The health needs of South Africa's almost 160,000 prisoners and remand detainees are in the hands of 818 professional nurses, 11 doctors, 24 pharmacists and 24 psychologists. That, according to a Mail & Guardian report, is one professional nurse for every 195 inmates and one doctor for every 14,545 prisoners. These are the only medical staff the Department of Correctional Services has on its payroll
The World Health Organisation says prisoners need more doctors as they are generally sicker than people who are not in prison. Health activists argue that the same is true for prisoners in South Africa. According to Sonke Gender Justice, an organisation that advocates for access to medical services in prisons, among other campaigns, tuberculosis is seven times more common in the country’s prisons than in the general population.
Sonke says the department of correctional services has not been able to uphold inmates' human rights because of its inability to fill the required posts. This, said Sonke's Marlise Richter, "has had a far-reaching effect on inmate and staff health and safety".
Correctional services department spokesperson Manelisi Wolela admits that the "high turnover of healthcare professionals" and the department's inability to "recruit and retain medical staff" adversely affects the department's ability to provide prisoners with healthcare services. Lieve Vanleeuw, a researcher who formerly worked at HIV advocacy organisation the Treatment Action Campaign (TAC), said: "Most prisons are attended by a doctor for one day or a half-day a week. This doctor might have to oversee the health of hundreds or thousands of inmates. This problem, together with overcrowding in prisons, leads to inadequate and substandard health care and violates inmates' rights."
Emily Keehn, from Sonke, said it is vital that government finds a better way to deal with the spread of TB in prisons, especially in the context of HIV. "Having HIV and having spent time in prison are the two main risk factors for developing active TB. We know that in prisons the HIV rate is very high. Nationally, as of March 2014 … (more than) 16% of inmates were on record as being HIV positive." She said the department's policies have improved with the establishment of the national TB task team, which is working on better screening and treatment for inmates. "But without addressing the material conditions that drive TB, there will be limited progress…"
To remedy the issue of the shortage of medical staff in the country’s prisons, various correctional regions (provincial offices) have agreements with provincial health departments whereby these departments provide "medical and dental services for the inmate population on (a) sessional basis", said Wolela. But several challenges, such as inadequate infection control and maintaining the confidentiality and privacy of inmates, persist. Overcrowding, "which has a negative impact on the delivery of health care services and conditions of detention consistent with human dignity", remain a huge challenge, he said.
[link url="http://mg.co.za/article/2015-04-23-prisoners-health-rights-routinely-violated-in-sas-jails"]Full Mail & Guardian report[/link]