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Healthcare in Prisons 1989–2019 GLOBAL YEARS PRISON TRENDS 2019 SPECIAL FOCUS Pull-out section Healthcare in prisons Global Prison Trends 2019 Penal Reform International The Thailand Institute of Justice (PRI) is an independent (TIJ) is a public organisation This document is co-published and non-governmental organisation established by the Government produced with financial assistance that develops and promotes of Thailand in 2011 and officially from the Thailand Institute of Justice fair, effective and proportionate recognised by the United Nations (TIJ). It is the fifth edition in Penal responses to criminal justice Office on Drugs and Crime as Reform International’s (PRI) Global problems worldwide. the latest member of the United Prison Trends series. Nations Crime Prevention and We promote alternatives to prison that This report was authored by Criminal Justice Programme support the rehabilitation of offenders, Vicki Prais and Frances Sheahan. Network Institutes in 2016. and promote the right of detainees The authors drew on information to fair and humane treatment. We One of the primary objectives of provided by contributors to PRI’s campaign for the prevention of torture the TIJ is to promote and support expert guest blog series available and the abolition of the death penalty, the implementation of the United at www.penalreform.org/blog and and we work to ensure just and Nations Rules for the Treatment of information kindly provided by appropriate responses to children and Women Prisoners and Non-custodial partner organisations. The report women who come into contact with Measures for Women Offenders was edited by Martha Crowley. the law. (the Bangkok Rules). Its contents are the sole We currently have programmes in In addition, the TIJ strives to serve responsibility of PRI. the Middle East and North Africa, as a bridge that transports global This publication may be freely Central Asia, the South Caucasus and ideas to local practices with an reviewed, abstracted, reproduced Sub-Saharan Africa, and work with emphasis on fundamental issues and translated, in part or in partner organisations in other regions. including interconnections between whole, but not for sale or for use the rule of law and sustainable To receive our monthly e-newsletter, in conjunction with commercial development, human rights, peace please sign up at purposes. Any changes to the text and security. www.penalreform.org/keep-informed of this publication must be approved For more information, please visit by PRI. Due credit must be given to Penal Reform International www.tijthailand.org PRI, the TIJ and to this publication. Headquarters Enquiries should be addressed to 1 Ardleigh Road Thailand Institute of Justice [email protected] London N1 4HS GPF Building 15th–16th Floor United Kingdom Witthayu Road, Pathum Wan ISBN: 978-1-909521-64-3 Bangkok 10330 +44 (0) 207 923 0946 First published in May 2019. Thailand Email: [email protected] © Penal Reform International 2019 Twitter: @PenalReformInt +66 2118 9400 Facebook: @penalreforminternational Email: [email protected] Twitter: @TIJthailand www.penalreform.org Facebook: @tijthailand.org www.tijthailand.org Acknowledgements Dr Catherine Appleton, University Aisha Osman, Penal Reform Sunita Stürup-Toft, Public Health of Nottingham International England & WHO UK Collaborating Jean-Sébastien Blanc, Association Oscar Ouedraogo, Penal Reform Centre for Health in Prisons for the Prevention of Torture International Programme Dr Miranda Davies, Nuffield Trust Jaanki Patel, Penal Reform Dr Philippa Tomczak, University of Nottingham Dr Abigail Dymond, University International of Exeter Stephen Pitts, Independent Rozelien Van Erdeghem, Penal Reform International, University Dr Matti Tapani Joutsen, Thailand Consultant, community-based justice of Vienna Institute of Justice Dr Emma Plugge, WHO UK Professor Dirk van Zyl Smit, Dr Ian Marder, Maynooth University Collaborating Centre for Health in Prisons Programme, Public Health University of Nottingham and Chair Matthew Mcevoy, Omega Research England & Tropical Medicine, Nuffield of Penal Reform International Foundation Department of Medicine, University Marie Nougier, International Drug of Oxford Cover photo © Carlos Jasso for Reuters. Policy Consortium Yoga class inside a juvenile detention Prarthana Rao, Thailand Institute centre – part of a voluntary programme Cholpon Askerbekovna Omurkanova, of Justice that uses yoga to reduce stress, violence Chair of the Public Council Professor Mary Rogan, Trinity and addiction amongst detainees in of the State Service of Execution College Dublin, the University juvenile centres in Mexico City. of Punishment under the Government of Dublin of the Kyrgyz Republic Graphic design by Alex Valy. Chiara Sangiorgio, Amnesty Printed on recycled paper, manufactured International using 100% post-consumer waste. CONTENTS Contents Foreword 2 Introduction 3 Key facts and figures 4 1. Crime and imprisonment 7 Crime rates and the use of imprisonment 7 Prison overcrowding 8 Closing space for civil society 10 Restorative justice 11 2. Trends in the use of imprisonment 12 Pre-trial detention 12 Sentencing 13 Death penalty 15 Life imprisonment 16 Drugs and imprisonment 18 3. Prison populations 20 Women 20 Foreign national prisoners, minorities and Indigenous peoples 21 Children and young people 22 Elderly people 25 Lesbian, gay, bisexual, transgender and intersex people 26 4. Prison management 27 Security and violence 27 Prison staff 28 Contact with the outside world 31 Rehabilitation and reintegration 33 Fragile and conflict-affected states 34 Violent extremism in prison 35 5. Role and use of technologies 37 6. Alternatives to imprisonment 40 Key recommendations 42 Endnotes 44 CENTREFOLD Special Focus 2019 (pull-out section) Healthcare in prisons Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 | 1 FOREWORD Foreword The daily life of a prison is a mirror The right to healthcare that is the spread of infectious diseases and reflection of society, as Nelson accessible, acceptable, high quality act as a catalyst for the destabilisation Mandela said in 1998: ‘The way and safe is an inalienable human right, of prisons. The UN Standard Minimum that a society treats its prisoners is and is the subject of this edition’s Rules for Non-custodial Measures one of the sharpest reflections of Special Focus. Article 12 of the (the Tokyo Rules) call on states to use its character.’ The 2019 edition of International Covenant on Economic, alternative measures to imprisonment Global Prison Trends, produced by Social and Cultural Rights and Rule 24 more widely, taking into account the Penal Reform International and the of the UN Standard Minimum Rules political, economic, social and cultural Thailand Institute of Justice, highlights for the Treatment of Prisoners (the conditions of each country, as well as the following issues within prisons Nelson Mandela Rules) oblige states the goals and objectives of its criminal systems: overcrowding; a lack of to provide prisoners with medical justice system. Alternative measures effective programmes for rehabilitation care in case of health problems, and enable offenders to avoid the negative and reintegration; an emphasis on to not discriminate against offenders consequences of imprisonment. In security above all; insufficient staff and because of their status as prisoners. many parts of the world, alternative low wages; the influence of criminal Each prison should make efforts to measures are still at a developmental subcultures; the vulnerable position of ensure that prisoners are treated by stage and greater collaboration and women, children, the elderly, prisoners qualified medical personnel and are cooperation is needed to ensure with disabilities and ethnic and racial provided with appropriate medicines their effectiveness. minorities; insufficient or ineffective and healthcare services. Vulnerable application of alternative measures to categories of prisoners – such as imprisonment; and violent extremism women, children, the elderly and Cholpon Askerbekovna Omurkanova and radicalisation in prisons. people with disabilities – need Chair of the Public Council of the State additional guarantees of access to Within Global Prison Trends 2019, Service of Execution of Punishment under medical care. The aim of Goal 3 of the Government of the Kyrgyz Republic the chapter on prison management the Sustainable Development Goals deserves special attention. Prison – agreed by United Nations member management should be implemented states in 2015 – is to ‘ensure healthy by well-trained and professional staff, lives and promote well-being for all at and the human rights of prisoners all ages’ by 2030. Thus, by ensuring should be respected, including the appropriate prison health services and right to non-discrimination. There the well-being of those in custody, should be safe conditions for all prisons have an important role in members of the prison, opportunities promoting the health of some of the for constructive dialogue with society, most disadvantaged people in society transparency, and accountability. and in contributing to the achievement In many countries, work in prisons of Sustainable Development Goal 3. is menial and low-paid, and is not seen as an opportunity to gain skills In most countries, preference is still for future employment. In prison given to imprisonment, including for management, women are not afforded minor offences. The consequence of equal status and many
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