Esther

MACA (Abidjan central prison) is the biggest prison in Côte d´Ivoire. It has a sorry reputation of overcrowding. What are the facts?
The reputation is deserved: MACA contains half of Côte d´Ivoire´s prison population, with over 5,000 prisoners for the 1,500 places it was built for in the 1970s. Living conditions for the inmates are complicated, difficult, with some cells containing up to 70 men, so the overcrowding is appalling.

Does this overcrowding lead to tension and violence?
Everything is a problem: access to food and water is limited; violence is part of the inmates´ daily lives. To that you must add the problem of malnutrition and deplorably insanitary conditions: tuberculosis is a major problem and HIV prevalence is estimated at more than 10%, at least double the national rate in Côte d´Ivoire.

What does the project supported by ESTHER consist of?
It is based on twinning, like most ESTHER programmes; the MACA health centre is twinned with the care unit at Bordeaux prison, supported by Dr Denis Lacoste´s team at Bordeaux teaching hospital. The project is extensively supported by the Côte d´Ivoire authorities: the ministries of public health and justice. The aim is to set kup an operational programme for the care of PLWHAs in MACA, whether inmates or staff.
We consider that prison can be seen as an opportunity to support prevention activities and facilitate screening and information about the diseases and the modes of transmission. I also believe that it is possible here to promote appropriate care and provide inmates with therapeutic education. In recent years, advances have been made in care for tuberculosis in MACA. We should not neglect AIDS. And our work must also concern the staff working in the prison, and their families. The project is designed for them too.

What are the next stages?
Training courses have already begun: in October we supported courses in care and training for peer teachers among staff and inmates. The next stage is the official launch of the project by the Ivorian ministers of health and justice, the prison administration and our French partners at Bordeaux teaching hospital.