RESULTS AND DISCUSSION
3.2 Sample Characteristics
3.2.2 Crime Profiles of Respondents
Table 3: Crime Profiles of Participants
Respondent Date of Sentence Crimes Committed sentence
1 12/09/2003 3 Years 1. Possession of firearm
imprisonment 2. Possession of ammunition 2 13/05/2002 8 years and 721 1.Theft of motor vehicle;
days 2.Parole break
imprisonment
3 16/04/2002 15 years Murder
imprisonment
4 28/09/2000 18 Years Rape
imprisonment
5 25/06/2004 15 Years 1. Two Counts: Possession of
imprisonment stolen vehicle
2. Bribery and corruption
6 11/02/2002 6 Years Indecent assault
7 2/03/2004 20 Years 1. Three counts of attempted
murder
2. Robbery with aggravating circumstances
In this study the records showed that four of the seven respondents spent periods of between one and four years awaiting trial in prison prior to being sentenced. Three of these participants were diagnosed HIV positive whilst awaiting trial in prison. The medical files reflected that they received medical treatment both whilst awaiting trial and after having been sentenced. It is encouraging to note that the offenders had access to medicaltreatment during the different stages in the sentencing process.
The remaining three respondents were admitted to the prison hospital in the year that they were sentenced. This suggests that they could havebeen already ill at the time they were sentenced and admitted to prison. This places a serious burden on the Department of Correctional Services, as prisons do not have adequate health care facilities and resources. It is difficultto provide the intense and specialized care needed by terminally ill patients in prisons. It also results in additional costs to the Department of Correctional Services bUdget and according
already overworked
Four of the respondents in the study were transferred to the prison hospital at Durban Management Area from prison hospitals across the province of KwaZulu- Natal. As discussed in the literature review (Chapter 2,40) one of the principles of palliative care is that a coordinated, continuous plan of care is maintained from the time of admission to bereavement and support of the family. In this study the medical records reflected that medical services rendered at the transferring hospitals, were followed through at the prison hospital at Durban Management Area, thereby ensuring continuity of treatment. As discussed in the literature review (Chapter 2, 42) one of the principles of palliative care is that a
coordinated, continuous plan of care is maintained from the time of admission to bereavement and support of the family.
According to the crime profiles (Table 2) the offender-patients were sentenced to periods of imprisonment ranging from 3 years to 20 years. The crimes that they were sentenced for ranged from parole break, theft of motor vehicle to murder and rape. Two of the respondents who were sentenced in 2004, less than a year prior to the study, were already terminally ill. This means that they had not had the time to adjust to being imprisoned and to work through possible feelings of guilt about the crime, or to deal with unfinished business in their personal lives.
One can argue that the primary purpose of rehabilitation is being defeated in this situation. They have committed serious crimes and have been sentenced to long terms of imprisonment, that is, 15 and 20 years respectively. Circumstances such as these pose many dilemmas for the South African criminal justice system and for the Department of Correctional Services. The questions that can be asked are: What are the legal and social implications of alternate sentencing for persons who are ill with HIV and AIDS and have committed serious crimes?
Should the justice system be looking for alternate community based sentences for these offenders? Should the illness be taken into account as a mitigating factor by the courts during the sentencing process?
As discussed in the literature review (http://www.aegis.com/news/ads/2001) (Chapter 2, 27) the justice system in other countries do not consider HIV or AIDS as a mitigating factor during sentencing. The situation in South Africa appears to be similar. Discussions with an advocate in the Pietermaritzburg High Court revealed that the South African justice system as a rule also does not consider HIV or AIDS as a mitigating factor during sentencing for two reasons. Firstly, the court has to consider the interests of society, the seriousness of the crime and the interests of the accused in passing sentence. Secondly, the court believes that prisons have the necessary medical facilities to care for the sick person.
(Personal interview: Advocate Blumrick: Pietermaritzburg High Court: 14/09/05).
3.2.3 Medical Details Of Participants
Table 4: Medical Details of Participants
*all the above information was transcrrpted directly from the medical files.
PARTICIPANTS DETAILS OF MEDICAL CONDITION OF PARTICIPANTS 1 Admitted to prison hospital in September 2004. Has
developed paralysis in his right leg due to a stroke; suffers from weakness in his knees; walks with crutches.
2 His condition is deteriorating; has received treatment for TB but defaulted with treatment regularly. Was referred to Wentworth Hospital for specialist treatment.
3 Diagnosed to be HIV-positive in 2002. Suffers from TB. Was transferred from Kokstad prison hospital to Durban prison for treatment 3 months ago. Has been referred to an external hospital for X-Rays.
4 First became ill in November 2003. Admitted to Waterval prison hospital, but asked for a transfer to Westville as he believed he will receive better treatment. He was transferred as requested, but is still not happy with his treatment and has asked for a referral to an external hospital. Suffers from massive glands, his legs are affected and he is extremely weak. Uses a wheelchair.
5 Initially admitted to Eshowe prison; transferred subsequently to Durban prison for treatment. Is HIV-positive and receives treatment for TB; is extremely weak. Walks with crutches.
6 Diagnosed HIV-positive in 2002. Was transferred from Ncome prison to Durban in early 2003 to be near his family.
He also suffered a stroke and suffers from hypertension.
Walks with crutches; his condition is deterioratinQ.
7 Diagnosed HIV-positive in July 2002 whilst awaiting trial.
Received treatment for TB but defaulted treatment from October - December 2002 because he felt better.
Counselled about compliance. During 2003 he remained terminally ill with a poor appetite, recovered slightly during early 2004 when he was able to walk with crutches. At the time of the interview he was totally bed-ridden again.
According to the treatment and care model (Chapter 2 Page 35) services for voluntary counselling and testing should be made available at the asymptomatic stage. According to prison policy all offenders have access to this whilst in prison. All the respondents confirmed that they received pre-test and post-test counseling during the testing phase.
It is clear from the contents of the medical records (table 3) that four of the respondents suffered from tuberculosis, an HIV related opportunistic infection.
Also, it can be inferred from the above medical records of the respondents that the roller coaster nature of the HIV and AIDS disease was evident.
The patients suffered from declining health alternating with periods of stability, which is considered normal in the course of the disease as discussed earlier in the literature review (Chapter 2; Page 47). The mobility of the offender-patients had also deteriorated because of the disabling nature of the illness.
According to the medical profiles many of the respondents had developed complications requiring specialized care. The prison hospital does not have the resources for specialist care. According to information from the files there were plans to refer these offender-patients to provincial hospitals for specialist care.