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Tackling TB in a Malawi Prison

Due to the confined and congested living conditions, Malawi’s prisons are often a fertile ground for TB infection. Prison authorities and medical staff are keen to find solutions.

Zomba Central Prison was built in 1923 and serves as the only maximum security prison in the country. The building itself has fallen into disrepair with a leaking roof and cracked cement floors. However, the biggest challenge is overcrowding as the prison houses more than 2,000 inmates in a facility originally built for only a few hundred. The health clinic for the prison serves both inmates and staff alike but critical patients are sent to the nearby Zomba Central Hospital. Despite the challenging working conditions, the Prison Clinic has managed to receive accreditation as a stand-alone testing and treatment site for prisoners with tuberculosis (TB).

James Jenda works at the Prison Clinic as a lab technician and deals with TB cases. On a typical day, James dons a white lab coat over his military attire and perches on his stool with eyes glued to a microscope.

“Since our Clinic became a stand-alone site, we have noted a decline in the number of TB cases,” states James proudly. “This is a great feat for such a resource-constrained institution.”

With support from the U.S. Agency for International Development (USAID) in 2014, Dignitas organized a training on the use of state-of-the-art iLED microscopes and then donated a microscope to the Prison Clinic.

James benefitted from the training and eagerly points out, “This is a 2-in-1 microscope. It can work as a standard microscope but it also makes use of iLED technology. The time required and the size of the sample needed to identify TB cases has been significantly reduced. With the battery pack, it can work even when there is no electricity.” James is already training three more prison staff to work in the TB lab.

Next month, the prison medical team is organizing a large scale TB screening where they expect to test and treat nearly 400 inmates. Apart from supporting TB care, Dignitas has also hired two full-time dedicated clinicians to work at the Prison Clinic so that patients don’t have to wait to receive timely treatment and care.

Prison-warder-Liddy-Kitalo-at-Zzomba-Central-Prison“Left! Right! Left! Right!” shouts the Parade Commander. Liddy Kitalo thumps her steel toe boots on the concrete floor. In 2002, Liddy graduated from the Mpanga Prison Training School in Blantyre at the age of 19. Since then, she has worked her way up from prison warden to prison patient attendant. Today, she is assigned as the escort for prisoners that have to be transferred to the hospital. Liddy has begun upgrading her education and wants to become a health care worker. She loves serving the prisoners was one of three prison employees who expressed interest in joining the next microscope training. She aspires to be a laboratory technician, pharmacist or radiographer one day.

James serves Liddy’s mentor and is pleased that the staff are enthusiastic about being trained so that the prison can deliver quality medical care.

“Our ultimate aim is to create an environment where we can heal others,” shares James.

Dignitas InternationalTackling TB in a Malawi Prison