Being pregnant, HIV-positive or having a baby is not strange in the women’s wing of Luzira Prison. Petride Mudoola brings you the story of Harriet Nandudu, who is HIV-positive, pregnant and a mother of a one-year-old son
Women prisoners who are brought in pregnant, give birth and breastfeed their babies behind the prison walls. Others who turn up HIV-positive are guided and sustained on positive-living practices (including provision of ARVs).
Those with little children, are looked after by Family of Africa, an NGO that accommodates children living with mothers in prison.
However, picture a scenario where one person shoulders the burden of all the above. That is Harriet Nandudu’s situation. The 20-year-old is HIV-positive, pregnant and lives with her one-year-old son inside Luzira Prison.
Nandudu is serving a one-year jail term that ends in August, after her arrest last year in Nakasongola. She was charged with stealing a mobile phone.
She denied the charges and after being proved guilty, she was given a stiffer jail sentence after she escaped the first time she was arrested, according to her file. Nandudu was incarcerated together with her son, who was less than a year old and the child’s father did not know that she was arrested and taken to Luzira. To compound matters, she was pregnant with another man’s child.
Nandudu’s son is among the 29 children living with their mothers in Luzira. He lives with Family of Africa since children above one year old are restricted from staying inside the prison, but are allowed entry on visitation days. Younger infants are allowed to live with their mothers for bonding purposes.
Nandudu has had no visitors since she was arrested. She lost her father and mother at a tender age and her only relatives are in Bududa, although none of them has ever visited her in jail for lack of knowledge about her whereabouts.
“I feel rejected since I have no one to turn to. I will not be able to get baby clothes when I give birth because I was arrested before preparing for delivery and did not expect detention,” she laments.
Soon after she was imprisoned, Nandudu discovered that she was HIV-positive. Prisoners are tested for HIV upon admission and it was only then that Nandudu discovered this other dimension to her woes.
She says she was shocked to find that she was HIV-positive, having tested negative when she gave birth to her first son. It took a lot of counselling from prison warders and the promise of anti-retroviral treatment for her to accept her new challenge.
Nandudu says she used to feel dizzy when she had just started the anti-retroviral therapy because of taking medicine on an empty stomach. When she explained the problem to the medical superintendent, the head of the women’s prison referred her to the sick bay for special attention. Nandudu says her condition has improved since.
Besides medication, she is given the opportunity to share a supplementary diet with mothers who are on post-natal treatment. Dressed in the loose yellow gown that is a standard uniform for female prisoners, Nandudu rests in the sick bay as she awaits her delivery day.
The Uganda Prisons Service currently has between 20 and 25 expectant mothers in custody in its 21 women detention facilities countrywide.
Luzira Women’s Prison has the biggest number, with five women who might give birth in jail, according to Frank Baine, the prison’s publicist.
He, however, says the population of expectant mothers in custody is not static because while some of them are convicts, others are still on remand, noting that prison admits and discharges prisoners.
Members of the public assume that female inmates are impregnated by male prison warders while in custody, but Baine refutes such claims.
“On admission, prisoners are separated according to sex and female inmates are exclusively watched by female staff. The male warders only come in as watchmen outside prison. They do not have access to the female prisoners,” Baine explains.
He clarifies that expectant mothers happen to be in prison because the law does not exempt them from arrest. While arresting wrongdoers, law enforcement officers look out for a person who has committed an offence. They do not care whether a woman is pregnant or not,” he says.
Baine could not readily establish the specific amount of money allocated to cater for expectant mothers in prison. However, when it comes to HIV care, sh70m is budgeted for the support of HIV-positive prisoners countrywide.
He says although there is no budgetary allocation for this category of people, the imprest of the officers-in-charge of the women prisons is enhanced to ensure that the women get the basic needs, since mothers are regarded as a special group.
Inmate mothers waiting for post natal care within Luzira Women Prison maternity ward recently
Meeting the medical needs
The director of Prison Health Services, Dr. Michael Nswemu Kaggwa, says all male inmates are subjected to HIV/AIDS testing, while female inmates undergo HIV and pregnancy tests upon admission.
Kaggwa says incase an inmate is found HIV-positive, they are started on anti-retroviral therapy. Expectant mothers who are positive get prevention of mother-to-child transmission of HIV option B-plus.
After delivery, the child is given anti-retroviral therapy to prevent it from getting infected. The baby is then removed from exclusive breastfeeding and given cow milk.
According to research carried out by the Uganda AIDS Commission, findings indicate that HIV prevalence among inmates was higher, standing at 11.2%, almost twice higher than the 6.4% national average.
“Uganda’s prisons have over 2,000 HIV-positive prisoners. 350 inmates living with HIV are in Luzira Prison and of these, 178 are currently on ARVs,” Kaggwa says.
The medical supritendant of Murchison Bay Inmate’s Hospital, Dr. Joseph Andama, says mothers who are due to give birth are admitted to the sick bay and referred to the staff clinic when they experience labour pains.
“Delivery is carried out within the staff clinic, but incase a mother develops complications, with the assistance of female warders, she is put in an ambulance and referred to Mulago Hospital for further management,” Andama says.
While in hospital, the mother is guarded with adequate security until she is discharged and taken back to prison.
Andama says discharging the mother from the hospital to the prison depends on her condition.
Discharge from hospital
The personnel must ensure that both the mother and child are in good condition before handing them over to the prison medical team.
Upon receiving the mother back into the prison hospital, she is admitted for post-natal treatment administered by the health team until she heals and is later discharged to the cells to continue serving her sentence.
After six months, the baby is given cow milk obtained from prison farms, while the mother is given psychosocial support from authorities and members of her family. She is provided with a supplementary diet that includes potatoes, vegetables, fruits and eggs.
Andama clarifies that the hospital has not recorded any prisoner’s baby infected with HIV during delivery, but one or two babies who seek health services from the prison hospital have been found to be HIV-positive.
A prison official assists an inmate to breastfeed her baby
Neglected mothers and babies
For most women who come to prison pregnant, or with young babies, there is hardly any help from their spouses. Child neglect is one of the challenges that the women prisons section faces, as the mothers are neglected by their husbands while in detention, thus transferring the burden to the state.
“Many husbands do not want to associate with women involved in crime. As a result, they desert them upon realising that their partners have been detained, hence leaving all the responsibility to prison authorities,” Stella Nabunya, the officer in charge of Luzira Women’s Prison observes, adding that they may try to convince the husbands to take care of their wives and the innocent children, but most times, nothing comes of their efforts.
“Prisons Department caters for the child by providing it with a baby shawl and clothing to ensure it gets warmth and attention that befits a newborn,” Nabunya explains.
Nabunya notes that most of the items given to these children are donated by non-government organisations which visit the detention facility.