What Works with Women Offenders Lessons from other countries on dealing with drug related offenders

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What Works with Women OffendersLessons from
other countries on dealing with drug related
offendersHealth care needs of women in prison
The gap between policy and implementationDr.
Morag MacDonaldand Dr. Donatella ZoiaPrato,
Italy20-22 June, 2005
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Overview of Presentation

• This presentation will discuss the
• Current situation of women in prison.
• Particular health care needs of women.
• Barriers to implementation of services to meet
  health care needs of women prisoners.

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Women in Prison

• Location of women prisoners
• Prevalence of female drug users in European
  prisons

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Prevalence of female drug users in European
prisons
Zurhold (2004) Study of 27 Countries/Regions only
17 had data of these 50 had approx. 10-30 of
women PDUs 50 40-60
Fowler (2002) estimates 75 women
entering European Prisons are PDAUs EMCDDA
(2002) Giodano, (1992) PDU higher amongst female
than male prisoners
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Health Care needs of Women

• Women prisoners not a homogeneous group
• Migrant women
• Roma women
• Problematic drug users (PDUs)
• Infectious diseases

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Barriers to implementation of services to meet
health care needs of women 1

• Organisation of prison life
• Structure of staffing
• Services activated on demand
• Lack of organised harm reduction
• Drug treatment
• Prison 1st point of contact with medical care

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6. Prison first point of contact with medical
care (1)
if we are sent to Rahova hospital we lose days
from our sentence and we get searched and have to
wear a uniform. We are transported in very
miserable conditions just like animals. As we
have to be kept separate from male prisoners it
is very crowded. If we want to move we can only
stand up and there is no ventilation as there is
only a small vent in the van and the staff smoke
a lot. On short journeys it is bearable but it
is awful on long journeys. (Prisoners focus
group, Târgsor prison 2004)
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6.Prison first point of contact with medical care
(2)

• Some prisoners refuse the check up because
• they didnt want to go to Rahova hospital
• for reasons previously mentioned and
• some women felt that in the mass
• screenings they lost control over their
• own bodies
• some women were not able to talk about
• the results with the doctor who did the
• tests
• Missing visit from family unable to let
• them know due to lack of notice.

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Conclusion 1

• Prison could be a unique moment in the lives of
  many women migrants, problematic drug users, Roma
  and sex workers if they are given access, often
  for the first time, to health care and
  counselling.
• Prison medical staff should be specifically
  prepared to provide education on prevention and
  on how to stay healthy.
• Information, prevention and screening programmes
  for women prisoners is essential and particular
  attention should be given to different groups of
  women and their specific needs.

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Conclusion 2

• There is a clear need for prisons to provide
  treatment, education and information about
  communicable diseases, harm reduction, prevention
  and drugs that both engages prisoners and meets
  the needs of non-native speakers.
• It is necessary to organise contacts with
  community services, NGOs and other groups in the
  areas of health and social support including
  through care.

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Conclusion 3

• The growing number of women prisoners and those
  with problematic drug use makes it important that
  research in Europe focuses on women in order to
  
• - provide a more comprehensive evidence
  base of the services they require
• - show the number of women drug users in
  prison
• - detail the treatment and drug services
  that are provided
• - provide profiles and characteristics of
  problematic women drug users on which to base
  the health care services that they require.
  (Zurhold et.al. 2004)

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• Zoia, D, 2005, Women and health care in prison
  An overview of the experiences of imprisoned
  women in Italy.
• International Journal of Prisoner Health
• Volume 1 Issue 2

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• MacDonald, M, 2005
• A Study of Health Care Provision, Existing Drug
  Services Operating in Prisons in Ten Countries
  from Central and Eastern Europe
• From HEUNI
• http//www.HEUNI.fi/