Where We Work: DOMINICAN REPUBLIC



Health through Walls partners with both Fundación Génesis, a Dominican Republic based non-profit, as well as with AIDS Healthcare Foundation (AHF) to advance the prevention, diagnosis and treatment of HIV and AIDS, tuberculosis, Hepatitis C and other infectious disease in the prisons and community in the Dominican Republic. AHF made it possible to offer free HIV testing and treatment for prison visitors as well.


Situation of COVID-19 in the National Penitentiary La Victoria in the Dominican Republic

After a tourist arrived in the Dominican Republic, and later Dominicans returning from Spain, brought COVID-19 into the country, it soon found its way into its prisons.

Dr. Martha Butler of Fundación Génesis, who serves as the Health through Walls' Program Director in the Dominican Republic, explains:

Ordinarily, the prison system allows for 2 conjugal visits per week (around 5000 visitors per week) which meant an open door was left for the virus to reach the inmates and police officers. In an attempt to stop the virus entering La Victoria, all visits were halted by the end of March. Unfortunately, the virus had already sneaked in and was affecting an indefinite number of inmates at this penitentiary, which is the main and most overcrowded prison in the DR, hosting around 8,600 inmates. Limited provisions of personal protective equipment (PPE) and testing kits would delay a prompt response. Unfortunately, some casualties occurred.

On April 4, the Prison Directorate and the MOH devised a plan to screen all inmates to initiate transfer of those symptomatic and/or with positive rapid test results for COVID-19. They were then transferred to an isolation facility that was designated for such purpose. Disinfection of the premises and supply of appropriate chemicals, as well as limiting entrance to the jails, were among the first activities in place. Medical personnel at the prison were provided with some PPE, but the support to the inmates was limited to some disposable masks. The plan included the separation of elderly and chronically ill inmates, active COVID patients and regular non symptomatic inmates, by relocating them into 3 distinct facilities (including regular La Victoria premises).

As early as mid-March 2020, Fundación Génesis and HtW were aware of the potential threat of SARS CoV-2 entering the correctional centers in the Dominican Republic, and began mobilizing a response. We initiated social media solicitation of funds and kind donations from the civil society and private donors to provide masks and other personal protection items for all inmates and for the health care providers who are permanently assigned there.

The inmates were provided with materials to manufacture their own cloth masks with the initial donations received. It was then when the support from HTW and AHF came through to further this initiative and provide for other immediate needs. So far, with funds from AHF, the inmates have received basic disinfection materials (Soap, bleach and other disinfectants), two sewing machines and a cutting table, and enough cloth and materials to make an extra 5,000 cloth masks. To improve the health care provision, the personnel was provided with PPE (surgical and N95 masks, gloves, alcohol, protection gear, etc.) and the unit provided with basic meds. To facilitate the psychological support needed amidst this health and human crisis, the health area was painted and support group sessions were hosted via zoom with FG volunteer psychologist. Also, the library was organized to accommodate book donations and create a space for distraction. Inmates were actively involved in all activities, along with volunteer staff from FG.


Dominican Republic Prisons Begins Initiative to Cure Hepatitis C

HtW is coordinating efforts of the prison authority of the Dominican Republic with local partner, Fundación Génesis, to offer hepatitis C testing and treatment to nearly 9,000 prisoners in the Caribbean's largest prison, La Victoria Penitentiary.

In 2020, volunteer and staff teams will begin offering hepatitis C testing at the prison. Additional partners include Gilead Sciences and the Ministry of Health under guidance of Dr. Annalice Roa, Medical Director of Prisons and Dr. Grace Butler, HtW's D.R. Program Director. Using the successful model of the University of New Mexico's Project ECHO, prison health promoters and healthcare staff participate in distant learning and case presentations to understand and manage the disease. This model was demonstrated at the International Corrections and Prisons Association conference in Buenos Aires in October 2019. While the initiative is still pursuing final funding, it will become the first and largest hepatitis C eradication project in the Caribbean.


Testing and Treating Prisoners for HIV and Tuberculosis - 8,000 + prisoners screened

Planning comprehensive health screenings of all prisoners at La Victoria Penitentiary in the Dominican Republic began with funding from the Elton John AIDS Foundation (EJAF) in early 2014. EJAF support allowed HtW and other partners to come together for strategic planning. These partners included the Ministry of Health, the Division of Tuberculosis Control, the General Directorate of Prisons, AIDS Healthcare Foundation and Fundación Génesis. Together we have implemented a massive undertaking to offer HIV and TB screening to each prisoner at La Victoria. The project, which started in early September 2014, requires approximately 70 additional staff and volunteers and multiple supplies and equipment. The goal is to examine all 8,000 prisoners within a few months. Examinations include digital chest x-rays of all prisoners to identify tuberculosis, an infectious, highly contagious airborne disease that can be fatal if left untreated.

Salud Integral Penitenciaria 2014 - La Victoria, Santo Domingo Norte, República Dominicana by Fundación Génesis. Health through Walls and other partner organizations participated in training and conducted health screenings and medical exams of all 8,000 plus prisoners at La Victoria prison in the Dominican Republic in an effort to identify and treat HIV, TB or other infectious, contagious disease.

Cases of multidrug-resistant tuberculosis have also been identified in prisons in the Dominican Republic. HtW worked closely with a young man in the La Victoria prison who was suffering from MDR TB. He was finally permitted to reunite with his family who cared for him at home. HtW was engaged in providing his continued medical care, medications and support until his death.


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. In the Dominican Republic, HtW held successful exams and distribution of reading glasses in the La Victoria prison. See the photos to the right and in our Photo Gallery.


BACKGROUND

Great article by journalist Antigone Barton tells the story of how Dr. John P. May and Dr. Martha Butler first met and visited the Dominican Republic's notorious prison, La Victoria. HIV High in Dominican Republic/Prisons, Florida doctor tries to rescue Dominican jails from HIV quagmire, by Antigone Barton, Palm Beach Post Staff Writer, October 1, 2006

Haiti and the Dominican Republic share the island of Hispaniola and claim 75% of all cases of HIV in the Caribbean. Within their combined prisons live 30,000 persons with varying access to HIV or tuberculosis testing, prevention, care and treatment. In the Dominican Republic's La Victoria prison, more than 11,000 visitors enter each week making the health of prisoners an important component of the community's health. Health through Walls works in the largest prison in the Dominican Republic, La Victoria Penitentiary. With 8,000 prisoners it has the biggest population of any single prison facility in the Caribbean. HtW assists the prison's healthcare program in the management of HIV and tuberculosis. In 2013, more than 80 correctional officers were provided health training. A team of 20 prisoners were trained as Health Promoters (peer educators) and supported by HtW to facilitate HIV/AIDS and health education to other prisoners. They work to reduce stigma, educate, and improve access to care and treatment within the prison. HtW also provides discharge planning and follow-up for prisoners with HIV and tuberculosis who are being released from prison.

       

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Training of Peer Educators
April 2011


Clistenes Diaz receives Radiation Technology certificate. Sponsored by HtW for two years.



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