Government to tackle TB treatment for inmates

Government to tackle TB treatment for inmatesScreening every inmate for TB, treating them upon diagnosis - coupled with improved cell ventilation and an urgent focus on alleviating overcrowding are the cornerstones of government'€™s plans to tackle this curable disease, deputy president Kgalema Motlanthe told a group of Pollsmoor inmates yesterday (SUNDAY).

Screening every inmate for TB, treating them upon diagnosis – coupled with improved cell ventilation and an urgent focus on alleviating overcrowding are the cornerstones of government’€™s plans to tackle this curable disease, deputy president Kgalema Motlanthe told a group of Pollsmoor inmates yesterday (SUNDAY).

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Arguably South Africa’€™s most overcrowded prison with an unsurprisingly high TB prevalence, Pollsmoor was yesterday the focus of government’€™s World TB Day events attended by Motlanthe, health minster Dr Aaron Motsoaledi and Correctional Services minster Sbu Ndebele.

However, while talk was focused on future interventions, Motlanthe said it was poignant to remember that Nelson Mandela had contracted TB while incarcerated at Pollsmoor.

‘€œSo, you are following in the footsteps of an icon and that should give you some level of assurance and comfort,’€ he told a group of inmates, who posed a number of questions to the government delegation.

Motlanthe added that ‘€œwe have travelled this (prison) route ourselves and we understand why things must change and change for the better.

Speaking exclusively to the Cape Times, Motlanthe said that overcrowding was the biggest challenge and that it amounted to an overhaul of the criminal justice system. ‘€œWe need to look at prevention and find ways to deter people from ending up in prisons in the first place. I believe that if as a start we treat home invasions and crime in people’€™s homes as the most serious offences, we will go a long way towards reducing the high levels of criminal offences.’€

Inmates who later addressed an attentive Motlanthe spoke of a range of challenges including poor nutrition, lack of exercise, drug stock outs, poor access to doctors and a lack of regular TB screening.

Motsoaledi announced new TB guidelines for prisons, which includes the roll-out of the Gene Xpert machine, a rapid TB diagnostic, which can cut down a two week diagnosis to two hours.

He said the goal was to interview every inmate, referring those with suspicious symptoms for sputum tests and x-rays based on their responses to a set of questions.

The plan is to screen every new inmate as they arrive as well as current prisoners.

Professor Robin Wood of the University of Cape Town has modeled how the conditions of detention at Pollsmoor affect TB transmission. Wood and colleagues showed that conditions in the prison are ideal for the spread of TB, including drug-resistant strains, and result in transmission risks of a staggering 90% per annum. This means that if 100 people go into Pollsmoor prison for a year, 90 are likely to contract TB.

Some communal cells at Pollsmoor are at 200% occupancy with between 40 and 60 men crowded on top of one another in each unit for up to 23 hours.

The cells are often filthy and ventilation poor.

Wood has identified a number of simple ways to improve conditions including opening cell ventilator grills, using barred instead of solid doors, letting prisoners outside for longer periods, testing inmates when they first arrive at Pollsmoor and actively seeking out and treating inmates with TB.

The Treatment Action Campaign held a protest at the Pollsmoor gates and handed over a memorandum praising the government action, but called for more urgency.

‘€œWe must ensure that systemic problems like overcrowding, lock-up time, and unfilled nurse and doctor positions be resolved,’€ said TAC general secretary Vuyiseka Dubula.

Read the Deputy President’s address here:http://www.thepresidency.gov.za/pebble.asp?relid=15108