Healthcare

Throughout Africa, prisoners lack access to adequate healthcare. The severe overcrowding prevalent in most African prisons means that communicable diseases such as tuberculosis and scabies are rife. The unsanitary conditions coupled with a real lack of healthcare mean that treatable conditions such as diarrhea and TB are often fatal. Mental healthcare is almost non-existent in most prisons, this fact coupled with broad societal misconceptions and legal inadequacies surrounding mental illness mean that a huge proportion of the prison population suffer from mental illness.

The aim of the APP health programme is to bring systemic change to the way that healthcare is provided in prisons. This is done in three ways: through education, improving infrastructure and providing care.

    The principles behind our health initiatives are that:

    • Every human being has a tremendous inherent dignity and value. Therefore, regardless of background or previous history every person should have the right to life, should be protected from disease and if sick should have the opportunity to receive adequate treatment.
    • No one should die in prison, however, if the person has a sickness which cannot be treated and they are not released, they still ought to receive compassion, their pain should be relieved and they should be made comfortable. Every person is entitled to be treated with dignity and respect.
    • Medical staff hold the key to inmate and staff well being. By equipping, developing and empowering these professionals we believe they can be a source of change and can bring about a dramatic improvement in the wellbeing of those they serve.
    • We believe they deserve to have a clean and well equipped environment in order that they feel motivated and are best able to make use of their skills and training.
    • Inmates have a great role to play in attending to and caring for their peers who are sick or dying.

    APP will bring about systemic change in healthcare in prisons in Africa by:

    1. Short term

    • Holistic care for those who are critically ill and the terminally ill. To do this we will work in partnership with other organisations for example Hospice Africa.
    • APP Health camps with medical professional volunteers, including utilising mobile clinics.
    • Promoting healthy bodies and minds through sports tournaments.
    • Provision of health related counseling and guidance.

    2. Medium term

    • Constructing and refurbishing health centres and other medical facilities serving prison communities. We will do this when it is clear that current facilities, if any, are no longer fit for purpose and that there are needs which are not being met. It will motivate, empower and equip prisons medical staff. We believe that the health centre can be a repository for a multitude of expertise and initiatives to meet the needs of inmates, staff and community members
    • APP Hospices in line with out palliative care work.
    • Mobile clinic - diagnosis and treatment of acute medical problems and medical education initiatives.
    • Provision of water and sanitation facilites through partner organisations.

    3. Long term

    APP will share skills, knowledge and training with staff and inmates in the following areas (and will partner with other organisations in order to do so).

    • Training of prison medical staff in specialist areas such as palliative care and mental health. In recognition of the fact that these staffs are best placed to meet inmates’ medical needs APP will strengthen and facilitate their learning.
    • Training of trainers to provide sensitization workshops for prisoners and staff educating them on topics such as: basic health and hygiene, mental health, psychological wellbeing, HIV/AIDS, malaria and Infectious diseases.
    • Establishing links between prisons and independent health organizations.
    • Facilitating research by academics into health in prisons in Africa.

    Past and present healthcare projects

    • Refurbishment and renovation of medical facilities and sleeping accommodation in Uganda, Kenya and Sierra Leone
    • Community psychology projects in partnership with Makerere University Community Psychology Association
    • Total care for critically and terminally ill inmates at Mulago Hospital, Kampala
    • Medical support for pregnant women
    • Nutritional support for vulnerable groups
    • Palliative care in conjunction with Hospice Africa Uganda
    • Sports and recreation groups

    Impacts

    The aim of our healthcare work is to improve standards of health amongst prison inmates and staff through preventative, curative and palliative care. Ultimately we believe this will contribute to systemic change in prisons healthcare and beyond, including:

    • Decreased mortality rates amongst prisoners, staff and their communities
    • People in prison being able to provide health education and some types of care to members of their community
    • Increased effectiveness of prisons medical services
    • High quality staff being attracted to work in prisons because of the good healthcare services available

    To give you an idea of the level of impact we are having, this is what we achieved in this area in Uganda in 2010:

    • Continuing critical and palliative care of inmates at Mulago (approximately 50).
    • Work with Hospice Africa Uganda to provide care to terminally ill prisoners.
    • Partnership with Lazarus Caring Ministries to care for hospitalized inmates.
    • Networking on behalf of prisons medical services to link them with contacts overseas.
    • Ongoing sports initiatives: 7 over the past year.
    • Ongoing nutritional support to HIV positive death row inmates: 4 times this year.
    • Opening of a level 3 Health Centre at Gulu Prisons in northern Uganda.
    • Visit by palliative care experts to advise of palliative care work and needs.