HEALTH IN PRISONS

Being sent to prison is the punishment; conditions of imprisonment should not constitute an additional punishment.

Any form of torture or cruel, inhuman or degrading treatment or punishment is illegal under international law, and usually under domestic law, at all times and under all circumstances.¹ Yet such ill-treatment regularly occurs in all regions of the world.²

People with mental health problems who have not committed a crime, or who have committed a minor offence, are often imprisoned rather than given appropriate medical care. Prison conditions, including overcrowding, lack of privacy, enforced isolation and violence may increase or cause mental health problems, including self-harm and suicide.

The same prison conditions, particularly in relation to overcrowding, are also injurious to physical health, particularly in the spread of infectious diseases including tuberculosis, HIV/Aids and hepatitis, as well as skin infections and diseases, respiratory and intestinal disorders.

International standards

The International Covenant on Economic, Social and Cultural Rights (ICESC) recognises the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The UN Committee on Economic, Social and Cultural Rights has described this right as:

An inclusive right extending not only to timely and appropriate health care but also to the underlying determinants of health, such as access to safe and potable water and adequate sanitation, an adequate supply of safe food, nutrition and housing, healthy occupational and environmental conditions, and access to health-related education and information, including on sexual and reproductive health.³

The UN Standard Minimum Rules for Treatment of Prisoners recommends measures to safeguard prisoners’ health with regard to accommodation, personal hygiene, clothing and bedding, food, medical services, discipline and punishment, work and education and recreation.

PRI’s work on health in prisons

PRI’s projects on health in prisons have ranged from training sessions for doctors working in prisons in Morocco, particularly in dealing with pandemics of tuberculosis and scabies, to the replacement of iron shutters with bars at Dranda Prison, in Abkhazia, to create a healthier environment and a reduction in the transmission of infectious diseases.

In Malawi, PRI and the Malawi Prisons Service have developed a cost-effective model of integrated farming in prison which has had a direct impact on the health of prisoners. Such programmes also provide prisoners with useful farming skills which can assist them to reintegrate after release. PRI in collaboration with Youth Watch Society in the north of Malawi has set up a programme to facilitate the release of terminally ill prisoners. Similar income-generating activities and skills-training workshops for prisoners are being undertaken in collaboration with local NGOs in Benin and Senegal.

As part of efforts to raise awareness amongst practitioners and decision makers of the need for an integrated approach to penal and prison health reform, PRI in cooperation with the Royal Netherlands Tuberculosis Foundation (KNCV) has produced a manual entitled, Human Rights and Health in Prisons: a Review of Strategy and Practice, based on the experience of the PRI/KNCV integrated prison health programme in Kazakhstan.

In the Russian Federation, PRI has undertaken work on the prevention of HIV/Aids in prison. In Moldova, PRI is implementing projects aimed at developing sustainable health conditions for mentally ill prisoners and reducing the incidence of tuberculosis. In the South Caucasus region, PRI has provided materials and expert support to health information and training organisations to enable them to work in the prisons of western Georgia and in the women’s and juvenile colonies in Tbilisi, Georgia.

PRI resources and publications

Health in African Prisons

Dublin Declaration on HIV/AIDS in Prisons in Europe and Central Asia

Human Rights and Health in Prisons: A Review of Strategy and Practice

Kampala Declaration on Health in Prisons in Africa

HIV in Prisons: a reader with particular relevance to newly independent states

Making Standards Work: an international handbook on good prison practice

Soigner en Prison

1. As contained in the International Convention on Civil and Political Rights (ICCPR) and the Convention Against Torture (CAT).
2. For further details, see Amnesty International’s Annual Report www.amnesty.org/ailib/aireport/index.html
3. General Comment No. 14, UN Doc E/C.12/2000/4, 11 August 2000