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Death and disease in Zimbabwe's prisons
Jocelyn Alexander, The Lancet, Volume 373, Issue 9668 - March 2009
March 30, 2009

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60592-4/fulltext

A bare struggle for survival, with food at its core, has come to define prison life in Zimbabwe. Describing the conditions in two of the capital city Harare's main prisons in late 2008, a prison officer explained: "we've gone the whole year in which-for prisoners and prison officers-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 floor 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 horror 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 officer 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 Zimbabwean non-governmental organisation reported an average of two deaths per day at Harare's two main prisons while prison officers 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 find: severe overcrowding, broken, overflowing 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 filthy 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 five prisoners a day with a peak of 18 deaths in 1 day, according to prison officers.

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 Zimbabwe's state institutions have had to face repeated food shortages in recent years. State hospitals and the army for example have struggled to acquire sufficient 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 fighting over food was horrific", as one former prisoner put it: "Some guys would snatch other guys' food and stuff it in their mouths before they'd get beaten. There'd be fights 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 officers asked visitors to bring more food, but only a tiny minority of prisoners had relatives who could afford to feed them. As one officer remarked, "The problem is the poor".

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