How China’s COVID-19 medical aid mitigated a health tragedy in Cameroon’s overcrowded prisons

By Cameroonian journalist Isidore Abah, first published on Journal du Cameroon.

Before the outbreak of the coronavirus pandemic, Cameroon was already reeling in the throes of internal strife, characterised by five major crises: Boko Haram insurgency in the Far North Region; repeated cross-border attacks perpetrated on the population in the East Region by rebels from the Central African Republic (CAR); post-presidential electoral upheavals in the Littoral, Centre, West, South and East Regions; and the ongoing armed conflict rocking the North West and South West Regions of the country.

Kondengui Maximum Security Prison, Yaoundé, Cameroon.

The country did not envisage another crisis. So, when the coronavirus, broke in the Wuhan Province of the People’s Republic of China during the latter part of 2019, Cameroonian authorities did not only regard it as an alien virus far-off from its shores, but also as one crisis too many for her to grapple with.

So, the government was initially cagey to engage in the coronavirus battle. However, it did not take long for what many Cameroonian authorities regarded as a foreign virus to come knocking at the country’s doorsteps. On March 6, 2020, the first case of COVID-19 was diagnosed in Cameroon and five days later, the World Health Organisation (WHO) on March 11, 2020, tagged it as a global pandemic. There was total pandemonium in Cameroon as it became clear that the virus was no longer foreign; it was right here with the people, and the hitherto unfazed Cameroonian authorities became restive on how to adequately tackle the situation.

Government swings into action, rolls out austerity measures

Barely a week after the first COVID-19 case was diagnosed in Cameroon, the number of positive cases soared to about 10 and the government was forced to roll out austerity COVID-19 barrier measures to contain the spiralling number of positive cases.

Addressing the nation on Tuesday, March 17, 2020, Cameroon’s Prime Minister, Chief Dr Joseph Dion Ngute, prescribed 13 austerity measures to contain the pandemic, ranging from the closure of the country’s borders, schools, the prohibition of gatherings of more than fifty persons, compulsory wearing of masks and the strict implementation of preventive measures recommended by WHO.

Fighting COVID-19 with water, soap, cloth and thread

The eruption of COVID-19 only came to compound the glut of challenges bisecting Cameroon’s healthcare system. As the country was busy wrestling with its perennial healthcare problems, the coronavirus pandemic struck and further exacerbated the country’s fragile healthcare system.

When the virus showed its ugly head in Cameroon, the country literally had no basic medical equipment to tackle it. Few months after the first case was diagnosed, 12 healthcare workers reportedly died of the virus. They had no protective gears to effectively protect themselves with. As such, the patients they came in contact with who had contracted the virus simply passed it on to the medics with relative ease. The consequences were alarming, and Cameroon, which was initially regarded as a safe haven for COVID-19, became the epicentre of the virus.

The only sophisticated medical equipment Cameroonians had to combat the virus with was water, soap, cloth and thread. Government officials insisted on regular hand-washing, while tailors were busy using clothes and thread to produce locally made facemasks, since the wearing of facemask in public places had been made mandatory.  There were very few hand sanitisers, which could not even be afforded by all; the hand-washing exercise was not even effective in some conurbations of the country, given the acute shortage and irregular water supply. Consequently, Cameroon was left at the mercy of the pandemic.

Cameroon’s overcrowded prisons, a ticking time bomb for COVID-19

The coronavirus outbreak in Cameroon was an unwelcome guest, especially in the country’s prisons and other detention facilities.  Apart from being bedevilled by an array of challenges, prisons and other detention facilities in Cameroon are still regarded by the government as punitive, and not as reformation or correctional centres. That is why little attention is paid to them.

In his 2018 Human Rights Report, Cameroon’s Minister of  State, Minister of Justice and Keeper of the Seals, Laurent Esso, revealed that as at December 31 same year, prisons in Cameroon had 31,815 detainees for 17,915 available places.

This means that some 13,900 detainees had no accommodation. And with the ongoing internal strife, characterised by haphazard arrests and detention, the Minister’s number of inmates in Cameroon, which was even vigorously challenged by opposition party leaders as being grossly inadequate, had either tripled or quadrupled.

According to the Minister’s report, of the 31,815 prisoners, 18,435 of them were awaiting trial, giving a percentage of 57.9% of the total population incarcerated.

At the Buea Central Prison and the Kumba Principal Prison in the South West Region, for example, 500 to 700 inmates were cramped in a single room in late 2018. In the heat of the Anglophone Crisis, detention facilities in the North West and South West Regions were brimming over in such a way that inmates were forced to sleep in the wild under the guard of heavily-armed security forces.

The situation of inmates was further compounded by the precarious healthcare system in Cameroon’s prisons. In a correspondence addressed to the Minister of Justice, on March 26, 2020, the Human Rights and Liberties Commission of the Cameroon Bar Association decried inadequate, and in some cases, the non-existence of health services in these detention centres.

According to members of the Commission, the health coverage in Cameroon’s prisons of one medical doctor to 1,383 detainees was inadmissible.

They also pointed out the poor hygienic conditions, lack of potable water and toilets, and urged the government to decongest Cameroon’s prisons because, according to them, prisons were “an imminently foreseeable threat to COVID-19, as access restrictions have been placed on staff responsible for the supervision of prison activities and visitors; hydro-alcoholic gels and other products containing alcohol have been prohibited in prisons. Prisons are a real breeding ground for the COVID-19 pandemic…” the Commission members alerted.

The Cameroon Bar Association Human Right and Liberties Commission argued that the restrictions must urgently be accompanied by various measures geared toward immediately reducing congestion in prisons since health problems can lead to the lethal spread of the disease.

In addition to requesting the release of sick and irregular detainees, the Commission also called on the Ministry of Justice to adjourn the execution of short prison terms; release the oldest prisoners, pregnant women, disabled and those who are approaching the end of their sentences.

The supervisory ministry of the prison administration was also urged to limit the use of pre-trial detention during this period of health crisis as they questioned the whereabouts of the decree of application of alternative sentences.

“Because of the break of contact between prisoners, their family members and friends as a result of the steps put in place to stem the spread of coronavirus; it should necessarily lead to more flexibility in the use of the telephone, electronic messaging, television and the internet.”

The lawyers said this should be part of precautionary measures to be included in the government’s action plan to fight the disease and avoid cases of violence and riots in the prisons.

“It is a set of necessary but extremely urgent precautionary measures intended to make visible the forgotten people of our society, crowded in promiscuity. It is an obligation for all, the respect for fundamental rights of detainees overlapping here with the endangering of prison staff,” Barrister Bissou, Chair of the Cameroon Bar Association’s Human Rights and Liberties Commission, stated.

Barely 48 hours after the Human Rights and Liberties Commission of the Cameroon Bar Association’s missive to the Justice Minister, Human Rights Watch (HRW) on March 27, 2020 issued a press release, calling on the Government of Cameroon to decongest the country’s prisons in order to protect the population from the COVID-19 pandemic.

In the communiqué, HRW Central Africa Director, Ilaria Allegrozzi, said: “In Cameroon’s prisons, which are notably overcrowded, keeping social distance, practicing self-isolation, and taking measures such as hand washing are just not possible.”

She highlighted the case of the Buea Central Prison which was initially constructed for 700 prisoners but which currently harbours over 2,000 prisoners.

According to Allegrozzi, “Under international law, Cameroon has an obligation to ensure the health care of people in prisons, and it cannot do that with this pandemic with such overcrowding. Authorities should release individuals whose pre-trial detention is not absolutely justified on public safety grounds and put in place a system for considering early or supervised release for those most at risk.”

A report in the New York Daily News of March 16 asserted that it is difficult to prevent coronavirus in prisons through hygiene and sanitation, because “if someone gets the flu inside, the whole prison will get it before the illness passes its course. Prisoners live in such close conditions that diseases pass through with the speed of jailhouse rumour.” Nevertheless, hygiene and sanitation are basic ways of preventing COVID-19, but these aspects are neglected in most of Cameroon’s prisons.

According to 2013 research carried out by Helen Namondo Fontebo, hygiene in Cameroonian prisons is neglected, with prisoners usually abandoned.

“As regards sanitation, the septic tanks are always full beyond capacity and reports have indicated that the inmates themselves struggle to unblock these septic tanks. The insufficient number of toilets means that some inmates are left with diarrhoea stools on their bodies and they often go for several days without taking a bath,” she stated in her report.

The gory picture painted above is no different at prisons in the crisis-hit English-speaking regions which are more crowded now, given the mass arrest of citizens during the over four years of armed conflict that has rocked the two regions.

As one of the measures to curb coronavirus, decongesting prisons is indispensable to limit social contact among prisoners. There are growing concerns that there will be a health catastrophe in Cameroon’s prison if one inmate was to contract the virus in a prison cell.

Chinese business magnate wades in to rescue Cameroon from coronavirus

As Cameroonian authorities were still sweating on how to resolve the COVID-19 conundrum in the country, Chinese business magnate, Jack Ma, through the Jack Ma Foundation (JMF), donated millions of facemasks and COVID-19 test kits to each of the 54 countries in Africa to help combat the coronavirus outbreak.

Cameroon’s consignment in the aforementioned donation consisted of 1.1 million test kits, six million facemasks and 60,000 protective suits. The equipment was handed over to the Cameroon government by Ethiopian Airlines officials on behalf of the Chinese business mogul.

In response, the government of Cameroon lauded the donation from the Chinese business tycoon and said it will go a long way to mitigate the spread of the COVID-19 pandemic, first in it hospitals and especially in its detention facilities.

The Government lauded the mutually beneficial Sino-Cameroon bilateral relations and hoped that such cooperation ties between the two countries should continue in the future.

The 1.1 million test kits were distributed throughout the country to help in the detection of the various. The test kits arrived in Cameroon when only one centre was saddled with the responsibility of testing and providing results of COVID-19.

Prison Guards on duty at Kumba Principal Prison, Southwest Region, Cameroon.

This implied that the samples of all those who exhibited signs or symptoms of COVID-19 were collected from all the 10 regions and sent to Yaounde for testing.

The results were only made available several weeks later, after which those who tested positive for coronavirus had spread the virus to family members, friends and loved ones before even knowing their status. In some cases, the victims too had lost their lives before the results would reach them.

So the 1.1 million test kits helped the government to open up diagnosis centres in the country’s 10 regional capitals. This facilitated diagnoses and the early detection of the virus, as well as the early placement of patients on treatment or quarantine.

The 60,000 protective suits were shared out to medics and healthcare givers, who were frontline workers in the fight against the pandemic. Medics in the various prisons and detention facilities also benefited from the donation, but the reason healthcare services were not effective in prisons was the ratio of detainees to doctors and the fact that prisons in Cameroon are still largely regarded as punitive, not correctional centres.

Inmates run riot after surging COVID-19 cases 

Meanwhile, despite repeated appeals from the Human Rights and Liberties Commission of the Cameroon Bar Association, Human Rights Watch, and the Centre for Human Rights and Democracy in Africa for government to decongest prisons and detention facilities due to surging COVID-19 cases in prisons, the government gave a deaf ear to these appeals.

On Friday, April 8 to Sunday, April 10, 2020, prisoners at Kondengui Maximum Security Prison, the largest prison in Cameroon, ran riot in the detention facility after over a dozen inmates died under mysterious circumstances.

According to the inmates, their fellow detainees died after exhibiting symptoms of coronavirus. They said despite showing signs of having contracted the virus, prison administrators gave little or no attention to them.

One of the inmates stated in a social media note sent out to reporters, “That is why most of them died because of the virus. And with the way we are cramped in here like sardines, we were afraid of our lives that we may not survive the scourge of this virus. That is why we decided to riot to also tell the government that the fact that we are detainees here does not mean that we don’t have our own fundamental rights that must be respected at all times”.

Government caves in, liberates some prisoners

After the Kondengui prison riot, pressure mounted on government to decongest prisons. The pressure was further intensified by the fact that most African states were already liberating their prisoners as a way of fighting the coronavirus pandemic.

Ethiopia freed over 4,000 prisoners, Morocco 5,000, Nigeria 2,600, the Democratic Republic of Congo 1,200, Kenya 4,000, Senegal 2,000, and Ghana over 890. Cameroon could no longer remain indifferent to these appeals in the face of the global pandemic.

It was based on the above that President Paul Biya on April 15, 2020, signed decree No 2020/193, to commute and remit sentences.

Under the presidential decree, life sentences were reduced to 25 years, those who were already served life sentences and had them reduced to 25 years will have five more years taken off their sentences. Ten-year sentences were cut down by three years, five-year sentences were reduced by two years, and three-year sentences whittled down by one year.

After regaining his freedom following the Presidential decree, a former inmate of the Kondengui Central Prison, unnamed here for fear of victimisation, said: “Our conditions in prison were horrible. Inmates were dying and the authorities were unmoved so we had to riot for our own safety. We were afraid of the continuous death of our colleagues and we were sure that they were dying of COVID-19.  With the kind of awful conditions in the prison, we all regarded ourselves as potential corpses”.

Emmanuel, a detainee at the Buea Central Prison said: “If I say our prison was overcrowded is an understatement. Inmates were sleeping outside the prison cells. With the on-going Anglophone Crisis, people are just brought in at the dead of the night with nowhere to keep them. We were happy when the President ordered for prisons to be decongested but the conditions in the decree made only a few of us to benefit. Let us keep praying for our prisoners because should this coronavirus get in there, everyone will die”.

How prison administrators are fighting COVID-19

As the COVID-19 pandemic rages on, different prison administrators have adopted different strategies to combat the pandemic and keep their prisons safe. According to the Superintendent of the Bamenda Central Prison, Henry Asaah Ngu, some 138 inmates who were liberated following the presidential pardon tested negative for COVID-19.

According to him, with the decongestion of the prison, they will be able to effectively implement the COVID-19 barrier measure prescribed by the World Health Organisation and the government of Cameroon. “With the release of these detainees, we will be able to effectively implement barrier measures such as effective facemask wearing and social distancing within prison cells,” he asserted.

On his part, the Superintendent of the Buea Central Prison, Joseph Ngombe, stated that as measures to combat the virus, he has suspended face-to-face meetings between visitors and prisoners, and stopped prison outreach activities by religious and Non-governmental Organisations.

“At the entrance of the Buea Central Prison, we have instituted compulsory hand washing by visitors and the wearing of facemasks by prison attendants.”

Furthermore, the Superintendent in charge of the Kumba Principal Prison, Nyenti Leonel Ebot, said the government did not only prescribe COVID-19 barrier measures, but also put in place accompanying measures to help facilitate the implementation of these preventive measures.

“We stopped close proximity visits of members of the outside world with our inmates, we also prohibited outdoor activities. We reinforced hand washing with soap, use of facemasks, use of hand sanitisers, clean-up campaigns, but we could not ensure social distancing in prison because it is not possible,” he said.

Just like the above penitentiary officials, the other ten whom we talked with enumerated the same barrier measures put in place by the government of Cameroon and the WHO, which they said they are respecting religiously.

Why Cameroon’s prisons are overcrowded

According to the Department of Criminal Matters and Pardon in the Ministry of Justice, as of May 2019, Cameroon had 30,606 detainees spread out in 77 operational prisons across the national triangle.

The 30,606 detainees are held in facilities that were constructed to accommodate a maximum of 9,000 inmates, and the normal capacity for the 77 prisons is 19455 places. But political pundits say the number is grossly underrepresented and that the government is putting out such figures just for the international community.

An official at the Department of Criminal Matters and Pardon in the Ministry of Justice, who opted to remain anonymous, told this reporter that it is very difficult to decongest prisons in Cameroon because of the numerous bottlenecks stifling the smooth discharge of justice. Our source highlighted corruption, the non-independence of the justice systems, political witch-hunts and political score-settling as some of the reasons why prisoners are languishing in pre-trail detention and swelling up prisons in Cameroon.