By Ruth Hopkins
Bloemfontein, South Africa, November 1, 2013
A South African prison, run by the beleaguered multinational private security company G4S, allegedly forcibly injected inmates with antipsychotic medication and used electroshocks to subdue and control them.
Prisoners, warders and health care workers said that involuntary medication was regularly practised at the Mangaung Correctional Centre near Bloemfontein. The company, G4S, denies any acts of assault or torture.
The allegations are according to at least 35 sources – prisoners as well as security guards, prison and health officials – and based on medical records seen by reliable sources, legal documents and video footage shot inside the prison.
A 12-month-long investigation into the prison has uncovered video footage shot inside the prison hospital that shows prisoners being given medication against their will, as well as the use of electroshocks and assaults on prisoners.
The medication causes memory loss, muscle rigidity and other serious, potentially life-threatening side effects, and by law is only meant to be used under strictly controlled circumstances. But these drugs have been used at the prison up to five times a week, sometimes on inmates who show no sign of being psychotic.
Letters from prisoners tipped off the Wits Justice Project about conditions at Mangaung prison.
South Africa’s department of correctional services assumed command of the prison on October 9, after it established that the management had lost “effective control over the prison” following a lengthy spate of stabbings, riots, strikes and a hostage-taking. The department was obliged to step in after G4S dismissed 330 warders and replaced them with uncertified staff, which is unlawful in South Africa.
“I feel dizzy, my muscles are spastic and my memory has gone”
Inmate Sello Mogale looks like a big, burly baby, curled up in the foetal position on a bench in the visiting section of Mangaung prison. A warder shakes his arm and he opens his eyes. He slowly gets up and walks to the interview room with unsteady steps.
Mogale is followed by inmates Willem Vis, Joseph Maruping, David Kambhule and Aubrey Buthelezi. The men, dressed in the light-blue prison uniform, crowd into the small interview room.
Vis says: “It feels like my jaw is falling off. I feel dizzy, my muscles are spastic and my memory has gone.”
The other inmates nod as Vis relates the side effects of the anti-psychotic medicine called Clopixol Depot. He says that the prison started injecting him halfway through 2012 when he complained of hearing voices in his head and a general feeling of depression.
When he refused the medication, the prison’s emergency security team – known in the jail as the “Ninjas” or the “Zulus” – was called. The 16-man team is called in when the warders cannot handle the situation.
Vis alleges that six of them, armed with electroshock shields and Tasers, held him down on the bed, while a nurse injected the antipsychotic drugs into his buttocks.
Mogale, who was sentenced to life for rape in 2008, arrived at the maximum security prison in 2012. He says that the forced monthly injections of Clopixol Depot started soon after his arrival, when he complained of depression and suicidal thoughts.
“I sleep all the time, I cannot stay awake. My mouth is dry and my hands are jumpy. I feel like a zombie or a robot.”
Prison hospital staff said inmates given anti-psychotic drugs Clopixol Depot, Modecate, Risperdal and Etomine
A staff member at the hospital, who wishes to remain anonymous for fear of losing employment, told the Wits Justice Project that Mogale and Vis are given Clopixol Depot once a month. According to the hospital worker, inmates who are considered aggressive, difficult or suffering from mental problems are also given Modecate and Risperdal, antipsychotic medication with known side effects.
Fourteen members of the emergency security team, who spoke to the Wits Justice Project on condition of anonymity, said they helped restrain inmates who were injected involuntarily, up to five times a week. They also said that the injections are authorized through the command structures – which all lead to the head of the prison, Johan Theron.
A video shot on July 24 by the emergency security team, which is legally required to film its actions, reveals how Bheki Dlamini, who is serving a 21-year sentence for armed robbery, is forcefully injected. The team leader of the emergency security team announces that Dlamini is disturbing the peace and good order of the prison.
“We are moving him to healthcare in order to get his medication.”
Although Dlamini understands and co-operates with all their instructions, the team leader claims: “You can see the state of mind of the inmate. It is very risky.”
In the hospital a warder says that the injection has been approved. When they tell Dlamini he will be injected, he protests loudly.
“I am not a donkey, I am not an animal.”
He yells: “No, no, no” while the security team grabs him, twists his arms behind his back and drags him to a room where they wrestle him to a bed and a nurse is called.
According to the hospital worker, who has seen Dlamini’s medical records, he was given an antipsychotic drug called Etomine, which has a potentially life-threatening side effect known as neuroleptic malignant syndrome; it causes muscle rigidity and fever and in extreme cases it can lead to strokes and coma. Dlamini is not psychotic or schizophrenic.
Attorney Egon Oswald spoke to Dlamini on October 18. “Dlamini had complained to a warder that he did not like the vienna sausages they served him; he demanded that the warder should bring him ‘real meat’,” said Oswald.
“They got into an argument and the warder told him the emergency security team would deal with him.”
The video stops as the “Ninjas” pin Dlamini to the bed and they call out to a nurse. According to Dlamini the nurse initially refused to administer the drugs, as she claimed it was unlawful to inject someone without a prescription. But the “Ninjas” insisted she inject the inmate, as it had been approved. Dlamini allegedly suffered from the side effects of the drugs.
“He complained about fidgeting hands, dryness of the mouth, neck spasms and a feeling of lethargy,” said Oswald.
“It is illegal to medicate patients with these drugs if they are not experiencing a psychosis. The side effects are very severe.”
According to South Africa’s Mental Health Care Act, forced medication should leave a lengthy paper trail. It is only allowed if a guardian, spouse or family member has given permission or, if they are unavailable, a healthcare worker. Also, two healthcare practitioners must assess the mental health of the inmate. They have to report to the head of the health institution, who can then decide to treat the patient involuntarily based on the clinicians’ report and the approval of family members or guardians. Involuntary medication is only permissible if the patient is a danger to himself or others and if he is incapable of making an informed decision.
Professor Jan van Rensburg, associate professor at the department of psychiatry at the University of the Witwatersrand, said: “It is illegal to medicate patients with these drugs if they are not experiencing a psychosis. The side effects are very severe. If the prison is medicating the inmates with these drugs just because they are aggressive or as a measure of crowd control, then there is a huge problem.”
Inmate James Mothulwe, who is serving a 35-year sentence at Mangaung prison for rape and murder, is debilitated by the side effects of the drugs. They forcefully injected him for five years, he says.
In 2004, Mothulwe experienced extreme side effects: he was no longer able to straighten his neck, he lost all feeling in his left hand, he could no longer walk normally and he had fits that caused him to pass out. Despite his prolonged protests, he claims the prison kept ordering the injections. In 2007, Mothulwe needed a neck brace because his neck is in spastic paralysis. He was still wearing it in April, when the Wits Justice Project interviewed him. His body makes involuntary spastic movements; there is excess saliva dribbling from his lips. Mothulwe says he has lost feeling in the left side of his body.
Modecate, Risperdal and Clopixol Depot are known to have severe side effects; in extreme cases they can cause strokes and cardiac arrest. Sudden unexpected and unexplained deaths as well as seizures and brain damage are listed as side effects of Modecate.
In 2012, pharmaceutical company Johnson & Johnson was fined more than $1.1-billion for downplaying and hiding risks associated with the potentially life-threatening side effects of Risperdal, which include increased risk of strokes, death in elderly patients, seizures, weight gain and diabetes.
Clopixol Depot is equally dangerous, with side effects ranging from strokes to involuntary movements of face and tongue, muscle stiffness, drowsiness and sleepiness. When these side effects occur, the medication should be stopped or decreased.
“I was told not to talk to anyone, especially the media” – warder who alleges he, like inmates, was injected after a hostage-taking ended.
In 2009, the prison is alleged to have gone a step further and injected a warder.
Former G4S employee Pule Moholo was taken hostage in 2009 by 11 inmates. After a 16-hour ordeal, Moholo and his colleagues were freed and then whisked off to the prison hospital.
Moholo said: “I was told not to talk to anyone, especially the media. A nurse injected me in the buttocks. I hardly remember anything after that moment. I had to be taken out of the hospital in a wheelchair. Two days went by in a blurry haze. I lost my appetite and felt very stiff and disconnected, like a zombie.”
When Moholo finally came to, he said, G4S had started a disciplinary procedure to dismiss him.
Nontsikelelo Jolingana, the acting commissioner of the department of correctional services, said the department is carrying out an investigation into the problems at the Mangaung prison. The forced medicating of inmates is, she said, “illegal and unacceptable.”
“We are also investigating the controller to see why these very serious and shocking allegations were not reported to us,” said Jolingana. She said the official appointed to oversee and report on the prison’s compliance with the law is supposed to report any legal infringement.
The department has been aware of some of the allegations as the 2010 confidential department report was seen by then-minister Nosiviwe Mapisa-Nqakula. Jolingana said she would have to try to find this information.
Commenting on G4S, she said: “I can’t predict any scenario, but this is very serious.”
“G4S denies any assaults or use of torture, either by means of electroshocking or medical substances, on inmates.”
G4S states on its website, G4S.com, that it operates in more than 125 countries with 620,000 employees. The site says G4S is “the world’s leading international security solutions group, which specialises in secure outsourcing in countries and sectors where security and safety risks are considered a strategic threat.”
The company responded to the allegations:
“G4S denies any assaults or use of torture, either by means of electroshocking or medical substances, on inmates. It also has a zero tolerance policy against the use of undue or excessive force.
“The clinical management and diagnosis of inmate patients are managed by a reputable third-party medical facility, which treats a patient’s medical information as confidential. G4S therefore has no access to the specific medical records of inmate Bheki Dlamini. The medical practitioners are bound by ethical codes and the law.
“G4S and its personnel are not involved in the decision to apply, nor do we apply medication. We have not witnessed the illegal application of medication and do not condone it.
“Emergency support team operations are meticulously recorded and subject to review by DCS (South Africa’s department of correctional services).
“The solitary confinement room, referred to as the dark room, was built as part of the concession contract and was never used as a torture room. Since 2002, it has been used as a storeroom.
“Inmates have unrestricted and confidential access to the DCS controller, employees from the office of the inspecting judge, the director, healthcare personnel and psychologists, with whom they can log complaints and raise concerns.
“If any laws were broken, DCS would have strongly acted against G4S. We are taking legal advice to address the serious defamatory allegations made against G4S.”
Copyright © 2013 Ruth Hopkins
References and further reading:
Ruth Hopkins on CBC Radio program As It Happens (Podcast, starts at 14:05)
Amnesty International press release calling for investigation on South African prison
G4S press statement on the Manguang prison
London Stock Exchange page for G4S (GFS:London)
Wits Justice Program