1. Introduction

Mulanje Prison is located at Mulanje Boma (the administrative center of Mulanje district) and serves both Mulanje and other districts, like Phalombe. 

The facility was designed to keep 200 prisoners but currently it has 202. This is a reduction  

from more than 400 inmates before the Covid-19 pandemic The government released some inmates to decongest the cells to prevent corona virus infection in early 2020.

The prison has both male and female cells, 8 in total. Health workers are using an unused holding cell as a clinic. 

Mulanje Prison, October 2020

2. Activities and funding

With support from Scottish churches in Edinburgh such as St. Andrew and St. Georges West, Stockbridge Church and St Cuthbert's Church, Mulanje Mission Hospital is able to provide basic health services at the prison. This happens during clinics run by nurses, a clinician, an HIV Counselor and a pharmacy assistant, weekly on Friday morning.

A separate source of funding was used to procure infection prevention materials for the Prison during the early stages of the COVID-19 pandemic. The hospital supplied materials worth MK 350,000 (£330), such as buckets and taps for handwashing and soap. These funds were received from the English Reformed Church in Amsterdam and Wilde Ganzen.

3. Objectives of the Prison Health Project

Main objective: Improved health of the inmates.

Specific objectives: 

• To promote a hygienic environment
• To make sure prisoners are medically checked for diseases and treated
• To make sure prisoners are psychologically helped through counselling
• To make sure patients are referred to hospital when very sick

Activities: environmental inspection, provide personal protective equipment,       cleaning kit and decontaminants to cleaners to kill bacteria

Activities: HIV testing and counselling, screening during weekly clinics, treatment of minor ailments during Friday clinics.

Activities: Referral to Mulanje District Hospital or Mulanje Mission Hospital.         Pregnant patients are sometimes transported for antenatal care.

• To ensure a sound nutritional status of inmates

Activities: Regular supply of nutritious food, such as soya pieces and cooking oil. 

Prison staff overseeing work in the vegetable garden

 4. Indicators for the year 2019-2020

 a. Number of deaths: No death was registered during the period under review.

 b. Major medical problems at the prison are

•  Respiratory tract infections
• Skin diseases including Scabies
• Diarrhoea
• Sexually Transmitted Infections
• Gastritis
• Hypertension

 HIV TESTING

 c. Discussion 

The data above shows that there is good coverage of HIV testing, and the 27 cases with positive results started treatment straight away. The HIV treatment itself is accessed from the District Hospital nearby.

Healthcare worker during a clinic

5. Opportunities and challenges

During the year under review, MMH has managed to reach an agreement with the local District Health Office. The DHO is now providing basic drugs to prisoners free of charge. The hospital pays a small allowance for the DHO pharmacy assistant to be present at the prison clinic. 

This has reduced cost of the project, as can be seen under 6 below. 

 MMH will continue advocating for increased government support for prisoners.

Congestion at prison means there is an ongoing risk of diseases prevalence in crowded conditions, such as scabies and tuberculosis. The space available for the clinic at prison is rather small currently.

6. Financial report

7. Developments by other organisations

At the prison a biogas cooking installation was installed by an NGO. This infrastructure is using gas from toilets of the prison to cook in-mates food. This is important because it will cut down prisons demand for firewood which was destroying the beautiful Mulanje Mountain and also the prison will save money they used to pay for electricity. The biogas facility is currently running at 50% capacity.

Saint Egidio, an organization of Catholic church started constructing a Vocational skills training center, this is a place where in-mates will be taught different vocational skills like carpentry, tailoring, tinsmith etc. The project is not yet running. 

8. Future plans

MMH would like to continue the supplementary feeding programme. For now, this will include only soya and cooking oil. This will help in preventing malnutrition. 

The hospital will continue supporting prisoners with health care services such as HIV testing, treatment of minor ailments and psychosocial support. Pregnant women will be assisted and referral letters written as needed.

We will explore the involvement of the hospital chaplain in the prison ministry.

9.  Vote of thanks

On behalf of the entire team, we wish to thank all those individuals and groups who make this ministry service to the Prisoners at Mulanje possible. It is a privilege to serve those imprisoned on your behalf.

COVID-19 prevention materials

MMH November 2020