The world contains many thousands of political prisoners but in the last 50 years only one of them, Nelson Mandela, has turned his imprisonment into a tool to create political change and national liberty.
He accomplished this by intelligence, guile, patience, tolerance for his enemies — and a display of such majestic dignity he commanded the sympathy of the world, even the grudging sympathy of the white South Africans from whom he won power.
To a harsh, cold world he brought a strange and refreshing sweetness. News from Africa was almost always bad, just as it is today, but news involving him always carried a grace note of hope. His gift to everyone was an unquenchable optimism, maintained in the face of appalling conditions. That, and quiet good humour
While serving his 27-year prison term, Mandela was diagnosed with early stage tuberculosis in 1988 after being admitted to hospital in Stellenbosch near Cape Town with a bad cough and weakness and having complained of dampness in his cell.
Two litres of fluid were drained from his chest and he spent six weeks recuperating in the hospital before being transferred to a private clinic near his mainland Cape Town prison where he was the facility’s first black patient.
“When the report came back from hospital they indicated that fortunately we sent the specimen before there were holes in the lung,” he said in 2004. “I underwent treatment and was completely cured after four months.
In January 2011, Mandela set the nation on edge when he was hospitalised for two nights with an unnamed acute respiratory infection at the age of 92.
The damp conditions at Pollsmoor Prison were believed to have contributed to his illness, so upon his release from the hospital Mandela was moved to Victor Verster Prison, also outside Cape Town, where he had a secluded cottage with the pool. When he arrived, he was greeted by Coetsee, the justice minister, bearing a case of wine.
According to Professor Wood, Pollsmoor has several characteristics making it an ideal space for TB to spread.
“Conditions prevailing in Pollsmoor Prison are extremely conducive to the ongoing transmission of TB, including drug-resistant TB … Crowding, long lock-up times up to 23 hours per day, and inadequate ventilation result in prisoners re-breathing contaminated air for prolonged periods of time.”Added to this is a delay of up to four months in accessing medical care, he says. As a result, the state does not know how many prisoners actually suffer from TB during their incarceration.
Tuberculosis in prisons
- The level of TB in prisons has been reported to be up to 100 times higher than that of the civilian population.
- Cases of TB in prisons may account for up to 25% of a country’s burden of TB.
- Late diagnosis, inadequate treatment, overcrowding, poor ventilation and repeated prison transfers encourage the transmission of TB infection.
- HIV infection and other pathology more common in prisons (e.g. malnutrition, substance abuse) encourage the development of active disease and further transmission of infection
A history and physical exam will be performed. A Mantoux skin test (PPD) will identify previous exposure to tuberculosis (TB). A positive PPD does not necessarily mean one has tuberculosis (TB). Other tests need to be done to confirm an active TB infection. Sputum culture and culture of other fluids are done as deemed appropriate for the clinical presentation. Imaging studies are performed to define the extent of disease.
CBC, Chem 12, CT Scan, MRI, UA, X-Ray
Other Specific Tests: Mantoux skin test, blood cultures, urine cultures, CSF (cerebrospinal fluid) cultures, sputum cultures
Mandela”s health in general
In December, 2012 Mandela underwent nearly three weeks of treatment for a recurrent lung infection and surgery to extract gallstones.
He was admitted on December 8 and allowed to leave on December 26 for home-based care.
He also spent one night in hospital in early March 2013 for what was described as a scheduled medical checkup.
He was readmitted on March 27 for 10 days of treatment for pneumonia when doctors drained a build up of fluid from his chest, known as a pleural effusion.
On June 8, he was back in hospital with a renewed lung infection after his condition deteriorated. He was initially said to be in a serious but stable condition.
Mandela had surgery in 1985 for an enlarged prostate gland that had caused a urinary blockage.
In 2001, he received radiotherapy treatment for prostate cancer and told reporters the following year that he had been given a clean bill of health against the disease.
In February 2012, he spent the night in hospital after a minor exploratory procedure to investigate persistent abdominal pain.
He underwent a diagnostic laparoscopy, or keyhole surgery, in which doctors made small incisions in the abdominal area to probe it with a tiny camera.
Mandela’s tear ducts were damaged by years of being forced to smash limestone rocks in the quarry on Robben Island, due to the alkalinity of the stone, leaving them dry and prone to irritation.
He had cataract surgery aged 75 in 1994, a few months after being sworn in as the nation’s first black president.
Press photographers were asked not to use camera flash when taking pictures of Mandela.