The passerby who looks in the direction of the Magazine Prison in Borella, Colombo, may notice the words “Prisoners are human beings” in raised letters along the prison boundary wall.
How many of the hundreds who daily go past the prison give a thought to the humans who live within the prison precints? And how many of those who do give a thought to the prisoners ever wonder about the conditions they live in, locked up in their tiny cells?
Not many would know that prisoners are among the most vulnerable groups in respect of socially communicated diseases.
Every year, some 30,000 convicted persons are absorbed into the country’s 34 prisons. The moment they enter the closed and claustrophobic environment of a prison, they are exposed to a variety of diseases, including viral infections, fever, tuberculosis (TB), skin disease (rashes/dermatitis) and sexually-transmitted infections (STIs). The majority of prisoners are aged between 22 and 40. In 2010, there were 32,128 fresh admissions to prisons – 31,096 males and 1,032 females.
The Ministry of Health Ministry and the Ministry of Rehabilitation and Prison Reforms have formulated an action plan to boost prison health services and minimise the risk of prisoners spreading disease,.
“Starting in May, we will be screening all new admissions for communicable diseases,” Health Ministry Additional Secretary Dr. Palitha Mahipala told the Sunday Times. “Those already suffering from illnesses will be put under medical supervision and given the required medication.”
Dr. Mahipala chairs the steering committee that oversees health facilities in prisons. The committee comprises the Prisons Commissioner, the heads of all 34 prisons, and the health directors. The health directors oversee public health, tuberculosis, HIV/AIDS, environment and occupational health, and non-communicable diseases. Cleanliness, lighting, ventilation and sanitary conditions will be regularly reviewed.
Starting next month, and at the request of Rehabilitation and Prison Reforms Minister Chandrasiri Gajadheera, medical files will be maintained for all new admissions. Prisons will be monitored and guidelines issued to ensure the smooth operation and functioning of health facilities, including the supply of medicinal drugs. Surgical, skin, STI, TB and dental clinics will be conducted once a week. On admission, prisoners will undergo blood pressure, body mass index (BMI), and blood glucose checks, and they will be tested for non-communicable diseases. They will also be advised on healthy lifestyles. Female prisoners will attend regular health camps where they will be checked for breast and cervical cancer, sexually transmitted diseases, and general hygiene.
“After the pilot project at Welikada Prison, the health services will be introduced to other prisons,” Dr. Mahipala said.
Overcrowding is a major concern and a reason for the spread of respiratory illnesses. Cases of TB have surfaced in the Colombo, Kandy and Mahara prisons.
“An STI clinic was set up at Welikada prison two weeks ago,” Prisons Commissioner (Welfare) Lakshman Silva told the Sunday Times. “Those with STIs at Welikada, the Colombo Remand and the New Magazine prisons in Colombo are sent to the clinic for treatment. On opening day, between 30 and 40 male and female prisoners came to the clinic. Most had skin problems, while a couple of patients had mumps. More than 40 percent of prison inmates are injection drug users [IDUs] and active homosexuals, and therefore vulnerable to illness.”
While Colombo prisons are well served by medical staff, including doctors and nurses, prisons in the rest of the country, including the prison in Vavuniya, are greatly in need of medical practitioners, Mr. Silva said.