Corrections_Today_Fall_2025_Vol.87_No.3

COMMITTEES

The final station was myself, the other physician in the group, Dr. Marc, and the local Mozambican prison doctor, Dr. M. Each of us had our own translator, as the primary languages were a mix of Portuguese and the local language, Shangaan. The goal of the mission was to pull all the prisoners from both the male and female facilities, as well as staff, out to the yard to screen them for TB and HIV, while also perform ing general wellness exams. Before we began, we were offered a tour of the inside of the prison to better un derstand what we were dealing with. The prison director escorted us into a small cramped room that opened into the facility through a small metal door with a manual sliding lock. The inside of the prison was an atrium about 50 feet long and maybe 15 feet wide. There were about five or six cell doors leading off from the main room into living quarters. The atrium itself was full of bodies; a line of densely packed men stood waiting to get tea from a steaming 50-gallon drum at the front of the room. We were led into one of the adjacent cells to see the living condi tions. What I saw in that room will be seared into my memory forever. The dimly lit room, likely designed to house a dozen men, was home to probably around 75 to 100. There were maybe 20 dank mattresses on bunk beds, but it was clear from the sea of people lying and sitting on the ground that most lived in small spaces on the hard floor. I later learned that two people often slept to a mattress. Clothes and personal be longings hung like a spiderweb across the walls and any available piece

of string. The main source of light seemed to be a small 15-inch TV in the center aisle, illuminating the faces of about a dozen men sitting tightly around it. As we stepped deeper into the room, a profound sense of intrusion set in, as it took great effort not to step on people, despite their attempts to clear a path for us.

not from lack of available water, but because they disliked the taste of it. During the day, inmates could move between the atrium and cells until 5 p.m., after which they were locked into their respective cells. Back in the yard, our stations were ready to receive the first wave of inmates. They came in groups of 20. In contrast to the tattered shirts they wore inside, most appeared in fairly clean orange uniforms. I later learned these uniforms were distributed for the day and returned afterward. Once the inmates completed the full workflow, Dr. Marc, Dr. M, and I would see them for the final check. Our role was to review their health screening questions and results from the TB X-ray and AI stetho scope. Sometimes, this required walking over to squint at the actual X-ray image on a small laptop. If we suspected TB, we ordered sputum testing. This involved handing out a disposable cup for a morning sample and filling out an order form for the lab — always in Portuguese, using a template provided by Dr. M. The TB and HIV screenings were fairly straightforward, though there were some language chal lenges — particularly distinguishing between a dry, chronic cough and a suspicious productive one. Almost everyone reported “night sweats” if the question wasn’t phrased carefully. The challenge lay in addressing the “Other” section of the health screening — an open invitation for them to voice any other complaints. Although there wasn’t much we could offer beyond education for many issues, we could refer them to Dr. M, who could order tests or write

What I saw in that room will be seared into my memory forever.

Back in the atrium, I wandered deeper into the space to peek into the other cells, it was clear we had been shown the largest; the situation elsewhere was no better. In fact, there was one tiny room that appeared to be a supply closet, without beds, where about 15 men sat crammed together drinking tea. It was evident they also lived and slept there. Unique challenges to deliver medical services Over the next several days, I learned that most of the men never leave this space to go outside or receive visitors once they are locked in. A select few were allowed to do yard work based on good behavior, but this seemed rare. As we pulled each of them into the yard for health screening, it became clear that, for many, this was their first time seeing daylight in years. Malnutrition was a challenge; they received only one meal per day and almost never any fruit. Most were mildly dehydrated,

Fall 2025 | Corrections Today

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