Integrated Regional Information Networks - October 20, 2009

Judge Thumba Pillay ordered the national Department of Correctional Services to provide the medicines to the 15 prisoners, as well as to any other inmate in need of them.

He also ordered the department to adopt a comprehensive HIV/AIDS plan for the jail to ensure that inmates would receive not only ARVs, but adequate nutrition, regular and ongoing counselling, and access to health facilities. The government appealed the verdict but it was upheld, allowing thousands of prisoners across South Africa to receive treatment.

Yet many HIV-positive inmates at Westville say that while most of those who qualify for treatment are getting it, the prison authorities take little interest in their health and are not complying fully with the court order.

"Prisoners now have access to ARVs, but the support services are still not there," said Frank Ntombela, chairman of the Westville HIV/AIDS Support Group, which was instrumental in taking the department to court.

"Good nutrition, which is one of the requirements for people taking these drugs, is unavailable. We get the regular staple food, consisting mainly of rice and soya-bean stew, which is often not good enough," and the prison authorities did not allow inmates' families to provide them with healthier food.

Ntombela's section of the prison houses more than half the total prison population of 7,800, but has only four doctors and four nursing sisters, who only see patients on Tuesdays.

"Sometimes there are more than 50 people who want to see the medical staff, but they force us to choose only seven prisoners who are going to be seen for that week - the others would only get a chance next time, unless they are in an emergency," said Ntombela.

Another member of the support group who did not wish to be named, told IRIN/PlusNews that the ARVs were helping HIV-infected prisoners. "There was a time between 2005 and 2006 when an average of 140 prisoners died of AIDS a year - we saw corpses leaving the prison hospital every week."

However, because of overcrowding many HIV-positive prisoners still contracted tuberculosis (TB), including drug-resistant strains of the disease. The support group member estimated that about 60 HIV-positive inmates now died at the prison every year, with very few granted medical parole.

"Many people end up dying lonely deaths here, yet there is a legal provision which allows terminally ill prisoners to be paroled in order to die dignified deaths with their families."

After their court victory the support group was allocated an office for meetings and treatment and awareness programmes, but prison authorities recently closed down the office after gang violence claimed the lives of two inmates.

"I think they used the gang wars to get to us, because they always resented the fact that we had won the court battle," said the support group member. "As a result, most of our programmes came to a halt."

The number of Westville inmates living with HIV is unknown but the prison is located in KwaZulu-Natal, the province with South Africa's highest HIV prevalence rate. According to the latest government survey, 39 percent of women attending antenatal clinics were infected.

Pastor Leon Assenderpe of the Family Support Group, a faith-based organisation that runs AIDS awareness and care programmes in prisons throughout the country, described the HIV/AIDS situation at Westville as "dire".

"I know that the government is trying to implement a treatment plan but they are overwhelmed because of the number of prisoners needing treatment," he said.

Nana Mpungose, the Westville coordinator of Treatment Action Campaign, the national AIDS lobby group that helped the inmates bring their case to court, said her organisation was concerned about the number of complaints from HIV-positive prisoners at Westville and other facilities.

"We are also concerned that the department is not fully compliant with the court order," she said. "When we ask for permission to meet with prison authorities, or to speak to prisoners, we are denied that opportunity."

The Department of Correctional Services could not be reached for comment.

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