"Our work is borne out of our deep concern for the rights of prisoners to life, a healthy environment and meaningful and timely medical care."
— Michelle Karshan, Vice President, Health through Walls

Health through Walls (HtW) is a non-profit organization based in Florida whose mission is to assist developing countries in implementing sustainable improvements in the health care services of their prisons. A primary focus of this effort is the identification, prevention, and management of infectious and contagious disease, especially HIV and tuberculosis.

A Word on Public Health & Prisons

Recently, we have been confronted with a new and deadly infectious disease -- COVID-19 -- in the prisons where we work in four countries. In Haiti, our nurses and a doctor were exposed to the virus while working inside Haiti's main prison. We have supplied our staff with PPE for their protection. We are actively working to fight COVID-19 on all fronts - diagnosis, testing, treating, PPE for our staff, oxygen, increased sanitation, nutrition and medications and advocating for creative solutions to the need for isolation space for COVID-19 patients.

The efforts of HtW are urgent. Reducing COVID-19, HIV and tuberculosis worldwide requires intervention in the overcrowded prisons of nations struggling with social and economic hardship. Prisoners carry disproportionately high amounts of infectious disease. Infectious diseases such as HIV and tuberculosis are often introduced into prison by newly arriving prisoners. If these diseases are not properly identified and managed, they can spread. Even more dangerous is the potential for the development of diseases that are resistant to common treatments such as multi-drug resistant tuberculosis. This phenomenon has been documented in many prison systems throughout the world. The condition can easily transmit to correctional staff and visitors. Eventually, most prisoners return to their communities and further the risk of transmission.

Additionally, most prisoners come from poor communities or high-risk environments. They often had little prior exposure to regular health care services. Correctional health care programs are uniquely positioned to screen and identify health conditions of which the inmate might have been previously unaware. This creates an opportunity for disease education, early intervention, and adoption of healthy behaviors to reduce further health burdens.

World health experts recognize prisons as important points of intervention for the control, identification and treatment of infectious disease and other illness. Prison-based health interventions have proven to be beneficial and effective, resulting in lower disease in prisons and communities -- where prisoners live post-release and prison staff reside. Prison health professionals in most countries understand this potential, but often lack the resources to implement, and sustain, effective disease risk reduction techniques and strategies. HtW assists developing countries in creating replicable and sustainable improvements in their prison health care delivery services as well as providing continuity of care once a prisoner returns to the community.able improvements in their prison health care delivery services.


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Health through Walls and description translated into French for Haiti's national prisoners and staff.

HtW volunteer nurses interview prisoners about their medical history during the screening process of prisoners in one of Haiti's national prisons.

Flow chart explains HtW health screening process of prisoners inside Haiti's national prisons.

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