Victims & Offenders An International Journal of Evidence-based Research, Policy, and Practice

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An Examination of COVID-19 Outbreaks in African Prisons and Jails

Sabrina S. Rapisarda & James M. Byrne

To cite this article: Sabrina S. Rapisarda & James M. Byrne (2020): An Examination of COVID-19 Outbreaks in African Prisons and Jails, Victims & Offenders, DOI: 10.1080/15564886.2020.1835769 To link to this article: https://doi.org/10.1080/15564886.2020.1835769

Published online: 23 Nov 2020.

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Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=uvao20 VICTIMS & OFFENDERS https://doi.org/10.1080/15564886.2020.1835769

An Examination of COVID-19 Outbreaks in African Prisons and Jails Sabrina S. Rapisarda and James M. Byrne

School of Criminology & Justice Studies, University of Massachusetts Lowell, Lowell, Massachusetts, USA

ABSTRACT KEYWORDS This article examines country-level variations in the extent of COVID-19 International; prisons; outbreaks in prisons and jails across the African region. Differences in corrections; COVID-19; the use of front-end, in-prison, and back-end mitigation strategies are pandemic; Alternatives to identified. We conclude our regional overview by providing a preli­ incarceration; Early release mechanisms; Prison reform minary assessment of the short-term impact of these varied mitigation strategies on inmate and staff health outcomes, including both physi­ cal health and mental health. Both the intended and unintended consequences of governmental responses to COVID-19 outbreaks are considered.

Introduction and overview The extent of reported COVID-19 outbreaks in prisons and jails varies significantly from one sub-region of Africa to the next, with the largest outbreaks in countries in the Northern and Eastern regions of Africa, and the lowest reported outbreaks in countries in the Western region (see Figure 1). Reviews of prison systems in countries in this region have revealed conditions conducive to large potential outbreaks (Heard, 2019). It appears that most African countries were already encumbered by weak healthcare systems, inadequate sur­ veillance and laboratory capacity, and limited resources, far before the start of the pandemic (Nkengasong & Mankoula, 2020). Moreover, Africa had previously been characterized by rapid population growth, increased cross-border and cross-continental movement of peo­ ple, and endemic diseases like HIV, tuberculosis, malaria, Ebola, Lassa fever, and others, all of which facilitate the rapid and widespread transmission of COVID-19 (Nkengasong & Mankoula, 2020). Surprisingly, despite being the second largest continental landmass and second most populous continent globally and facing multiple public health challenges, Africa currently1 has between 2.8– 5.8 times fewer reported COVID-19 cases than any other continental region2 with a regional tally of 1,212,508 positive cases (Coronavirus Resource Center 2020; Nkengasong & Mankoula, 2020).3 The entire region of Africa reported around 10,000 cases in early April, while the U.S. confirmed over 600,000 (Worldometer, 2020). Based on these data, an argument can be made that Africa’s experience with the virus may be slower to develop than other regions of the world. Others such as Dr. Tedros, a WHO director-general, believe that Africa has been able to better contain the virus due to the “great deal of experience” in combatting infectious diseases (e.g., polio, measles, Ebola and more) in the past (Bruce-Lockhart, 2020).

CONTACT Sabrina S. Rapisarda [email protected] School of Criminology & Justice Studies, University of Massachusetts Lowell, 113 Wilder Street, Health and Social Sciences Building, South Campus, Lowell, MA 01854, USA. © 2020 Taylor & Francis Group, LLC 2 S. RAPISARDA AND J. BYRNE

Figure 1. Africa’s largest prison systems. The labeled countries in Figure 1 are among the top 50 largest prison systems globally and represent the 10 largest prison systems in Africa. See the fifth footnote (on page 9) for a closer look at the African countries’ rankings (World Prison Brief, 2020).*Notes: The rankings for African countries within the top 50 largest prison systems are based on relatively current data (updated between 2019 and August of 2020); however, a few countries such as Ethiopia and Egypt have not updated their prison population data in 4 to 7 years (see Table 1).

Governments across the African region have also been credited with their rapid response to slow the spread of the virus, despite the economic cost (Bruce-Lockhart, 2020). Notwithstanding its relatively low prevalence of positive COVID-19 cases continent- wide, certain parts of Africa have been affected more than others. For example, South Africa, Egypt, Morocco, Nigeria, and Ethiopia have borne the brunt of the virus (Worldometer, 2020). According to Coronavirus Resource Center (2020), an estimated total of 613,017 cases and 13,308 deaths have afflicted South Africa to date,4 with Egypt at 97,619 positive cases and 5,298 deaths, and Morocco and Nigeria at over 50,000 cases (N = 55,864; N = 52,800, respectively) and around 1000 deaths each (N = 984; N = 1007, respectively; Coronavirus Resource Center, 2020). Meanwhile, other African countries like Rwanda and Somalia have reported less than 4,000 cases (N = 3,275; N = 3,537, respectively) as well as COVID-related deaths in the double-digits (N = 15; N = 95, respectively), since the inception of the pandemic (Coronavirus Resource Center, 2020). VICTIMS & OFFENDERS 3

Table 1. Africa’s largest prison systems in the world’s top 50. Rank Global Region Country Prison Population Date of Most Recent Report 12 Southern Africa South Africa 154,437 April 2020 14 Eastern Africa Ethiopia 113,727 2013–2014 15 Northern Africa Egypt 106,000 August 2016 21 Northern Africa Morocco 85,767 September 2019 26 Eastern Africa Rwanda 65,000 October 2019 26 Northern Africa Algeria 65,000 2019 28 Western Africa Nigeria 62,258 August 2020 36 Eastern Africa Uganda 55,229 2019 39 Eastern Africa Kenya 53,348 2019 49 Eastern Africa Tanzania 35,803 December 2019 *Data were extracted from the World Prison Brief database.

COVID-19 outbreaks in countries with the largest prison populations in the African region Some of the countries that are currently experiencing the greatest prevalence of COVID-19 infections and deaths are also home to the largest prison systems in the African region (see Table 1). According to World Prison Brief (2020), Africa accounts for 20% (N = 10) of the world’s top 50 largest prison systems. Countries such as South Africa, Ethiopia, Egypt, Morocco, Rwanda, and Algeria are included in this top rank.5 Seven of the 10 African countries found in the world’s top 50 largest prison systems – South Africa, Ethiopia, Egypt, Morocco, Algeria, Nigeria, and Kenya – are also within the top 8 countries reporting the highest COVID-19 case counts across the continent (Worldometer, 2020; World Prison Brief, 2020). We have identifiedwithin-region variations in the extent of reported outbreaks of COVID-19 and the types of mitigation strategies employed in these large prison systems (see Table 2).6

Reported outbreaks of COVID-19 in South Africa’s prisons and jails South Africa has the largest prison population in Africa and is ranked 12th worldwide, incarcerating well over 150,000 individuals (World Prison Brief, 2020). In May, the pre­ sident of South Africa announced that approximately 19,000 inmates (just over 12% of the total prison population) who are considered low-risk to public safety and have passed serving their minimum sentence periods, would be eligible for parole by mid-July to alleviate the potential threat of spreading the virus within its prisons (Mabuza, 2020). However, by July 17, 2020, just under 6,800 inmates had been released on parole, which mainly encompassed elderly individuals, those with underlying health issues, and female offenders with infants (Mabuza, 2020). South Africa has the highest total count of COVID-19 community cases in Africa to date (Coronavirus Resource Center, 2020). Additionally, as of August 15, 2020, the Correctional Services Department of the Republic of South Africa reported 6,202 positive cases and 94 deaths among inmates and prison staff. By August 23, 2020, the department confirmed 6,448 positive cases, of which 4,116 were prison staff and 2,332 were inmates (News24, 2020). Eighty-nine percent of inmates and staff in South African prisons have recovered (News24, 2020).7 While the virus infiltrates jails and prisons through those entering from the community (e.g., prison staff, visitors, legal representatives, etc.), it can also exit prisons in the same fashion (Ollove, 2020). 4 S. RAPISARDA

Table 2. A comparison of mitigation strategies used in Africa’s prisons and jails. Country

(Rank) Front-End Within Back-End AND South Africa Reconsidering the sentencing of certain offenses and Designation of facilities to quarantine sick incarcerated Early release; Alterations to current sentencing th a J.

(12 ) those awaiting pre-trial incarceration; Non-arrest for individuals; Enhanced testing protocols for inmates and policies; Engagement with community-based BYRNE certain offenses, particularly those that are lockdown- staff; Provision of PPE for inmates support related; Suspension of prison visitation Ethiopia Suspension of family and legal in-person visitation Increased medical supplies and PPE; Increased testing Release of 4,000 inmates who were elderly, female (14th) with children or expecting, incarcerated for minor offenses, or approaching their release date Egypt Suspension of family and legal in-person visitation –b Appx. 13,000 inmates released into the community (15th) between February and July Morocco Newly admitted inmates undergo required testing; Staff Court hearings conducted remotely to limit inmate Release of 5,645 inmates in April (21st) are screened prior to entering; Suspension of movement in and out of prisons transportation in and out of prisons Rwanda Suspension of prison visitation; Newly admitted inmates Limitation to staff movement outside of prisons; Frequent Appx. 3,600 inmates released into the community (26th) are isolated for 14 days and tested prior to integrating handwashing; Emphasis on maintaining good hygienec with general populationsc Algeria Newly admitted inmates are isolated for 14 daysd Some prisons have undergone isolation protocol; Appx. 15,000 inmates pardoned between February (26th) Movements in and out of prisons (e.g., to attend court and Marchd hearings) have been suspendede Nigeria Lockdownf Wearing protective equipment (masks and gloves)f Over 3,700 inmates released into the communityh (28th) Treatment and isolation sites within prison facilities for inmates that test positiveg Uganda Lockdowns; Inmates are closely monitored for 2 weeks Received essential, donated goods from UNODC, including Evacuating prisoners and staff who test positive to (36th) prior to transfersi medical supplies and hygiene products to increase the off-site treatment centersi medical response and sanitation within Ugandan prisons, as well as technology to support videoconferencing in facilitation of virtual (in lieu of in- person) court hearingsj (Continued) Table 2. (Continued). Country (Rank) Front-End Within Back-End Kenyak (39th) Temporary scale down of services and activities in the Mandatory screening for all prison officers; Sanitization at Aggressive program of deinstitutionalization justice sector to curtail the number of offenders all entry points; Regular disinfection of prison facilities; implemented – an estimated 12,000 persons had entering the system – the National Council on the Mandatory quarantine of symptomatic inmates; Testing been released from prison within a span of five Administration of Justice discouraged the arrest and of all new inmates entering the prison system; Use of months since March 2020 detention of minor offenders; Suspension of visitation PPE; Maintenance of a well-organized shift system for officers Tanzania Temporary suspension of all visitationl Handwashing stations installedm Release of nearly 4,000 inmates into the community (49th) in Apriln *Note: Sources regarding unmarked countries in this table can be found in the text of this article. aSee Kras and Fitz (this volume) for more details regarding South Africa’s response to COVID-19 in its prison system. bLittle is known about procedures in response to COVID-19 within Egypt’s prison, largely due to information blackouts. cSee All Africa https://allafrica.com/stories/202004010634.html. dSee Anadolu Agency. It is important to note that it is unknown if the release of Algerian inmates was specifically to address the pandemic https://www.aa.com.tr/en/africa/algerian-president- pardons-over-5-000-prisoners/1788147. eSee the Global Detention Project https://www.globaldetentionproject.org/countries/africa/algeria. fSee UNODC https://www.unodc.org/nigeria/en/nigerian-correctional-service-partners-with-unodc–unaids-and-eu-to-prevent-the-spread-of-covid-19-in-custodial-centres.html. gSee the Guardian https://guardian.ng/news/covid-19-51-medical-officers-17-inmates-test-positive-in-bauchi-state/. hSee the Nigerian Correctional Service https://m.facebook.com/story.php?story_fbid=295620761827295&id=101563864566320. iSee the World Health Organization https://www.who.int/news-room/feature-stories/detail/uganda-ministry-of-health-and-who-respond-covid-19-cases-spike-in-prison. jSee UNODC https://www.unodc.org/easternafrica/en/Stories/boost-to-covid19-response-in-uganda-prisons.html. VICTIMS kSee Deche and Bosire (this volume) for more information on Kenya’s mitigation strategies to COVID-19 in its prison system. lSee Human Rights Watch https://www.hrw.org/news/2020/05/21/tanzania-prisoners-rights-ignored-covid-19-response. m See Reliefweb https://reliefweb.int/report/united-republic-tanzania/covid-19-prisons-handwashing-stations-tanzania-inmates. & nSee the Citizen https://www.thecitizen.co.tz/news/-Magufuli-pardons-3-973-prisoners-on-union-day/1840340-5534890-93usycz/index.html. OFFENDERS 5 6 S. RAPISARDA AND J. BYRNE

There have been conflicting reports on COVID-19 response tactics of prison administrators, depending on the source (i.e., members of the correctional department versus inmates). In Pretoria, which contains South Africa’s largest correctional facility, Kgosi Mampuru II, after an outbreak of 118 inmates in mid-August, inmates accused guards of not only general neglect and brutality, but for spreading the virus while conducting unnecessary raids under fabricated allegations of contraband (Koko, 2020; Mahlangu, 2020). Inmates also alleged that social distancing is impossible (Mahlangu, 2020). A department spokesperson refuted these claims by stating that inmates within the prison were intentionally instigating prison staff as a tactic for release and ensured that necessary preventative measures had been implemented, such as isolating infected inmates and quarantining and monitoring the remaining prison population (Koko, 2020; Mahlangu, 2020). The spokesperson also detailed the current multi-pronged approach of prevention, containment, and treatment implemented across South African pris­ ons, which includes the use of personal protective equipment (goggles, gloves, masks, gowns and more) as well as screening and testing (Mahlangu, 2020). Moreover, it was reported that over 700 additional nurses were employed to better bolster the prisons’ response to COVID-19 across South Africa (Mahlangu, 2020). After months of banned visitations, on August 25, 2020, the Correctional Services Department announced the possibility of reinstituting visitations to inmates, as South Africa lifted some restrictions while moving to level 2 of lockdown measures (Mlamla, 2020).

Reported outbreaks of COVID-19 in Ethiopia’s prisons and jails Ethiopia houses the second largest prison system in Africa and ranks 14th worldwide with almost 114,000 inmates (World Prison Brief, 2020). As a country, Ethiopia has tallied 45,221 positive COVID-19 cases and 725 COVID-19 related deaths to date (Coronavirus Resource Center, 2020).8 However, estimations of case prevalence within correctional settings have been imprecise. According to Marks and Negeri (2020), as of August 21, 2020, the Ethiopian Health Ministry would not respond with a verified number of infected inmates. Based on multiple sources, it appears that COVID-19 has been spreading throughout prisons in the city of Ziway, where 23 cases were confirmed in just two weeks (early-to-mid August); it has been reported that authorities have responded by ramping up testing (Marks & Negeri, 2020). It has also been speculated that recent spikes in positive cases within jails can be attributed to “widespread unrest” that led to almost 200 deaths and thousands of individuals incarcerated.9 Jails reported an influx of inmates, which contributed to overcrowded conditions that were conducive to increased risk of transmission. Despite recent rises in cases within correctional settings in Ethiopian cities such as Ziway, many initial precautions were reported to combat the virus’s spread in the early stages of the pandemic. According to the United Nations Office on Drugs and Crime (UNODC, 2020), approximately 4,000 inmates who were elderly, female with children or expecting, incar­ cerated for minor offenses, or approaching their release date, were released in March. Prior to release, inmates were quarantined to ensure that the virus would not spread into the community (UNODC, 2020). Furthermore, the Government of Sweden, amongst other agencies such as UNODC, provided Ethiopia with essential medical supplies and PPE to aid in the effectiveresponse of frontline workers to COVID-19 in prisons and the community at large. VICTIMS & OFFENDERS 7

Reported outbreaks of COVID-19 in Egypt’s prisons and jails The third largest prison system in Africa is located in Egypt, which ranks 15th worldwide with 106,000 incarcerated individuals (World Prison Brief, 2020). To date, Egypt has confirmed almost 98,000 positive COVID-19 cases and 5,317 deaths (Coronavirus Resource Center, 2020). On February 14th, Egypt was also the first country to report a positive case in Africa (Aljazeera, 2020). As a preventative measure, approximately 13,000 inmates had been released between February and July to reduce the risk of spreading the virus (Human Rights Watch, 2020); though, critics claim that this number is far too small to effectively decongest prisons and jails, making social distancing practices near-to- impossible. Moreover, Egyptian prisons and jails were not equipped to provide sufficient medical care and had poor access to testing and symptom screening, which can be corroborated by Egypt’s low testing rate (N = 1,316 per 1 million individuals, to date10), ranking 40th out of 57 African territories (Human Rights Watch, 2020; Worldometer, 2020). According to the Committee for Justice (2020), by August 7, 2020, Egyptian prisons had 220 suspected cases, 111 confirmed cases and 17 deaths. However, prison case counts to date have been questioned, due to perceived lack of transparency (Madhok & UNICEF, 2020). Despite suspected outbreaks among prisons, Egypt had officially implemented a strict information blackout regarding the state of correctional sites countrywide, in addition to banning all prison visits, including meetings with lawyers, since early March (Human Rights Watch, 2020). The Egyptian government threatened to take legal action against media outlets or journalists that reported on COVID-19 in ways that departed from official statements. These intentional, isolating actions align with accusations of (and potentially reveal) corruption and mismanagement of resources allocated to respond to COVID-19, and the avoidance of transparency and accountability in these matters (Amnesty International, 2020).

Reported outbreaks of COVID-19 in Morocco’s prisons and jails Of Morocco’s nearly 86,000 inmates, 5,645 were released in April as a precautionary measure (Eljechtimi, 2020). In response to hotspots of COVID-19 in some of its prisons in early July, Morocco intensified its response. For example, all incoming inmates were required to be tested before entering prison, and staff were screened before resuming their work (Mebtoul, 2020). The Moroccan judiciary continued to hold its trials remotely, rather than to transport inmates in-and-out of prisons. Three of the most affected prisons in Morocco (as of early July) were placed on quarantine to prevent further outbreaks (Mebtoul, 2020). In a similar fashion, hotspots within the community were also met with increased restrictions and augmented responses to the virus. As of August 26, 2020, Morocco had a cumulative community count of 55,864 positive COVID-19 cases and 984 deaths (Coronavirus Resource Center, 2020).

Reported outbreaks of COVID-19 in Kenya’s prisons and jails Kenya is ranked 39th in the world’s top 50 largest prison systems (N = 53,348) and 8th in cumulative COVID-19 case totals among other African countries (N = 34,016).11 Similar to other African countries, Kenya has not been immune to prison-based COVID-19 outbreaks 8 S. RAPISARDA AND J. BYRNE

(Coronavirus Resource Center, 2020; World Prison Brief, 2020). In response to over 100 confirmed COVID-19 cases and 3 deaths among inmates and staff in Kenyan prisons by early April, nearly 4,000 inmates were released and monitored outside of custodial settings (Wasike, 2020). The Kenyan Commissioner General of Prisons noted that this preventative tactic was intended to achieve at least one meter in distance between inmates within prison settings to reduce the spread of the virus (Wasike, 2020). On August 21, 2020, it was reported that a prison in Kericho, Kenya confirmed 48 positive cases among inmates and staff, which prompted a total lockdown, indefinitely suspending any members of the community from entering Kenyan prisons (Mbewa, 2020a; Rotich, 2020). This incident also prompted the Chief Justice of Kenya to address the public and propose an effective response. He announced that the judiciary would be aiding in the decongestion of prisons; however, he noted that a “fair allocation of funds” must be made available to increase the number of judicial officers and expand infrastructure for the process to be efficient and successful (Muiruri, 2020).

Reported outbreaks of COVID-19 in Uganda’s prisons and jails Uganda has reported a very small number of COVID-19 cases (N = 2,524) and deaths (N = 26) relative to other African countries and worldwide (Coronavirus Resource Center, 2020). However, this may represent the calm before the storm. On August 23, 2020, just over 150 inmates and 1 staff member tested positive in one Ugandan prison in less than 24 hours, thus spurring this Northern Ugandan prison to close for nearly a month (Agade, 2020; Mbewa, 2020b). The Ugandan Commissioner General of Prisons attributed the spike in cases within this Ugandan prison to a combination of influences, including abated lockdown restrictions, higher transmission rates in the community, and continued senten­ cing and incarceration (e.g., newly admitted inmates potentially infiltrating jail or prison settings with the virus, particularly in asymptomatic cases; Agade, 2020).

COVID-19 outbreaks in other countries throughout the African region Rwanda released approximately 3,600 inmates (almost 6%) of its estimated 65,000 inmate population nationwide (Prensa Latina, 2020; World Prison Brief, 2020), while Algeria pardoned over 15,000 of its inmates between February and March,12 which accounts for nearly a quarter of its prison population (Jibril, 2020). Interestingly, Nigeria has both a relatively small prison population size (N = 62,258) as well as total community COVID- 19 case count (N = 53,021), despite that it is the most populous country on the continent (Agence France Presse, 2020).

Concluding comments COVID-19 outbreaks in both the general community and in the largest prison systems in the African region appear to be lower than other global regions, at least during the initial several months of the pandemic. One plausible explanation for this trend is that, unlike any other global region in the world, all 10 African countries containing Africa’s largest prison systems have engaged in back-end mitigation strategies with the prominent goal of reducing prison overcrowding. Nine out of 10 of the African prison systems have, to some degree, VICTIMS & OFFENDERS 9 engaged in releasing thousands of inmates into the community. However, this situation may change in the coming months, as evidenced by the recent increase in reported cases in both prisons and the general community. The well-documented problems related to the pre- existence of many diseases, prison crowding, prison heath care, and prison infrastructure underscore the need to reduce the prison and jail populations in these regions, because in- prison mitigation strategies will likely be difficult to implement, due to lack of resources.

Notes

1. As of late-August (2020). 2. Not including either the Oceanic region or Antarctica. 3. Africa’s total COVID-19 case count is based on data extracted from Coronavirus Resource Center on August 26, 2020. 4. As of late August (2020). 5. The African countries within the world’s 50 largest prison systems include South Africa (ranked 12th), Ethiopia (ranked 14th), Egypt (ranked 15th), Morocco (ranked 21st), Rwanda (ranked 26th), Algeria (also ranked 26th), Nigeria (ranked 28th), Uganda (ranked 36th), Kenya (ranked 39th), and Tanzania (ranked 49th; World Prison Brief, 2020). 6. For more detail, see the country-specific reviews of South Africa and Kenya included in this volume. 7. As of August 23, 2020. 8. As of August 26, 2020. 9. For more detail, see Marks and Negeri (2020). 10. As of the end of August (2020). 11. As of August 26, 2020. 12. However, the Algerian president was not explicit as to whether his choice to release inmates was related to the pandemic.

Disclosure statement

No potential conflict of interest was reported by the author(s).

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