Kampala/Geneva — On the occasion of World Tuberculosis Day, 24 March, the International Committee of the Red Cross (ICRC) is calling attention to the fact that the contagious and potentially fatal disease is a major health problem in prisons. A project run by the organization in three jails in Uganda shows that tuberculosis can be fought successfully in detention facilities.
"In 2013, the number of inmates infected by tuberculosis diminished for the first time since the project began in 2009," said Dr Raed Abu Rabi, who coordinates the ICRC's activities relating to detainee health care. "The treatment success rate was also significantly improved in comparison with the national average." A recent assessment, conducted by an independent expert two years after the project was handed over to the Ugandan authorities, showed that the treatment success rate increased from 63 to 86 per cent between 2009 and 2012.
In jails in Luzira, Fort Portal and Gulu, success rates for the treatment of tuberculosis exceeded targets set by the Ugandan health ministry (75 per cent) and by the World Health Organization (85 per cent). "This is a revolution in health care in prisons," said Dr Johnson Byabashaija, Uganda's commissioner-general of prisons. "In prisons, the incidence of the disease is normally much higher - as are mortality rates - because of overcrowding, unsanitary conditions and inadequate screening and treatment."
The ICRC worked hard with the prison authorities to identify deficiencies in areas such as health information, staff knowledge, laboratory testing and diagnosis, and access to health care. "The key to success was the strong commitment to the project of the detaining authorities and the ministries concerned," said Dr Abu Rabi.
Other important factors were improvements made in facilities and staff training. Prison laboratories were fitted with better equipment and now have solar panels providing a reliable supply of electricity, which enables them to operate around the clock. The prison health centres also provide high-quality care for the local population.
Given this success, the Ugandan authorities who took over the project from the ICRC in 2012 have started to take similar action in other prisons across the country. The ICRC has launched initiatives of this kind in prisons in nine other countries around the world. All will eventually be transferred to local control.