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(Kampala) - Inmates in Ugandan prisons are subject to brutal compulsory labor, frequent violence, miserable overcrowding, and disease, Human Rights Watch said today in a report examining conditions in 16 prisons throughout the country. Over half of those in Ugandan prisons are in pretrial detention and may be held for years without having been convicted of any crime, Human Rights Watch said. Profits from prisoner labor often benefit individual prison officers, while prisoners suffer illness from inadequate food, water, and basic hygiene.

The 80-page report, "‘Even Dead Bodies Must Work': Health, Hard Labor, and Abuse in Ugandan Prisons," documents routine physical abuse and the failure of the criminal justice system to protect the rights of prisoners. Prisoners at rural prisons, including the elderly, individuals with disabilities, and pregnant women, are frequently caned, or are even stoned, handcuffed to a tree, or burned, when they refuse to perform hard labor. HIV and tuberculosis (TB) patients may be denied care and sent to farm prisons far from treatment programs, the report says.

"Prisoners in Uganda, many not convicted of any crime, are brutally beaten and forced to work under conditions resembling slavery," said Katherine Todrys,  a health and human rights researcher at Human Rights Watch and one of the authors of the report. "Few prisoners with HIV or TB get adequate health care, risking their lives and the development and spread of drug-resistant strains."

Every year 50,000 people pass through Uganda's prisons, which include both larger, regional prisons and smaller, rural prisons. While conditions in a few regional prisons have improved in recent years, conditions and treatment in the numerous rural prisons that once were under local administrative control amount to cruel, inhuman, and degrading treatment and even torture. The lack of attention to prisoner health affects broader public health efforts. For example, drug-resistant strains of HIV or TB can develop in and spread from prisons as prisoners, visitors, and staff return to their communities.

The Ugandan government should order a halt to beatings and compulsory prison labor for private profit throughout the prison system, Human Rights Watch said. Wardens should be held accountable for any prisoner mistreatment. In collaboration with international donors, the government should provide the prisons with enough funding to ensure adequate living conditions and health care.

Fifty-six percent of Uganda's prisoners - over 17,000 people - have not been convicted of a crime and are locked up awaiting resolution of their case, sometimes for years. Limited use of bail and inadequate legal representation contribute to these delays.

Partly as a result of such justice failures, overcrowding is endemic in Ugandan prisons. One of the prisons Human Rights Watch visited was filled to 32 times its intended capacity.

Prisoners sleep on their sides or in shifts. The food is insufficient, and nutritional deficiences leave inmates vulnerable to infections and can cause blindness. Sex is traded by the most vulnerable inmates to other inmates for food.

Clean water is frequently unavailable, and boiled water has become a commodity sold by inmates at some prisons. Lice and scabies crawl in the prisoners' filthy blankets. Under such conditions, disease spreads quickly. The prevalence of both HIV and TB is thought to be almost twice the rate in the general population, but only a few prisons provide TB testing. Treatment for both diseases is available at only one prison medical facility in the entire country. "Help us, we'll die," wrote 10 of the prisoners at Muinaina Farm Prison in a note to Human Rights Watch.

Physical abuse exacerbates the already poor health of prisoners. Prison wardens beat prisoners and instruct inmates to beat other prisoners in the name of enforcing discipline. Human Rights Watch found multiple incidents where prisoners had been stripped of their clothing and put into small, dark, cells, the floors covered with ankle-deep water, where they were given minimal food. "They hit me so hard, I was crying blood," said one inmate, describing a beating by prison wardens and other prisoners.

Medical care is uneven and practically nonexistent at many of the over 170 formerly locally administered prisons countrywide. Health care needs of prisoners are routinely assessed by medically unqualified wardens and officers, who frequently deny the prisoners' right to access what community-based healthcare facilities are available.

"Anyone who commits a crime should be held to account," Todrys said. "But no one should be sentenced to malnutrition, disease, and beatings."

Over the past several years, funding for Ugandan prisons from international health donors has increased, but funding is still limited. To supplement the inadequate prison budget, some prison officers rely on prisoners' forced labor on privately owned farms. Others send prisoners - convicted and pretrial detainees alike - out to work, then take the proceeds for their personal use. Thousands of prisoners are forced to work under brutal conditions, frequently beaten or abused for moving too slowly or refusing to work. Prisoner productivity translates directly into profit for prison authorities, but the funds raised through prison labor often go unaccounted for.

Prisoners doing hard labor are regularly refused access to medical care because officers will not allow them to miss work in the fields, Human Rights Watch said. Sick inmates are transferred from facilities that could provide them with medical care to those that cannot in order to boost labor on prison farms.

Human Rights Watch called on the Ugandan government to issue direct orders to halt forced prison labor for private profit, to discipline prison officers for abusing prisoners, and to establish guidelines for the immediate referral of all prisoners with confirmed TB or HIV to facilities where they will receive treatment. The Ugandan government, in partnership with international agencies and donors, should  improve access to external health facilities, assign at least one health worker to each prison, improve general conditions, and decrease the duration of pretrial detention by increasing access to bail, court sessions, and legal representation.

"The Uganda Prisons Service has made some reforms over the past decade," Todrys said. "But terrible conditions, forced labor, and brutal beatings imperil prisoner health and must be ended."

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