On antiretroviral treatment in Haiti’s prison and telemedecine
The health-care situation in many of the world’s prisons is desperate and the truth is that although “there have been standard minimum rules for the treatment of prisoners for over 50 years, most countries cannot achieve them. They should just try to ensure that no harm is done” to people while in prison, says John May, MD, President of Health through Walls (in blue in the photo). “For example, prisoners should not contract HIV in prison and they should not develop problems due to malnourishment”.
Health through Walls is an organization based in Florida, United States, that helps medical professionals in developing countries to improve the health-care services provided in prisons. One of the countries it works in is Haiti, where it has been present since well before this year’s earthquake and where the focus is on preventing HIV transmission and increasing access to antiretroviral treatment.
Even today, Health through Walls continues to build on the successes gained before 12 January. John, who has been to Haiti four times since the earthquake, explains that “part of the prison building is still standing and all of the 600 prisoners who are still there have medical records. We are screening them for HIV and several are receiving antiretroviral treatment”.
John is also here on behalf of the International Corrections and Prisons Association, to share information with Congress participants about the benefits of telemedicine, which he describes as “the ability to transmit medical information and carry out consultations over the Internet so that doctors and patients can communicate without having to be in the same place”.
This has obvious advantages for resource-poor countries and for the corrections environment, since it avoids having to transport prisoners and it makes specialty care options available to people who typically wouldn’t have such access. It is affordable and the technology required is relatively simple. Telemedicine makes it possible “to listen to patients with a stethoscope, to examine their eyes and ears, and now we are about to start a TB screening programme using digital x-ray pictures”, John says.
In addition, John identifies the following as among the most important contributions he and his colleagues are making:
- Giving moral support to lone medical staff in correctional facilities, since “working in prisons can be very isolating”
- Identifying people with HIV/AIDS and providing antiretroviral therapy
- Involving prisoners, for example by training them to be peer educators