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Penal Reform International (2002)
36 pages (61KB) Prisons are among the unhealthiest places in societies. Here, not only are people deprived of their freedoms, but they are subjected to violence, addiction and infectious disease. Why are prison conditions a threat to prisoners’ health? What exacerbates this and what are the structural problems? Which principles should rule prison life? This article, and series of connected papers, from Penal Reform International, addresses the wide issue of health in prisons and focuses on the African case in particular. Proper healthcare is a basic human right; prisoners have the right to the highest standards of care. Prisons do not have to be unhealthy per se, indeed some are not. Many heads of prisons are recognising that there has to be good access to health care and health promotion as well as links between their institution and society. TB is up to 100 times and HIV 75 times more prevalent in prisons than in the general population. In general, the prison conditions by themselves are a threat to prisoners’ health, in particular promiscuity and overcrowding. The report also highlights the need to take account of the following:
- The HIV epidemic is a new and complex problem, involving technical challenges and substantial barriers of ignorance and stigmatisation.
- African countries face unique structural problems, particularly scarce resources, trained personnel, inadequate recruitment, lack of access to healthcare (particularly drugs) and a more general lack of concern.
- Violence as an everyday reality in many prisons. There are wide-reaching reasons for this including ethnic tensions, gang rivalries, boredom and power struggles.
- Prisoners human rights should be respected and follow standard minimum rules set down by the United Nations for care in custody.
- Protecting public health while respecting individual rights is crucial and involves all prison staff, prisoners, family members and visitors.
- Women prisoners often come from marginalized and socially-deprived backgrounds. Many may be affected with HIV when entering a prison and in some cases pregnant. Most prisons are designed with men in mind.
Africa is paying the heaviest price in terms of HIV/AIDS and women have a particular experience of this. However, good prison policy can provide a unique moment in women’s lives where they have access to counselling, testing, healthcare and education that they may not have when they leave. Other policy recommendations include:
- Keeping premises and people clean, providing soap and detergent, separating infectious patients and allowing external organisations to provide medical care.
- Peer information and counselling should be encouraged to disseminate knowledge about the prevention of transmittable disease and to emphasize the importance of education.
- Governments should ensure good management practices are enforced including equality of access to healthcare, reducing punitive measures, being more open to the outside and developing prison activities.
- There should be a continuing public health program to include counselling, treatment and confidential private health examinations for all prisoners.
- NGO’s and civil society should assist in awareness programs, develop networks to co-ordinate their work and include prisons in the planning of their activities wherever possible.
- Donors should ensure their assistance benefits the targeted persons, support NGOs and encourage developmental programs in the field of prison health in recipient countries.
Source: Penal Reform International, 2002, 18-20 September, Health in Prisons, Paper presented at Pan-African Conference on Penal and Prison Reform in Africa Access document:
Available online
Related resources: This document forms part of the GRC Exchange topic guide page on "Penal Reform" - part of the wider GRC Exchange topic guide on "Safety, Security and Access to Justice".
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