Where We Work: JAMAICA

Of the approximately 4,200 prisoners in Jamaica, nearly 3,000 are in the country's two largest prisons, St Catherine and Tower Street Adult Correctional Centers. Within these prisons more than 40 prisoners have been identified with HIV infection, but care and treatment is intermittent from a visiting physician. Clinical outcomes have not been measured and many prisoners shun testing and treatment due to stigma of HIV infection. HtW together with the Jamaica Department of Correctional Services, has identified the need for HIV program management, case management, peer education and discharge planning. A program manager and care coordinator will ensure that patients with HIV infection receive regularly scheduled care and treatment while developing a campaign including prisoner peer educators to encourage testing and decrease stigma.

A recent grant from the Gilead Foundation entitled "HIV Care and Treatment in Prisons of Haiti, Dominican Republic and Jamaica", has enabled HtW to increase its presence in Jamaica prisons to conduct exams, treatment and other services towards the prevention, identification, and treatment of infectious and contagious disease, particularly HIV and tuberculosis. Through this new grant HtW will reach more prisoners throughout additional prisons in Jamaica and work more extensively with the prison authority toward strengthening their capacity to deliver quality healthcare.

Telemedicine

In 2007, the Jamaica Department of Correctional Services worked with HtW and the International Corrections and Prison Association to install and operate a telemedicine program at the Tower Street Prison in Kingston. This is one of the first successful implementations of prison-based telemedicine in any resource-poor country.

Telemedicine, through the use of computer, Internet, camera and sound, enables doctors with particular expertise -- based in Jamaica, or abroad -- to consult on difficult cases or in making diagnoses. The patient is presented onscreen for a medical interview and viewing of their condition. Prison medical staff can engage in discussion with the consulting doctor via the screen as well. Telemedicine allows doctors in prison systems to consult with HIV Specialists inside their country or abroad where access is otherwise limited.

HtW provides regular, ongoing, specialty consultations via the telemedicine equipment for those prisoners with complex medical needs including HIV infection. The service allows prisoners access to specialty care while reducing security risks and costs that would be incurred if the prisoner needed to be transported off-site for the consultation. The use of telemedicine has improved health outcomes and become a model for other prison systems. In 2010, HtW delivered a presentation on telemedicine at the 12 U.N. Congress on Crime Prevention and Criminal Justice in Salvador, Brazil, with a live connection between the conference site and the Tower Street Prison.

HtW held the first-ever Prisoner Networking Zone in the Global Zone of the XIX International AIDS Conference held in Washington, D.C. in July 2012. During the HtW's presentations, Dr. John May of HtW and Dr. Donna Royer-Powe of the Jamaica Department of Correctional Services demonstrated telemedicine in Jamaica's prisons. Dr. May connected live with the medical staff in the Jamaican prison and they were able to speak to each other as well as see each other via the telemedicine technology. (See photo)

Health through Walls' Medical Missions

Each year HtW joins faculty and students of NOVA Southeastern University's (NSU) medical, dental, pharmacy, physical therapy, and optometry schools for annual medical missions to Jamaica that include service in Jamaica's prisons. The 2010 trip was postponed due to security concerns and instability on the island, but support from HtW to the Jamaica Department of Correctional Services continued.

HtW Board Member, David L. Thomas, MD, JD, NSU Chairman of Surgery and Chairman of Division of Correctional Medicine performed surgical procedures at the prison while students observed and learned. See 2009 photo. Additionally, the NSU dental faculty and students provide care and treatment in Jamaican prisons during their annual trips to Jamaica. See 2009 photo.

Providing Reading Glasses to Prisoners

For the last few years HtW has been partnered with the Reading Glass Project, an innovative program that encourages the distribution of reading glasses, particularly to workers, artists, and families internationally. Their reading glasses have been distributed in 43 countries. Reading glasses are particularly important for prisoners in Haiti, the Dominican Republic and Jamaica where prisoners often spend long hours without sufficient lighting, and most have never had their eyes examined for glasses. HtW is provided with instructions and eye charts to fit glasses with the people who need them. Where we can, we work with a visiting, volunteer optometrist to dispense these reading glasses. Once the prisoners receive their glasses they are finally able to see details up close and read letters from family, legal documents, their medication instructions, or health information flyers, books, etc.

HtW conducted eye exams and provided reading glasses to prisoners some of the Jamaican prisons. HtW's Secretary/Treasurer, Mark Andrews, shared with the Reading Glass Project that "One of the prisoners said he had been waiting for a pair of reading glasses for FOUR YEARS! He wanted me to thank reading glass project one thousand times! As you can see, we also gave the guards reading glasses... after all the prisoners got theirs."

In the Dominican Republic, HtW held successful exams and distribution of reading glasses in the LaVictoria prison. HtW's coordinator in Haiti, Karine Duverger, wrote the Reading Glass Project: "The medical parade went very well at the Women's Prison in Petion-Ville, Haiti. We completed the entire prison, 247 women, in 3 days. Each prisoner now has a medical record. Adding to our physicians and nurses, we had a dental team and an optometrist on one day. You cannot imagine how we were happy to have the reading glasses available to distribute as the optometrist was doing his screening. Health through Walls wants to say thank you and on behalf of all the inmates that have benefited from those glasses."

   

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Dr. John P. May demonstrates Telemedicine by connecting to Jamaica prison during HtW Prisoner Networking Zone at XIX International AIDS Conference (July 2012)




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