Dental, ophthalmological, traumatological, gynecological, dermatological problems… A report by the OIP (International Observatory of Prisons), published on Wednesday July 6, and to which franceinfo had access, denounces the lack of access to specialized care for prisoners in the jails.
>> Access to care in prison: “The doctor was not there, or transmitted prescriptions without having seen him”, deplores the companion of a detainee suffering from cancer
According to this report, the difficulties include “waiting times to obtain an appointment at the health unit or the hospital center of attachment, cancellations of extraction, or even a renunciation of care to avoid unworthy extraction conditions”. The report points out that there is also a “impossibility of bringing into detention the medical equipment yet prescribed by the caregivers”.
In 2021, the OIP received more than 900 requests from detainees or their relatives relating to health in detention, including nearly 400 concerning access to care. Half (197) concerned access to so-called “specialized” care, for which patients reported waiting a long time for examinations, care and/or treatment.
Among the testimonies collected by the OIP there is in particular that of this detainee on remand since July of last year at the Dijon remand center. “I couldn’t bring my braces, which are no longer usable anyway now that the gums have reformedhe says. But I no longer have molars. So since I can’t chew, I’m prescribed medicine for bad digestion, heartburn.”
The OIP also reports the case of Laura, imprisoned in Roanne, in the Loire, to whom a gynecologist refused to perform a smear. Benefiting from an adjustment of sentence, a year and a half later, she was finally able to carry out this examination which revealed cancer of the cervix of the uterus.
“For the specialties most in demand, detainees sometimes have to wait several months before getting an appointment, when they get it.”
International Prison Observatory
Moreover, despite the high prevalence of infectious diseases in prison, and in particular HIV and hepatitis C, “their prevention as well as their care are slowed down by the constraints linked to detention. These failures contribute to a deterioration in the state of health of prisoners, with sometimes dramatic consequences: worsening pathologies, cancers not detected, and more generally a loss of chance”to heal and to be cared for.
The report emphasizes the obstacles which are numerous in prison to the proper management of certain pathologies, including “monitoring is inconsistent with the restrictions imposed by detention”. However, the principle of equality of care between detainees and the general population is enshrined in the reform of 18 January 1994 which transferred responsibility for the health care of detainees from the Ministry of Justice to that of Health.
There are issues of escort availability and breaches of confidentiality of care. “For longer care, on the other hand, the existence of specialized structures, secure hospital units, guarantees conditions that are more respectful of the fundamental rights of detained patients. But other problems arise there”in particular a “lack of space in the units dedicated to mental health”this “which contributes to a limitation of access to care.”
Among the recommendations to improve the health care of prisoners, the OIP requires “a reform of penal policies to put an end to prison overcrowding.” The International Prison Observatory refers to the budget allocated to health in prison calculated according to the theoretical number of prisoners when we know that there is currently a prison overcrowding of 120%. It also calls for “provide the medical units with the medical equipment necessary for the exercise of the specialties present in detention” and to promote permission to go out for treatment.
Finally, according to the observatory, the State must “put in place a national roadmap which aims to ensure sustainable funding of medical and paramedical staff positions, in particular with dedicated and sufficient staff within prison health units (USMP) for specialties which must be accessible on site and for which telemedicine is not a solution (dentistry, physiotherapy, gynecology, ophthalmology, etc.)”.