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SEPTEMBER 2006
Spotlight:
Health Through Walls, Sustainable Prison Healthcare in Developing Countries: An Interview with John May, MD Elizabeth Closson
IDCR Managing Editor Disclosures: EC - Nothing to disclose. JM - Speaker's Bureau: Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences. Elizabeth Closson (EC): What is your current job? Dr. John May (JM): I am Chief Medical Officer for Armor Correctional Health Services, based in Coconut Creek, Florida. We provide comprehensive health care services at several jails in Florida and a few prisons in Virginia. I am also an Associate Clinical Professor at NOVA Southeastern College of Medicine. In 2005, I founded Health through Walls, a non-profit organization of U.S.-based correctional health care professionals providing volunteer consultation and assistance to prison health care programs in developing countries. EC: How would you describe your volunteer activities overseas with correctional institutions? JM: Nearly every two months since 2001, we have provided patient care, resources, staff training, or consultations inside the Caribbean prisons of Haiti, Dominican Republic, or Jamaica. In addition we work in the African countries of South Africa, Tanzania, and Ghana. U.S. doctors, nurses, and others with correctional experience donate their time, travel at their own expenses, and collect and deliver needed materials to the prison programs. Our primary focus is the screening, prevention, and treatment of infectious disease, particularly HIV and tuberculosis. Our role is to guide and be in solidarity with prison health staff, build sustainable alliances within the community, and advocate for our patients. EC: How did you get involved in providing help to overseas correctional institutions? JM: I think it's natural for many correctional health care professionals to extend themselves to the underserved and disenfranchised and also to recognize that managing prison health and infectious disease is essential to public health. Health through Walls began as a personal quest to do just that, and has grown as countries learn of our work and request our services. EC: What do you think the most pressing needs are in the countries you visit? JM: It begins with a political and cultural commitment to recognize the humanity and dignity of incarcerated persons. This includes a commitment to the rights of the individual, including health, and the allotment of adequate resources for the population. In the countries in which we operate, some prisons struggle and fail to provide adequate nutrition and clean water. Many are so overcrowded that infectious diseases flourish. All need improved access to diagnostic services and medications, particularly antiretrovirals. Prisoners are dying because they cannot access treatment. EC: How could other providers get more involved? JM: The American Correctional Association has a project to deliver donations to prison systems of developing countries. They can facilitate contributions of equipment and supplies. Health through Walls needs clinicians, evaluators, diagnostic equipment, technical support, and unexpired medications especially antiretrovirals. Providers can contact me if they have something to contribute by email atjmay@armorcorrectional.com. EC: What lessons have you learned through your volunteer activities that have applied to your domestic work? JM: I never let a supply or medication go to waste or be used unnecessarily. I've gained admiration for the diagnostic skills and clinical judgment of clinicians practicing in settings of limited resources. And I've been inspired by the stronger emphasis in many countries on rehabilitation, openness to harm reduction measures, and keeping the prisoner more closely connected to family and community. Not surprisingly, they don't have the same high level of recidivism as we do.
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