article about my work

The international aid agency for whom I work asked me to write an article about my job a few months ago. Since I'm doing such a bad job at finding time to write anything substantive about what I do day-to-day, I thought of posting this.

As a supporter of the Prison Abolition movement in the U.S., my friends thought it was a leap for me to take a placement as HIV Programmes Coordinator in the Malawi Prisons Services. There is a definite stigma to working in prisons where I come from – you are greeted with suspicion and seen as upholding a corrupted system…as having an unhealthy attraction to punishment which must mean you have a creepy interest in controlling other people. Add to that the horrifying details of the torture of inmates by my countrymen at Abu Ghraib, and folks back home think prisons in the Third World are surely 100 times worse than all of the caricatures we see in television news magazines and in movies.

I was also an unlikely fit in a prison setting because of my background as a rape crisis counselor. When I know that so many inmates are here because they have caused misery and pain to women in Malawi, sometimes it is difficult to get perspective on the importance of alleviating the suffering of prisoners. I wonder every day: does a crime define the life and value of the person who committed it? It’s amazing to me how many people say yes – especially people who think prisons in Malawi (since both corporal and capital punishment have fallen out of favor after the fall of Dr. Banda) have become like vacation homes for prisoners. Because conditions outside the prisons are often so basic for many people in Malawi, if our prisons offer beds and mosquito nets - almost all of them do not, by the way - then we suffer through stories in the news about how people will likely start committing crimes just to go to prison and enjoy the luxury. That perspective outside of the prison has made it nearly impossible for the Prisons Service to advocate for more funding to improve conditions for prisoners.

And the conditions are bleak. The Prisons Service houses approximately 11,000 prisoners of whom about 300 are women. The majority of the 29 prisons were built by British colonialists to house a capacity of 4,500 prisoners. This means that our structures are crumbling, and woefully overcrowded. The staff scrambles against the odds to feed inmates – most of whom receive only one meal per day – and keep up with the many health issues that arise from overcrowded conditions including scabies and TB.

The prevalence of HIV in prisons is difficult to measure. The prisons have a continually shifting population – trying to get reliable statistics that have long-term relevance is challenging. The last nation-wide survey conducted by the previous volunteer indicated an approximate rate of 30% - more than double the rate in the general population. Those rates are based upon a small sample because VCT (HIV testing and counseling) is not offered consistently to the prisoners. There are only a handful of the 29 stations that have in-house VCT. Many prison officers are doing the best they can to get services to the inmates and will often walk prisoners to the nearest health center for testing upon request. This set-up presents several obstacles to testing of prisoners. First, we know from the Ministry of Health that the majority of people who voluntarily go for HIV testing are women (some statistics point to a discrepancy as high as 85%/15%). So it is already an uphill battle to entice men to go for testing, let alone request to walk several kilometers for it. Next, there are certain populations in prisons – particularly people on remand awaiting trial and those with life sentences – who cannot be taken outside of the prison as they are flight risks. This means that a sizable chunk of the prison population is denied access to testing services if not offered inside the prison.

The HIV positive prisoners (whether they know they are positive or not – so I tend to think of them all as potentially-positive) fall into two categories: those who entered custody sero-status positive, and those who contract the virus whilst in prison. For the former group, the most I can hope to organize is care and support. This takes the form of programs to provide extra nutrition and slightly better living conditions to positive prisoners as well as ARV medicines when they need them and serious education about how they can prevent transmitting the virus to others. For those in the latter category, those who become HIV+ in prison, there are some important issues. The first thing to understand about this group is that they are men almost exclusively infected because of sex with other men. It is a mistake to say that this is all rape, however, because some of this sex is consensual. When focusing on the men who have sex with men in prison – whether consensual or not – prevention becomes very difficult. The Penal Code of Malawi – written by the British with penalties listed in pound sterling – prohibits men from having sexual relations with other men. This puts Malawi Prisons Service into a sticky wicket: the sex occurs in prisons and directly contributes to the transmission of HIV amongst the male prisoners. Yet distributing condoms in prisons would provide a resource to conduct illegal behavior. Additionally, it would be an admission that Prisons Service cannot control the behavior of its inmates. Consequently, the Prisons bosses feel they have no choice but to deny condoms to prisoners. This aggravating situation has put the Prisons Service in the firing line of much criticism and is a policy with which I personally disagree. Nonetheless, I have no choice but to design HIV prevention programs that don’t include condoms. (George Bush would be so proud of me!)

I am in my third month working for Malawi Prisons Service which has given me time to assess some of the problems. Soon I hope to be able to write of some solutions. What I can say now is that I know I am in a position to directly impact the lives of 11,000 other people. This to me seems like a tremendous privilege – how many people can say that?

Though I worry that working here makes it seem like I am supporting the existence of prisons, what I do know unequivocally is that no one deserves to contract and suffer from HIV. And that no one deserves to be raped. So, to whatever extent HIV impacts the lives of prisoners and to whatever extent rape is present in prisons, we need people in prisons working on this. Treating inmates with decency and care is, in my opinion, the best way to restore their humanity and ensure that they don’t hurt women once they are released.