HEALTH experts have called for a review of the country’s prison healthcare system, including reinstating in-house medical care for inmates to reduce the risk of transmitting diseases – including HIV – between the prison and the community.

Universiti Malaya’s professor Dr Adeeba Kamarulzaman said having functioning clinics on prison grounds would greatly reduce patient mortality, as well as safeguard the community outside the prisons from infectious diseases.

As an example, she said that the presence of a functioning clinic at the Kajang prison had resulted in a tremendous drop in HIV-related mortality of inmates, from 19 deaths involving HIV-positive prisoners in 2011, to two deaths in 2014, two years after the clinic was set up.

She lamented the loss of in-house treatment centres due to budget cutbacks, saying that programmes such as the HIV specialty clinic at prisons were halted in 2015.

Dr Adeeba, who is dean of UM’s Faculty of Medicine, said government doctors which are sent to serve in prisons for short periods of time also lack specialised training in areas of mental health, infectious diseases and addiction.

She said that apart from HIV, Tuberculosis (TB) remains a huge problem in Malaysian prisons, as poor ventilation, overcrowding and suboptimal screening practices have led to the spread of the airborne disease.

A study held in Kajang prison recently showed that out of the 559 surveyed prisoners, 64.7% inmates were released from prison before they were able to complete their treatment for TB in prison.

Dr Adeeba said the absence of routine screening and suboptimal health infrastructure at prison resulted in a delay of detection and treatment, which meant the prisoners were released before they were treated.

“This gives the opportunity for this airborne bacteria to be disseminated (to the public).”

Dr Adeeba also said that the number of prisoners in the country needed to be reduced, as between 40% to 60% of inmates are incarcerated for minor drug use.

“They should be treated in the community; they should be working. By putting them in prison, we are burdening the health system and prison system. They go in and out, they get infected in prison, so it’s a futile exercise,” she said.

“It’s not cost-effective, it’s doing more harm than good.

“Unless of course if they commit a crime, then yes by all means put them away,” she said. – June 5, 2017.