A report by Uganda's Commissioner of Prisons reveals that serious overcrowding and understaffing in jails have created a health threat. A backlogged judicial system along with poor funding are posing a serious threat to prisoners, staff and the community.
In Uganda, incarceration rates have skyrocketed. The current prison system was meant to hold around 16,000 prisoners. However a recent report shows nearly 42,000 prisoners are serving time. Human Rights Watch says over half of those inmates are still awaiting trial.
There are only five doctors in the entire prison system. This has created a number of health crises, including the rise of multidrug-resistant tuberculosis.
MDR-TB is an especially brutal strain that occurs when treatment of TB remains incomplete. Its mortality rate can reach as high as 80 percent.
Dr. James Kisambu, the head of prison health services, says that over 50 percent of the cases of MDR-TB in Uganda come from the prison system.
“Now, the problem is when they [prisoners] go to the MDR centers, security around the MDR center is low," he said. "It is low for one reason, that is when the prison guards come to learn that these people in there suffer from MDR, which may not cure, they keep a distance. So the security is lax. So when this guy recovers a little bit, able to run away, he runs away. Into the community, unhealed, with multidrug-resistant TB to spread it to everyone else."
Backlog of cases
Kisambu is calling for the creation of an MDR-TB treatment center inside the prison at Murchison Bay to make sure patients complete the treatment. The prison has proposed renovating an old isolation ward for those with MDR-TB. However, funding remains a challenge.
Kisambu stresses that the lack of proper health facilities puts all Ugandans at risk, as prison guards often fall victim to the same illnesses plaguing the inmates, and pass them on to their own communities.
The Commissioner of Prisons report cites a slow-moving judiciary as one of the major causes of prison overflow. Inmates can stay locked away for years just waiting for their case to be heard.
Part of this is due to a huge backlog of cases. Vincent Emmy Mugabo, the president of the Uganda Judicial Officer's Association, says it is impossible for the current amount of judges to oversee all cases. But, he says, efforts are underway to increase the number.
"We have requested parliament to increase the number of judges," he said. "Indications are that they are accepting it, they are working on the financial implications. But at least we have indication that they have realized that if we need to take this service to all the people, then [there must be] creation of more courts and also appointment of more judicial officers. We have made two proposals, one is creation of more courts... but at least we know that we have the goodwill of parliament and Cabinet to increase the number of courts and officers.”
Progress is slow, and a number of organizations such as the U.S. Centers for Disease Control have helped in the past to improve healthcare within the system. But for those stuck inside these prisons, life hangs in the balance.