It's a Hard Life in Ugandan Prisons

Justice requires that Uganda's prisons stop using prisoners as a private workforce, and that sick prisoners be given the care they need.
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President Museveni's proposal to eliminate bail for certain nonviolent crimes is a challenge to the constitutional rights of Ugandans. But it also raises an interesting question: where would more prisoners go?

Prisons are crammed to over 200 percent of installed capacity; food and water are sometimes scarce; and health care is often nonexistent. More than half of the prisoners have not been tried and are waiting there for their cases to be heard and resolved. It's clear that overcrowding and pretrial detention are interlinked. Between November and March this year, the Human Rights Watch visited 16 prisons across Uganda. We interviewed 164 prisoners and 30 prison officers. We found dangerously unhealthy conditions at many prisons, ripe for the spread of tuberculosis and HIV.

Prisoners told us that they were packed together in cells with tiny air vents, in some places day and night, while their colleagues coughed vigorously. Sometimes the most vulnerable trade sex for food. HIV and TB infection rates are almost twice as common in prison as they are outside the prisons.

But HIV and TB do not stop at prison gates. Wardens and visitors leave prisons every day. Each year, 50,000 prisoners pass through Uganda's prisons, and ignoring their health means that they will leave sick and in need of care in the communities to which they return. And it means that they may bring disease home with them, to their families and neighbours.

"Help us, we'll die," read a note from 10 prisoners at Muinaina Farm Prison to Human Rights Watch. They were right to worry. There is hardly any medical care available at Muinaina, yet many of its prisoners are sick. In fact, prisoners with HIV and TB may even be sent to Muinaina despite the fact that no treatment is available. That's an easier way to develop and spread deadly drug-resistant strains.

Why are these people being sent to places like Muinaina? To work. Throughout the Uganda Prison Service thousands of prisoners, including those yet to face trial for any crime, are subjected to forced labour, slaving away on fields belonging to the government, to prison staff personally, or to private landowners.

The money they earn goes to the prison system or into the pockets of prison staff. They are brutally beaten if they fall behind or complain during the hard labour in the fields. "[The prison wardens] hit me so hard, I was crying blood," said one prisoner.

Among Uganda's 223 prisons, only Murchison Bay in Kampala provides comprehensive HIV and TB treatment -- but only to prisoners who can get there, a decision often made by prison officers with no medical training. As one prisoner said, the wardens at his prison would only take prisoners to the hospital if they were "almost dying"; Otherwise, "the warden will tell you: 'Go and work. You are just pretending. There are no sick people here. This is a prison, not a hospital.'"

In the prisons, we spoke with elderly men, pregnant women, individuals with disabilities, and children who said that they were as young as 14. Some wait in prison for more than five years for their cases to be heard and resolved. Meanwhile, they risk being exposed to serious, life-threatening disease, and putting others at risk if they are released.

Improving health conditions in prison requires more than just investment in medical facilities; it takes fundamental reform of the justice system. And justice requires that the prisons stop using prisoners as a private workforce, and that sick prisoners be given the care they need.

"A country like Uganda... we thought it would be a country that takes care of its own people," said one remand prisoner at Muinaina who has not been to court since 2006.

Lock up those found guilty by courts, and if they are sentenced and found fit, make them work for reasonable hours under reasonable conditions. But sending people with HIV or TB, the elderly, pregnant women, and people who have not been convicted of any crime to work to fatten the wallets of wardens or until they collapse in the fields fosters injustice within the very heart of the nation's justice system.

No doubt there is poor health care for many people in Uganda. But reducing the availability of bail and adding more people to Uganda's already incredibly overcrowded prisons should concern all Ugandans. It is bad for justice and terrible for public health.

A version of this article originally appeared in The Independent on July 14, 2011.

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