Purpose
The purpose of this
paper is to analyze poor management of tuberculosis (TB) prevention and
treatment and explore parameters and causes of this problem drawing on
qualitative interviews with former prisoners and medical specialists in
Kaliningrad Oblast in Russia.
Design/methodology/approach
The authors
undertook a qualitative study, to explore access to HIV and TB treatment for
people who inject drugs in Kaliningrad. The authors interviewed (outside of
prisons) 15 patients and eight health specialists using a semi-structured
guide. The authors analyzed the accounts thematically and health consequences
of imprisonment emerged as a major theme.
Findings
Prisons are overcrowded
and lack basic hygiene and infection control. Demand for medical services
outstrip supply, HIV and TB prevention lacking, HIV and TB treatment is patchy,
with no second-line drugs available for resistant forms. The prison conditions
are generally degrading and unhealthy and many respondents perceived surviving
prisons as a miracle. Cooperation with medical services in the community is
poor.
Research limitations/implications
The authors used qualitative research
methods, which do not rely on a representative sample. However, many of the
structural barriers preventing effective TB treatment and prevention
highlighted in this paper have been noted elsewhere, suggesting that findings
are likely to reflect conditions elsewhere in Russia. The authors tried to
include all possible points of view, as of the medical staff and the patients.
However, due to resistance of the officials the authors were unable to conduct
interviews with employees of the FCS. Since all the interviews are recalling
past experience, the situation may have changed. This does not undermine
importance of the findings, as they shed light on particular treatment experiences,
and development of prison health system.
Originality/value
The paper
contributes to the literature on prisons as a contributor to TB epidemic,
including drug resistant forms. An urgent penitentiary reform in Russia should
focus on HIV and TB prevention, case detection, availability of medications and
effective treatments. Key to decreasing prison population and improving health
is political reform aimed at introduction of effective drug treatment,
de-penalization and de-criminalization of drug users and application of
alternatives to incarceration.
Purchase full article at: http://goo.gl/g6J0AR
By:
- 1Andrey Rylkov Foundation for health and Social Justice, Moscow, Russia.
- Int J Prison Health. 2016 Mar 14;12(1):45-56. doi: 10.1108/IJPH-07-2014-0022.
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