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Coping with Mental Distress in Ugandan Prisons

Giida Nikuze at her work station.


 It’s been four years since Susan Nakabugo was released from Luzira Women Prison, but tears still roll down her face whenever she recalls the mental anguish she endured in detention.

Nakabugo was living with her 10-year-old son in Kireka, a suburb of Wakiso District, when she was arrested in 2008.

“The police came at 1am while we were asleep. I awoke my son and told him I was going to be arrested,” narrates the 40-year-old mother.

Nakabugo also told her son to stay in the house until morning and travel to her sister’s home in the village.

The journey to prison

Nakabugo was arrested for grievously harming a child. When the child died a few months later, she was charged with manslaughter and sentenced to six years in prison. She claims she is innocent.

Nakabugo had been working in a restaurant. After saving enough money, she invited a friend to join her. Together, they opened a restaurant in Katoogo, Kireka.

“Business was good. We even managed to hire a waitress. However, with time, my friend and I developed misunderstandings,” she says.

On the fateful day, Nakabugo’s friend went to visit a witchdoctor to get ‘medicine’ to lure more customers to their restaurant. Upon returning to Kireka at 6pm, Nakabugo’s friend did not go to the restaurant.

“I was puzzled by her attitude but I continued working,” Nakabugo says, adding, “Towards midnight, I called her to pick her portion of the day’s profits. She refused to come, so I left the money on the table and locked up.”

A few minutes later, Nakabugo’s friend called her back and told her to take everything she owned out of the restaurant since they were going separate ways. A fight ensued, a small crowd gathered to watch, and amidst the throwing of punches and blows by the two friends-turned-foe, a saucepan of boiling beans got emptied on a child.

“She bit my finger, almost taking it off. Then, she threw things at me. As she stepped back, she knocked over a bench, which fell on a saucepan of beans. Her child was standing behind her and he was burnt.”

Nakabugo spent a year on remand before she was sentenced.

Psychological wellbeing of prisoners

 Losing one’s freedom can be distressing and disorienting. From interacting with friends and family at will, the prisoner now must interact with fellow prisoners and warders.

“I felt bad but I had nothing to do. I saw prisoners try to escape but the warders captured and beat them. I had to find the courage to block your emotions. But the stress is terrible. I was constantly thinking of my son,” Nakabugo says.

While on remand, Nakabugo was not given demanding work to do. Every morning, she was taken to a workshop to make mats. With so much time on her hands, her thoughts were given flight.

“I would just stare into space the whole day. I was so depressed. I kept asking myself why I was bothering to make those mats yet my son might be starving,”

With time, though, Nakabugo learned to encourage herself to stop worrying.

Doreen Asiimwe Kazoora, the officer-in-charge (OC) of Luzira Women Prison says all prisoners are counseled as they enter the prison and during their stay.

“Our welfare officers do counseling according to observance. You can look at an inmate and see that she is not well,” Kazoora explains.

She says every morning, the prison warders move around the wards to count the inmates. If an inmate has an issue, they raise their hands and ask to speak to either the OC, welfare officers, or to make a phone call.

Kazoora adds that each ward has a leader – Katikiro – who is a point of contact. Any inmate who needs help talks to her.

“It is rare for someone not to get help. We also have psychiatrists who come from Butabika hospital to treat extreme cases.”

Butabika National Referral and Teaching Mental Hospital is the only referral mental health institution in Uganda. It provides diagnosis and treatment for mental, neurological and substance use disorders.

Irene Namwano, the executive director of Prison Fellowship Uganda, says for inmates serving long sentences, depression stems from worries about what will happen to them after they leave prison.

“Some of them were living in rented rooms before they were jailed. After 15 years in prison, where will they go? Sometimes, families of their victims are waiting to harm them when they leave prison.”

Namwano, also a former inmate at Luzira Women Prison, adds that anger builds up over time.

“Those women have needs that no one can meet. For some, their husbands have moved on, married again and are doing well. Some have been on remand for a long time. They see a dark future and even if a counselor talks to them, they cannot have peace. The problems come back the minute they enter their beds.”

For Nakabugo, hard labour started after her conviction. For two weeks, she was incarcerated at Kigo Maximum Security Prison before being returned to Luzira.

“We dug a lot. From 8am to midday, we worked on the prison farm. Then, we went to collect firewood in a wetland. The wardens would cut pine trees and give us the heavy logs to carry. You had to carry that log and navigate your way through the wetland. If the log fell, the warden beat you.”

Rehabilitation to cope with stress

 To keep the inmates busy, most prisons have rehabilitation programmes. Luzira Women Prison offers classes in tailoring, crafts making and hair dressing. There are also recreational activities such as netball, music, dance and drama. For those inclined to education, there are classes from pre-primary up to A-level, as well as studying law.

“We also have a zero grazing project and a mushroom growing project. Inmates take part in these activities before midday. In the afternoons, they are free to join fellowships and spiritual gatherings or talk to external counselors,” Kazoora says.

For Nakabugo, she sought solace in preachers and counselors, whom she would tell her problems. This was important, considering that for six years, none of her family members visited her in prison.

“My father is too old to travel and besides, villagers fear prisons. They believed they would be arrested if they came to visit me. I survived on handouts from kind inmates,” she says.

One of the counselors Nakabugo frequently spoke to was Namwano. After Nakabugo shared her worries about her son, Namwano traveled to Bugerere in Kayunga District and brought the boy back to Kampala. He was malnourished and was not going to school. Namwano took care of his school dues until Nakabugo left prison.

Namwano says although prisons have welfare officers to counsel inmates, the latter prefer talking to independent counselors because they think welfare officers are just mechanically doing their job and might gossip about them to other officers.

“They do not bring out all they want to say. They keep it in and the pressure builds up.”

Namwano says when she was still in jail, a fellow inmate attempted to commit suicide. When Namwano spoke to the inmate, she opened up, and told Namwano about her frustration over her case, which had been in court for years.

Namwano adds that although the state of prisons has improved, there are complex psychological situations that inmates have to deal with.

“There are more murders today. It is not just about the act. There are complications around it, such as hatred and fear. The inmates anticipate hell. If they have money, they live well but psychologically, they are in a bad place and anything can trigger a mental breakdown.”

Nakabugo also took solace in routine activities such as meal time, and even the work they undertook. On Saturdays, Nakabugo would dig for well off inmates and they would reward her with a cup of raw rice to supplement the single meal the prison offered every day.

“Later, I was assigned to work in the administrative building where I mopped the offices, swept the compound, and washed the OC’s car. When I would call inmates to see their visitors, some of them showed their appreciation by giving me food.”

According to Namwano, most of the people in prisons who suffer from mental health issues have one thing in common – an unstable family background.

“They do not have a stable ground on which to stand. If they do not know God, there is no one to cry to. They keep it inside.”

Getting legal assistance

When Nakabugo was taken to court, a state lawyer represented her. After her conviction, she decided not to appeal.

“I did not want to disturb the court. I also did not have money. I kept seeing people appeal their cases, in vain. They remained in prison yet they had spent a lot of money.”

Since many inmates come from low socio-economic backgrounds, accessing the good legal representation is a huge challenge.


However, lawyers with the African Prisons Project (APP) run legal awareness sessions in prison to inform inmates about the legal processes relevant to their situation. They do this pro bono.


Emmanuel Oteng, a tutor with the University of London programme under APP says, “From these sessions, inmates become aware of their rights and who within the prison community can assist them to ensure those rights are enjoyed.”


APP also empowers prisons staff and inmates with legal skills to assist their less knowledgeable inmates who have legal problems.


There is a belief that state lawyers almost always get their clients convicted. Like many public sectors, low funding to the judiciary hampers delivery of justice.  As a result of poor quality of work, some of the inmates’ files get lost and this leads to a frustrating delay in their cases.


Oteng says much as APP meets these challenges they remain true to their work.

“Delays occasioned by lost or misplaced files hamper appeal processes. Our response is to engage in file tracing because we would never abandon someone we have committed ourselves to helping, someone most likely used to being abandoned by others.”


Preparing prisoners for release


Nakabugo was not consciously prepared for the time when she would walk out of prison. She was only told to forgive the person responsible for her incarceration.


“When I walked out of the gate, my first glimpse of the outside brought fear,” she said. “I was used to life in prison. I was emaciated. I knew nothing, I was like a fool. I was only given transport to my village.”


According to Kazoora, the prison has a discharge board that sits monthly to find out about the inmates who are about to be released.


“The welfare office gets in touch with their relatives and they also engage the inmates about where they are going and what they are going to do. Some inmates are counselled on forgiveness and reconciliation. Those who have learned a skill are given some materials, such as sewing machines.”


Namwano says that the information welfare officers give to inmates who are about to be released is not always effective or practical.


“An inmate who is thinking about how to start life all over again will not really listen to information about reconciliation. They train them with skills but if the inmate does not have a home, where will she practice the skill?”


She said many inmates upon release hold onto other ex-prisoners for company, while others, with nowhere to go, sleep on verandahs.


When Nakabugo returned to Kampala to find work, she was stigmatized but she ignored what people were saying. In fact, she once passed by her accuser but did not talk to her.


Nakabugo worked as a waitress in a restaurant upon release but the pay was not sufficient to pay her son’s school fees. Although she is now the caretaker of an old woman, she longs to be her own boss.


When former inmates reoffend


When former inmates are not adequately prepared, they may fail to cope with life outside prison even when they have reformed. Failing to make ends meet on a daily basis can easily force a former inmate to re-offend. Namwano, who, through her organization, visits different former inmates, has faced this dilemma. Five of the former inmates she has counselled have been taken back to prison.


“One time, I proudly told an OC in a prison about the reformation of one of the women I had counseled. He laughed and told me she had been rearrested. I could not believe it. He sent someone to call her, and indeed there she was. I asked her if she was not yet tired of prison. She just looked down.”


Namwano realized that words may not always make an impact.


“When she was released, I took extra steps. Since she knew how to make mats, I bought raw materials and then took the completed mats to church and forced people to buy them. I also paid her rent. Now, it is over ten years since she was released.”


Various stakeholders have been emphasizing the need to sensitize the public about the psychological state of inmates so that when they are eventually released, they are welcomed back into the community. This is crucial in ensuring they do not commit more crimes, as a result of improper rehabilitation.





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