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Final-Rep-UNODC-Eng.Pdf Barriers to Health and Other Services for Ex-Prisoners 2012 2 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 “All human beings are born free and equal in dignity and rights. They are endowed with reason and concience and should at towards one another in a spirit of brotherhood” (Universal Declaration of Human Rights) 3 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 CONTENTS Executive Summary Glossary References Acknowledgement Chapter I Introduction ................................................................................ 1. Background of the Study ........................................... 2. Strategic Objectives .................................................... 3. General Objectives Chapter II Literature Review ....................................................................... Chapter III Research Methodology 1. Research Setting ............................................................... 2. Data Gathering Technic ................................................... 2.1.Focus Group Discussion ............................................ 2.2.Indepth Interview ...................................................... 2.3.Observation ................................................................ 3. Research participants and recruitment process ................ 4. Data analysis .................................................................... 5. Ethical issues .................................................................... Chapter IV Understanding Drug Abuse Related Harm: Knowledge, Experience and Rights .......................................... A. Medan (North Sumatera) ................................................. B. DKI Jakarta ...................................................................... C. Tangerang (Banten) ......................................................... D. Bandung (West Java) ...................................................... E. Denpasar (Bali) ................................................................ F. Malang (East Java) .......................................................... G. Makassar (South Sulawesi) .............................................. Chapter V Conclusion and Recomendation ................................................ 4 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 GLOSSARY 1. HIV : Human Immuno-deficiency Virus 2. WBP : prisoner 3. WB : prisoner 4. IBBS : Integrated Biological and Behavioral Surveilance 5. LAPAS : prison 6. WPSL : direct sex worker 7. WPSTL : in-direct sex worker 8. LSL : man who have sex with men 9. LSM : non govenrment organisation 10. KDS : peer support group 11. STBP : Integrated Biological Behavioral Surveilance 12. LJSS : needle syringe service 13. LASS : sterile syringe services 14. ODHA : orang dengan HIV-AIDS (peolple living with HIV-AIDS) 15. KIE : Information Education, Communication (IEC) 16. PTRM : methadone maintenance therapy (MMT) 17. VCT : voluntary counseling and testing 18. CD-4 : is a type of white blood cells or lymphocytes, which is an important part of our immune system. CD4 cells are sometimes called T-cells. 19. HCV : hepatitis C Virus 20. JANGKAR : Indonesian Harm Reduction Network 21. ARV : anti retro-viral 22. CST : care, support and treatment 23. KPA : National AIDS Commission 24. IMS : Sexual Transmitted Infection 25. HAM : Human Rights 26. THD : take home doses; 27. HCPI : HIV Cooperation Program Indonesia 28. WHO : World Health Organization 29. BNN : National Narcotics Board 30. UNODC : United Nation on Drugs and Crime 31. FHI : Family Health International 5 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 ACKNOWLEDGEMENT Thank you for all the support given, so that the process of collecting data on fieldwork can be going well. 1. Yayasan Galatea 2. Yayasan Karisma 3. Yayasan Sringganis 4. KDS Sringganis 5. Komunitas Methadone Kota Tangerang 6. Rumah Cemara 7. Yayasan Dua Hati 8. Yayasan Sadar Hati 9. Makassar Harm Reduction Community 10. Persaudaraan Korban Napza Makassar (PKNM) 11. Yayasan Peduli Kelompok Dukungan Sebaya (YPKDS) 6 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 Executif Summary Barriers to Health and other services for Ex-prisoners Background of the study The National Survey of Drug Abuse Development reported that the police had caught 1 of 5 abusers; even 1 of 2 injection addicts had dealt with police. Furthermore, there was 1 of 7 respondents in the survey admitted that had been in prison, especially the injection addicts group (BNN, 2011). One of the strongest lessons from the end of the last century is that public health can no longer afford to ignore the prisoner health. The rise and rapid spread of HIV infection and AIDS, the resurgence of other serious communicable diseases such as tuberculosis and hepatitis and the increasing recognition that prisons are inappropriate receptacles for people with dependence and mental health problems have thrust prison health high on the public health agenda (WHO, 2007). Substance use disorders among inmates are at epidemic proportions. Almost two- thirds (64.5 percent) of the inmate population in the U.S. (1.5 million) met medical criteria for an alcohol or other drug use disorder. Prison and jail inmates are seven times likelier than are individuals in the general population to have a substance use disorder (Califano et.al, 2010). This activity was carried out as an advocacy tool, as an important part of the strategy in implementing Harm Reduction Network in raising the issue of drug user’s especially former prisoners. Particulary to explore the information about health services accessed by former prisoners narcotics, to explore the availabality of health services for the former prisoners and exploring accessed of former prisoners to the health services. By taking samples in seven provincial cities, the recording process is done by an objective and conducted by the research team. We’re collecting data using a qualitative method, data collection through in-depth interviews and focus group discussions. The instrument used in this study had previously been tested in two provinces, Medan –a city as the representation of western region- and Bali, for the eastern region. The results of this trial had then been discussed in a meeting attended by FHI staff, NGO staff of Charisma, Ministry of Health officials, Directorate General of Corrections and UNODC, to get feedback on improving the instrument. The results of this meeting was followed by a Data Collecting Team workshop and delivered new instrument that was then used in the farther data 7 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 collection. Our workshops were conducted to similize perceptions of the reseracher members in the process of data collection in the field. Data Collection FGDs conducted in order to identify issues related to access former drug addict inmates to health services. The participants of FGD is a former narcotic prisoners with age between 18-25 years old, amounted to 8-10 people consisting of addicts which had been joined by NGOs and those who have not been accompanied by the NGO. Five group discussion conducted in 7 provinces, attended by 43 participants from NGO and non- NGO. Most of them are male. An interviews were conducted to collect information about the understanding of informant to the topic of this study, and see how far the manifestation of the knowledge of their behavior, related efforts in maintaining health. We also collect information about how families provide support to the informant at the time in custody and after release of the sentences, while the informants experiencing health problems. 48 interviews consist of former narcotic prisoners, prison staff and staff of health services. Ethical Issues Before starting the data collection process, we have gained ethical approval from the Research Ethics Committee Atma Jaya Catholic University in Jakarta on July 2, 2012. To obtain the approval of the informer, we were helped by a local NGO partner in this research. Before investigators headed to their respective provinces, the study protocol was sent to a local NGO partners and later inform them about the study to their beneficiaries. Because the study is devoted to drug users whose mobility is high enough, then there are two cities that do not do FGD namely Jakarta and Malang. Recruitment of informants was fully supported by the following local partner NGO network in the province KDS respectively. Once the researchers met with the informant, investigators returned to give an explanation regarding the expected information obtained from informants. Besides informed consent is also included to require that person's consent to be interviewed and recorded the interview process. All the names of participants are not the real name. 8 | P a g e Barriers to Health and Other Services for Ex-Prisoners 2012 Results 1. Medan From the FGD, the understanding of infectious disease was a disease that can be transmitted through multiple media. Infectious diseases they meant HIV, TB, Dengue Fever, and Hepatitis B. One focus group participant was accompanied by the NGO added explanation about HIV as a disease that is transmitted by an infected person. The infectious diseases can also be transmitted through personal devices such as toothbrushes, razors, and tools such as drinking glasses. Another participant was assumed that HIV could be transmitted if we are close to someone which has been infected with HIV. So, he prefer to
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