July 14, 2011

III. Addressing the Causes of Poor Health in Uganda’s Prisons

Criminal Justice Failures

Prolonged Pretrial Detention

Last time I was in court was October 31, 2002, when I was committed…. Can you help me find my way to court?
—Edward, a prisoner awaiting resolution of his case for almost nine years, Muinaina Farm Prison, March 4, 2011

The heavy backlog in the criminal justice system results in overcrowding in prisons,[348] and prolonged periods of time on remand have adverse effects on prisoner health. Despite international legal requirements that pretrial detention be “an exception and as short as possible,”[349] in Uganda, suspects may wait in prison for years for their trials to be resolved. Fifty-six percent of all inmates are on remand, incarcerated awaiting resolution of their case.[350] The average wait is estimated at one year and three months for capital offences, such as defilement,[351] murder, aggravated robbery, rape, and treason.[352] The average wait for lesser offences, such as assault and theft, is three months.[353]

Table 6: Months in Detention for Remand Prisoners Interviewed

As a first step upon arrest, international and regional law provide for the right to be brought before a judge, and to be charged or released.[354] Under Ugandan law, a suspect must be charged by a court within 48 hours of arrest.[355] Yet, 85 percent of prisoners interviewed by Human Rights Watch had not been brought before a court for an initial appearance within 48 hours, and prisoners reported having waited significantly longer.[356]

Table 7: Interviewed Prisoners’ Appearance before a Judge or Magistrate

Human Rights Watch researchers spoke to seven individuals who had been awaiting resolution of their cases for over five years,[357] and seven prisoners who said they had not set foot in a courtroom in over two years.[358] The remand prisoners that Human Rights Watch interviewed had been awaiting resolution of their cases for a median of five months and mean of 15 months. Prisoners find themselves in a position of deciding whether it will be faster to plead guilty and serve a sentence than to plead not guilty and await trial, later to be found innocent. Several described pleading guilty in order to hasten their release.[359]

Long remand times result from several problems within the judicial system, all of which contribute to large prison populations.[360] An insufficient number of judges has led to too few court sessions.[361] In Mubende district, where the High Court sits for only two months a year, the lack of a High Court judge has led to average remand periods of five years at Muinaina Prison.[362] Despite constitutional guarantees of a speedy trial,[363] prisoners languish in detention for long after their cases have been committed to the High Court for trial before any trial begins,[364] and partially heard trials continue indefinitely without complainants or witnesses appearing in court. Prisoners said their trials adjourned repeatedly without any progress.[365] Ekanya said, “I have been to court 16 times…. There is no evidence during trial. The complainant hasn’t come to court. I stand up, then they say go back. Then they say come back on such-and-such a date.”[366] Civilian cases in the military court system trying gun crimes—in itself a violation of international law—progress particularly slowly, given the court’s few sessions.[367]

The Justice Law and Order Sector (JLOS), a group of government bodies including the judiciary, police, prisons, prosecution, Uganda Human Rights Commission, Ministry of Justice and Constitutional Affairs, Ministry of Internal Affairs, and international donors, has been concentrating its efforts through a “Case Backlog Quick Wins” project to reduce the case backlog, particularly by weeding out non-meritorious cases lacking evidence during investigations, appointing more judges, and holding more court sessions, resulting in the clearing of 80,000 cases between March 2010 and March 2011.[368] However, the number of new cases continues to outpace the clearing of old ones, and the backlog continues to grow at 8.5 percent per year.[369]

While the Ugandan constitution provides for a right to bail, few defendants have the opportunity to request bail, increasing the burden on the prison system.[370] In non-capital cases, suspects can represent themselves and orally request bail at magistrate’s court.[371] Suspects in serious cases, meanwhile, can be detained for an indeterminate period of time until their case is sent, or “committed,” to the High Court for trial.[372] During this time, defendants who are unable to afford a private lawyer are effectively prevented from exercising their right to bail because they are brought before a magistrate’s court first, which does not have jurisdiction over the case and therefore cannot hear a bail application. A suspect can apply for bail before the High Court, a complex process often requiring legal help which is prohibitively expensive for most defendants.[373] However, it must be noted that a recent proposal by Ugandan President Museveni, if enacted, would amend the constitution to eliminate bail entirely for suspects accused of crimes including rioting and economic sabotage, in addition to rape and murder.[374]

Only six percent of all prisoners interviewed by Human Rights Watch had ever been released on bail. Seventy-four percent of prisoners interviewed said that they were never offered bail. Eighteen percent said that they were given the option of bail but were unable to afford cash bonds or to post sureties.[375]

Judges also interpret the constitutional provisions on bail as allowing them to impose a mandatory period of detention on remand before bail applications can be heard.[376] Numerous prisoners told Human Rights Watch that magistrates had informed them they were not entitled to apply for bail until they served a minimum period of time on remand.[377] One prisoner who had been on remand for a year and four months was told he had not spent enough time on remand to qualify for bail.[378] Prisoners complained of corruption in the bail system, either through the payment of bail money which did not result in bail or which was never returned to them.[379]

A lack of legal representation also contributes to prison congestion. For serious offences punishable by death or life imprisonment, the state must provide legal representation in courts (referred to as “state brief” lawyers).[380] However, Ugandan law does not specifically stipulate when in the process the right adheres, and in practice suspects rarely meet with their lawyers until the commencement of trial.[381] A handful of nongovernmental organizations provide legal advice in prisons, but their reach is usually constrained to large prisons near larger towns.[382] JLOS’s development partners have found “most disappointing…the continued delays in the development of a legal aid policy.”[383]

Without lawyers, individuals are unable to advocate for bail, request dismissal on the basis of lack of evidence or advocate for a reduced or non-custodial sentence.[384] International standards mandate that people who are charged with a criminal offence be informed of their right to have access to a lawyer.[385] However, only 21 percent of defendants interviewed by Human Rights Watch had been represented by a lawyer. More than three quarters (79 percent) of prisoners who ever had a lawyer had been represented by a government state brief lawyer, and those who did have a state brief lawyer only met the lawyer at trial. Prisoners often said they tried to speak for themselves in court, only to be told by the judge or magistrate they were not allowed to do so.[386]

Corruption in the criminal justice system, particularly bribery and extraction of fees for free services, is reportedly widespread,[387] leading JLOS’s development partners to state they were “disappointed by the lack of meaningful progress in implementing a sector anti-corruption strategy.”[388] Numerous prisoners told stories of rampant corruption throughout the justice system, starting from the time of arrest through trial, eroding their trust in the system to process their cases with good faith or any measure of speed.[389]

Unnecessary and extended pretrial detention imposes significant financial costs on the government, and savings could be generated by increasing the option of bail instead of pretrial detention, freeing up money for crucial social services.[390]

Detention Following Conviction

For defendants who have been convicted of some lesser crimes, community service as a non-custodial option exists, and, in 2010, 11,000 cases were granted community service options.[391] JLOS reported that “[t]he public now support community service as punishment and appreciate its impact in reducing the rates of recidivism.”[392] However, the commissioner of community service stated that the success of his program depended heavily on “the personality of the magistrate” and his or her willingness to use it as a sentencing option.[393] Two prisoners told Human Rights Watch that they were advised by a member of the community service program to plead guilty and ask for the option, only to be later sentenced to prison time instead, when the prosecution and magistrate failed to agree.[394] Hassan said,

After some hundred days, while I was appearing in court, someone came in and advised me that if I accept the case, the sentence will be minimized with a community service agreement. It was a lady from a project related to community service….I admitted, was sentenced, but later realized I had made a mistake because I did not do the crime. That lady talked to all of us, but I was the first to appear. When I was sentenced, the others refused to say they were guilty. She was not a lawyer, but she had assisted others who were being released. She told us she had talked to the magistrate, perused our files, and was conversant with the case and the evidence.[395]

For prisoners who have been convicted and sentenced to a custodial term, there is no parole system in Uganda.[396]

Under international law, everyone convicted of a crime has the right to have his conviction and sentence reviewed by a higher tribunal according to law.[397] However, numerous prisoners described filing an appeal and hearing nothing in response, despite waiting for years.[398] A paralegal working with prisoners said, “No response to appeal?—that’s just a lack of follow up. People with money to get legal representation get justice.”[399]

Detention of Children

Sometimes, children are also detained with adults in Ugandan prisons. Human Rights Watch found six people who said they were children currently being detained with adults in three different prisons, in addition to four young adults who said they had been detained in adult prisons since they were under 18.[400] Detention of children with adults is prohibited under Ugandan and international law[401] and carries severe risks for children, including the potential for violence and sexual abuse.

Determining a child’s age is not a straightforward matter in Uganda. Fewer than four percent of children have a birth certificate despite the state’s obligation to register births.[402] Ascertaining age is an arbitrary process, either based on appearance or inspection of teeth. Because of the logistical difficulties in handling children, police often inflate their ages.[403] Only one of the children interviewed by Human Rights Watch was ever given the opportunity to present evidence of her age.[404] When Human Rights Watch raised concerns about the ages of two prisoners remanded at Bubukwanga Prison with the magistrate, the children were released when they were produced before court, which agreed that they were under age 18.

Prisons Service Failures of Management and Health Services

The Role of Prison Officers in Denying and Delaying Care

When you want to go to the hospital, you tell the wardress. But for the time I have been here, I have never seen any person taken to hospital. It is so close, but the wardress just gives us panadol. When you tell them you want to go to hospital, they just beat you. They say, “Is this a hospital?”
—Nathan, November 12, Muduuma Prison, 2010

Prison wardens and officers in charge play a direct role in denying or delaying prisoners’ access to appropriate medical care.

Ugandan law provides that the OC, on the advice of the medical officer, may order a prisoner to a hospital.[405] As of March 2011, only 63 of Uganda’s 223 prisons had any on-site healthcare worker, covering an estimated 17,741 prisoners at upcountry units and 4,500 at the Luzira complex.[406] But for those at prisons without medical facilities or for those with more serious ailments that could not be dealt with at their prison health unit, prisoners across facilities repeatedly described that prison wardens act as gatekeepers. Wardens denied or delayed inmates’ access to community medical facilities because of suspicions that prisoners were using ill health as an excuse not to engage in forced labor, as a pretext for escape,[407] or for more malicious motivations: Mary, a pregnant inmate at Jinja Women’s Prison, was not allowed to return to the doctor after the doctor told wardens that their beating had “dislocated her pregnancy.”[408]

Delays sometimes last up to a month[409] before wardens will accompany a prisoner to care and at some prisons, access to outside facilities was denied entirely.[410] The prison medical authority acknowledged: “It is so amazing, a health facility which could be 100 meters away from a prison is not accessed by the prisoners. Those things happen. Some of them, it is a lack of responsibility. Why should you deny me to walk 100 meters away?”[411]

In practice, even when medical personnel are present at the prison and do recommend that a prisoner be allowed out to access medical care, a non-medical officer may well override the recommendation of his or her medical colleagues. A medical officer told Human Rights Watch that at the time of the year when Ramadan and Christmas are being celebrated, the escape rate is higher and “they [the wardens] argue with us to reduce the rate of referral.”[412] The prison medical authority admits that there is little integration between medical and non-medical workers and a “lack of sense of ownership of the responsibility and mandate over healthcare issues” exists on the part of OCs.[413]

Prisoners reported that in the time they had waited for medical care, their conditions had deteriorated significantly. Esther said her baby’s fingers had to be amputated because of the delay in allowing her go to the nearby hospital.[414] Prisoners even claimed that deaths occurred as a result of delayed access to outside facilities, claims that could not be independently verified by Human Rights Watch. At Masaka Main Prison, prisoners reported the recent death of an HIV-positive prisoner who had requested care and was taken to the prison-based clinic, only to be refused access to the community hospital and taken back to the ward, where he died.[415] As Peter recounted:

He spent the whole day requesting to go to hospital. He said if he was to die, let him die in hospital. But the guards refused to take him. They knew he was suffering from HIV. Late in the evening, they locked us in the wards. A few minutes later, [he] fell and died. The guards were saying, “You’re afraid of going to court, so you want to go to hospital and escape from there.”[416]

The prison death register confirmed the death in September 2010 from “HIV stage 4 with psychosis” with the cause of death listed as “multiple organ failure.”[417]

Prisoners falling seriously ill in the night are sometimes denied immediate access to care, and have to wait until the following day,[418] including female prisoners experiencing labor pains at night. [419] Inmates reported that, during the nighttime, they had seen their colleagues die,[420] claims Human Rights Watch could not fully verify. Mafabi, at Butuntumura Prison, said: “In September, there was a prisoner who died in full view. He fell sick at night, and we called the wardens, who said ‘wait until tomorrow.’ During morning parade, they carried him out and put him on the ground.”[421] Inmates forced to watch their fellow prisoners suffer in the night said that they tried to treat them with whatever medications they had available.[422]

Prisoners were sometimes not allowed to receive medicines purchased by family and friends on the outside, even when the prison was unable to provide them with appropriate medications.[423] The prison medical authority claims that prisoners are allowed to bring in drugs if the health workers are in contact with their relatives. However, where there are no health workers, “I don’t know what happens there.”[424]

Prisoners with serious ailments also reported they have been denied or delayed access to Murchison Bay or regional prison health referral facilities. Prisoners reported that they or their colleagues waited up to six months[425] for transfer. While admittedly transport unavailability is a challenge,[426] upcountry officers’ incompetence or malice in delaying or denying referrals to prison referral facilities are also to blame for the poor health outcomes.[427] During the time waiting for transfer, a prisoner reported that his head was oozing pus,[428] another that his skin was “peeling off,”[429] another that he was in such terrible pain he was not able to sleep or eat properly,[430] and another that he was unable to walk or move.[431] Medical workers confirmed that in some cases delayed referrals lead to death on arrival at Murchison Bay: “Absolutely we have had delays…and when they occur, they are inappropriate. When he reaches here, and is declared dead, it is not a surprise.”[432]

Once ill prisoners have reached a facility where they can receive treatment, though, they cannot rely on or expect continuous or consistent access to it. It is common practice to transfer sick inmates to upcountry prisons despite there being no healthcare facilities. Coordinating the transfer of prisoners is the mandate of recipient OCs—at Murchison Bay or regional centers—to ease congestion or facilitate work, and is conducted without consultation of trained health workers. The prison medical authority concluded, “You end up having sick people transferred from a facility that offers service to the prisoners for years to an area without. How inhuman can you be?”[433]

Failures in the Delivery of Prison Health Services

To its credit, the UPS has made a marked effort to improve prison medical care in recent years, particularly at the large facilities in regional centers. Yet major gaps remain. At rural, former local administration prisons, often no medical care is available. The deputy OC at Bubukwanga Prison said the prison had no medical staff, no medicines, and no idea who was sick.[434] A medical officer at Masaka Prison noted that, while regional units had supervisory duties over lower units, because of limited funds, “those that are far, we don’t go there. In the faraway units, healthcare is poor.”[435] Only panadol and other basic painkillers, dispensed by the officers, were sometimes available (but quickly exhausted[436]).

Even at prisons with associated medical facilities, obtaining care is far from a sure thing. Health infrastructure at most clinics is “dilapidated” or “make shift” and aside from Murchison Bay, only three of ten regional referral health units even have lab services.[437] X-ray and CD4 count facilities are currently lacking at the regional level,[438] and Murchison Bay lacks an adequate operating theater.[439]

Adequate staffing is a major challenge. At all facility levels, though significant improvements have been made,[440] human resources for health fall far short of the prisons service’s stated needs.[441] UPS employs only six physicians (none of them at upcountry units).[442] Prisoners contend that health staff frequently do not see those who come to them for treatment.[443] Ali, at Murchison Bay Prison, lamented, “The doctors are nowhere to be seen.”[444]

Prisoners at prisons with associated health units told Human Rights Watch that the medicines they needed were frequently unavailable[445] or only partially provided.[446] “You get half-treatment,” Yusuf, at Murchison Bay, concluded.[447] Prison authorities confirmed that problems remain with inadequate access to medications for prisoners, particularly in prisons outside of Kampala.[448] UPS has concluded that the number of health units reporting stock outs of essential medications remains high for reasons including low per capita expenditure.[449] Access to supplies at upcountry medical units from the national drug stores via neighboring Ministry of Health facilities has also “failed.”[450] Uganda’s auditor general has concluded that UPS provision of free medical services to non-prisoners in neighboring communities has a significant negative effect on the resources available for prison health and should be halted.[451]

Funding for referral services is also inadequate.[452] Some prisoners said that, despite the fact that all medical services are to be offered free of charge,[453] when they are taken to Mulago public hospital in Kampala for specialized medical care they are asked for money and denied treatment when unable to pay.[454] The OC at Murchison Bay acknowledged delays in prisoner treatment at Mulago because of the process for funding approval: “By the time they are worked on, it is not even meaningful.”[455]

Donor Funding to Ugandan Health and Prisons

Uganda is a recipient of significant international donor aid, particularly for health. In 2009, Uganda received over US$1.7 billion in bilateral and multilateral donor aid.[456] Health-related, and particularly HIV-related, donor funding to Uganda has been led by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). In FY2010, PEPFAR gave over $280 million to Uganda for AIDS relief,[457] with disbursements from 2004 to July 2010 totaling $1.4 billion.[458] The United States (US) contributes approximately 70 percent of all funding for HIV/AIDS activities in Uganda.[459] In 2007, 93 percent of Uganda’s funding for HIV came from international bilaterals; in 2008 they contributed 83 percent.[460]

However, little funding has been donated to prisons. Total donor funding between FY 2005/06 and FY 2008/09 for UPS fell from 2.11 billion shillings (approximately $875,000) to 0.72 (approximately $300,000), just 1.5 percent of the total prison budget for that year.[461]

While some donor initiatives have been executed or planned for health in Ugandan prisons, their scope is minimal compared to overall health funding to Uganda and given the high rates of HIV and TB infection among the prison population. According to Uganda AIDS Commission estimates, approximately $28 million would have been required to fund comprehensive HIV/AIDS interventions in Uganda Prisons and Police Services from 2007/2008 to 2011/2012; however, actual contributions from external partners totaled only one percent of this amount, and pledges approximately 10 percent.[462] Prison authorities have noted the need for increased funding to fight both HIV and TB.[463]

Officially, UPS’ health division has a number of partners,[464] but undoubtedly the largest monetary contributors are the International Committee of the Red Cross and the U.S. Centers for Disease Control and Prevention (CDC)/PEPFAR. The ICRC has helped to improve water and sanitation and has upgraded HIV, TB, and malaria services at Fort Portal, Luzira Upper, and Gulu Prisons;[465] their support has been extended for two years at $70,000 per year.[466] The CDC has made a five-year commitment to the prisons, between 2009 and 2014, of US$1.6 million, but less than half of the money from the first two years has been absorbed by the UPS because of a delay in the process of creating the prevalence and risk behavior survey on which interventions will be based.[467] Between the ICRC and CDC projects, the UPS should, in theory, receive monetary donor contributions of $390,000 for health over the government-provided budget.[468]

[348] See, e.g., UPS, “Summary of UPS Prisoners Statistical Returns”; Uganda Human Rights Commission, “12th Annual Report,” p. 24.

[349] ICCPR, art. 9. See also UN Human Rights Committee, General Comment No. 8 on the International Covenant on Civil and Political Rights, Article 9, U.N. Doc. A/40/40 (1982). The UN Human Rights Committee has made clear that detention before trial should be used only to the extent that it is lawful, reasonable, and necessary. Necessity is defined narrowly: “to prevent flight, interference with evidence or the recurrence of crime” or “where the person concerned constitutes a clear and serious threat to society which cannot be contained in any other manner.” UN Human Rights Committee, Hugo van Alphen v. the Netherlands, Communication No. 305/1988 (1990), para. 5.8. International standards provide that except in special cases, a person detained on a criminal charge shall be entitled to release pending trial subject to certain conditions. Body of Principles, prins 38-39; United Nations Standard Minimum Rules for Non-custodial Measures (“The Tokyo Rules”), adopted December 14, 1990, G.A. Res. 45/110, annex, 45 U.N. GAOR Supp. (No. 49A) at 197, U.N. Doc. A/45/49 (1990), paras. 6.1-6.2 (“Pretrial detention shall be used as a means of last resort in criminal proceedings.”); Martin Schönteich, “Pretrial Detention and Human Rights in Africa,” in Jeremy Sarkin, ed., Human Rights in African Prisons, (Cape Town: HSRC Press, 2008), pp. 93-116.

[350] UPS, “Summary of UPS Statistical Returns.”

[351] Defilement, defined as “a sexual act with another person who is below the age of eighteen years,” accounts for roughly a third of all capital cases in prisons. There is a wide literature on the use of the crime as a means of extracting civil redress for families, often in instances of consensual relationships. Penal Code Amendment Act of 2007, sec. 2. UPS, “Census of Prisoners in 48 Central Government Prisons,” September 30, 2007. In 2008, due to the high number of defilement cases, the law was amended to allow magistrate’s courts as well as High Courts to hear such cases.

[352] Chief Justice of Uganda Benjamin Odoki, “Speech at the Case Backlog Review,” March 7, 2011. Capital offences must be heard by a High Court, while lesser offences can be heard by either a magistrate’s court or High Court.

[353] Justice Law and Order Sector, “Annual Performance Report,” September 2010.

[354] ICCPR, art. 9; Body of Principles, prins. 10, 11 and 37. See also, African Charter, art. 7. The African Commission on Human and Peoples’ Rights has determined that detaining two applicants, for, respectively, five months and slightly over one month without being brought before a judge violated Charter’s protections on fair trial. African Commission on Human and Peoples’ Rights, Huri-Laws v. Nigeria, Comm. No. 225/98 (2000), http://www1.umn.edu/humanrts/africa/comcases/225-98.html (accessed March 4, 2010).

[355] Constitution of Uganda, art. 23 (4); Uganda Prisons Service, “Census of Prisoners in 48 Central Government Prisons.”

[356] UPS in 2007 said that of inmates in the central region, where adherence to law is usually best in the country, 70 percent were not taken within this 48-hour period. UPS, “Census of Prisoners in 48 Central Government Prisons.” Only 15 percent prisoners Human Rights Watch surveyed were taken to court within this time period. The vast majority stay in police stations for long periods of times—in some cases up to several months—without understanding the charges against them and in overcrowded cells without water or bathing facilities, in some instances without even being allowed to contact relatives. Human Rights Watch interviews with Roger, Masaka Ssaza Prison, November 22, 2011; Ross, Masafu Prison, March 8, 2011; Kenneth, Masafu Prison, March 8, 2011; Benjamin, Masafu Prison, March 8, 2011; Lucas, 17, Masafu Prison, March 8, 2011; Obua, Masaka Prison, March 23, 2010; Byamukama, Masaka Ssaza Prison, November 22, 2010.

[357] Human Rights Watch interviews with Sebastian, November 8, 2010; Winifred, November 10, 2010; Asuman, Luzira Upper, November 10, 2010; Edward, Muinaina Prison, March 4, 2011; Tobias, Muinaina Prison, March 4, 2011; Michael, Muinaina Prison, March 4, 2011; Bradley, Muinaina Prison, March 3, 2011.

[358] Human Rights Watch interviews with Edgar, Murchison Bay, May 13, 2011; Henry, Murchison Bay, November 20, 2011; Hugh, Jinja Main Prison, March 1, 2011; Edward, Muinaina Prison, March 4, 2011; Edmund, Muinaina Prison, March 4, 2011; Eric, Muinaina Prison, March 3, 2011; Mark, Muinaina Prison, March 4, 2011.

[359] Human Rights Watch interviews Jonathan, Masaka Ssaza Prison, November 22, 2010; Moses, Kitalya Prison, February 28, 2011; Ibrahim, Kitalya Prison, February 28, 2011; Pius, Muinaina Prison, March 03, 2011; Duncan, Muinaina Prison, March 4, 2011; William, Muinaina Prison, March 4, 2011

[360] A recent study of over 2,000 remand detainee records documented that in 32 percent of cases examined, capital detainees had been detained over 180 days prior to committal, and non-capital detainees had been detained for over 60 days before commencement of trial. That study attributed long remand times to issues including unlawful arrests by a multitude of overlapping security forces, a shortage of judges and magistrates, lack of legal representation, poor trial administration, and ineffective investigation practices. Avocats Sans Frontieres and University of Toronto International Human Rights Program, “Presumed Innocent, Behind Bars: The Problem of Lengthy Pretrial Detention in Uganda,” 2011. Furthermore, Uganda’s auditor general has noted that, among almost 40,000 criminal cases handled between July 2006 and June 2010, only 18 percent had been completed within 12 months, the maximum target for completion of capital cases. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report on Disposing of Cases in the Judiciary,” March 2011, p. 19 (citing the Judiciary Staff Handbook, p. 56).The auditor general attributed long remand times to a combination of problematic court procedures, inadequate infrastructure , low staffing levels, and lack of monitoring and evaluation of the judiciary. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report on Disposing of Cases in the Judiciary.”

[361] Bruce Kyerere, president of Uganda Law Society, “Review of the Case Backlog Quick Wins Reduction Program,” March 7, 2011 (highlighting Kiboga, Entebbe, Mubende, and Mpigi districts as having infrequent court sessions).

[362] Human Rights Watch interview with OC, Muinaina Prison, Mubende District, March 3, 2011. Mubende, Mityana, Kasanda, Kiboga, and Kyankwanzi are the five districts the court covers. According to prisoners, it sat only once the previous year, and for only two months. Human Rights Watch interviews with Bradley, Muinaina Prison, March 3, 2011; Mohamed, Muinaina Prison, March 4, 2011.

[363] The Ugandan constitution states, “In the determination of…any criminal charge, a person shall be entitled to a fair, speedy and public hearing before an independent and impartial court or tribunal established by law.” Article 28(1).

[364] In one recent study, detainees under the jurisdiction of the High Court spent an average of 488 days on committal from the date of committal to the date of data collection. Avocats Sans Frontieres and University of Toronto International Human Rights Program, “Presumed Innocent, Behind Bars,” p. 34.

[365] Human Rights Watch interviews with Donald, Masaka Main Prison, November 23, 2010; Ekanya, Bubukwanga Prison, November 16, 2010; Christopher, 17, Bubukwanga Prison, November 16, 2010; Sylvia, Fort Portal Women’s Prison, November 15, 2010; Abigail, Fort Portal Women’s Prison, November 15, 2010.

[366] Human Rights Watch interview with Ekanya, Bubukwanga Prison, November 16, 2010.

[367] Human Rights Watch, “Violence Instead of Vigilance: Torture and Illegal Detention by Uganda’s Rapid Response Unit,” March 23, 2011, http://www.hrw.org/en/reports/2011/03/23/violence-instead-vigilance; Avocats Sans Frontieres and University of Toronto International Human Rights Program, “Presumed Innocent, Behind Bars,” 2011; Human Rights Watch interview with OC, Kigo Prison, November 19, 2009. The African Commission, interpreting the African Charter on Human and Peoples’ Rights, has prohibited the trial of civilians in military courts. The African Charter, to which Uganda is a party, guarantees the right to equality before the law and equal protection of the law, fair trial, and judicial independence. The African Charter does not admit any exceptions to the rule against the use of military courts to try civilians, such as emergency situations. The Commission’s Principles and Guidelines on the Right to a Fair Trial and Legal Assistance in Africa also prohibits the trial of civilians in military courts. Law Office of Ghazi Suleiman v. Sudan, Comm. Nos. 222/98 and 229/99, para. 64 (African Commission on Human and Peoples’ Rights 2003); Media Rights Agenda v. Nigeria, Comm. No. 224/98, paras. 60-66 (African Commission on Human and Peoples’ Rights 2000). African (Banjul) Charter on Human and Peoples’ Rights art. 2, June 27, 1981, 21 I.L.M. 58 (entered into force Oct. 21, 1986) [hereinafter African Charter], arts. 2, 3, 7, and 26. African Commission on Human and Peoples’ Rights, Principles and Guidelines on the Right to a Fair Trial and Legal Assistance inAfrica (Nov. 1999)

[368] Chief Justice of Uganda Benjamin Odoki, “Speech at the Case Backlog Review,” March 7, 2011.

[369] Justice, Law, and Order Sector, “Annual Performance Report, 2009-2010,” September 2010. Uganda’s auditor general notes that the case backlog increased from 65,423 in FY 2006/07 to 126, 521 in 2009/10. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report on Disposing of Cases in the Judiciary,” March 2011, p. 1.

[370] Article 23(6) as amended by the Constitution of the Republic of Uganda (Amendment) Act 11/2005 provides: “(6) where a person is arrested in respect of a criminal offence –(a) the person is entitled to apply to the court to be released on bail and the court may grant that person bail on such conditions as the court considers reasonable; (b) in the case of an offence which is triable by the High Court as well as by a subordinate court, if that person has been remanded in custody in respect of the offence for sixty days before trial, that person shall be released on bail on such conditions as the court considers reasonable; (c) in the case of an offence triable only by the High Court, if that person has been remanded in custody for one hundred and eighty days before the case is committed to the High Court, that person shall be released on bail on such conditions as the court considers reasonable.” Before the constitutional amendment, (b) and (c) stated 120 and 360 respectively as the number of days that must pass before a person is entitled to bail. See alsoUganda v. Besigye, Constitutional Court of Uganda at Kampala, Constitutional Reference No. 20 of 2005, September 22, 2006 in which the Court held that under article 23 (6) (a) of the Constitution the court has a discretion whether to grant bail or not to grant bail and that bail is not automatic. However the Court also observed that “while considering bail the court would need to balance the constitutional rights of the applicant. … and the considerations which flow from people being remanded in prison custody which adversely affects their welfare and that of their families and not least the effect on prison remand conditions if large numbers of unconvicted people are remanded in custody.” In Foundation for Human Rights Initiative vs. the Attorney General, Constitutional Petition No. 20 of 2006, March 26, 2008 the Constitutional Court confirmed that Article 23(6) of the Constitution confers discretion upon court whether to grant bail. Foundation for Human Rights Initiative is appealing the ruling to the Supreme Court. Human Rights Watch Interview with executive director, Foundation for Human Rights Initiative, Kampala, March 9, 2011.

[371] Human Rights Watch interview with paralegal, Kampala, November 19, 2010.

[372] The Magistrates Court Act requires the Director of Public Prosecutions (DPP) to provide the magistrate’s court with an indictment and a summary of the case in order to commit a case to the High Court. Magistrates Court Act of 1971, sec. 168. The Trial on Indictments Act does not allow a person accused of a criminal offence triable by the High Court to be produced in the High Court unless and until such person has been committed for trial by the DPP. Trial on Indictments Act of 1971, sec. 1. Due to the criminal process’s dependency upon the speed of the DPP’s actions, prisoners can continue on remand without any statutorily defined time limitations.

[373] Human Rights Watch interview with paralegal, Kampala, November 19, 2010.

[374] See, e.g., James Sebugenyi, “Bail is a Fundamental Right,” New Vision, May 22, 2011, http://www.newvision.co.ug/D/8/20/755380 (accessed June 21, 2011); Ofwondo Opondo and Wafula Oguttu, “What Does the Proposed Amendment to Scrap Bail Mean for Uganda?” Sunday Vision, May 21, 2011, http://www.sundayvision.co.ug/detail.php?mainNewsCategoryId=7&newsCategoryId=614&newsId=755249 (accessed June 21, 2011). However, eliminating the possibility of bail for nonviolent crimes is inconsistent with human rights standards, under which pretrial restrictions must be consistent with the right to liberty and the presumption of innocence. ICCPR, arts. 9 and 14. Indeed, under international law, the presumption is that “It shall not be the general rule that persons awaiting trial shall be detained in custody, but release may be subject to guarantees to appear for trial.” ICCPR, art. 9(3).

[375] For lesser crimes, the Magistrate’s Court’s Act says that courts consider the nature and gravity of the charge, prior charges, whether the suspect has a fixed abode, and the suspect’s likelihood to “interfere with any of the witnesses” into consideration when adjudging bail applications.” Magistrates Courts Act, Sec. 77(2). For capital crimes, the High Court is to consider whether the suspect has a fixed place of abode, sound securities, prior instances of failure to comply with bail, or other charges. Trial on Indictment Act, sec. 15(4).

[376] Although Article 23 (6) (a) of the Constitution (as amended) has been held to bestow discretion on the courts as to whether to grant bail—where a person is arrested in respect of a criminal offence the person is entitled to apply to the court to be released on bail and the court may grant that person bail—the Constitutional Court also held that is not true of articles 23 (6) (b) and (c). Article 23 (6) (b) provides that for “an offence which is triable by the High Court as well as by a subordinate court” if a person “has been remanded in custody for sixty days before trial, that person shall be released on bail” on conditions set by the court. Under article 23 (6) (c) if the offence is triable only by the High Court, then bail is to be granted if the accused has been in remand for 180 days. The Constitutional Court has said that in the cases of both Article 23 (6) (b) and (c), bail must be granted and there is no discretion. See Uganda v. Besigye, September 22, 2006. In practice, though, this does not happen.

[377] Human Rights Watch interviews with Nyombi, Masaka Ssaza Prison, November 22, 2010; Olivia, Masaka Prison November 23, 2010; Emma, Jinja Women’s, March 2, 2011; Duncan, Muinaina Prison, March 4, 2011; Washington, Muduuma Prison, November 12, 2010.

[378] Human Rights Watch interview with Bradley, Muinaina Prison, March 3, 2011.

[379] Human Rights Watch interviews with Matthew, Masafu Prison, March 8, 2011; Christopher, 17, Bundibuygo Prison, November 16, 2010.

[380] Constitution of Uganda, art. 28(3)(e). The government reportedly spends 38 million Uganda shillings (approximately $19,000) per month on providing state briefs. Justice, Law, and Order Sector, “Annual Performance Report, 2009-2010,” September 2010.

[381] Constitution of Uganda, art. 28(3)(e).

[382] The Uganda Paralegal Advisory Services dispatches its own paralegals and also funds other legal aid organizations, such as AHURIO in Fort Portal, Uganda Christian Lawyers Fraternity in Kampala, and Foundation for the Development of Needy Communities in Mbale, as well as in some instances giving UPS social workers training on paralegal services. Law & Development Partnership, “Evaluation, Paralegal Advisory Services, 2007-2010,” January 7, 2011. For a description of legal aid services available in Uganda, see generally, UN Office on Drugs and Crime, “Handbook on Improving Access to Legal Aid in Africa,” 2011, http://www.unodc.org/documents/justice-and-prison-reform/Webbook_Legal_Aid_in_Africa_lr.pdf (accessed April 25, 2011).

[383] Sarah Callaghan, Chairperson JLOS Development Partners Group ,“JLOS Development Partner Group Response to Annual Progress,” October 4-5, 2010.

[384] Police bond can also be issued by discretion of the police. Human Rights Watch interviews with David, Kitalya Farm Prison, February 28, 2011; Noah, Fort Portal Prison, November 15, 2010; Christine, Fort Portal Women’s Prison, November 15, 2010; Arthur, Mutufu Prison, March 7, 2011; Matovu, Kitalya Farm Prison, February 28, 2011; Kevin, Muinaina Prison, March 3, 2011.

[385] ICCPR, art. 14(3)(d); Body of Principles, prin. 17.

[386] Human Rights Watch interviews with Donald, Masaka Prison, November 23, 2010; Ibrahim, Kitalya, February 28, 2011; Lucas, 17, Masafu, March 8, 2011.

[387]Law & Development Partnership, “Evaluation, Paralegal Advisory Services, 2007-2010,” January 7, 2011; “Leave Bail Money Alone,” New Vision, August 30, 2008; “Billions Lost in Bail Cash Abuse,” Monitor, August 29, 2008; JLOS, “Report of the Joint JLOS/DPG Monitoring Visit, Lango and Acholi Sub-Regions,” June 2010, http://www.jlos.go.ug/uploads/m%20and%20E%20Report%202010.pdf (accessed April 11, 2011). The Inspectorate of Courts received 740 complaints of judicial misbehavior in 2009-2010, though the government purported that it has taken measures to combat corruption by conducting 71 inspections during that period. Justice, Law, and Order Sector, “Annual Performance Report, 2009-2010,” September 2010. According to Transparency International, Ugandans said on a scale of 1-5, with 5 being “extremely corrupt,” they perceived the judiciary to be at 3.9. Transparency International, “Global Corruption Barometer 2010,” 2010, http://www.transparency.org/policy_research/surveys_indices/gcb/2010/results (accessed April 28, 3011).

[388] Sarah Callaghan, Chairperson JLOS Development Partners Group, “JLOS Development Partner Group Response to Annual Progress,” October 4-5, 2010.

[389] Police offered suspects the option of paying to two million Uganda shillings (approximately $840) to dismiss files, magistrates offered to dismiss cases for 50,000 Uganda shillings ($21). Human Rights Watch interviews with Abdul, Luzira Upper, November 8, 2010; Johnson, Bubukwanga Prison, November 16, 2010. Prosecutors could close files for 200,000 Uganda shillings ($100). Human Rights Watch interview with Saul, Masaka Ssaza Prison, November 22, 2010. Court personnel requested money for services that should have been free, such as the transfer of files. Human Rights Watch interview with Catherine, Jinja Women’s Prison, March 2, 2011.

[390] Martin Shönteich, “The Scale and Consequences of Pretrial Detention Around the World,” Justice Initiatives: Pretrial Detention, Spring 2008, http://www.soros.org/initiatives/justice/focus/criminal_justice/articles_publications/publications/pretrial_20080513/Justice_Initiati.pdf (accessed April 25, 2011).

[391] Human Rights Watch interview with commissioner, National Community Service Programme, March 21, 2011.

[392] Justice, Law, and Order Sector, “Annual Performance Report, 2009-2010.”

[393] Human Rights Watch interview with commissioner, National Community Service Programme, March 21, 2011.

[394] Human Rights Watch interview with Hassan, Masaka Ssaza, November 22, 2010; Thomas, Mutufu Prison, March 7, 2011.

[395] Human Rights Watch interview with Hassan, Masaka Ssaza, November 22, 2010.

[396] Human Rights Watch interview with executive director, Foundation for Human Rights Initiative, March 9, 2011.

[397] ICCPR, art. 14.

[398] Human Rights Watch interview with Gabriel, Jinja Main Prison, March 1, 2011; Humphrey, Jinja Main Prison, March 1, 2011.

[399] Human Rights Watch interview with paralegal, Kampala, November 19, 2010.

[400] Prison personnel were unwilling to corroborate their claims of age below 18, but Human Rights Watch observed that several of them looked very young.

[401] Convention on the Rights of the Child, art. 37(c); ICCPR, art. 10(2)(b); Constitution of Uganda, art. 34; Children Act, cap. 59, sec. 91(6).

[402] Foundation for Human Rights Initiative, “Juvenile Justice in Uganda,” September 16, 2009, http://www.fhri.or.ug/pr001.html (accessed April 15, 2011), p. viii.

[403] Ibid.

[404] One of the children interviewed by Human Rights Watch was given the opportunity to present evidence of her age via testimony of her brother, but the police rejected it as false. Human Rights Watch interview with Hellene, 16, Butuntumura Prison, November 11, 2010. All the other children said they told police, court, and prison authorities their age but were ignored or accused of lying. UPS is ostensibly supposed to ascertain that a person is not below 18 years on admission. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report on Uganda Prisons Service,” p. 8. However, conducting an age assessment requires particular protections for children. According to the UN Committee on the Rights of the Child, children should be informed about the purpose and the implications of an age assessment and be given effective representation by a guardian and lawyer. Such exams should not rely exclusively on physical appearances but should take into account psychological maturity, demeanor, ability to interact with adults, social and educational history, and life experiences. UN Committee on the Rights of the Child, General Comment No. 6, para. 31(i). Jacqueline Bhabha and Nadine Finch, “Seeking Asylum Alone: United Kingdom,” http://www.ilpa.org.uk/seeking%20asylum%20alone.pdf (accessed July 8, 2009), p. 61.

[405] Prisons Act of 2006, sec. 75.

[406] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011. Prison authorities noted that “[s]ince the majority of prisoners (nearly 70%) are resident at the 63 units, it implies that only 30% of our prisoners are not having access to a prisons health services run facility as the primary point of contact for health care services.” Letter from prison authorities to Human Rights Watch, June 29, 2011.

[407] Human Rights Watch interviews with Byamukama, Masaka Ssaza, November 22, 2010; Peter, Masaka Main Prison, November 23, 2010; psychiatric nurse, Masaka Main Prison, November 23, 2010; UPS, “Work Plan and Budget,” p. 6.

[408] Human Rights Watch interview with Mary, Jinja Women’s Prison, March 2, 2011.

[409] Human Rights Watch interview with Tess, Masaka Ssaza Prison, November 22, 2010; Ross, Masafu Prison, March 8, 2011.

[410] Human Rights Watch interviews with Phillip, Muduuma Prison, November 12, 2010; Nathan, Muduuma Prison, November 12, 2010; William, Muinaina Farm Prison, March 4, 2011; Matthew, Masafu Prison, March 8, 2011; Walter, Mutufu Prison, March 7, 2011.

[411] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011.

[412] Human Rights Watch interview with psychiatric nurse, Masaka Main Prison, November 23, 2010.

[413] Human Rights Watch interview with prison medical authority, UPS, March 11, 2001.

[414] Human Rights Watch interview with Esther, Fort Portal Women’s Prison, November 17, 2010.

[415] Human Rights Watch interviews with Adam, Masaka Main Prison, November 23, 2010; Joshua, Masaka Main Prison, November 23, 2010.

[416] Human Rights Watch interview with Peter, Masaka Main Prison, November 23, 2010.

[417] Human Rights Watch interview with OC, Masaka Main Prison, November 23, 2010. A medical officer at Masaka, however, claimed that the deceased prisoner had previously been at the outside hospital, but had been incompletely attended to and that his death happened “out of the blue.” Human Rights Watch interview with psychiatric nurse, Masaka Main Prison, November 23, 2010.

[418] Human Rights Watch interviews with Fred, Luzira Upper Prison, November 8, 2010; Kakooza, Masaka Main Prison, November 23, 2010; Kaahwa, Bubukwanga Prison, November 16, 2010; Benjamin, Masafu Prison, March 8, 2011.

[419] Human Rights Watch interviews with Juliana, Jinja Women’s Prison, March 2, 2011; Mary, Jinja Women’s Prison, March 2, 2011; Stella, Jinja Women’s Prison, March 2, 2011.

[420] Human Rights Watch interview with Ralph, Luzira Upper Prison, November 9, 2010.

[421] Human Rights Watch interview with Mafabi, Butuntumura Prison, November 11, 2010. Additional inmates at Butuntumura corroborated the death and that the prisoner had not received treatment. See Human Rights Watch interviews with Kakuru, Butuntumura Prison, November 11, 2010; Logan, Butuntumura Prison, November 11, 2010.

[422] Human Rights Watch interviews with Christopher, 17, Bubukwanga Prison, November 16, 2010; Brian, Murchison Bay Prison, November 13, 2010.

[423] Human Rights Watch interviews with Aaron, Luzira Upper Prison, November 8, 2010; Ralph, Luzira Upper Prison, November 9, 2010; Akello, Luzira Women’s Prison, November 10, 2010.

[424] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011.

[425] Human Rights Watch interviews with Brian, Murchison Bay Prison, November 13, 2010 (two weeks); Samuel, Fort Portal Men’s Prison, November 15, 2010 (two weeks); Bradley, Muinaina Farm Prison, March 3, 2011 (two weeks); Tobias, Muinaina Farm Prison, March 4, 2011 (two weeks); Noah, Fort Portal Men’s Prison, November 15, 2010 (three weeks); Ali, Murchison Bay Prison, November 20, 2010 (one month); Asuman, Murchison Bay Prison, November 10, 2010 (one month); Alex, Murchison Bay Prison, November 10, 2010 (two months); Henry, Murchison Bay Prison, November 20, 2010 (three months); Owen, Kitalya Farm Prison, February 28, 2011 (six months); Gilbert, Kitalya Farm Prison, February 28, 2011 (six months); Edgar, Murchison Bay Prison, November 13, 2010 (six months).

[426] The Prisons Service recently acquired an ambulance for upcountry referrals to Murchison Bay, but more are required to avoid transfer delays. Human Rights Watch interview with prison medical authority, UPS, November 18, 2010.

[427] The OC at Murchison Bay urged that at least a clinical officer be posted in each health unit to improve timely referrals. Human Rights Watch interview with OC, Murchison Bay Prison, November 10, 2010.

[428] Human Rights Watch interview with Alex, Murchison Bay Prison, November 10, 2010.

[429] Human Rights Watch interview with Brian, Murchison Bay Prison, November 13, 2010.

[430] Human Rights Watch interview with Asuman, Murchison Bay Prison, November 10, 2010.

[431] Human Rights Watch interview with Ali, Murchison Bay Prison, November 20, 2010.

[432] Human Rights Watch interview with prison medical authority, UPS, November 18, 2010. See also Human Rights Watch interview with doctor, Murchison Bay Hospital, November 10, 2010.

[433] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011.

[434] Human Rights Watch interview with deputy OC, Bubukwanga Prison, November 16, 2010.

[435] Human Rights Watch interview with psychiatric nurse, Masaka Main Prison, November 23, 2010.

[436] Human Rights Watch interview with OC, Muinaina Farm Prison, March 3, 2011; Human Rights Watch interview with OC, Jinja Women’s Prison, March 2, 2011.

[437] UPS, “Work Plan and Budget,” pp. 7-8; Human Rights Watch interview with prison medical authority, UPS, November 18, 2010; Letter to Human Rights Watch from prison authorities, June 29, 2011.

[438] Human Rights Watch interview with prison medical authority, UPS, November 18, 2010.

[439] Human Rights Watch interview with OC, Murchison Bay Prison, November 10, 2010.

[440] UPS, “Work Plan and Budget,” p. 14. Prison authorities report that in 2008, only 26 percent of health care posts were filled, and in FY2010/11 this number had increased to 51 percent. Letter from prison authorities to Human Rights Watch, June 29, 2011.

[441] In November 2010, 222 of 436 (51 percent) of health posts established by UPS were filled with professional health workers. In some regions, however, this number fell far lower; in the northeastern region only six percent of established posts had been filled. Human Rights Watch interview with prison medical authority, UPS, November 18, 2010. Uganda’s Auditor General has concluded that “[t]he staffing level in the Health Services Division is too low to deliver adequate medical services in all prisons.” The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report of Uganda Prisons Service,” p. 35.

[442] Human Rights Watch interview with prison medical authority, UPS, November 18, 2010.

[443] Human Rights Watch interviews with Sebastian, Luzira Upper Prison, November 8, 2010; Brian, Murchison Bay Prison, November 13, 2010; Evan, Masaka Main Prison, November 23, 2010.

[444] Human Rights Watch interview with Ali, Murchison Bay Prison, November 20, 2010.

[445] Human Rights Watch interviews with Fred, Luzira Upper Prison, November 8, 2010; Brian, Murchison Bay Prison, November 13, 2010; Daudi, Murchison Bay Prison, November 20, 2010; Donald, Masaka Main Prison, November 23, 2010; Mukasa, Luzira Upper Prison, November 9, 2010.

[446] Human Rights Watch interviews with Jonathan, Masaka Ssaza Prison, November 22, 2010; Edgar, Murchison Bay Prison, November 13, 2010; Henry, Murchison Bay Prison, November 20, 2010; Donald, Masaka Main Prison, November 23, 2010.

[447] Human Rights Watch interview with Yusuf, Murchison Bay Prison, November 13, 2010.

[448] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011. Prison authorities confirmed in June 2011 that “[s]everal prison health units continue to experience stock out of essential medicines and health supplies.” Letter from prison authorities to Human Rights Watch, June 29, 2011.

[449] Human Rights Watch interview with prison medical authority, UPS, November 18, 2010; UPS, “Work Plan and Budget,” pp. 6-7.

[450] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011.

[451] The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report of Uganda Prisons Service,” p. 23.

[452] Not all patients referred from Murchison Bay to Mulago Hospital are actually taken because of limited transportation and human resources for the transfer. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report on Uganda Prisons Service,” p. 21.

[453]Human Rights Watch interviews with doctor, Murchison Bay Hospital, November 10, 2010; OC, Murchison Bay Prison, November 10, 2010.

[454] Human Rights Watch interviews with Ralph, Luzira Upper Prison, November 9, 2010; Asuman, Murchison Bay Prison, November 10, 2010; Mafabi, Butuntumura Prison, November 11, 2010; Alex, Murchison Bay Prison, November 10, 2010.

[455] Human Rights Watch interview with OC, Murchison Bay Prison, November 10, 2010.

[456] OECD, “Creditor Reporting System,” undated, http://stats.oecd.org/Index.aspx?DatasetCode=CRSNEW (accessed April 13, 2011).

[457]The United States President’s Emergency Plan for AIDS Relief, “Uganda: FY 2010 Approved Funding by Program Area, Agency, and Funding Source,” undated, http://www.pepfar.gov/about/2010/africa/150628.htm (accessed April 13, 2011).

[458] Eric Goosby, “PEPFAR Programs in Uganda: An Update,” July 13, 2010, http://blogs.state.gov/index.php/site/entry/update_pepfar_uganda (accessed April 13, 2011).

[459]Ibid.

[460] UNAIDS, “Report on the Global AIDS Epidemic: Annex 2: Country Progress Indicators 2004 to 2010,” 2010, http://www.unaids.org/documents/20101123_GlobalReport_Annexes2_em.pdf (accessed May 5, 2011), p. 238.

[461] In that final year, the amount of donor funding to the UPS was less than half the amount of the “internally generated” revenue from prisoners’ forced labor. The exception was FY 2006/07. The Republic of Uganda Office of the Auditor General, “Value for Money Audit Report of Uganda Prisons Service,” p. 4.

[462] Uganda AIDS Commission, “National HIV & AIDS Strategic Plan 2007/8-2011/12: Moving Toward Universal Access,” undated, http://www.aidsuganda.org/Publications/nsp.pdf (accessed April 13, 2011).

[463] “Uganda: Overcrowded Prisons Heighten TB Risk,” IRIN PlusNews, July 4, 2008, http://www.plusnews.org/report.aspx?ReportId=79104 (accessed April 13, 2011); Andante Okanya and Abou Kisige, AIDS Rocks Local Prisons,” The New Vision, October 1, 2009, http://allafrica.com/stories/200907300248.html (accessed April 11, 2011).

[464] The ICRC, AIDS Information Centre, Northern Uganda Malaria HIV/AIDS and TB Program, the African Prisons Project, U.S. CDC, USAID/SPEAR, National TB Control Assistance Programme, UNODC, and the National Franciscan Prison Ministry are all health partners. UPS, “Work Plan and Budget,” pp. 8-9. There is also an objective for TB in prisons in Uganda Global Fund Round 10. Human Rights Watch interview with director, National TB and Leprosy Programme, March 10, 2011.

[465]Human Rights Watch interview with OC, Fort Portal Prison, November 15, 2010; UPS, “Work Plan and Budget,” pp. 8-9.

[466] Human Rights Watch interview with prison medical authority, UPS, March 11, 2011. The first phase of the project, which is a collaboration under PEPFAR between the CDC, USAID and UPS, will focus on assessing HIV, TB, STI, and malaria epidemiology and service provision, in order to inform the development and implementation of prevention, care and treatment services for staff and prisoners. Ibid.

[467]Ibid.

[468] Ibid.