By Petride Mudoola
Donning the striped, bright yellow uniform for prisons and grey sandals, Sunday Kamuhanda passes for an ordinary inmate at Katojo Prison in Fort Portal.
However, a closer look and interrogation will reveal something odd about this 50-year-old. His speech is jumbled up. Sometimes he becomes so aggressive that the prison warders isolate him.
Kamuhanda was arrested and imprisoned for murder in December 1991. However, the prisons warders noticed something odd about his behaviour.
He was subjected to psychiatric examinations at Butabika National Referral Mental Hospital and results showed he was mentally ill.
Under Uganda’s laws, Kamuhanda should have been taken for treatment at a psychiatric facility and thereafter released. In 1994, Kamuhanda was committed, pending the minister of justice’s orders after the medical examination.
However, his release can only be effected on the written orders of the minister of justice. Twenty-three years down the road, the order is yet to be issued. Many people like Kamuhanda are languishing in jail.
Information from prisons authorities shows there are currently 30 mentally ill inmates at the 224 detention facilities in the country.
Handling a mentally ill prisoner To keep him calm, Kamuhanda is put on medication usually administered to aggressive persons with mental illness. As a result of being on the drugs for a long time, he has developed severe side effects such as a distended stomach and face.
Although he looks uneasy in the presence of strangers, Kamuhanda relates well with fellow prisoners and prison officers.
Although Kamuhanda was not aggressive, he stared at me for a long time without blinking. This scared me, but the prisons authorities assured me that he was not violent.
He looked scared and wondered why I wanted to talk to him. He insisted on knowing who I was and what I wanted from him.
“Ninyenda kugaruka omuka. Ninihira ontabalire. Ninyenda kuruga omunkomo. Njwahire kwikara omunkomo. Ninyenda kurora omwana wange (I want to go back home. I hope you have come for me. I want to leave. I am tired of this place. I want to see my child),” he lamented.
Julius Oraije, the officer in charge of Katojo Prison, says Kamuhanda is always demanding to be allowed to go home. Kamuhanda claims he has a son or daughter whom he has not seen for the last 23 years.
Oraije, however, says the prison has no clear information on whether or not the child exists since none of Kamuhanda’s relatives has ever visited him ever since he was incarcerated.
Prisons no place for mentally ill
According to Dr. David Basangwa, a senior consultant psychiatrist at Butabika Hospital, prisons are the worst place to keep patients who are mentally ill.
“Prisons are dangerous and damaging places for the mentally ill,” he explains. Dr. Joseph Andama, the medical superintendent, Murchison Bay Inmates’ Hospital Luzira, says they lack a resident psychiatrist and depend on Butabika Hospital.
Although other prisoners commit crime while already mentally ill, Andama says some end up with a mental breakdown because of the sentences meted out to them.
“Sentences such as death and life have a negative impact, especially if the person has not been counselled,” Andama observes.
A senior consultant psychiatrist says a prison should not be a place for mentally ill patients
The Uganda Prisons service spokesman, Frank Baine, says there are no funds given to them to cater for mentally ill inmates.
“We are, therefore, forced to incur protection and other appropriate activities for mentally ill offenders,” he says.
Baine adds: “Our staff end up doing the work they are not professionally trained to handle yet prisons were designed as correctional facilities and not for provision of mental health care.”
He notes that keeping the mentally ill offenders in prison is challenging since many of them do not know why they are under custody.
“Sometimes they become violent and can easily harm the staff or their fellow prisoners yet prison lacks space to isolate them.”
The prisons spokesman calls for amendments to the Mental Treatment Act to ensure that those responsible for pardoning the mentally sick prisoners do so in time.
He notes that this will decongest prisons hence reducing the costs the Government incurs while taking care of prisoners.
“Amendments to the Act should articulate the period for pardon or trial of the mentally ill offenders.”
Baine observes that criminal justice policies towards mentally ill offenders are unjust because over time, they (offenders) have even not been considered for pardon. As such, they end up serving much longer sentences than they should have.
“Prison’s authority has regularly submitted this matter to the minister for consideration, but little action has been taken,” he says.
According to Baine, the minister last exercised his powers in 2012 when he released 17 juveniles. However, the mentally ill were not considered.
Odoki’s promise that never was
Last year when then-Chief Justice, Benjamin Odoki, visited Katojo Prison, Kamuhanda’s long detention was brought to his attention in a memorandum presented by the inmates.
Odoki reportedly expressed shock at the incident.
“Why are mentally ill prisoners here yet they are meant to be in a mental facility to access better care and treatment?” he reportedly queried.
Odoki is said to have promised to bring the issue to the attention of the Minister of Justice and Constitutional Affairs
When contacted, justice minister Maj. Gen. Kahinda Otafiire said neither Kamuhanda’s issue nor that of any mentally ill prisoners requesting judgment had been brought to his attention.
Justice minister Maj. Gen. Kahinda Otafiire
“You said there is a prisoner in Katojo Prison who has spent 23 years waiting for my orders?” he asked.
“That cannot be true. I have not received any names requesting for my orders, but thank you for bringing this matter to my attention,” he added.
Otafiire vowed to investigate the case and thereafter take appropriate action.
UGANDA’S LAWS: Mentally unstable offenders are not supposed to be jailed
The Prison’s Act stipulates that mentally unstable persons shall not be detained in prison, but referred to a psychiatric hospital for treatment.
The Magistrates Act sentencing guidelines also stipulate that once a person is confirmed to be mentally ill, the decision for his/her judgment shall be determined by the Minister of Justice and Constitutional Affairs.
The Act mandates the minister to make judgment for the mentally disturbed inmates and child offenders. The Uganda Prisons service spokesperson, Frank Baine, says they are stuck with mentally ill inmates because the facility at Butabika Hospital meant to accommodate them was phased out by the Ministry of Health.
Dr. Asuman Lukwago, the health ministry permanent secretary, says the unit was phased out because the local communities accessing medical services at Butabika used to stigmatise the prisoners.
Lukwago could, however, not readily establish when the facility would be reestablished
State of mental illness in Uganda
Dr. David Basangwa, a senior consultant psychiatrist at Butabika Hospital, says of Uganda’s population of 35 million, up to 35% (11.5 million) suffer from different psychiatric disorders. Of these, 15% (about fi ve million people) require immediate treatment from mental health units.
Basangwa says currently, mental cases constitute 12% of the global disease burden and are projected to reach 15% by the year 2020.
However, barely half of these people seek medical attention from health centres because people associate mental illness with witchcraft.