Everyday life in many European prisons is often characterised by overcrowding, drug use and violence, often leading to a higher risk of communicable diseases. As a result of this increased risk, infection prevention is particularly important in these areas.
Last year, around 1.6 million people were imprisoned within Europe. UNAIDS (The Joint United Nations Programme on HIV and AIDS (UNAIDS) is the main advocate for accelerated, comprehensive and coordinated global action on the HIV/AIDS pandemic) explained:
“Prisoners are the community. They come from the community, they return to it. The protection of prisoners is the protection of our communities”.
People in prison have more and more diverse health and social needs than the general population. This is partly due to a combination of overlapping and sometimes interrelated risk factors for infection and disease. Examples include drug use, overcrowding and unprotected sexual contact.
However, imprisonment can also be seen as a unique opportunity to provide people in prison with quality health care. For example, socially disadvantaged groups, who were often medically undernourished before imprisonment, can be reached. In 2016, around 590,000 people were imprisoned every day in the 28 EU Member States.
The number of prisoners per 100,000 inhabitants varies considerably among EU countries, from 51 in the Netherlands to over 200 in the Czech Republic, Estonia, Latvia and Lithuania. The EU prison population is a complex sociodemographic one, with 19% of prisoners not being nationals of the country in which they are held, and is characterised by high fluctuation with an average detention period of nearly 9 months. It is generally recognised that detention and fluctuation of the prison population play an important role in the mechanism of disease concentration and increased risk of transmission. Prevalence estimates for viral hepatitis in prison are available from just over a third of EU countries and reported a much higher proportion of infected persons than in the general population, ranging from 0.3% to 25.2% for the hepatitis B virus (HBV) and from 4.3% to 86.3% for the hepatitis C virus (HCV). Prevalence estimates were also available for HIV in prisons in half of the EU countries, ranging from 0.2% to 15.8%.
Prison health as part of public health
In recent years, international and European authorities have increasingly recognised the importance of seeing and treating prison health as an integral part of public health. There is already an exchange of best practice on infection prevention at the EU level. Common minimum standards for prisons are also being developed. This also reflects the growing awareness of the principle of equivalence of care between the community and prison, which is an internationally agreed standard enshrined in European and international prison recommendations. New initiatives are underway to help bring about positive change, such as the publication of the first evidence-based public health guidelines on the prevention and control of communicable diseases in prisons.
Over the past 20 years, recognition of the value of evidence-based decision-making in areas such as public health has made this approach mainstream. However, prison health has been on the brink of this transformation, not least because of the scarcity of related research.
What we can do
The question now is what we can do to improve the situation in prisons for prisoners. The simplest, most effective form of infection prevention is still hand hygiene. Properly washing and disinfecting hands several times a day can reduce the risk of contracting communicable diseases many times over. The provision of dispenser systems and complete solutions for hand hygiene, as well as regular information on infection routes, is an effective initiative that can be implemented at short notice to improve the precarious situation in prisons.
It is important that solutions in this area are vandal-proof so that the devices can be used in the long term and cannot be used as weapons against other prisoners. Solutions such as the SanTRAL® Complete Series, with its robust and vandal-proof design, offer an optimal basis for equipping prisons with life-saving tools for infection prevention.
We at OPHARDT hygiene are committed to making our contribution to improving people’s lives on a global scale. This commitment includes both marginal areas and prisons.
For more information on the SanTRAL® Complete Series, please click here.