Malaria: A hidden challenge among Arua inmates

By Andrew Cohen Amvesi 

Beatrice Alezuyo, 24, an inmate has been hit by Malaria for five times in a period of three months of remand at Arua Government Prison in Arua district.

Alezuyo, also a mother of two has been battling Malaria in the female ward of Arua government prison together with her 18 months-old baby boy.

Alezuyo was arrested and sent to prison alongside her baby on allegations of assault.

Three months down the road, Alezuyo is still on remand waiting for Justice to prevail over her case.

But while in prison, Alezuyo told Red Pepper in an interview on Wednesday that Malaria has been her biggest challenge ever since she was remanded to prison.

“For the three months I have been in prison, Malaria has been my biggest problem. It has so far, attacked me for five times. My baby has equally been battling the disease besides me,” Alezuyo said.

“Mosquitoes are too many in our female ward yet we are not allowed to use treated mosquito nets,” Alezuyo narrated during a function organized by Reproductive Health Uganda (RHU) to mark sixteen days of activism campaign against gender based violence in Arua government prison.

According to Geoffrey Ogutu, the RHU – Arua project manager, the event was aimed at sensitizing inmates on public health including family planning, Malaria control, Tuberculosis, HIV/AIDS and Hepatitis B testing and Counseling among other services.

However, during the function, Alezuyo revealed that when the prison authorities realized the danger malaria was posing to her life and the baby through the frequent attacks, they later, in a special way, allowed her relatives to bring a mosquito net from home.

Ever since they started sleeping under the treated mosquito net two weeks ago, Alezuyo confessed that Malaria has not attacked them anymore.

Alezuyo is not the only inmate grappling with the silent malaria challenge in Arua government prison which now houses over 900 inmates up from the recommended 200 prisoners.

In the male ward, Ratib Asuma, a 3-year convict of threatening violence said malaria at least attacks him after every four months of the fourteen months he has so far served in prison.

Asuma blamed the malaria surge in the prison on the congestion in wards.

“I sleep in Ward One which has a total of 145 inmates. We are so congested, sleeping next to each other on the floor without mosquito nets. Besides, when it is hot, we don’t cover our selves, a condition that has made mosquitoes to bite us at will and spread malaria from one inmate to another,” Asuma explained.

As a result, Asuma said malaria has on several occasions, forced many inmates to miss out on their Court days, a challenge that has delayed justice for many.

Similarly, Joseph Aliobe, 44, a committal murder inmate, who is positively living with HIV and Hepatitis B, observed that malaria has posed a great worry to inmates of his health status.

Aliobe, who also doubles as the Chairperson of Arua Prison inmates living with HIV/Hepatitis B, an association of about 125 members, said malaria has weakened the immune system of many of his members in the prison.

He said the situation is normally worse at night when some of his colleagues collapse of acute malaria and delayed to be taken for treatment due to the chain of command to be followed in prison.

“We have ever shouted on top of our voices from our various wards for help whenever one of us collapses of acute malaria. Our lives have been endangered especially at night because of the bureaucracy here,” Aliobe said, adding that one has to first call the officers in charge of the prison before the ill inmate is rushed out for treatment.

He said in most cases, inmates with acute malaria attacks are referred to Arua regional referral hospital for better management since Arua Prison Health Center III lacks admission facilities and adequate drugs apart from Quatem which is normally administered to malaria victims.

Aliobe urged government to consider coming to their aide by equipping Arua prison HCIII with drugs and other necessary equipments as well as upgrading the facility to a Health Center IV status so as to allow admissions within the prison premise.

In a related incident, Francesca Draleru, the in charge – Arua prison Health Center III acknowledged that they only manage simple malaria cases and refer complicated ones to Arua regional referral hospital.

Draleru said on average, they register 30 malaria cases at the health facility on weekly bases. She said the number includes children lodged in prison with their mothers.

Draleru, however, noted that despite the challenge posed by Malaria in Arua government prison, they have not yet registered any death case this year.

Meanwhile, speaking on behalf of the OC Arua Government Prison, John Bosco Owiro, a Prisons officer said currently, there is an indoor spraying program in all wards of the prison after every six months.

He said in an effort to reduce the ever increasing cases of malaria infection, the prison authority intends to scale down the indoor spraying program from six to after every four months.

But Owiro asserted that their policy doesn’t allow the use of mosquito nets in prison wards fearing that some inmates may use the nets for committing suicide and accessing the ceiling board to escape from detention.

When contacted on phone, Dr. Bishop Drileba, the Arua deputy district health Officer (DHO) noted that Malaria has remained the highest cause of mobility in Arua district; standing at 36 percent.

Drileba observed that one of the best ways of controlling Malaria is by sleeping under treated mosquito nets which he said is unfortunately, not allowed in the prison facilities for reasons best known by its authorities.

Alternatively, Drileba encouraged the prison officials to effectively embrace the indoor spraying program in a bid to address the looming malaria challenge in Arua prison.

On Arua Prison Health Unit, Drileba said the facility is not under their management apart from having a supervisory role over it but advised its medics to continue referring inmates in dare conditions to Arua hospital when need arises.

Similarly, Nelson Droti, the communication for health communities project manager spearheading the Obulamu campaign in West Nile region, urged prison authorities to consider being mindful of the health of inmates by softening their stance on conditions like restricting the use of treated mosquito nets which he said puts lives of prisoners at risk.

Arua government prison which was meant to accommodate a total of 200 inmates now houses over 900 prisoners including 70 female, 4 children, Civil Debtors, Convicts, those on remand and Lodgers.

According to the World Health Organization (WHO), Malaria remains a major cause of childhood morbidity and mortality in tropical Africa.

However, although African children account for 90 percent of the mortality associated with Plasmodium falciparum worldwide, there have been no comprehensive clinical descriptions of severe malaria in this group.


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