Malawi prisoners deprived of health rights?

MALAWI: It is a fact that God created the human race in order for them to live happily and fill the universe.

While He freely gave man life and the universe, He also established laws for him to follow in order for his life to be more meaningful.

However, throughout history, man has failed to faithfully follow and abide by God's laws in one way or another, and this has had consequences.

In any country, there are laws that the government enacts in order for citizens to follow in order to maintain peace and national development.

Failure to do so, or breaking the law, results in penalties and repercussions.

Criminals may be prosecuted and then imprisoned as part of the measures. When one is imprisoned, some of one's liberties are taken away, and life is no longer the same.

The authorities violate the prisoner's human rights to a certain extent while he or she is serving his or her sentence.

In Malawi, for example, inmates' health rights are jeopardized because they suffer from a variety of infections, including tuberculosis and now Covid-19, but the medical care they receive is arguably inadequate.

"There are problems of drugs in the prisons and not enough well-wishers or organisations come to the prison formations to help us with Covid-19 preventive materials such as masks. For those living with Tuberculosis, the treatment they receive is not adequate. They are always told that the prison department faces a shortage of financial resources," laments one Patrick Mwafulirwa, who was recently released from the prison after serving a three-year jail term.

While agreeing with Mwafulirwa, Caswell Mapanje, another former inmate who was also imprisoned for three years, stated that it is considered 'normal' for prisoners to live with Tuberculosis and other infectious diseases without adequate medical care.

Mapanje says: "Due to harsh conditions which are there in our prisons, most inmates just take it as normal when they feel ill. They assume that they are not feeling okay just because of congestion inside the prison walls; not knowing that they are TB-positive. Of course, there is screening that is conducted twice a year by medical personnel against infectious diseases; but that is not adequate.”

“In terms of the number of medical personnel, I would say they are never enough to cater for all inmates who suffer from such communicable diseases. For instance, at Mzuzu Prison Formation, where I was, there was only one medical assistant and one nurse against a big number of prisoners."

However, Malawi Prison Services Department spokesperson Chimwemwe Shaba says that the department has always been ready to combat any communicable infections that have erupted in prison formations across the country, including Covid-19.

He claims that thanks to coordinated efforts from Malawi's Ministry of Health, only two inmates have died since the pandemic was discovered in the country in April 2020.

"Basically, after we had registered the first case of Covid-19, the Office of the Chief Commissioner for the Malawi Prison Services, developed a special standing order on Covid-19 Prevention and Management that was sorely to address issues pertaining to Covid-19.

"So, what we did as a matter of preparation, was that we had come up with regional isolation centres. Ideally, these were supposed to accommodate new prisoners coming from police cells; either those waiting for trial or those that have just been sentenced to start serving. The rationale behind this was that they should first be observed by the medical personnel, get tested, and isolated before they are sent to various prisons to mix up with those already serving or those waiting for trial so that we reduce the risk of outsiders bringing in the virus to those who are already serving," Shaba said.

Concerning the prevalence of tuberculosis among inmates, Shaba dismissed claims that inmates die arbitrarily of the disease, stating that it is a mistake to conclude that inmates are not adequately treated for the disease because the department collaborates with district hospitals to provide timely medical attention to inmates suffering from the infection.

Attempts to reach the Ministry of Health's spokesperson, Adrian Chikumbe, went unanswered on numerous occasions.

However, Kennedy Nkhoma, Principal Secretary in the Ministry of Homeland; under which prisons fall, believes that, while there are cases of communicable infections such as Covid-19 and tuberculosis, the department, with ministry support, is doing enough to stem the disease's rampant spread.

Nkhoma explained: “The issues of health rights are enshrined in the constitution for each and every citizen. It matters less whether this person is in custody or otherwise, but he is a person under the laws of Malawi. So, it is true that at certain times there may be certain alarming issues, but the information I have is that we have not seen so many deaths in prisons as regards Covid-19. We haven’t recorded much about it. What we have recorded is that people fell sick but they are okay. So, I have no information to the negative that anyone died in prison because of the Covid-19.

“Similarly, the issue of TB, I think TB in Malawi has been there for some times, but it is not as anything in prisons because of issues to do with congestion or what. I reliably have information since I have worked with the prison department before and I know what happens in there. There is a very good health system in prisons, which may be because of issues to do with non-adherence to procedures by the inmates themselves, it may be seen as if it is something too bad to record, but currently, we have seen some good changes in terms of how health is taken care of in our establishments. But I can admit that sometimes, the disease has attacked some of the prisoners.”

When asked to comment on the health rights of inmates in Malawi, Victor Mhango, Executive Director of the Centre for Health Rights Education, Advice, and Assistance (CHREAA), blamed the government for not doing enough to ensure that prison formations in the country are adequately equipped, ready to receive and host inmates who are equal human beings.

He stated that questioning the treatment provided by the department to inmates is very unfortunate, as it is simply a recipient of government policies and decisions.

"Most of the times, I don't want to be pointing fingers at the prison department. In the first place, the prison department is at the receiving end. They don't bring people to prison; they just receive people from elsewhere. They don't build prison structures; they just keep people in the structures which are already built.

"So, I don't want to point fingers at the prisons, but I always blame the allocation of resources to Malawi Prison Services. The department is keeping people each and every day, but if you go back to the budget allocations in parliament, you will find out that it is one of the least prioritized institutions. So, they just receive whatever comes, and as a result, we only see the Prison Department without seeing who is doing this. So, for me, I blame the Members of Parliament for not taking issues of the prisoners seriously most of the time," lamented Mhango.

The goal of addressing the public health issue is to reduce prison overcrowding in Malawi. Reducing overcrowding would improve inmates' living conditions and limit the spread of communicable diseases like tuberculosis and Covid-19, thereby protecting inmates' health rights.

In December 2021, Irish Rule of Law, an international human rights organization, observed that overcrowding inmates in prison formations was a gross violation of human rights, and that the authorities in Malawi needed to ensure that prisoners' human rights were protected at all times.

Malawi is a signatory to the International Covenant on Civil and Political Rights (ICCPR), a United Nations protocol whose goals include granting people, including inmates, the right to be free from torture and other cruel, inhuman, or degrading treatment or punishment, as well as the right to a fair trial.