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Impact of Prison Environment to Health of Detainees in Tarlac

Provincial Jail: Basis for Health Care Enhancement

IMPACT OF PRISON ENVIRONMENT TO HEALTH OF DETAINEES IN TARLAC

PROVINCIAL JAIL: BASIS FOR HEALTHCARE ENHANCEMENT

Eric Vincent R. Maminta, RN, Thea Laurene Suba, RN and John-John S. Mislang, RN

ABSTRACT

The purpose of this study is to define or conclude the Impact of prison environment to

the health of the detainees in Tarlac Provincial Jail, and will serve as a basis for health care

enhancement in the institution.

The researchers will be using Quantitative method, wherein descriptive research

method will be thought appropriately. The research will use survey questionnaires as the

instrument. To establish the impact of prison to health of detainees, 56 trustees among the

detainees will be surveyed and appraised. Questionnaire will be prepared and will be

distributed to the trustees and these trustees will serve as the subjects of the study, to ensure

the safety and security of the researchers. The data gathered will be tallied, tabulated and

interpreted by the researchers. Frequency distribution and weighted mean will be used as

statistical treatment.

At the end of the study, the researchers will come up with a proposal of programs that

will serve as an enhancement for better health care delivery system for the detainees of Tarlac

Provincial Jail.

Findings:

Keywords: Healthcare delivery, Trustees

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

Introduction

“Prisoners suffer a disproportionate burden of health problems as their health

needs are often neglected” according to World Health Organization (WHO). In addition, The

United Nations (1990) Basic Principles for the Treatment of Prisoners set out that "prisoners

shall have access to the health services available in the country without discrimination on the

grounds of their legal situation" (Principle 9, A/RES/45/111). There are many ways to

preserve human life and protect the health in an environment. The environment itself must

not be an encumbrance to people living in. In a prisoner’s life, environment must be taken

earnestly and should not be overlooked or deserted for it is a necessity and essential not an

option. To protect the health of a detainee, everyone should have an equal fair access to

health and safe environment.

According to Jean-Daniel Tauxe, the International Committee of the Red Cross

(ICRC) head of delegation in Manila, they have seen that the overcrowding of jails and

prisons has serious consequences for detainees, access to safe water, sanitation, healthcare,

and acceptable living conditions are a major problem in overcrowded detention facilities. He

also added that, the steady spread of tuberculosis had become a serious concern. The

environment is an enormous factor for supporting and upholding health and life. It is

significant to continuously contemplate the needs in order to have a clean and innocuous

environment. Through this, it could benefit and protect the health of an individual living in a

prison environment.

Life in prison is based on deprivation of liberty, which is markedly different than the

freedom of action and choice enjoyed by the members of the outside community (Castellano,

1997). The ample change in a prison’s way of living is way different from outside. These

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

changes might affect the detainee’s daily routine in dealing with the different situations,

changes that can alter the detainee’s physical, emotional and mental health.

Physical and mental health might be deeply affected because of different aspects; one

of these factors is the environment, which is a huge change for a person’s way of living inside

the jail. Mental health might as well be affected because of stress and degradation, the

limitations and boundaries as well as the adaptation with the rules and regulations. The entire

change of the environment and way of living may influence the entire health of an individual.

A clean or clear environment is a need for a person’s well- being. People interrelate with the

environment and environment has something to do with the quality of life that people live in.

The researchers’ study concentrates on the health of the detainees with the arising

problems that might come across when it comes to the environment inside the jail. This will

be a basis for enhancing the healthcare delivery system of Tarlac Provincial Jail. The

occurring health problems with such an environment of the detainees pushed the researchers

to conduct this study. The research team wants to pursue this research study to establish and

expound quantities of indications that the environment inside the jail accompanies the health

of the detainees. Another thing the researchers want to present in this study, is to generate the

knowledge of the institution on how do they enhance their healthcare services for better

healthcare delivery system and outcomes, and the impact of prison environment to the health

of detainees in Tarlac Provincial Jail, Dolores, Tarlac.

The researchers will be mostly guided by the different theories in nursing. One of

these theories is by Florence Nightingale (1860/1969), which is the Environmental Theory.

Florence stated in her nursing notes that “nursing is an act of utilizing the environment of the

patient to assist him in his recovery” (Nightingale 1860/1969). This denotes that the nurse

must give importance and deeply consider the environment accordingly to help in patient’s

gradual restoration of health, and must also consider and take note of the external triggers that

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

might affect the condition of the patient. The researchers can relate to this study with the

external factors specifically the environment that might affect the health of the detainees.

This implies that physical environment deeply influence the health of every individual.

The theory of Abraham Maslow which is the Humanistic theory of Learning, this

implies that higher level of necessities cannot be met unless certain lower level needs have

been achieved. Abraham Maslow’s hierarchy of needs is composing of five levels; these

levels must be achieved accordingly to satisfy an individual’s needs. The first level is

composed of the Physiologic needs, this includes water, air, breathing and among others. An

individual needs these in order to maintain and have a good life because this deals with the

maintenance of a human body that is vital to being. Then second level is the need for safety

and security. These level includes own safety that would keep an individual from any harm

and security when it comes to personal and financial securities. In this level, health,

environment, shelter and job securities are very particular. Stability is important in achieving

the hierarchy of needs and same as with an individual who does not feel safe in an

environment; it can alter the process and its goal in achieving the highest level. The third

level pertains to love and belongingness, composing of affection, intimacy, acceptance,

family, friendship and as well as social needs. These needs can be met by an agreeable and

gratifying affiliation or connection. And if so, this will result to reception by others. After

physiologic and security needs have been attained, an individual can look for a relationship

where love and belongingness can be reached effectively. The fourth level is attaining self-

esteem. After love and belongingness have been achieved, an individual will start to believe

himself. This is the stage where gaining of self-confidence begins. Gaining self-confidence is

having self-esteem, these includes respect, accomplishments and achievements. The last and

the highest level is self-actualization. This pertains to gaining ones’ potential in

accomplishing his goals. Attaining the uppermost level is having self-fulfillment to pursue

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

everything that would satisfy him and to have growth, both personal and career through

experiences and grow as a whole. The researchers can relate to this theory for it reflects on

how a detainee can adapt to his environment and help him accept the situation. This will test

the resiliency of every detainee towards the situation inside the prison. Every detainee needs

to meet his physiologic needs in order to survive and maintain his body’s needs and health.

Every detainee’s need when it comes to personal safety and security must be achieved for

every detainee must have a sense of having of own safety and away from any harm. He also

needs to feel the love and affection from his support groups specifically his family to have a

sense of belongingness and same as with his co-detainees, this will them adapt with the

environment and the situation. From that, he will gain self-confidence and self-esteem and

the feeling of sense of fulfillment. He will gain respect from others and to be accepted again

in the society as a productive and a healthy individual.

The researchers decided to use conceptual framework to place a prominence on the

impact of prison environment to health of detainees in Tarlac Provincial Jail as a basis for

healthcare delivery enhancement. In General System Theory, the input data included will be

the environment’s description in terms of; number of occupants per cell, ventilation and

warming, lighting, noise, cleanliness and nutrition. It will also include the health problems

reported by the institution within 3 years, the healthcare services offered, and the

enhancement healthcare programs that can be proposed for better healthcare delivery. Based

from the data, the control process will use quantitative method specifically descriptive

research method to determine the different edges of the problem, allowing them to generate

the accurate inferences for the exemplification of the precise evidences. After the exploration

and scrutiny, the output will be produced and will deliver information about the impact of

prison environment to the health of the involved study participants and serve as a basis for

enhancement of healthcare delivery

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

 Florence Nightingale’s Environmental


Theory (1860/1969)
 Abraham Maslow’s Humanistic Learning
Theory/ Hierarchy of Needs

 What are the  What are the  What


reported health healthcare enhancement
problems of the services offered healthcare
institution by the program can be
within three institution? proposed for
years? better
healthcare
delivery?

The research study will be able to produce and


deliver information about the impact of prison
environment to health of the involved study
participants and serve as a basis for enhancement
of healthcare delivery.

Figure 1. Paradigm of the study

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

Statement of the Problem

This study will determine the status and problems occurring in the environment and in

the health of the detainees in Tarlac Provincial Jail.

Specifically, the study seeks to clarify the following:

1. What are the demographic profile of the respondents in terms of the following:

1.1 Name(Optional)

1.2 Age

1.3 Sex

1.4 Length of stay

2. How is the prison environment described in terms of:

2.1 Number of occupants per cell

2.2 Physical Structure

2.3 Nutrition

2.4 Sanitation

3. What are the reported health problems of the institution within three years?

3.1 Communicable Disease

3.2 Non- Communicable diseases

3.3 Water and food-borne diseases

4. What are the healthcare services offered by the institution in terms of the

following?

4.1 Health Promotion

4.2 Health Protection

4.3 Disease Prevention

5. What enhancement healthcare program can be proposed for better healthcare

delivery?

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

The result will be utilized as basis for further study on the impact of prison

environment to the health of detainees and will served as a basis for a better healthcare

delivery. The following will get the benefits of this study:

For Nursing Practice. The study will run the healthcare staffs specifically the nurses

with further and sufficient knowledge in the delivery of healthcare to the detainees of Tarlac

of Provincial Jail.

For Paramedic Service. The outcome of the study will provide them information

about the problems occurring in the institution. Furthermore this study will help and assist in

developing and implementing strategies for foster management in healthcare delivery.

For the Administration. This study will serve as an eye- opener for the institution

about the impact of the environment that could affect the health of the detainees thus,

providing them ways or alternatives that could enhance the healthcare delivery system

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

RESULTS AND DISCUSSION

I. Profile of Respondents

A total of 30 repondents were chosen for this study, 20 of which are

detainees and 10 are jail guards. Fifty percent of the respondents are ages 26 to 35

years old, and most of them have been staying at Tarlac Provincial Jail (TPJ) for

more than three years.

II. Environment

Figure 1. Response of detainees and jail guards on the physical structure

of TPJ.

Figure 1 shows the response of detainees and jail guards on the physical

structure of TPJ. The respondents believe that prison cells are always well lighted,

comprising 56.67%, in contrast to the cells being always crowded (86.67%).

Prison cells, however, are sometimes well ventilated (76.67%), have available bed

per detainee (53.33%), and shower and comfort rooms are sometimes available

(53.33%). Hence, the physical structure of TPJ sometimes met the quality

standard set for all provincial jails; all but crowdedness of prison cells.

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

Table 1. Response of detainees and jail guards on nutrition inside TPJ.

Nutrition Always Sometimes Never


(%) (%) (%)
1. Eat at least 3-5 times a day. 83.33 16.67 0.00
2. Equal servings of meat and vegetables per meal. 33.33 53.33 13.33
Diet serving according to reported health
13.33 66.67 20.00
condition.
4. Drink water at least 8-10 glasses a day. 93.33 6.67 0.00
5. Meal serves on time. 53.33 43.33 3.33

Table 1 shows the response of detainees and jail guards on nutrition inside

TPJ. The respondents believe that they always eat for at least 3-5 times a day

(83.33%), drink water for at least 8-10 glasses a day (93.33%), and that meals are

always served on time (53.33%). Equal servings of meat and vegetables per meal

are sometimes served to the repondents, comprising 53.33%. Additionally diet

servings are sometimes in accordance to reported health condition (66.67%).

Overall, nutrition conditions inside TPJ are always satisfactory, and that all meals

are adequate, balanced, and in accordance to reported health conditions.

Table 2. The sanitation of TPJ as perceived by the detainees and jail


guards.

Sanitation Always Sometimes Never


(%) (%) (%)
1. Clean comfort rooms and shower rooms. 63.33 43.33 0.00
2. Clean area within the cell. 63.33 36.67 0.00
3. Presence of hazard (rats, coackroach, cobwebs,
etc.) 10.00 76.67 13.33
4. Segregation of waste materials. 43.33 26.67 30.00
5. Change bed linens. 56.67 40.00 3.33

As shown in Table 2, sanitation of TPJ is being described differently by the

respondents. TPJ has always clean comfort and shower rooms (63.33%), has clean

area within the cell (63.33%), has proper segregation of waste materials (43.33%),

and always has change bed linens (56.67%). Apparently there are occasional

presence of hazards such as vermin, cockroaches, cobwebs, etc (76.67%). Overall,

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

the sanitation conditions of TPJ are beyond satisfactory, as a result of the

cleanliness programs of the present TPJ administration.

III. Programs

Figure 2. Health promotion on TPJ as perceived by the respondents.

Figure 2 shows the response of respondents on health promotion

at TPJ. The majority of them agree that different programs on health promotion

are occasionally given to them. These include nutritional programs (60.00%),

exercise (56.67%), mental health programs (63.33%), smoking cessation programs

(73.33%), and healthy lifestyle programs (70.00%). Notably, none of the

respondents believe that no exercise and healthy lifestyle are being practiced at

TPJ.

Table 3. Health protection at TPJ as described by the respondents.

Sanitation Always Sometimes Never


(%) (%) (%)
1. Medical screening 36.67 60.00 3.33
2. Healthcare waste management programs 33.33 53.33 13.33
3. Oral hygiene and dental care programs 26.67 70.00 3.33
4. Occupational health hazard programs 20.00 66.67 13.33
5. Water and sanitation programs 23.33 56.67 20.00

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

As shown in Table 3, health protection at TPJ is viewed unanimously by

the respondents. Sometimes medical screening (60.00%), healthcare waste

management programs (53.33%), oral hygiene and dental care programs

(26.67%), occupational health hazard programs (66.67%), and water and

sanitation programs (56.67%) are being enjoyed by detainees and jail guards alike.

Table 4. Disease prevention at TPJ as described by the respondents.

Disease Prevention Always Sometimes Never


(%) (%) (%)
1. Flu vaccine immunization 10.00 40.00 50.00
2. Tuberculosis control and testing program 63.33 36.67 0.00
3. Educational and social services (STD services,
risk reduction services, etc.) 40.00 56.67 3.33
4. HIV screening 20.00 80.00 0.00
5. Hepatitis B vaccine 16.67 36.67 46.67

Table 4 shows the disease prevention at TPJ as described by the

respondents. The tuberculosis and testing program has been always satisfactorily

implemented (63.33%). Educational and social services (STD services, risk

reduction services, etc) and HIV screening are sometimes performed at TPJ

(56.67% and 80.00%, respectively). However, flu vaccine immunization (50%)

and hepatitis B vaccine (46.67%) has never been given to TPJ detainees and

employees.

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Provincial Jail: Basis for Health Care Enhancement

IV. Common Reported Diseases

Figure 3. The common communicable diseases occurred at TPJ as known


by the respondents.

Figure 1 shows the common communicable diseases occurred at TPJ as

known by the respondents. Apparently dengue fever, pneumonia, and influenza

occurred minimally at TPJ, with 80.00%, 63.33%, and 43.344% responses,

respectively. In contrast, tuberculosis has high probability of occurrence among

detainees at TPJ, with 56.67% of respondents who agreed. Acute respiratory tract

infection falls in the middle, where it occurs often at TPJ (43.33%).

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

Figure 4. The non-communicable diseases at TPJ as perceived by the


respondents.

Figure 4 shows the non-communicable diseases at TPJ as described by the

respondents. These include hypertension, diabetes mellitus, asthma, rheumatoid

arthritis, and heart diseases. As perceived by the respondents, hypertension and

asthma always occur at TPJ (63.33% and 43.33%, respectively). Furthermore

diabetes mellitus, rheumatoid arthritis, and heart diseases often occur at TPJ, with

46.67%, 50.00%, and 56.67% of responses, respectively.

Figure 5. Food and water-borne diseases at TPJ as described by the


respondents.

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

Figure 5 shows the food and water-borne diseases at TPJ as described by

the respondents. At some times, amoebiasis, hepatitis A and C, typhoid fever, and

food poisoning occur, which has responses of 73.33%, 66.67%, 66.67%, and

76.67%, respectively. However, acute watery diarrhea occurs often, which gave a

response of 43.33%.

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

CONCLUSIONS

This study aims to provide background information on prison environment to

detainees of Tarlac Provincial Jail (TPJ) which will be used as a basis for health care

enhancement. A total of 30 respondents, 20 of which are detainees and 10 jail guards, were

used in the study to gather information through questionnaires.

The prison cells at TPJ are always crowded, however are always well lighted and

sometimes ventilated. Beds per detainee, shower rooms, and comfort rooms are sometimes

available to them. Despite crowdedness, they always have clean prison cells, comfort rooms,

and shower rooms. The detainees also practice proper waste segregation and change bed

linens. However there is still occasional presence of hazards such as vermin and cockroaches.

The detainees, fortunately, always eat 3-5 times and drink water 8-10 glasses a day. Equal

servings of meat and vegetables per meal are sometimes being served, in accordance to

reported health conditions.

Ample health promotion programs are being implemented at TPJ, such nutritional

programs, exercise, mental health programs, smoking cessation programs, and healthy

lifestyle. Sometimes medical screening, healthcare waste management programs, oral

hygiene and dental care programs, occupational health hazard programs, and water and

sanitation programs are being enjoyed by detainees and jail guards alike. Tuberculosis control

and testing program is performed on a regular basis. Educational and social services (STD

services, risk reduction services, etc) and HIV screening are sometimes performed at TPJ.

However, flu vaccine immunization and hepatitis B vaccine has never been given to TPJ

detainees.

Fortunately dengue fever, pneumonia, and influenza occurred minimally at TPJ. In

contrast tuberculosis has high probability of occurrence, while acute respiratory tract

infection falls into the middle. Hypertension and asthma always occur at TPJ, whereas

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Impact of Prison Environment to Health of Detainees in Tarlac
Provincial Jail: Basis for Health Care Enhancement

diabetes mellitus, rheumatoid arthritis, and heart diseases often occur. At some time,

amoebiasis, hepatitis A and C, typhoid fever, and food poisoning occur. However , acute

watery diarrhea occurs often.

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