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Global Trends in Prisoner Health

Global Trends in Prisoner Health. John May, MD Armor Correctional Health Services International Corrections and Prisons Association Health through Walls Presentation to American Correctional Association, August 2013. Global Prison Health Issues.

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Global Trends in Prisoner Health

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  1. Global Trends in Prisoner Health John May, MD Armor Correctional Health Services International Corrections and Prisons Association Health through Walls Presentation to American Correctional Association, August 2013

  2. Global Prison Health Issues Universal finding: Disproportionate burden of disease

  3. Challenges in prisons of developing countries Structures often out-dated, damaged, and contain safety risks (colonial time forts or prisons) Limited water and electricity Inadequate nutrition Overcrowding Limited security, high violence Inefficient court systems Transportation limitations Absent medical staff Little diagnostic capacity Equipment is limited and basic Interruptions in drug supplies

  4. United Nations Standard Minimum Rules for the Treatment of Prisoners • (25) The medical officer shall have the care of the physical and mental health of the prisoners and should daily see all sick prisoners, all who complain of illness, and any prisoner to whom his attention is specially directed. • (26) The medical officer shall report to the director whenever he considers that a prisoner's physical or mental health has been or will be injuriously affected by continued imprisonment or by any condition of imprisonment.

  5. Overwhelming PopulationsPreventable Deaths • Infectious Disease • TB • Malaria • HIV • Malnutrition and clean water • Anemia • BeriBeri • Cholera • Safety • Fires • Violence

  6. Tuberculosis Unit

  7. Cholera

  8. Prison HealthGovernance • Ministry of Justice ? • Ministry of Health

  9. Technology • Implementation of technology to low income countries • Telemedicine • Diagnostic Capacity • Rapid testing • Pap Smear • GeneXpert • Digital Radiography

  10. How to Screen for Tuberculosis ?

  11. Digital Radiography

  12. Mobile to other prisons

  13. Films sent digitally to radiologist

  14. “Disease, most often, opts for the poor.” - Dr. Paul Farmer

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