PUBLIC HEALTH AND THE PRISONER

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PUBLIC HEALTH AND THE PRISONER

• Is there a Problem?
• Peter Sims UPNG

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Teaching and Learning Tasks
Learning Objective To understand the composition
of the Prison population in terms of its
epidemiology
3
Performance Objectives
To appreciate 1.The variation in the use of
prison worldwide 2.The changing size and
composition of the prison population 3.Diseases
common in prison and among prisoners 4.The
success and failure of prison 5.The problems of
prison and imprisonment-individual and
societal 6.Possible solutions
4
Write the vision, and make it plain upon
tables, that he may run that readeth it
Habbakkuk
ch.2 v.2

• Peter Sims
• Professor of Public Health Medicine
• The School of Medicine
• University of Papua New Guinea
• ltpetersims_at_upng.ac.pggt

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WHY PRISON?

• The Public Health and Private Good
• Who is in Prison?
• What for?
• What is it like?
• Does Prison work?
• What else can we do?

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WHAT ARE PRISONS FOR?

• To protect society from the activities of evil
  doers
• Prison,as Punishment will be an effective
  deterrent, both for the ex-convict and the
  person tempted into criminal activity
• In Prison the criminal will have opportunity to
  repent, reform and be rehabilitated

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WHO GOES TO PRISON?The Mad, the Bad and the Sad
Young Menlt35 Low IQ Ethnic minority
The sad Depressed Anxious Inadequate
The Mad Psychopaths Personality disorders
The Bad Criminal cultures Evil fanatics
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A Crime committed-the Law broken

• The Process of Law

Crime committed
The Court Process Verdict Judgement Punishme
nt
Investigation
Arrest Remand
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The Men and Women in Prison

• In the UK at any time there are 60,000 people in
  prison
• 20,000 are on remand,awaiting trial
• Less than 4,000 are women
• The average time in prison is 18 months
• In 1 year 150,000 people pass through Prison

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Types of Institution

• High-Medium-Low security Prisons
• Men-Women Prisons ,Juvenile Offenders
• Special Prisons for
• - Criminally insane -Military -Political
• Prisons are built in remote places to make escape
  difficult,the buildings are comfortless
  fortresses, the ambience is gray, cold, stone and
  is designed to depress and crush the human spirit

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Hierarchies,currencies,abuse

• Prison Hierarchies

The Screws
The Bosses
The Blokes
Drugs,Tobacco
Sex offenders
Bullying,abuse
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Risks to Health-the diseases of Prison

• Tuberculosis
• Diarrhoeal disease
• Infections-typhus
• HIV and STDs
• Trauma
• Mental illness
• Suicide

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Health risksDrug addiction and HIV disease

• Drug abuse -drugs are easily available
• -people are bored and unhappy
• -there is a culture of drug taking
• -drugs are the currency
• -shared, dirty needles spread HIV
• -there will be opportunity for voluntary/involunta
  ry homosexual sex

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Prison Health Care

• Preventive Services
• Eyes, teeth, ears,and skin care
• Spectacles, dentures Hearing aids etc
• VD treatment
• Drug addiction
• Alcohol addiction

• Treatment services
• High consultation rates/sickness
• Trivial problems
• No self therapy
• No trust of doctor
• No continuity of care
• Poor compliance

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Does Prison Work?-No

• The re-offending rate remains stubbornly high
  worldwide at 70 and little affected by
• The Prison-High /Low secure
• The Prisoner-offence, age, sex
• The regime-tough,punitive or rewarding of effort
  and educative
• The length of sentence, remission, parole

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A Future VisionPrison as a therapeutic
communityPrison as a Healthy Setting

• Imaginative sentences
• Tailored to individual
• Family links
• Paid work
• Education
• New skills
• Probation/follow up
• Parole,furlough

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After Prison-what?

• Financial security
• Real work provided on discharge,properly paid and
  reflecting new skills
• Family support-health,relationships housing,
• Restitution and responsibility
• A real alternative to criminal culture

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Society can be measured by the way its Prisoners
are treated

• Winston Churchill