Even Dead Bodies Must Work - Office of the High Commissioner for ...

acquire them. If we inappropriately handle them—causing drug resistance,
as for TB—we act as a petri dish, then they just give it back to the community.
—Prison medical authority, Uganda Prisons Service, November 18, 2010
Transmission
The conditions in Ugandan prisons—combining overcrowding, frequent housing together of
the sick and healthy, poor ventilation, and lack of natural light—facilitate the transmission of
tuberculosis. 216 “If one prisoner has Tuberculosis (TB) in a room filled with 50 inmates, at the
end of a day, everyone will be infected,” the commissioner general of prisons has said,
according to media reports. 217
TB prevalence, already high in Uganda’s general population, is significantly higher in the
prison population. Uganda is ranked 16th of the World Health Organization’s 22 high-burden
countries for TB worldwide 218 and in 2010 had a prevalence rate of 330 cases per 100,000
members of the population. 219 In 2008, the UPS and UN Office on Drugs and Crime (UNODC)
estimated that Ugandan prison TB prevalence was 654 cases per 100,000, almost double
national population prevalence. 220
The Prisons Service acknowledges that TB education programs thus far have been limited. 221
However, the risk of contracting TB through the coughing of their fellow inmates was not lost
on many of the prisoners. As Johnson, a prisoner at Bubukwanga who had coughed for the
entire five months since he had been detained, said, “I am sure I could be infecting other
216 UPS, “Work Plan and Budget,” p. 4. See also Human Rights Watch interview with prison medical authority, UPS, November
18, 2010 (“Most of our structures are very poor. They don’t allow in air or sufficient light. What do you expect? The transfer of
infections such as TB take advantage of that. And they are overcrowded. You can see the scenario.”). As well as being the most
common opportunistic infection among people living with HIV in Africa, TB is pervasive in African prisons because of
overcrowding, poor ventilation, and lack of prevention practices. UNODC, UNAIDS and World Bank, “HIV and Prisons in Sub-
Saharan Africa: Opportunities for Action,” p. 2; E. Rutta et al., “Tuberculosis in a Prison Population in Mwanza, Tanzania (1994-
1997),” The International Journal of Tuberculosis and Lung Disease, vol. 5(8), 2001, pp. 703-06.
217 Tabu Butagira and Lulu Jemimah, “Prisons Chief—Sodomy Is My Biggest Headache,” The Monitor, June 21, 2009,
http://allafrica.com/stories/200811240127.html (accessed April 10, 2011).
218 Human Rights Watch interview with director, National TB and Leprosy Programme, March 10, 2011; World Health
Organization, “Global Tuberculosis Control: A Short Update to the 2009 Report,” 2009,
http://whqlibdoc.who.int/publications/2009/9789241598866_eng.pdf (accessed October 6, 2010), p.5. High-burden
countries are defined as the countries that rank first to 22nd in the world in terms of absolute numbers of TB cases and which
have received particular attention at the global level since 2000. Ibid, p. 4.
219 Republic of Uganda Ministry of Health, “Manual of the National Tuberculosis and Leprosy Programme,” March 2010, p. 3.
220 Uganda Prisons Service and United Nations Office on Drugs and Crime (UNODC), “A Rapid Situation Assessment of
HIV/STI/TB and Drug Abuse Among Prisoners in Uganda Prisons Service: Final Report,” 2008,
http://www.unodc.org/documents/hiv-aids/publications/RSA_Report.pdf (accessed August 11, 2010).
221 UPS, “Work Plan and Budget,” p. 10.
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