Congestion in prisons derailing war against TB

HILLARY Mwandi, 34, an inmate at Kamfinsa Correctional Facility can attest that being on Tuberculosis (TB) treatment while in incarceration is tough. Inadequate food and lack of ventilated rooms are the common challenges.
Mwandi, who was successfully treated for TB says he contracted the disease while in prison where he is serving a 15-year jail term for defiling a child.
He says he was first incarcerated at Mukobeko Maximum Correctional Facility in Kabwe in 2010 before being moved to Kamfinsa on the Copperbelt to finish his sentence.
Mwandi suspects that it was at Mukobeko where he got TB and he only discovered that he had the air-borne disease when he was moved to Kamfinsa in 2015.
He narrates that while at Kamfinsa, he would often get sick and that people would think that he had malaria.
“I was coughing a lot and I would easily get tired. People thought I had malaria but when I was screened, it was discovered that I had tuberculosis,” he said.
Mwandi explains that he was immediately put on TB treatment and used to take three tablets per day for two months.
During treatment, he was isolated from his colleagues and had to sleep in the sickbay, until he finished his medication.
Mwandi says it is not easy to battle TB while in prison because of inadequate food and other essential commodities.
The reason is that TB patients need to eat well nourishing foods and sleep in highly ventilated rooms as well as use clean bedding.
Mwandi says there is need to build isolation dormitories in correctional facilities where TB patients should stay to reduce the risk of the disease spreading to other inmates.
He says congestion in Correctional Facilities makes it difficult for health personnel to combat the air-borne diseases.
However, Mwandi has advice for TB patients, “Seek early treatment for TB because it is curable.
“Today I am free of tuberculosis because I adhered to the treatment that they had given me here at Kamfinsa,” he shared with inmates on TB Day for Inmates in Kitwe recently.
According to the Zambia Correctional Service (ZCS), the population of inmates countrywide currently stands at 21,707 against the holding capacity of 8,550.
ZCS Commissioner General Percy Chato acknowledges that prisons in Zambia are congested, making it difficult for the service to contain the spread of air-borne diseases.
Mr Chato says Correctional Facilities are overcrowded by 250 percent, making them breeding grounds for TB and other communicable diseases.
He points out that inmates have the potential to transmit TB to the general population when they are released from prison and during incarceration to prison officers and people who visit them at correctional facilities.
Mr Chato said currently, there are about 175 inmates that are on TB treatment countrywide, which represents 0.81 percent of the prison population.
He said correctional facilities have limited health facilities and currently, there are only 25 clinics offering medical services to inmates against 54 correctional facilities around the country.
This makes it difficult for the service to effectively deliver health services to inmates, some who are living with HIV and AIDS.
There are about 2,835 inmates living with HIV/AIDS, which represents 13 percent of the entire total population, the ZCS boss says.
The other challenge is that ZCS only has 87 medical officers working in various correctional services, making it difficult for the service to effectively combat TB among inmates.
The good news is that TB cases in the prisons have drastically reduced due to concerted efforts from various stakeholders.
In its efforts to effectively combat TB and other communicable diseases, Government is building new Correctional Facility and expanding the existing infrastructure.
Currently, two correctional facilities are being built in Mwembeshi, Lusaka Province, which will accommodate 3,300 inmates.
New dormitories are also being built at Kamfinsa in Kitwe, which is the second largest facility after Mukobeko.
Mr Chato also explained that mass TB screening is being done at Mukobeko Maximum Correctional Facility in Kabwe, Lusaka Central Correctional Facility and Livingstone Central Correctional Facility among others.
A team of officers has been mobilised to gather information on TB and HIV in correctional services for planning purposes.
Inmates in various correctional centres are also being trained as caregivers for the purpose of disseminating information on TB within the facilities.
“We have realised that we cannot leave out inmates in the fight against tuberculosis,” Mr Chato said.
Some correctional facilities now have Gen X-pert machines used in diagnosing TB.
The equipment allows for the screening of inmates for TB before they are allowed to enter correctional facilities.
Home Affairs permanent secretary Chileshe Mulenga said congestion in Correctional Facilities is likely to reduce by 50 percent in the next two years because of the new correctional facilities that Government is building.
“In the next two years, congestion in prison will be reduced by 50 percent because all the on-going projects would have been completed by then,” Dr Mulenga said.

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