Behind the high walls, steel gates and crowded cells of Bulawayo's correctional facilities, an extraordinary story of resilience, hope and transformation is unfolding.
While overcrowding continues to place immense pressure on prison infrastructure, healthcare systems and rehabilitation programmes, innovative HIV intervention initiatives led by the National Aids Council (NAC) in partnership with the Zimbabwe Prisons and Correctional Service (ZPCS) are helping thousands of inmates rebuild their lives and protect their health.
Bulawayo Metropolitan province's correctional facilities are currently housing 5 456 inmates against an approved holding capacity of 4 554, creating significant challenges in accommodation, healthcare delivery and rehabilitation services.
Yet despite these difficult conditions, prisons such as Khami Maximum Prison, Khami Medium Prison and Mlondolozi Special Institute have become centres of positive change through peer education programmes, inmate support groups and income-generating projects designed to strengthen HIV prevention, treatment adherence and psychosocial wellbeing.
For prison authorities, maintaining the health of inmates remains central to successful rehabilitation.
Khami Prison officer-in-charge, chief superintendent Panonetsa Chemugariri, acknowledged that overcrowding presents serious operational challenges.
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“Overcrowding places significant pressure on accommodation facilities, health services, food provision, security management and rehabilitation programmes,” Chemugariri said.
“Nevertheless, we continue to ensure that inmates have access to healthcare, rehabilitation opportunities and humane living conditions within the resources available to us.”
He, however, said through strategic partnerships with stakeholders such as NAC, ZPCS has continued to deliver critical services to inmates.
Chemugariri said communicable diseases such as HIV and tuberculosis required continuous monitoring, counselling and treatment, making healthcare one of the most important pillars of correctional rehabilitation.
“Healthcare remains one of our priority areas. Every inmate undergoes health screening upon admission to identify communicable diseases, chronic illnesses, mental health conditions and any ongoing treatment requirements,” he said.
“For inmates who are already receiving treatment before admission, mechanisms are in place to ensure continuity of care throughout incarceration and, where necessary, after release.
“One of the emerging challenges confronting correctional institutions is the growing prevalence of drug and substance abuse.
“We continue to receive increasing numbers of offenders whose criminal activities are directly linked to substance abuse.
“In many instances, offences such as theft, robbery and violent crimes are committed under the influence of drugs or in pursuit of sustaining substance dependency.
“Consequently, drug and substance abuse rehabilitation has become a major component of our correctional programmes.
“To strengthen healthcare delivery, we have established internal support systems including peer education programmes, inmate support groups and the training of inmate nurse aides who assist healthcare personnel in promoting health awareness and basic health services within institutions.”
He said healthcare was an important component of rehabilitation.
Chemugariri said NAC has played a pivotal role in strengthening HIV and Aids interventions within ZPCS institutions through support for HIV prevention, testing, counselling, treatment adherence and continuity of care programmes.
“NAC has also assisted in the training of inmate peer educators who play a critical role in health promotion and behaviour change communication among fellow inmates,” he said.
“Beyond health education, NAC has supported occupational therapy and rehabilitation initiatives through the funding of income-generating projects and skills development programmes that promote mental wellness, positive engagement and successful reintegration.
“These interventions have significantly enhanced the quality of life of inmates and contributed to a healthier and more productive correctional environment.
“We remain grateful for NAC's continued partnership and commitment to leaving no one behind in the national HIV and Aids response.”
At the heart of the prison HIV response is a peer-led intervention model that empowers selected inmates to become educators and advocates for positive behaviour change among fellow prisoners. The programme is supported by NAC.
“This programme equips us with knowledge and communication skills to promote HIV prevention, encourage testing and reduce stigma within correctional institutions,” said Moses Moyo, a peer educator.
“For many prisoners, information delivered by us their fellow inmates carries greater weight because it comes from individuals who understand their daily realities.
NAC Bulawayo provincial manager Sinatra Nyathi described correctional facilities as critical intervention points in Zimbabwe’s HIV response and praised the progress achieved through the partnership with ZPCS.
“We are pleased with the progress that has been achieved through our partnership with the Zimbabwe Prisons and Correctional Service,” she said.
“Inmates are part of our key populations programming and it is important that they have access to comprehensive HIV prevention, treatment and psychosocial support services.”
Nyathi said the peer-led model has become one of the most effective tools for behaviour change within prisons.
“The strength of the peer-led model lies in its ability to create trust and openness among inmates,” she said.
“Peer educators are able to communicate HIV prevention messages effectively because they understand the environment and the challenges faced by fellow inmates.
“We have seen encouraging results in terms of increased awareness, reduced stigma and improved uptake of HIV services.”
Beyond awareness campaigns, inmate support groups have emerged as lifelines for prisoners living with HIV.
Within these groups, inmates share experiences, discuss treatment challenges and encourage one another to remain adherent to antiretroviral therapy (ART).
The result has been improved treatment outcomes, stronger mental wellbeing and a culture of mutual support.
The effectiveness of these interventions is reflected in the prison’s treatment adherence record.
Khami Maximum Prison resident medical officer, chief correctional officer Ashley Pasihapaori, said the institution has virtually eliminated cases of ART defaulting through a strict directly observed therapy (DOT) system.
“Our nurses go to the hostels during medication times carrying individually labelled medication for each inmate. They personally observe every inmate taking their medication,” Pasihapaori said.
“As a result, we do not have issues with inmates defaulting treatment or adherence problems.”
The institution also provides prevention of mother-to-child transmission (PMTCT) services for pregnant inmates and specialised nutritional support for children staying with incarcerated mothers.
Pasihapaori revealed that the prison currently has four expecting inmates receiving antenatal care while seven children are living with their mothers at the correctional facility.
“We have a special allocation diet for the seven children because their nutritional requirements differ from those of adults,” she said.
The spirit of rehabilitation extends beyond healthcare.
NAC-supported income-generating projects are helping inmates acquire practical skills while creating opportunities for productive engagement during incarceration.
The initiatives complement vocational training programmes already offered by correctional facilities and provide inmates with skills that can support livelihoods after release.
The commitment to inmate welfare is also evident at Mlondolozi Special Institute, a specialised correctional facility that caters primarily for psychiatric inmates.
Acting officer-in-charge assistant commissioner Tinashe Zhou said the institution currently houses 825 inmates, including 704 psychiatric patients and 126 ordinary inmates.
“The majority of our inmates are psychiatric patients and require specialised care and attention,” Zhou said.