Using COVID-19 to Address Environmental Threats to Health and Leverage for Prison Reform in South Africa, Malawi and Zimbabwe

Abstract

Health rights of prisoners has long been a neglected political issue in Africa, where over one million people are detained, and almost half of whom are in pre-trial detention. African prisons constitute high-risk environments for communicable disease transmission. During the COVID-19 pandemic, the public health literature on African prison responses focused on preparedness as it related to testing capacity, quarantine practices and personal protective measures to mitigate disease spread. This article combines the right to health as narrowly defined by a prisoner’s right to access non-discriminatory equivalent health care, with a broader focus on assessing normative standards of detention. A comparative legal realist assessment of prison operations in South Africa, Malawi and Zimbabwe during COVID-19 state disaster measures is presented, focusing on the environmental determinants of health (ventilation, minimum floor space, water, sanitation, hygiene and nutrition) in prisons. It reveals the inherent tensions in ensuring a balance between respecting the fundamental rights of people living and working in prisons, ensuring adequate environmental health standards and mitigating disease during public health emergencies. Despite insufficient government resourcing and inadequate coverage of COVID-19 responses, few severe outbreaks were reported. This could be due to lack of testing, reporting or other factors (asymptomatic infection, acquired immunity). Prison congestion and unrest however affected prisoners and staff fearful of hazardous living and occupational health conditions. COVID-19 as public health emergency amplifies the need to address systemic deficits in infrastructure, resourcing and efficiency of criminal justice systems. Policy level and pragmatic recommendations for enhanced human rights practice are outlined.

“We sleep 10cm apart so there is no social distancing”: COVID-19 preparedness in a Zimbabwean prison complex

“…Zimbabwe continues to operate at 120% capacity, caused in part by substantial pre-trial detention rates (18.6%) (World Prison Brief, 2021). The importance of a strategic public health and human rights-based approach to protect those living and working in prisons from disease cannot be underestimated (Amon, 2020;Badu et al, 2020;Kinner et al, 2020;Nweze et al, 2020;Van Hout, 2020a, 2020b, 2020c, 2020d.…”

“…The COVID-19 pandemic has highlighted the significant risks to health in African prisons, where lack of resourcing in government COVID-19 responses has contributed to an inadequate COVID-19 response (Nkengasong and Mankoula, 2020; Muntingh, 2020; Van Hout, 2020a; Van Hout, 2020b; Nweze et al , 2020; World Prison Brief, 2021; Van Hout and Wessels, 2021; Van Hout et al , 2021). The threat of COVID-19 was not confined to those in detention but extended to prison staff and their families, visitors and local communities (Van Hout, 2020c; Van Hout, 2020d).…”

A multi-stakeholder situation assessment of COVID-19 disease preparedness and mitigation measures in a large prison complex in Malawi

“…Prison system efforts included the segregation of infected prisoners, ban on visitation and the suspension of out of prison formations to work (Masina, 2020b(Masina, , 2020c. Media reports emerged of inadequate PPE disinfection and sanitation supplies for staff and prisoners and insufficient medical staff on-site, with lockdown measures confining prisoners to cells and access restrictions to the prison disrupting prisoner reliance on family and civil society support in the supply of food, soap and clothing (Van Hout, 2020c, Guta, 2021. Donations of COVID-19 materials to the prison system were made by the United Nations High Commissioner for Refugees (Chikoti, 2020).…”

“…In Africa, where prison capacity is stretched, it is estimated that one million people are deprived of their liberty with, on average, 42% in pre-trial detention (World Prison Brief, 2020). The threat of COVID-19 is immense, particularly to the health and safety of those living and working in African prisons (and their families) and is exacerbated by colonial infrastructure, historical poor conditions of detention and low government resourcing of a COVID-19 response in its prison systems (Nkengasong and Mankoula, 2020; Muntingh, 2020; Van Hout, 2020a, 2020b, 2020c, 2020d; Nweze et al , 2020; World Prison Brief, 2020; Lucero-Prisno, 2020; Van Hout and Wessels, 2021).…”

“…There is little transparent and publicly available data on COVID-19 positivity rates, deaths and recoveries in African prisons (with the exception of South Africa) and little information provided on the profile of those released during prison decongestion measures (Muntingh, 2020; Nweze et al , 2020). Prison situations were also volatile due to the lack of disease mitigation, continued intake of remand detainees and existing poor conditions of detention, with riots and protests by staff and prisoners reported in many African states (Prison Insider, 2020; Van Hout, 2020c; Van Hout and Wessels, 2021).…”