Report of the medical and psychological situation in prisons

Report about the mental health situation
in Lebanese prisons in the year 2011

Lebanon has 22 prisons, the largest prison Roumyeh (adults and juveniles), and the rest of the prison is distributed in areas of Lebanon, all the buildings were not established for that purpose with the exception of the central prison Roumyeh, but developed in the headquarters of the official institutions of the Serai and municipalities.
The purpose of the prison in the first place reform and rehabilitation to help the inmate to be a good citizen contributes after his release in and integration into society. And dealing with the prison must be based on being part of a national deal with the problem of crime, dealing with prison conditions begins in legislation, regulation and passes in the judiciary does not end in the after-care and community prevention. And it is not able to hand one to solve all the dilemmas that arise in the question of prisons astronomical work reaches to his destination must be the participation of all authorities in the state of the legislative, executive, judicial, and this is not without real pressure from civil society to keep up with work retrofitting and reformist.
The health conditions in prisons, one of the acute problems faced by prisoners because of the nature of prisons and the absence of real health care.
This report covers the 35 visits carried out by the Centre to 14 prison from June 2009 until 2011.
Year Nb of visits Nb of consultations Doctures and specialists
عNb of surgery Diabet Test Transfer to specialist/x-ray Health,social & psychological awerness Haire dressing Psychological Consultation
2009 14 visite 482 (7) Doctors –(3) Social worker -
(3) Psychologist-
Hair dresser 0 45 11 3 12 13
2010 17 Visit 268 (4)Doctors -
(3) Social worker –(2) Psychologist -
Haire dresser 6 8 6 6 43 77
2011 4 visits 80 (2) Doctors –(1) socila worker-(1) psychologist –Hair dresser 2 1 2 2 27 8
المجموع العام 35 Visits 830 (7) Doctors-(3) Social worker-(3) Psychologist –Hair dresser 8 surgery 54 19 11 82 98

* The Medical assistance in the prisons

The above table shows that the number of beneficiaries of the health service during 35 visits to the inmates and inmates on 14 jailed Lebanese prisons (Roumyrh- Nabatiyeh - Tibnin - dome \ Tripoli \ women and men - Jeb Jenin - Aley - minor \ Dahr Albachq - Tyre - Baabda - Women's Jezzine - Saida - Zahle prison for women - Barbar Khazen for women - Rashaya reached 830 medical examination, and examination of diabetes for 54 cases, were transferred 19 cases to the doctors and were 8 simple surgery Abcess - extract to diets and fat - hernia - excessive lifting the pole for the two inmates and clean burns and wounds to Nzelican, and for seminars and to provide guidance for health, social and psychological focused center of tents on the implementation of the seminars I was 11 a seminar on: disease, inflammation of the eyes APOLO - breast cancer and cervical cancer - osteoporosis - swine Flu - personal hygiene - Urology - Dermatology different - clean food and vegetables .. due to the spread of these diseases frequently to and how to prevent them and therefore how to care for health through the presence of these diseases in inmates or inmates. The Centre distributed a number of brochures health (thinning of bone - breast cancer - diabetes) and brochures and a private place of work and for other minimum Rules for the Treatment of prisoners.

* As for the psychological services:
A psychological seddions for men and women with the activities of therapeutic psychological terms of work includes psychological meaningful activities is a revitalization of myself - a social and activity of the role-play designed to empty the energies charged with the prisoners and the activity of a representative meaningful, and benefited from these activities and treatments 98 cases and in accordance with the request involved in the activity of collective psychological or psychiatric session collective or even individual psychotherapy.
Psychological and presented a lecture - medical dealt with personal hygiene, conflict resolution within the prison and its impact on the hearts of inmates.
Has been shown the absence of social interaction with parents, especially when prisoners as suffering from isolation, anxiety, and some of them were released, but returned to prison again, for lack of rehabilitation and care in prison.

* Social Services decorative cosmetic psychological:
Which has on several occasions, including: March 8, International Women's Day and June 26 International Day in Support of Victims of Violence and Torture, and the occasions of holidays (New Year and Id al-Fitr and Adha) ... The number of women who benefited from that service \ hair cut and clean eyebrows \ for some (women ) 82 boarders.
During those visits was 26 cases were studied, including the study of 12 inmates, an examination of all social conditions and circumstances within and outside the prison at the moment. Additionally, the Centre needs to provide a supportive and, as necessary, according to some potential to facilitate the lives of prison inmates in the prison: the Sawmills washing (number 4) - Brad (number 1) - Some medicines and medical supplies
• diseases that were detected when male and female prisoners in Lebanese prisons each year, and drugs given to the cases of free
And that out of 830 were as follows:

Diseases 2009 2010 2011
Arthritis 27 23 4
Lower back pain 44 23 4
Bronchitis 23 22 10
Osteoarthritis 1 1 0
Cefalfia 16 7 3
Dermatitis 6 3 0
Nervosis 1 10 0
Mycosis 58 25 3
Onychomycosis 2 2 0
Dermatitis 36 33 5
Veriscolar 1 0 2
Scabies 10 2 0
Pyelone phritis 10 5 4
Aene vulgaris 1 2 3
Depresion 18 5 5
Gastritis 21 13 7
Tensilitis 16 8 1
Parkinson 2 0 0
Otitis 10 5 0
Aene 14 12 2
Piodermia 6 3 2
Colesterol 8 0 0
Migraine 9 3 1
Hypertention 5 1 0
Diabet 11 1 1
Anxaity 3 1 2
Asthma 3 3 0
Neurology 0 0 0
Eczema 7 4 0
Alopecia 4 5 0
Osteoporose 1 2 0
Furunculosis 2 3 0

Warts 1 2 0
Psoriasis 1 1 3
Tuberculosis 1 0 2
Hematauria 2 3 0
Thyroiditis 1 2 1
Trauma 0 3 3
Phobie 0 1 0
Chest pain 0 0 2
Hepatitis 0 0 2
Consultation 23 11 7
Neoplasia of cervix 0 0 1
Gastitis 0 0 1
Epatitis 0 0 2
المجموع 37 مرض 33 مرض 23 مرض

Appeared during those 3 years 41 different diseases between (skin - my body \ internal - myself), In 2009, 370 disease appeared , in 2010,33 and 2011, 32 disease.

of skin suffering from inmates and inmates, the majority of them in prison because of their exposure to the sun and in sufficient quantity to protect them from the non-proliferation of viruses and microbes, and quickly and the room humid and parasites that accumulate due to humidity, which cause their chest diseases from asthma and allergies, and therefore diseases colds and infections, almonds and bronchi pulmonary and also contributes to the growing these diseases and easily owned in the body of guest not eating regularly and the food quality and speed of healing the patient. The diseases of the joints and bones appear when each guest and remove it if it is true, especially lower back pain for no mobility and walking, due to sit for long hours and lack of work and poor diet and not eating regularly. Followed by the disease: high blood pressure - fat in the blood - Diabetes is a result of repression and lack of attention to the patient's health since the beginning and thus to malnutrition and the diseases and ailments: pain in the head - Neurology - depression - paid for increasing the psychological pressure experienced by the guest of fear, anxiety and Altfkerbalakab and the absence of trials and the suffering of their families and how the supervisors and those responsible for the guest with them, especially when moving from one prison to another major scourge and smoking .... And inflammation in the urinary tract and the sand is the result of non-clean water often, and therefore not drinking regularly or sufficient quantity of water on a daily basis.
As for diseases, including chronic (diabetes - ulcers - pressure - fat ...) Some of them were present when the prisoners out of prison, but the lack of increased interest in the delivery of drugs to their respective holders.

In addition to the suffering of the prisoners, some of these diseases and their inability to buy medicines or treatment and the indifference of prison administrations have social and psychological pressure, which they suffer as a result of an imposed mixing them prisoners in rooms filled with various offenses .. A number of them suffer from depression and diseases of nerves, which are increasing.
And after each visit and preview the receipt of necessary medicines and medical capabilities available by the Centre for the departments of prisons and the name of each guest and management is the task of providing the drug.
Each prisoner patient acute and chronic.

The list of mediciens destrebute to the prisoners is:

Brufen 400mg-Bactrim fort-Panadol tab-Amoxil 500mg-Prozac 20mg-Deanxit

tab-Bactrim fort-Erythromycin-Avil retard 75mg-Difen B12 inj-Omepral 20mg-

Dermovate cream-Singular 25mg-Amydramine expet- Histamed tab-Micenazale

cream- Quadriderm cream-Duofilm sol-Flagyl 500mg-Betaserc 8mg- Capoten

25mg-Tettracycline cream- Nizoral tab-Ranitidine tab-Lotriderm cream-Medisten

tab-Micenazole cream-Glycophage 850mg0- Neotropil 800mg-Futasene cream-

Brufen 400mg-Panderm cream-Neurobion inj-Mirudaud cremSpidogole sol-Multi-

vitamin Simvastatin 40mg...........

Also after each visit was the place to hand over a quantity of drugs for each prison, prisons, especially painkillers and some medicines for skin diseases, acute and, consequently, the seasonal diseases.

* Nationalities of inmates and inmates:
Since the prisons in Lebanon, the majority of inmates are Lebanese, followed by guests from the Syrian nationality and then guests aliens and a lot of countries: Ethiopia - Philippines - India - Bangladesh - Nepal, Sri Lanka .. and a few countries: Brazil - Turkey - Russia - Morocco - Palestine - Egypt - Iraq - Tunisia, Algeria ..

* Age groups and the reasons for entry to the prison:
Ranged in age prisoners who have been Mainthm between births (1930 - 1990), due to the presence of female inmates are pregnant is up operations of the birth of these inmates, necessitating the presence of the child with his mother (and to point out that it was Preview children through health work was born in 2008 \ was born in prison) was also preview the child of a Alamrchehr and a half and another girl of the month (born 2010) They were born and are indirectly guests. ) The upper age bracket (1980) in the prisons of Allnads and men born in the year, followed by (1970) and then (1960) .. Here, note that the age group and boys that do not receive upon themselves a lot of responsibilities (not married - not working - lazy submissive - like money and assembled in an easy - love for life and sports - teen ...) which are the most implementation of the work of the anomalies which violate the law. The violations that he committed most of the prisoners and prisoners: the killing - a murder in the post - stolen - theft and robbery - Securities fraud - drug abuse - drug trafficking and promotion - because of residence (foreigners) - immoral acts (prostitution) ...

* As for the working group of doctors and specialists:
• The number of the Working Group in the field visits of the 35 prisons of Lebanon 16 specialist were divided between: 7 doctors jurisdiction (public health - skin diseases - diseases - Women's) / nurse and one 3 / psychologists / 3 social workers / 1 Hairdressers Women / and the driver of the number of one, drawing attention to the existence of mobile clinic in each health visit. Ncheraly and he was ahead of the visit was to be agreed with the doctors specialty departments of the prison to them as their needs and according to most common diseases among prisoners.

- proposals for:
The majority of the Lebanese prisons, lack of medicine to the health, particularly chronic medication of it, so that there are many prisons do not contain the necessary medical equipment such as: pressure measuring machine - diabetes screening machine - a machine to check the pain of ear ...
It was also noted that the pathogen is not a nurse in particular, that is, it is possible to have someone from the security forces, or one of the guards and has no relevance of Batababh or even if the nurse follows the guidelines and instructions of the Supreme does not exercise his profession faithfully (sometimes Nothing shall a patient in need of necessary or even to a physician specialty ...).
Until the necessary daily needs of prisoners and prisoners in some prisons sometimes Garmamenh (Sawmills for washing - food - especially the needs of girls \ sanitary towels - Cleaning - Refrigerator - Heating and cooling ...)
Also that most of the prisons is not valid for the detention of human beings and even of the population is supposed to change the place, or even prisons need to qualify: painting - the development of ports (windows) for the ventilation of rooms. And toilets also need to be equipped for people with special cases (ADHD) also work on maintenance and care each period for all aspects (maintenance and cleaning).
It is clear that some of the prisons is not a specialty of the nurse, and sometimes the patient does not take his medication or not to follow the treatment by the nurse the next.
Missing the majority of prisons and a private pharmacy therapeutic drugs only, and thus because of the importance of pharmacy in every prison, and are only for the development of medicines.
Show that there is an urgent need for psychological support, presence of a psychiatrist or psychologist in every prison is very important, it's a requirement for many of the prisoners.
Summery:
By visiting the 14 prison, we see that the Lebanese prisons do not meet the international standards for prisons and some of them, especially prisons, areas must be sealed and is required to build new prisons separate ie outside the Serail governmental Despite the importance of restoration and rehabilitation that have Bas association, but they remain the last of the effect of validity end of any period of short-term temporary housing for the suffering of the prisoners. Improving the conditions of prisoners, combined with a change of venue and vice versa, despite the improvements of this but the need to change or create new prisons qualifications, uninhabitable healthy and psychologically to prisoners remains the right solution, but this requires is a government plan to address this issue purely humanitarian and not given the importance of the required date.
Not to mention the overcrowding within the prison rooms so that there are many prison inmates outnumber its ability to accommodate the numbers of prisoners (prison dome - Jeb Jenin prison - a prison Romans ...)
It is necessary to separate some of the prisoners from the others (those who suffer from chronic and infectious, as smokers, and the separation of prisoners according to their actions criminal. And the issue of overcrowding of these must be followed by a solution in the expeditious conduct of trials for those who are without a trial, which account for about 60% of the the prisoners.
The absence of health care organization and the lack of doctors, specialty essential and therefore control over the medical work is reflected manifestations in the emergence of many diseases, proliferation and thus the presence of mortality and with young age due to the accelerated Maagathm health, which was the last of the victim Raymond Muslim in prison Roumyeh, who died on 14 / 12/2011 The number of those who died in prison in Romyeh and about 60 other prison inmates. (Statistics and the World Organization for Human Rights) This requires coordination between the departments of prisons - on health work - and make it linked to the Ministry of Health as a whole.
It is imperative that the other ministries that play a role in the education and rehabilitation and to accelerate the transfer of prison administrations to the Ministry of Justice
The prison administration is to take care of prisoners who complain of lack of medicine or physical inability to secure permanent and ordered the inmate to facilitate transactions when they are in need of tests or surgery is.
It is worth drawing attention to the importance of treating departments of prisons for inmates as a human being, and that must be the staff inside the prison are eligible for that work and coach him and this requires the supervisors of the prison and the competent authorities of public scrutiny of this matter and other matter, and therefore the implementation of the sessions of the gendarmes, prison guards and staff the entire prison on how to handle and deal with the inmates ..
Prisons in Lebanon, a hotbed of disease and epidemics, anxiety, and professional crime and most of the deaths were the result of neglect and lack of health care and health monitoring, inspection visits, which requires urgent steps to avoid disaster health in prisons.
This small sample did not include all the prisons did not observe all the diseases, especially in the prison of Romans. Which requires urgent action from the Ministry of Health to oversee the full prisons and promote medical cadre, medicines and medical supplies.
The Lebanese government to adhere to medical services as set minimum rules for the treatment of prisoners and in particular Article 22, "should be available in every prison services, a qualified doctor and at least one shall be at least mm psychiatry, and remains the organization of medical services closely Department of Public Health, and include the branch of Psychiatry in order to diagnose and treat mental abnormalities as necessary.
And that the transferred prisoners who require specialist care to jails to hospitals or specialized civilian and remains that are available in the prison treatment services provided by hospitals. And be available to every prisoner to benefit dental services in women's prisons should be available to provide facilities for the care and treatment before and after birth and take the necessary measures to provide a nursery staffed by qualified persons.
And the prison doctor that the officer shall regularly inspect the following aspects:
- The amount of food quality and preparation.
- How to follow the rules of health and hygiene in the prison and the prisoners.
- The case of sanitation, heating, lighting and ventilation in prison.
- The quality and cleanliness of prisoners' clothing and bedding.
- Compliance with the rules relating to religious education, sports, and shall visit daily and shall reside near enough to be able to attend without delay in cases of emergency.
Unfortunately, this is absent in Lebanese prisons and there is often collusion between prison departments and some doctors who Aatakidon profession of medicine and ethics are their professional duties.

Recommendations:
1 - Linking prisons Ministry of Public Health and a network of government hospitals in the provinces.
2 – It has to be available in every prison, at least: public health physician, a dermatologist, a psychiatrist, a gynecologist in women's prisons, sports coach or trainer.
3 – It have to be that is available in every prison: pharmacy, medicine, Brad, machines to measure the pressure, diabetes....
4 - Treatment of drug addicts at the expense of the Ministry of Health.
5 - Preventive health seminars periodically in all prisons.
6 - The release of the severe conditions that can not hope transferred to civil hospitals.
7 - The implementation of vocational training courses, sewing, craftwork, makeup, maintenance of phones.....
8 - Training courses for prison staff on how the humane treatment of prisoners and respect human dignity.
9 - Take care of guests and residents, especially foreigners who have finished their prison terms and are still in prison.
10 - Attention to infrastructure of prisons, toilets, water, furniture.
11 - Classification of inmates into categories according to age and the crime.
12 - Quick decision in the trial of those arrested or released.
13 - The reasons for the investigation of all deaths in prisons and those perpetrators of acts of torture.

The health situation in prisons should be the priority of the government because the health of the prisoner and human dignity, in spite of all what you are doing some of the associations and foreign embassies, but this remains of the duties of the state and its role is the basis and the slow processing will lead to continued explosion of time bombs in prisons.
Again and again we say: Stop the massacre in the prisons of Lebanon.

6/1/2012
Khiam Rehabilitation Center for Victims of Torture