Misery and tuberculosis fill prisons in war-torn Ukraine
Food, medical supplies lacking in war-torn area
ZHDANIVKA, Ukraine — The cats living on the grounds of the Zhdanivka penitentiary disappeared when battles in east Ukraine peaked. Talk in the prison is that inmates ate them when food deliveries stopped.
Medical supplies have also been in short supply, threatening the lives of nearly 400 prisoners who need treatment. The principal scourge: tuberculosis. The disease spreads prodigiously in jails and develops into hard-to-treat forms unless properly addressed.
“TB is so common within the penitentiary system that many inmates don’t see it as a deadly disease — they see catching TB as a normal part of life in prison,” Doctors Without Borders said in a recent report. “Some even tell us they don’t care if they die or not.”
The gray, squat, threestory building stands inside a perimeter lined with barbed wire and observation towers. Zhdanivka has, since last year, been under the control of the armed Russian-backed separatists who established the wouldbe breakaway state of the Donetsk People’s Republic. Supplies from the Ukrainian government have ground to a halt — and the ragtag rebel authorities have been at a loss to fill shortfalls.
Prison authorities allowed Associated Press journalists to visit the hospital at the Zhdanivka prison recently, albeit under close supervision.
Most inmates were friendly and happy to talk, but were prevented from doing so by wardens. “My folks probably think I’m dead by now,” says one prisoner, before the conversation is cut short by a minder.
The only prisoners unwilling to speak were in Block 3— a group of about 70 people who rejected medical treatment in protest and said they are afraid doctors are testing unregistered drugs on them.
Responsibility for treating inmates in the underfunded prison shifted as early as 2011 to organizations like Doctors Without Borders. But the group’s role — and its burden — has grown sharply since war broke out last year. The group says 170 patients under treatment at five predetention centers and jails in areas surrounding the conflict zone have developed drug-resistant TB.
Janette Olson, field coordinator of the group’s multi- drug-resistant TB program, said prisoners are refusing to take drugs with unpleasant side effects, making long-term treatment complicated. The group says while the official death rate from tuberculosis in Ukraine is 15 per 100,000 people, the number is 10 times higher among prisoners.
Larissa Zagrebayeva, the laboratory head, said she has been working in the prison for 36 years, and things have rarely been this grim. “Our staff has left,” she said. “They quit.”
Specialists have been forced into flight by unrest and the uncertainty of life under the rebel rule.
Unable to manage on her own, Zagrebayeva has come to rely overwhelmingly on Doctors Without Borders, which has been running tuberculosis and HIV prevention and treatment programs at the prison for the past three years.
In another wing, a Doc- tors Without Borders social worker in a surgical mask held consultations with prisoners due for imminent release. The aim of the talks is to prepare inmates for life on the outside and to emphasize the importance of further treatment.
In countries battling TB outbreaks, prisons are a cause for special concern because they can serve as breeding grounds for the most resilient strains. Once outside, former convicts risk spreading their illness more widely.
Rebel areas are ill-equipped to deal with the medical catastrophe triggered by a war that has killed more than 6,000 people.
Many prisoners who are released find themselves on the streets without money, documents or a home. Without identification documents, it is difficult for them to leave rebel-held areas, so release from prison is a prelude to another entrapment.