Prisoners take on health duties

A DELEGATION FROM the Irish Prison Service will visit Wormwood Scrubs jail in London next month to outline the “huge success” …

A DELEGATION FROM the Irish Prison Service will visit Wormwood Scrubs jail in London next month to outline the “huge success” of a programme here, in which Wheatfield Prison has been the first in the world to make its inmates members of the Red Cross.

Since the programme began there in 2009, 22 prisoners have volunteered and completed the training to become full members of the Irish Red Cross in an initiative that has been so successful it has been extended to other prisons and the prison service is planning to roll it out across all its 14 institutions.

“I have to say it has made a huge difference, in a variety of ways,” says Wheatfield deputy governor, Frances Daly. “It’s the difference of having peer-to-peer healthcare advocates in the prison.

“Prisoners will listen to other prisoners about health and hygiene issues and take on board what they are being told, far sooner than they would listen to prison officers or HSE professionals.”

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Among the issues to have been addressed by inmates themselves have been TB, HIV, smoking and hand hygiene, while audits they have carried out have led to changes in prison management itself.

The proposal to train prisoners as Red Cross members was that of Dr Graham Betts-Symonds, healthcare manager at Wheatfield and the adjacent Cloverhill prison.

“In 2009, I was looking for some way to make a holistic difference to the way healthcare was being provided in the prison. We recognised the prison is a community in its own right, that as a community it should have the same kind of healthcare provision as any community and that prisoners needed to take action in looking after the health of their community.

“It has worked here due to the alliance between the prison service, the Irish Red Cross and the City of Dublin VEC – which provides education courses in the prison – and because of the enthusiastic buy-in of management.

“Prior to this there was just the healthcare department in the prison with doctors and nurses, where staff were treating people for illness and so on, and were essentially reacting to needs. This programme is about being proactive, and prisoners themselves doing that.”

Those prisoners who volunteer to become members of the IRC complete an intensive course over seven modules covering such topics as basic first aid, disease prevention and health promotion, community mobilisation, and assessment-based action in a community. Once fully qualified, the prisoners become, in effect, the healthcare advocates for their community.

“The course is delivered over a number of weeks and the way it works is, what is learned in the class setting on one day must be done in some way in the community over the next week. It’s very practical, experience-based. The volunteers are out and about in the prison looking at health hazards, identifying issues and problems, and drawing up action plans to address them.”

Among the prisoners who are now full members of the IRC is Paul, who describes himself as a “former robber”. From Dublin, he volunteered as he wanted to do something productive with his time.

“I like working with people, I get on with people and I thought it might be interesting. One of the first projects we did was a hygiene audit of the areas where prisoners are,” he says.

“We looked at the cleaning methods and realised there were not adequate cleaning materials for inmates to keep their own cells clean.” More cleaning products are now made available to prisoners, and a member of the IRC monitors stocks.

The volunteers identified smoking as a major health issue among inmates, finding not only were non-smokers becoming smokers once in prison “out of boredom” but that up to 60 per cent would like to quit.

“So we started up smoking cessation groups to give peer support to people trying to quit and printed information about how to quit, the benefits of quitting.”

One of the most successful projects was in June last year, when to coincide with World Aids Day a mass HIV testing programme was conducted in the prison in conjunction with St James’s Hospital.

“We did a course looking at HIV, stigma and how to reduce the stigma. So we encouraged as many people as possible to get tested,” says Paul. Of the 453 inmates in the prison that day, 276 were tested. And where just 2 per cent of the inmates knew their status before the testing, 50 per cent did after. All tested negative.

“The reason so many came forward to be tested was the advocacy of the Red Cross volunteers,” says Daly. “People were nervous and there were counsellors available on the day. But the results were available in five to 10 minutes and we had red balloons and ribbons, and made it a bit of a day.”

Since then, the population of Wheatfield, a medium security prison housing a high number of sex offenders and lifers – those serving the mandatory life sentence for murder – has risen to 676.

Other successes have been a hand hygiene awareness campaign which arose when a case of swine flu emerged in Cloverhill, and a TB information campaign, with leaflets and posters designed in and still hanging throughout the prison.

The volunteers also pushed to have a colour-coded mop system introduced, so different mops would be used to clean different areas. This has now been implemented by prison management.

Donal Forde, chief executive of the Irish Red Cross, describes himself as “very proud” of the prison project. “I am struck by how impressed others are by it too.

“We have had delegations from Norway and Britain looking at this, at the huge contribution the prisoners themselves can make.

“And it is exciting that we are going to Wormwood Scrubs in London on August 4th to tell them about the programme.”

The programme was extended to Cloverhill in February where 16 volunteers have just completed training, and to Shelton Abbey in Wicklow where 10 volunteered. Plans are underway to recruit volunteers in Cork Prison and St Patrick’s Institution in Dublin.

Governor in Cloverhill, Sean Quigley, describes the impact, just five months in, as “very positive”.

“Oh, I fully support it. The credibility factor of having these guys working to promote health within the prison, well only they have that.”

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times