educate over 5,000 prisoners in 21 jails about HIV. The initiative also incorporates treatment for prisoners who have sexually-transmitted infections.

According to UNAIDS, HIV prevalence in Malawi is at 15 percent. (END)

Send your comments to the editor