The spread of HIV/AIDS poses a big challenge to Rwanda . Experts worry that the release of prisoners suspected of genocide may make things even worse, since many are HIV positive.
AVEGA, the association that brings together genocide widows many of whom were raped, argues that AIDS prevalence rates among prisoners are directly linked to infection rate of their own members. “When people get concerned about HIV, they should remember the link with rape during the genocide. In 1999, AVEGA’s research showed that from 1,125 women raped in 1994, 70% were HIV positive”, says Kayiganwa Auria, officer in charge of Advocacy and Justice in AVEGA.
Controversy surrounds the issue of HIV/AIDS in prison. While some prisoners are already infected before they are detained, others get it during their time in prison. The question is how?
“Some times it is through sex with female prison guards. But usually it is through homosexuality. This happens a lot. Men are not afraid of sleeping with other men”, Uwitonda Charles an ex-prisoner disclosed.
Medical personnel and some prison officials agree that homosexual acts are spreading HIV infection in Rwanda ‘s jails. But two problems make this even worse. First, they are not allowed to distribute free condoms, because that would be endorsing homosexual acts. Second, prisoners are often reluctant to discuss this issue openly.
Liliiose Rutagengwa works for ARBEF a local association that promotes better reproductive health in Rwanda . The association works in partnership with prisons in Rwanda to raise awareness about AIDS and provides free counselling and testing services to detainees. “It is very difficult to deal with the fact that one is HIV positive, but we counsel our clients and tell them that they can live positively and live long. We advise them not to indulge in risk behaviour that could lead them to infect others or re-infect themselves”, tells Rutagengwa.
As a result of the counselling, many prisoners now understand more about HIV and AIDS. Some volunteer to test their health status.
“I decided to test because I want to clarify my status. I am not married but if I leave prison without AIDS I will have to choose my partner carefully and both of us will require an AIDS test before living together”, tells Ntakaburinvano Abubakar a prisoner.
“If I am positive and my wife is not, I will make sure I don’t infect her. Just as we have been taught, I will try to be careful not to engage risky behaviour in order to lead along and healthy life”, says another prisoner, Karamage Janvier. He says he has achieved much from the counselling sessions. “We have been told that there are organisations that support people living with AIDS. If I find out that I am infected I will go to those organisations”, he adds.
But for younger prisoners, even if they attend ARBEF’s Prison sensitization program, it’s sometimes difficult to follow the advice.
“Some boys don’t even get enough food to eat. So, often older prisoners use food, money or influence, to lure them into sex”, Uwitonda revealed.
Some prisoners appear not to know HIV might spread. “I don’t know how AIDS is spread in prison. No idea. I was detained only recently”, Mugisha Innocent says.
With ignorance, comes denial too. None of these we interviewed could accept or admit some men share sex in Rwanda ‘s prisons.
Even those who follow the ARBEF program on a personal basis are reluctant to discus it in the wider context. “Of course, everyone enters prison thinking they don’t have AIDS. How they get the virus? I can’t tell”, says Ntakaburinvano.
However, Antoinette Mukashema a medical assistant at Kimironko prison seems to know better. “We do not have female prisoners here so we wonder how people get infected. Apart from those who come in already infected, many get it through homosexuality”, Mukashema observes.
Francois Mazimpaka has been in jail for ten years. Like many long term prisoners, he lags behind in current affairs, including medical advice on AID. Although he is ready to test for HIV, he is too reluctant to admit that some prisoners get infected in jails. “Before I came here I had an active sexual life, that’s why I decided to find out whether I am alright. I can assure you, there are no people who get AIDS while in prison. However, newly detained prisoners show signs of infection early, because of poor nutrition”, Mazimpaka adds.
Mazimpaka is not anxious about the outcome of the AIDS test. “I am confident that I don’t that I don’t have AIDS. For ten years I have been locked up, how could I possibly be sick”? he tells.
Harriet Mukarwizano a lab technician at ARBEF says prisoners have many different attitudes towards HIV/AIDS, but the main thing is that they are listening. “We started this program in August, to establish HIV status among prisoners. Since we begun, 348 detainees from Kimironko prison have come for testing and counselling”, Mukarwizano remarks.
So despite what might be described as a state of ignorance and denial among prisoners, there appears to be progress too.
But life in prison is only half the story. What about life after prison?
“The release of prisoners will increase the rate of infection. These people are human, when they are set free after all these years, they will have sexual needs. I doubt whether they will have the courage to inform their partners if they are HIV positive”, declares Kayiganwa from AVEGA.
Charles Uwitonda was set free 14 months ago. He disagrees that released prisoners will increase the spread of AIDS. On the contrary, he reckons prisoners often know more about AIDS than people outside. “HIV and AIDS were widely discussed in prison. We are taught about prevention, infection and re-infection. We are told what to do if we find we are HIV positive. AIDS is not just a problem in prison but also outside, it has claimed many lives. I lost my wife a week after my release. We had four children, one also died”, Uwitonda argues.
Anastase Rwabulindi 72 spent six years in prison. Since his release last year, he has been living with his family in Gasata district, Kigali city. “During my prison term, I saw some who suffered from boils, skin diseases and other terrible pains, until they died. When I was released, I discovered the same disease that was also claiming lives back home. We have buried several people in our neighbourhood, who are said to have died of AIDS”, says Rwabulindi.
Some of the residents of Gasata we talked to said released prisoners will have no impact on HIV prevalence in their community.
“I am married. So there is no way an ex-prisoner or any other man is going to give me AIDS. He is not my husband; I don’t indulge in such behaviour. I think that with or without the release of prisoners, anyone who sleeps around or is not careful will get infected and infect others”, notes Mukagasana Marita, a resident of Gasata.
Lillian Uwera another resident of Gasata agrees that high- risk sexual behaviour is the real problem, not ex-prisoners. If you play with fire, she says, you will get burned. “Those who go with different men will definitely catch the disease. If someone is not your husband you should not sleep with them”, says Uwera.
Some people say a little knowledge is a dangerous thing. But with HIV/AIDS, it seems a little knowledge might save your life. “I don’t know much about AIDS, except that many people die from it. I think that those who sleep around will get the virus” tells Nyirasambu Bernadette, also a resident of Gasata.
So it is clear that a lot still needs to be done to curb the spread of AIDS IN Rwanda, and spread awareness about AIDS.
Since ARBEF started providing testing and counselling services in prisons, only 18 have openly declared they are HIV positive.
To help reduce such prejudice, prisons have formed associations to bring together people living with AIDS. The association in Kimironko prison has 43 members.
“To limit infection, we have sensitization program on the issue of HIV/AIDS. Some prisoners don’t know that AIDS can be spread through homosexuality. Some come to us asking, how I come I’ve got AIDS, when I haven’t seen a woman in years” says
Mukashema Antoinette, a Medical Assistant in Kimironko Prison.
According to Antoinette, there is no distribution of condoms in prisons. “No we can’t do that because then we would be legalising the practice. All we can do is carry out daily sensitization sessions on HIV/AIDS, to try and change their behaviour”, Mukashema indicated.
The society for Women and AIDS in Africa lobbies the Rwandan government to lift a ban on the distribution of condoms in prison, but without success. The Government says that the Rwandan constitution does not recognise “same sex” relationships, so giving condoms to prisoners is against the law.
We asked the prison authorities this. Wouldn’t condoms prevent AIDS?
“I think that distribution of condoms to prisoners would be disastrous gesture. We would be giving them the right to homosexuality. I have had discussions with a few prison directors and we agreed to maintain our control systems”, affirms the Director of prisons in Rwanda , Balinda Steven.
He said the prisons have implemented a number of measures to guard against the spread of AIDS through homosexuality. “We have been devised the usual means of trust, beside daily controls and intelligence networks from within. We find what we call people of integrity among the prisoners, and we give them this responsibility”, adds the Prison Director.
This debate will no doubt continue. Some say condoms in prison would prevent AIDS spreading in Rwanda and save lives. Other say condoms in Rwanda ‘s prisons would break the Rwandan law.
What is certain is that some Rwandans in and out of prison are infecting others day by day, week by week.
Perhaps the most important question is this: do Rwanda ‘s current sensitization campaigns and prevention mechanism work fast enough and actively enough, to reduce the rate of infection, or not?