Call for free condoms to combat spread of HIV in Malawi prisons

Kondwani , not his real name, has just been released out of prison where he spent ten years at the Maula maximum prison, located in the capital city of Malawi. In a white shabby shirt the 25 years old boy, suffers from peri-anal abscesses.

The second born in a family of five children looking weak and pale, is not willing to discuss what happened in prison, but from the look of things it is embarrassing for him.

Kondwani, who hails from Mkanda Village in Mchinji district, which marks boundaries between Malawi and  Zambia, is not very healthy. He sat on the veranda of his thatched grass house swallowing some kind of antibiotics which he says help ease body pains.

“I feel better if l take these antibiotics; otherwise it was even hell inside the prison walls because there was no access for such antibiotics for me. Sleeping on blankets on the floor, too tightly packed to reach the toilet while l was in pain was something else,” he says, with his voice a mix of rage and desperation.

Showing condom use tips

Showing condom use tips

“I might get better, but lam going through hell. When l was sentenced to go to jail l was H IV negative but once after serving my sentence l was diagnosed of this disease. lam not sure whether l contracted the virus inside the walls or not,” he said before asking for a glass of water to continue narrating his ordeal.

Kondwani admits that sexual activities are rampant in prisons despite no one want to acknowledge the fact that prisoners need HIV and AIDS intervention programmes.

“People do not want to acknowledge men having sex with men in our prisons, but l went through this and l have no doubt l contracted the virus inside the prison because people sodomise each other there,” he says, looking hopeless  with his face down.

During the National Dissemination Conference on the legal and policy Environment Assesment Report for HIV and AIDS in Malawi which was held in Lilongwe, Head of Prison Health Services, Dr Henry Ndindi told journalists that prisoners are among the high risk group to contract HIV and AlDS because of tendency of men having sex with men (MSM).

Dr Ndindi says there was evidence that MSM takes place in prisons citing a survey conducted in 2011.

“There is evidence that MSM takes place in prisons and this is supported by survey in 2011 which revealed that central prisons had a rate of 9.8 percent , medium size prisons 4.1 percent and small size prisons 3.8 percent,” he says.

He says that prohibition of condoms and lubricant distribution in prisons due to criminalization of MSM is one of the challenges faced in prisons where MSM cases are evident.

“Overcrowding, lack of basic necessities like soap and food limited access to HIV prevention treatment and care and support services and sexual violence are among the problems that are encouraging MSM in prisons,” says Dr Ndindi.

He also observes that lack of HIV policy for prisoners and MSM strategy legislation is another factor encouraging this behavior.

He therefore, emphasized the need for law reforms to be enacted to reduce human rights violations of those male prisoners who have sex with men and providing them with all prevention information and necessities.

The research which was conducted by Dorothy Jolofani and Joseph DeGabriele which focused on the three largest prisons in the country, namely Zomba

Central Prison, Chichiri Prison (Blantyre) and Maula Prison (Lilongwe) states that although many prisoners come into custody already infected with HIV, there is evidence that HIV transmission in prison is a problem, especially at Zomba Central Prison.

It says, 167 deaths in Malawi prisons during 1997, 40% were attributed to AIDS, 25% to pulmonary Tuberculosis’ and 20% to dysentery and bloody diarrhoea.

A study which is also contained in the PANOS Southern Africa booklet entitled, “Keeping the Promise” states that even though homosexuality is illegal in Malawi and invites a sentence of up to 14 years imprisonment, studies have shown that homosexuality is common in prisons and is the main method of transmitting HIV within the prison environment.

“Cases of prisoners with sexually transmitted infections and peri-natal abscesses have been reported and this is an indication of the existence of anal intercourse. Juveniles are particularly at risk and in some prisons such as Maula and Chichiri nearly all those who reported peri-natal abscesses were juveniles’,” reads the report.

A study of HIV transmission and the care of prisoners with HIV /A study of HIV transmission and the care of prisoners with HIV / AIDS in Zomba, Blantyre and Lilongwe Prisons AIDS in The research says only a very few prisoners admits that their main concern was that HIV was transmitted through shared razor blades and toothbrushes.

“Most prisoners and Prison officers acknowledged that homosexual activity was common and that this was the main method of transmitting HIV within the prison.

On the percentage of prisoners who had at least one homosexual encounter while in detention, the estimates for Zomba Central Prison varied from 10% to as high as 60%. Out of these, about one third is thought to have habitual sex with other prisoners,” states the research.

It also outlines that most homosexual activity takes place in cells that are overcrowded, and prisoners attempt some degree of privacy by hanging a blanket as a curtain.

It was also unearthed that other prisoners reported that due to the shortage of blankets, two or even three prisoners would share a blanket, where sex would sometimes occur.

For instance, one prisoner was quoted in the research as saying, “There are 22 of us in our cell, and two of my cell mates have juveniles as “wives”. They got them by bribing the Prison Officers at the main gate, “he says.

He says these juveniles agreed to have sex with these men because they had no clothes and no blanket, and they were hungry.

“One day these boys started to cry and refused to have sex. The men took away their blankets and after spending a night in the cold they agreed to allow the men to have sex with them again. We try to tell these boys that they will die of AIDS, but what can these boys do?, “he quizzed..

On the issue of distributing condoms in prisons as a preventative measure to HIV and AIDS, most prison staff refused to comment in the research by only saying that the official position was that condoms would encourage homosexuality which was illegal.

Homosexual activity or “unnatural offences” as it is described in the Malawi Penal Code (section 153) is illegal and carries a prison sentence of fourteen years. It is for this reason that some senior Prison Officers claim that it does not exist, because to do so would imply that they are not controlling their prisoners.

Although some MAs do not agree that condoms should be distributed to prisoners, they said that “they are human beings and should be allowed to make their own choice, whatever we think”.

According to the Dakar Conference document (section I.2.1, Observations, page 15) “Condoms encourage prisoners to have sexual relations”.

The research also narrates that most prisoners were not sure about the use of condoms and  that the fear of contracting HIV was real enough, but that probably a lot of prisoners would want “the real thing”, that is they would refuse to wear a condom.

“Some prisoners said that they think that they should be given a choice, and those who want them should have access to them.  Incidentally, in the prison clinics there are posters graphically describing the use of a condom, and we were informed that “some condoms are available, but nobody asks for them”, indicates the research.

As part of a wider strategy in preventing the spread of HIV in prisons, the research made the following recommendations: The availability of condoms in prison would help in reducing the spread of HI

Another recommendation is that there is need to be a more effective separation of juveniles from adult prisoners.

“The long term objective should be to have a juvenile block separate from the central prison. In the short to medium term, goals should include separate kitchen, recreational and medical facilities, including separate Out Patient clinics,” recommends the study.

“We prisoners are very concerned about HIV and AIDS; don’t think that we are not. We observe that some people even though they have been healthy outside, within a couple of weeks they start fall sick. This is due to stress, but mostly because of the poor food. Even when they are on medication, they don’t respond as well as they should, we know that they are HIV and we then know that end is very near for them. But if they had better conditions they would live longer, we die quickly here,” one prisoner was quoted in the reseach.

The Malawi Inspectorate of Prisons in its Report to Parliament (Activities Undertaken from October 1996 to September 1997) says the standard diet of nsima and beans is served once a day which is unable to protect prisoners against serious diseases.

The report also stresses that sometimes prisoners go without food for several days there by risking those prisoners who are sick to poor health.

It is probably impossible, at this point, to determine the consequence of introducing condoms into the prisons or lets quote what a certain prisoner at Zomba Central Prison told Dorothy Jolofani and Joseph DeGabriele study that “To be with AIDS in prison is to be in hell”.--Panos

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