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Nelson Mandela International Day: Spotlight on Kenya's first methadone dispensing clinic in prison compound 

Nairobi, 16 July 2020 - It is barely three months since an Opioid Substitution Therapy (OST) Clinic for dispensing methadone began operating at the Shimo La Tewa Prison in Mombasa County, achieving a first for Kenya.

The new OST Clinic is situated in the Shimo La Tewa Health Centre, in the compound of the maximum security prison, and serves prisoners who use and inject drugs as well as members of the surrounding community.

The clinic is the result of unique collaboration between the Kenya Prisons Service (KPS), Mombasa County, United Nations Office on Drugs and Crime (UNODC), and the National AIDS and STI Control Programme (NASCOP), with financial support from the UN Joint Team on HIV and the Government of Sweden. 

On Nelson Mandela International Day 2020, UNODC is highlighting the Shimo La Tewa OST facility as an example of innovation in Africa in applying the UN Standard Minimum Rules for the Treatment of Prisoners – also known as the "Nelson Mandela Rules". 

Observed each year on 18 July, Nelson Mandela International Day promotes humane conditions of imprisonment, raises awareness of prisoners as a continuous part of the community, and values the work of prison staff as a social service. 

“UNODC applauds the Kenya Prisons Service for its leadership with this unique clinic which has started operating at a critical time, given the chronic overcrowding at the only other OST Clinic at Kisauni, in Mombasa County, which was also catering for clients from the Shimo La Tewa Prison,” the UNODC Regional Representative for Eastern Africa, Dr. Amado Philip de Andrés, said. 

“Moreover, by ensuring the continuum of care whereby prisoners, including those living with HIV and those who use and inject drugs, benefit from the same standards of health care that are available in the community, the Prisons Service provides a prime example of the Nelson Mandela Rules in action,” Dr. de Andrés said. 

UNODC is the custodian of the Nelson Mandela Rules which set out generally accepted good principles and practices in the treatment of prisoners and prison management globally, including health-care services.

“Good prison health is good prison management because the provision of drug treatment in prison settings contributes to safety and security in prisons by reducing other risks and disruptive behaviour, including violence in prison settings,” the Head of UNODC’s Health and Social Development Pillar at the Regional Office for Eastern Africa, Dr. Fayzal Sulliman, said.

“Opening the additional methadone dispensing facility in the Shimo La Tewa compound has decongested the Kisauni Clinic and abolished the need for time-intensive daily trips to the Kisauni Clinic, thus diminishing the risk of possible COVID-19 transmission from the community to this vulnerable population in a closed setting, and also of security breaches,” Dr Sulliman added. 

Mauritius, Seychelles, Morocco and Kenya are the only African nations to have introduced OST services in prison settings.  

OST Clinics in different parts of Kenya provide medication in combination with counselling and psychosocial therapies with the aim of assisting people with Opioid Use Disorders. 

Prisoners assisted with construction of the Shimo La Tewa MAT clinic, with KPS assigning skilled and unskilled labourers. UNODC procured a shipping container that was retrofitted to serve as the dispensing OST Clinic, and provided additional building materials, furniture and IT equipment. 

Mombasa County now caters for all consumable medical commodities and supplies at the clinic while the methadone is supplied by the Ministry of Health. Additionally, UNODC supported the training of KPS and Mombasa County staff at the prison health centre. 

The operationalization of the OST dispensing facility at Shimo laTewa formed part of the combined response to the health threats posed by COVID-19 in Mombasa County by KPS and Mombasa County authorities. 

Since the first confirmed case of COVID-19 in Kenya in March, KPS has taken proactive steps to reduce the risk of transmission of the virus in its institutions across the country, to safeguard the health of prisoners, staff and stakeholders. 

Last month, 60,000 disposable gloves, 251,250 litres of hand sanitizer and other vital hygiene supplies were handed over to KPS to support their ongoing COVID-19 pandemic response. The supplies were procured by UNODC with funding from the European Union and the UK Government through the British High Commission to Kenya. 

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Health care services set out in the Nelson Mandela Rules include: 

Rule 24

1. The provision of health care for prisoners is a State responsibility. Prisoners should enjoy the same standards of health care that are available in the community, and should have access to necessary health-care services free of charge without discrimination on the grounds of their legal status. 

2. Health-care services should be organized in close relationship to the general public health administration and in a way that ensures continuity of treatment and care, including for HIV, tuberculosis and other infectious diseases, as well as for drug dependence." 

Rule 25

1. Every prison shall have in place a health-care service tasked with evaluating, promoting, protecting and improving the physical and mental health of prisoners, paying particular attention to prisoners with special health-care needs or with health issues that hamper their rehabilitation. 

2. The health-care service shall consist of an interdisciplinary team with sufficient qualified personnel acting in full clinical independence and shall encompass sufficient expertise in psychology and psychiatry. The services of a qualified dentist shall be available to every prisoner. 

Read the complete Nelson Mandela Rules.