Health conditions

All states are unequal...

Common things are commoner

Around the world, places of detention are not simple microcosms of the free world:

Compared with the general population, adults in contact with the criminal justice system have higher rates of mental and physical health problems… Some of the most prevalent problems include substance misuse, personality disorder, depression, anxiety, respiratory disease, diabetes, and other chronic health conditions…

And some are particularly serious

… Being held in prison is associated with increased suicide rates and high levels of mental health problems… Lack of access to healthcare can exacerbate existing problems and affect reintegration to society.
The health of prisoners: summary of NICE guidance

There is no doubt that detainees have worse health problems than their free compatriots.

… but some are more unequal than others

Detainees incarcerated in low and middle income countries (LMICs) tend to have a wider range of conditions presenting in even more advanced states. And being detained in a state with a poor human rights record and even a lack of formal offender healthcare lends further complexity, as does the fact that many of them are at least sub-tropical.

Commonest conditions

In countries with all four high risk factors - LMIC, poor human rights record, lack of formal offender healthcare and at least sub-tropical - detainees fare particularly badly. Here are the leading problems coded within our electronic medical records for patients in such countries’ places of detention:

Dermatology: abscesses, burns from forced ablation of gang tattoos, boils, fungal infections, infected gang tattoos, infections around gang initiation injuries, lice, scabies and wounds

  • Cardiology: dehydration-induced syncope, heart failure, heat exhaustion and hypertension

  • Endocrinology: diabetes and diet-induced hypothyroidism

  • Gastroenterology: diarrhoea, gastric ulcers, hunger, tuberculosis and vomiting

  • Head & neck: blindness, dental abscesss, dental caries, ear infections and fractured jaws

  • Infectious diseases: dengue and other haemorrhagic fevers, HIV, hepatitis, malaria and syphilis

  • Malnutrition: calorie deficiency, iron-deficiency anaemia, protein deficiency, vitamin C deficiency and vitamin D deficiency

  • Musculoskeletal: acute & unhealed fractures, amputations, arrest injuries, bullet wounds, contractures, handcuff injuries, hernias, interrogation injuries, osteoarthritis, acute & chronic osteomyelitis, rheumatoid arthritis, retained clips and sutures, and rickets

  • Neurology: cardiovascular accidents and seizures

  • Obstetrics & gynaecology: menstrual problems, pregnancy, risk of pregnancy and STIs

  • Oncology: undiagnosed cancer and untreated cancer

  • Paediatrics: child abuse, safeguarding problems and stunted growth

  • Palliative care: lack of access to appropriate medicines and treatments

  • Psychiatry: addiction to crystal meth, alcoholism, anxiety, autism, depression, learning disability, loneliness, personality disorders, post-traumatic stress disorder, psychosis, self-harm and solitary confinement syndrome

  • Respiratory: asthma, chronic obstructive pulmonary disease, empyema, occupational lung disease, pneumonia and tuberculosis

  • Urology: infected penile mutilations, renal failure, STIs and UTIs

“The Lord looked down from his sanctuary on high, from heaven he viewed the earth, to hear the groans of the prisoners…”
Psalm 102:18-20