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So, for once, the coronavirus pandemic is finally producing a few articles on the health and social situation in prisons, ranging from protests by prisoners deprived of visiting rooms in Italy to calls to release prisoners in France and Senegal. As the virus circulates from one continent to another, lawyers, NGOs and researchers are releasing ever more statements, relayed by the press and radio stations, both national and international. These include the joint declaration by a group of NGOs and national and international actors on behalf of prisoners in Africa, supported by Avocats sans Frontières-Belgique (‘Faced with the spread of Covid-19, take urgent and immediate measures to protect the rights of detainees in Africa,’ 24 March 2020); a call from researchers, lawyers and magistrates in France (‘Coronavirus: Let’s reduce the number of people serving short terms or coming to the end of their sentences,’ Le Monde, 19 March 2020); and Gwenola Ricordeau’s analysis, ‘Empty the jails, now’ (The Conversation, 25 March 2020).
At least the epidemic will have helped reopen the debate on prison health, in particular such issues as overcrowding and hygiene in places of detention that might favour the transmission of the virus. We may well wonder why it has taken so long to recognize and put on the agenda a health issue that has long been an urgent matter in prisons. However, we need to take the analysis of the situation further and to reflect on the place of penitentiary institutions in public health policies as well as the political dimensions of such a discussion. We propose to start by looking at African prisons, while guarding against making generalizations about the whole continent; and we will not restrict ourselves to an Afrocentric reading, as this would be to the detriment of our aims which, after all, are intended to be universal. Indeed, it is prison sentences as such, and their socio-political significance, that must always remain the focus of our reflections.
A brief reminder of the situation in prisons on the African continent will demonstrate the vulnerability of both prisoners and prison staff. We then seek to identify the responses of public authorities and prison actors more generally. Finally, we reflect on what we can learn about the politics of life from the way people are treated in prisons.
Heterogeneous situations which should not conceal profound vulnerability
Prisons in Africa are extremely diverse, both in the number of establishments, location and size. Incarceration rates are variable, and sometimes lower than those experienced in European or American states. If South Africa stands out, with a rate approaching 300 prisoners per 100,000 inhabitants, this is not the case in Burkina Faso, which has fewer than 50 prisoners per 100,000 inhabitants. As for Cameroon, its numbers are close to those of France, hovering around 100 per 100,000. In Senegal, in 2019 the prison population was estimated at 11,547 prisoners, an average of 68 prisoners per 100,000 inhabitants.
However, regardless of the incarceration rate, many institutions across the continent (and around the world) are marked by high levels of overcrowding, especially in the big cities. This results first of all in an insufficient number of beds for prisoners, and severe overcrowding in cells and common spaces. In addition, food rations, as well as infrastructure guaranteeing access to water (and drainage), are inadequate in the context of often low budgets. Many prisoners suffer from dermatosis (including scabies) and malnutrition (including beriberi, a vitamin B deficiency). Other diseases are also found: the prison population is distinguished by an over-representation of HIV and tuberculosis compared to the rest of the population. Detainees therefore comprise a vulnerable population as defined in this period of the Covid-19 pandemic. Due to prison overcrowding, prisoners are vulnerable in a context where social distancing is considered the essential weapon to break the chain of transmission of the virus. Prisons, closed and overcrowded environments, have long become ‘incubators’ for various viruses which spread rapidly, and we must not underestimate the historically-produced distrust of prisons as vectors of disease as well as moral contamination.
Indeed, detainees suffer from recurrent interruptions in their therapeutic itineraries (upon entering detention when they are already being treated, and on discharge if they have started treatment during their incarceration), and from a lack of systematic screening upon entering prison. Prison hospitals, when they exist, lack equipment and medicines. Most of the time they are considered to be on the lowest rung of the health system, and they are supplied only with medicines for primary health care. Otherwise, they are dependent on donations from NGOs, religious bodies, patrons and international agencies. Finally, family visits, and financial support from relatives are essential to facilitate medical care for sick detainees (purchase of medicines, provision of examinations and medical care outside the prison). Prison health suffers from a disconnection from health workers and health centres: it is, all too often, the great forgotten factor in public health policies. In Senegal, the Prison Administration’s area of responsibility is limited to the supervision of prisons and security of the detainees. Prison health and hygiene are the responsibility of the Ministry of Health, and are unfortunately of marginal concern to the health system.
In contexts where health infrastructure is insufficient, putting the issue of prison health on the agenda almost counts as an illegitimate step. Security logics most often prevail over health logics.
The active circulation of Covid-19, and the epidemiological threat that prisons represent in this context, mean that no one should continue to turn a blind eye to the denial of prisoners’ health rights – nor, of course, to the conditions of prison staff, both guards and carers.
First responses
This situation would indicate that the prison is not an isolated spot protected by its high walls, but rather a porous space, produced within, and part of, a variety of circulations. Prison administrations have taken stock of this situation. In Senegal, the growing concern of the agents of the medico-social division of the Prison Administration has led them to ask the Minister of Health for medical checks and hygiene measures to be immediately brought into the prisons. Very often, visits have been prohibited. However, it is essential to insist on the dependence of prisoners on their families (for money, food, medicine and moral support) and, conversely, on families’ dependence on certain prisoners who manage to carry out activities that generate income (informal or criminal). Breaking this bond can have devastating effects on the lives of prisoners and their relatives. At the Ouagadougou Detention and Correction House, where visits have been suspended, a system of parcels (which still have to be disinfected) has been put in place. This cannot replace a visit, even though the illegal circulation of telephones is an open secret. In Senegal, the Prison Administration has not yet banned family visits, but it has reduced them, promising a low-cost communication device to allow detainees to keep in touch with their families. However, all authorizations for access to penitentiary establishments by diplomatic representatives, associations, non-governmental organizations, students and researchers have been suspended until further notice.
However, we must also think about other forms of movement, especially movement to courtrooms. Will trials be suspended, as in Guinea, Senegal, or even, partially, Gabon (except for the most serious offences, deliberations and requests for provisional release)? Might this also risk extending the length of a preventive detention that already exceeds statutory deadlines? How, too, can lawyers’ visits be guaranteed? The health crisis is no justification for a suspension of rights.
There is also the question of newly arrived prisoners. And finally, the two-way trips made by guards cannot be ignored – often in the context of cities which generally have not established a lockdown because of the social, economic and political costs this would entail.
Obviously, one possibility is the implementation of measures such as barriers. And it is important to raise awareness – for instance of the need to take the temperatures of visitors and guards, oblige people to wash their hands at the entrance, provide detention quarters and administration offices with buckets of bleached water or soap (in the absence of sufficient hydroalcoholic gel), and finally, equip health workers with personal protective equipment (masks, gloves, overcoats). Now is also the time to ask for help from prisoners with skills in healthcare acquired prior to their incarceration, or from those with experience of the disease, paying careful attention to the languages used for communication (the display of posters, information meetings, etc.). This is all the more necessary since, in many countries, associations such as NGOs (whose authorization to act is often currently suspended) had previously met some of the health needs of prisoners. It remains to be seen whether these actions are tenable over time, and replicable in all prisons in the same country, not least for financial reasons.
Testing caregivers and new prisoners is a challenge, as the right kits are lacking. In addition, individuals screened must still be isolated from other prisoners – another challenge in the context of overcrowding. As for wearing masks, there is a shortage of these.
It is thus not surprising that there have been calls to release detainees, usually coming from NGOs (in South Africa and Cameroon for example) and lawyers (in Algeria), in order to allow health authorities to be able to monitor and protect the prison environment: the oldest, for example, and the most vulnerable, or depending on the length of sentence still to be observed, and the nature of the offence. If the law does not allow this, a presidential pardon is possible: this happens frequently in Africa, and Ethiopia resorted to this measure recently, on 25 March 2020, in the prisons of Kilinto, Shewarobit, Ziway, Dire Dawa and Qualiti. In Kenya, inmates at Shimo La Tewa prison will complete their sentences at home, by doing community service. Niger also announced that it had released 1,540 detainees. In Senegal, the President pardoned 2,036 detainees, convicted of various offences and imprisoned in several penitentiary establishments across the country. The releases mainly concern detainees benefitting from a total or partial reduction of their sentences; minors; seriously ill prisoners; and those over 65 years old. They also include the commutation of life sentences to 20 years’ imprisonment, which can lead to other immediate releases. It should be noted that detainees convicted of murder, rape, paedophilia, drug trafficking, or theft of livestock have been excluded from the pardon.
The Prison Insider website collates actions undertaken by country and by continent, on a day-by-day basis, and is a useful reference. In this context, it is worth noting that political detainees are the subject of calls for release: this is the case in Egypt and Niger. While these detainees have often made it possible to spotlight the conditions of incarceration, it is hardly enough to ignore ordinary prisoners when it comes to the question of releases.
What the pandemic says about prisons: a rights policy
Access to healthcare remains a right, and sentences already served should not be made worse by denying such care. However, screening detainees, whether new arrivals or not, and even guards, where possible, also entails that they be treated – by making cells available, building shelters in the courtyards, distributing the necessary medicines, and preventing contamination. This requires that prison health be clearly included in the system of health and care provision and that it not be left to the initiatives of human rights organizations and associations. The ministries responsible must also commit to investing in this area, in the name of the principle of the right to health for all.
The current health crisis demonstrates that there is an awareness of the ways prisons form part of the social environment, and of the circulation that takes place between prisons and the outside world. In the social sciences, there is nothing new about this, except that the myth of the impenetrability of prisons (on the pretext of security and punishment) can be more openly questioned. To deprive detainees of outside support is to expose the authorities to mutiny. To deprive prisoners of care, as prison doctors know, is to turn such establishments into new breeding grounds for the epidemic. We cannot therefore continue to turn a blind eye to the legitimate place of prison, prisoners and staff in public health policies, for the purpose of fighting epidemics (coronavirus today, Ebola, yet again, tomorrow, and HIV, tuberculosis and hepatitis, all the time). However, this recognition cannot be limited to pragmatic issues. It must also lead to the decriminalization of the least serious offences and to effective implementation of alternative sentences, as otherwise there will be no end to prison overcrowding. Above all, this should be an opportunity to talk about the rights of detainees and, in turn, the rights that we defend, or allow states to flout, in Africa as elsewhere.
*This article was first published in French on the Libération Africa4 blog.