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PUBLIC HEALTH AND THE PRISONER. Is there a Problem? Peter Sims UPNG. Teaching and Learning Tasks. Learning Objective To understand the composition of the Prison population in terms of its epidemiology. Performance Objectives. To appreciate 1.The variation in the use of prison worldwide
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PUBLIC HEALTH AND THE PRISONER Is there a Problem? Peter Sims UPNG Peter Sims UPNG
Teaching and Learning Tasks Learning Objective To understand the composition of the Prison population in terms of its epidemiology Peter Sims UPNG
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 Peter Sims UPNG
“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 • <petersims@upng.ac.pg> Peter Sims UPNG
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? Peter Sims UPNG
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 Peter Sims UPNG
WHO GOES TO PRISON?The Mad, the Bad and the Sad Young Men<35 Low IQ Ethnic minority The Mad Psychopaths Personality disorders The sad Depressed Anxious Inadequate The Bad Criminal cultures Evil fanatics Peter Sims UPNG
The Process of Law A Crime committed-the Law broken Crime committed The Court Process Verdict Judgement Punishment Investigation Arrest Remand Peter Sims UPNG
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 Peter Sims UPNG
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 Peter Sims UPNG
Hierarchies,currencies,abuse • Prison Hierarchies The Screws The Bosses The Blokes Drugs,Tobacco Sex offenders Bullying,abuse Peter Sims UPNG
Risks to Health-the diseases of Prison • Tuberculosis • Diarrhoeal disease • Infections-typhus • HIV and STD’s • Trauma • Mental illness • Suicide Peter Sims UPNG
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/involuntary homosexual sex Peter Sims UPNG
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 Prison Health Care Peter Sims UPNG
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 Peter Sims UPNG
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 Peter Sims UPNG
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 Peter Sims UPNG
“Society can be measured by the way its Prisoners are treated” Winston Churchill Peter Sims UPNG