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Death and disease in Zimbabwe's prisons

Authors:
Special Report
www.thelancet.com Vol 373 March 21, 2009
995
A bare struggle for survival, with food
at its core, has come to defi ne prison
life in Zimbabwe. Describing the
conditions in two of the capital city
Harare’s main prisons in late 2008, a
prison offi cer explained: “we’ve gone
the whole year in which—for prisoners
and prison offi cers—the food is hand
to mouth...They’ll be lucky to get one
meal. Sometimes they’ll sleep without.
We have moving skeletons, moving
graves. They’re dying.”
Prison staff have had to convert
cells and storage rooms to “hospital
wards” for the dying and to make-
shift mortuaries, where bodies “rotted
on the fl oor with maggots moving
all around”. They have had to create
mass graves within prison grounds
to accommodate the dead. In many
prisons, the dead took over whole
cells, and competed for space with the
living. Prisoners described how the
sick and the healthy slept side by side,
packed together like sardines, with
those who died in the night. A former
prisoner, a young man, struggled to
convey the horro r of these conditions:
“That place, I haven’t got the words….
I can describe it as hell on earth—
though they say it’s more than hell.”
Another simply said, “The story of the
prisons is starvation”.
Deaths from disease in Zimbabwe’s
prisons have risen since the start of
the precipitous economic decline and
political crisis that gripped Zimbabwe
in the late 1990s. From 1998 to
2000, the Zimbabwe Prison Service
estimated some 300 deaths per year
due to disease, tuberculosis being the
biggest killer. In May, 2004, a senior
prison offi cer reported 15 deaths a
week, and a peak of 130 deaths in
March of that year, in just one of the
prisons serving Zimbabwe’s second
city Bulawayo. In 2008, a Zimbab-
wean non-governmental organisation
reported an average of two deaths per
day at Harare’s two main prisons while
prison offi cers reported three deaths
per day in October, 2008 at Bulawayo’s
main prison. Across Zimbabwe’s
40-odd prisons the annual death toll
undoubtedly now reaches well into
the thousands.
The immediate causes of escalating
prison deaths are not hard to fi nd:
severe overcrowding, broken, over-
owing toilets, water and electricity
cuts, a lack of blankets, uniforms,
winter clothing, medicines and other
commodities like soap, and severe
food shortages. Prison populations
have high rates of HIV/AIDS infection,
with some reports estimating that
more than half of prisoners are
HIV positive. Antiretrovirals are
rarely available, and the dietary
requirements of treatment cannot
be met. There are few drugs available
for the treatment of tuberculosis and
other diseases, and the cramped and
lthy conditions ease the transmission
of infection. In late 2008 and early
2009, a cholera outbreak in Harare’s
Central Prison killed on average four
to fi ve prisoners a day with a peak
of 18 deaths in 1 day, according
to prison offi cers. Throughout
the prison system, prisoners were
rendered acutely vulnerable to disease
because of the lack of food, and they
increasingly contracted malnutrition-
related diseases like pellagra and died
of starvation.
Zimbabwe as a whole and Zim-
babwe’s state institutions have had to
face repeated food shortages in recent
years. State hospitals and the army
for example have struggled to acquire
suffi cient food, but their inmates
can at least seek alternatives to the
state, however inadequate. Most
prisoners cannot. In 2008, prisoners
at Bulawayo Remand Prison described
receiving one meal a day consisting
of a small piece of sadza (Zimbabwe’s
staple food—a stiff porridge of maize
meal) and half a cup of watery boiled
cabbage. At times the meal was
reduced to cabbage alone, at times to
nothing. Desperation meant that “the
ghting over food was horrifi c”, as one
former prisoner put it: “Some guys
Undercover image of prison conditions in Zimbabwe show human-rights abuses
“For the thousands of poor men
and women who populate
Zimbabwe’s prisons, the
de facto sentence for being
charged with such crimes is
the certainty of great suff ering
and the very real possibility
of death.”
Death and disease in Zimbabwe’s prisons
Jocelyn Alexander spoke to former prisoners and former and serving prison offi cers about the
precarious conditions inside Zimbabwe’s prisons, where illness and death are regular occurrences.
Sokwanele
996
www.thelancet.com Vol 373 March 21, 2009
Special Report
would snatch other guys’ food and
stuff it in their mouths before they’d
get beaten. There’d be fi ghts every day.
At shower times you’d see the amount
of guys who are just literally bones.”
Prisoners traded sex for food and ate
food normally regarded as waste;
those with resources traded for food
and other commodities with guards.
Prison offi cers asked visitors to bring
more food, but only a tiny minority
of prisoners had relatives who could
aff ord to feed them. As one offi cer
remarked, “The problem is the poor”.
Zimbabwe’s precipitous economic
decline is certainly in part responsible
for the state of the prisons, but
corruption and the politicisation and
impoverishment of the civil service
have also played a key role. The eff ects
on the prison service have been
dev as tating. Trained, experienced
prison offi cers have left the service
in their thousands, and they have
been replaced in part by ruling-party
loyalists recruited from the top ranks
of the military and from youth militias.
At the top end and at the bottom—
where prison offi cers are not paid
remotely enough to feed themselves—
attendance at work is erratic and
prison supplies are stolen. Cooking oil,
salt, and food were regularly purloined,
as were blankets, uniforms, and medi-
cines. One Harare prison offi cer refer-
red to “air supplies”: “They’ll give
you a small consignment and say
they’ve given you so many tonnes.”
Even when he was allocated maize he
faced the challenge of fi nding working
vehicles and fuel to transport it,
functioning grinding mills to convert it
to meal, and working electric cooking
pots to cook it. The few functioning
pots were often rendered useless by
electricity cuts, which had led the
prison service to decimate nearby rows
of Jacaranda trees in search of fuel.
Food supplies were further undercut
by the eff ects of theft and corruption on
the prison farms. These had once been
an important source of prison food,
but the necessary agricultural inputs no
longer arrived and—extraordinarily—
prison ers often could not be sent to
work in the fi elds because they were
dressed in rags and bits of blankets:
“you can’t take naked people to
do farm ing!”, as one prison offi cer
explained. Where possible, prison
offi cers sought to trade prison labour
for food: prisoners worked in govern-
ment offi ces and on farms owned by
senior government fi gures in exchange
for a meal or a supply of cabbages.
For Zimbabwe’s Government the
prisons are not a priority. At Bulawayo’s
remand prison, one prisoner described
how the offi cer in charge explained
that he had failed to make the case for
more resources to his superiors. They
had told him that the “people inside are
the ones who are killing the economy—
they’re the ones changing money or
the amakorokoza [gold panners], the
thieves. So they don’t care”. However,
most of these prisoners have not been
convicted of any crime, and they have
often sat in remand prison without
access to the courts for months and
in some cases years. Many of them are
charged with petty property crimes,
committed (if they were committed) in
the face of threats to survival caused by
an economic collapse rooted in political
crisis for which the government is
overwhelmingly responsible. For the
thousands of poor men and women
who populate Zimbabwe’s prisons, the
de facto sentence for being charged
with such crimes is the certainty
of great suff ering and the very real
possibility of death.
Jocelyn Alexander
Undercover image: hunger and malnutrition among Zimbabwe’s prisoners
Sokwanele
Panel: Further reading
Number of prisoners catching HIV rises, The Chronicle (Bulawayo), Jan 29, 2001.
On the death trail (http://www.sokwanele.com/articles/sokwanele/onthedeathtrail_
3may2004.html), Sokwanele, May 3, 2004.
Chirinda S. 2 inmates die per day at Zim’s biggest prisons (http://www.zimonline.
co.za/Article.aspx?ArticleId=3755), ZimOnline, Oct 9, 2008.
Ailed by hunger, disease three prisoners die each day, Harare Tribune, Oct 15, 2008.
Zimbabwe Association for Crime Prevention and Rehabilitation of the Off ender,
Human rights for prisoners in Zimbabwe, paper presented to the Zimbabwe Lawyers
for Human Rights Workshop, Bulawayo, Oct 3–4, 2008.
Third Report of the Portfolio Committee on Justice, Legal and Parliamentary Aff airs
on the State of Prisons, presented to Parliament of Zimbabwe on May 23, 2006.
51% of Zim prisoners HIV-positive, The Zimbabwe Independent, May 14, 2005.
Prisons release inmates to avert starvation and death, The Zimbabwe Standard,
Nov 22, 2008.
... Deaths from the disease in Zimbabwe's prisons have increased since the late 1990s because of the country's economic decline and political instability and resultant government corruption (Alexander, 2009). There are 46 main prisons in Zimbabwe with an official capacity of 17,000, but with a prison population total (including pre-trial detainees/remand prisoners) of 19,382 and a prison population rate of 114 (per 100,000 of national population) as at April 2019 (see https://www.prisonstudies.org/country/zimbabwe). ...
... While the prison population itself in Zimbabwe contains high numbers of HIV infected and vulnerable individuals, the environment is also conducive to other infectious diseases such as tuberculosis (TB), hepatitis (A, B and C) and sexually transmitted infections (STIs) which can significantly increase vulnerability to HIV acquisition. Multi-drug resistant TB is also on the rise (Alexander, 2009), as it is elsewhere in SSA prisons (Centers for Disease Control and Prevention [CDCP], 2003;Habeenzu et al., 2007). ...
... The ZPCS struggles to provide adequate food and sanitary conditions (United States State Department [USSD], 2016). The prison environment has been described as deplorable (Alexander, 2009) and underpinned by overcrowding because of lengthy pre-trial detentions, out-dated infrastructure and judicial backlogs (The Freedom House, 2016) and inadequate and poor quality nutrition, food shortages, inadequate lighting and ventilation, insufficient mattresses, blankets, warm clothing, sanitary supplies and hygiene products, poor hygiene and sanitation, lack of blankets, uniforms, winter clothing and limited access to clean water (Alexander, 2009;USSD, 2016;UNODC, 2017;Van Hout and Mhlanga-Gunda, 2018, 2019a, 2019b. Physical and sexual abuses are common. ...
Article
Purpose The Sub-Saharan African (SSA) region remains at the epicentre of the HIV epidemic and disproportionately affecting women, girls and prisoners. Women in prison are a minority group and their special health needs relating to gender sensitivity, reproductive health, their children and HIV/AIDs are frequently neglected. Our study responded to this need, and aimed to investigate the issue. Design/methodology/approach A qualitative study using focus group discussions and key informant interviews explored the perspectives of women in prison, correctional officers, correctional health professionals and non-governmental organisations around prison conditions and standards of health care while incarcerated in a large female prison in Zimbabwe. Narratives were transcribed and analysed using thematic analysis. Findings The three key themes that emerged are as follows: “Sanitation and hygiene in the prison”, “Nutrition for women and children” and “Prison-based health services and health care”. Divergence or agreement across perspectives around adequate standards of sanitation, hygiene, quality and adequacy of food, special diets for those with health conditions, access to health care in prison and the continuum of care across incarceration and community are presented. Practical implications Understanding prison environmental cultures which shape correctional staff’s understanding and responsiveness to women in prison, environmental health conditions and access to health care are vital to improve conditions and continuum of care in Zimbabwe. Originality/value Policy and technical guidance continues to emphasise the need for research in SSA prisons to garner insight into the experiences of women and their children, with a particular emphasis on the prison environment for them, their health outcomes and health-care continuum. This unique study responded to this need.
... For example, In Zimbabwe, detainees who do not have access to basic sanitation were reported to be dying as a result of cholera and other infectious diseases at a rate that would be considered a humanitarian emergency in normal populations, with detainees sleeping beside corpses that could not be disposed of faster. 13 Also, due to a lack of amenities and resources, girls may lack the materials such as sanitary pads and privacy needed to manage their menstruation. Lack of access to medical personnel and medications further exacerbates these health problems. ...
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Children in detention in Africa are part of the vulnerable population exposed to the COVID-19 pandemic due to factors such as overcrowding, poor healthcare of inmates, and lousy state of the facilities. The number of children in detention was estimated to be about one million in 2010, and this has further increased threat to global health. The fall in operating criminal justice systems, from the aspect of rehabilitation and reform in Africa, to its being plagued with crisis, overpopulation, and inability to conform to fundamental human rights and health standards. It was noted that children in detention in Africa end up in prison mainly because they are either given birth to by incarcerated mothers or sentenced to jail based on their alleged criminal activity. Also, certain limitations in some African countries to track the prevalence of COVID-19 and other diseases include inaccessible data, non-specificity of data, and unreliable information regarding the current prison situation. Sometimes, these data could be insufficient and hard to comprehend, primarily if written in the local language. The efforts to resolve the untreated wounds of children in detention during COVID-19 are somewhat tricky. However, this paper identifies these limitations and proffers recommendations such as; the identification and implementation of strategies that support the continuity of child-centered services, prioritizing children for immediate release, and ensuring adequate protection of their health and well-being, among others.
... For instance, at the peak of the hyperinflation and economic unsteadiness in 2008, thousands of Zimbabwean prisoners would go for more than a day without a meal. In a research on prisons in Zimbabwe, Alexander (2009) To add on this, the prisons are overcrowded and in most cases lack the sanitary requirements to uphold the population especially in the face of COVID19. Mavhinga (2020) insinuates that, "…facilities are often unsanitary, overcrowded, and have no running water in cells for detainees to comply with UN hygiene practices recommended to stem the spread of the disease". ...
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... For instance, at the peak of the hyperinflation and economic unsteadiness in 2008, thousands of Zimbabwean prisoners would go for more than a day without a meal. In a research on prisons in Zimbabwe, Alexander (2009) To add on this, the prisons are overcrowded and in most cases lack the sanitary requirements to uphold the population especially in the face of COVID19. Mavhinga (2020) insinuates that, "…facilities are often unsanitary, overcrowded, and have no running water in cells for detainees to comply with UN hygiene practices recommended to stem the spread of the disease". ...
... For instance, at the peak of the hyperinflation and economic unsteadiness in 2008, thousands of Zimbabwean prisoners would go for more than a day without a meal. In a research on prisons in Zimbabwe, Alexander (2009) To add on this, the prisons are overcrowded and in most cases lack the sanitary requirements to uphold the population especially in the face of COVID19. Mavhinga (2020) insinuates that, "…facilities are often unsanitary, overcrowded, and have no running water in cells for detainees to comply with UN hygiene practices recommended to stem the spread of the disease". ...
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Ailed by hunger, disease three prisoners die each day
  • S Chirinda
Chirinda S. 2 inmates die per day at Zim's biggest prisons (http://www.zimonline. co.za/Article.aspx?ArticleId=3755), ZimOnline, Oct 9, 2008. Ailed by hunger, disease three prisoners die each day, Harare Tribune, Oct 15, 2008.