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One doctor for every 7,314 Burmese prisoners
Irrawaddy - December 29, 2009
Ba Kaung – "Guard! Guard!" a prisoner screams in the middle of the night.
The scream means that a prisoner is experiencing a health emergency and help is urgently needed – and usually it is a political prisoner since no ordinary prisoner would dare to scream for a guard.
Often, after a little time, a guard will appear carrying a device to check the prisoner's blood pressure, and if he's lucky, leave him with basic medication. No matter how serious the problem, the routine is usually the same.
Bo Bo Oo, a former political prisoner who was released in September after more than 20 years in prison, remembers screaming for a guard's help when fellow prisoners had health problems.
He struggled with asthma in prison during 1990 and 1991. When he reported his breathing problems to the prison doctor, he would receive a cursory examination and a few paracetamol tablets which did nothing to relieve his asthma.
"From headache to fever to stomach ache, the only medicine given to prisoners was paracetamol," he said. "When prisoners had eye problems, they could not get eye drops and had to cover their eyes with banana skins."
Last week, a 38-year-old female political prisoner died of a heart attack in Burma's infamous Insein Prison, drawing attention again to Burma's dismal prison health service.
Burma's prison department has 34 doctors, 19 medical attendants and 22 nurses for a total of 248,664 prisoners and detainees in 42 prisons and 109 labor camps, according to prison-director general, Zaw Win, who revealed the numbers during a workshop on the prison health care system held in November. The figures suggests that there is one doctor for every 7,314 prisoners.
"Given this ratio of prisoners and medical staff, every sick prisoner cannot get medical care," said a doctor in Rangoon, when told of the statistics.
Another prison officer confirmed that there is a serious shortage of trained medical staff and that many guards who have received only basic medical training work for the prison health service. They usually have a crash course on how to give injections and how to dispense basic medicines, but they are not trained to provide professional care.
"All they can do is treat some minor health problems and ailments. They can't go beyond that," said the Rangoon doctor.
Many prisoners turn to traditional cures and herbal remedies, said a former political prisoner who was arrested during the 2007 demonstrations.
"During family visits, many family members pass over packages filled with traditional medicines. We treated each other with those medicines," he said.
According to former political prisoners, the health service was much worse until late 1999 when the International Committee for the Red Cross (ICRC) was allowed to visit Burmese prisons. The ICRC began providing large stocks of medicines to prison hospitals, making it possible for doctors to give out proper drugs for many illnesses. But the period was short-lived because the ICRC was denied access to the prison system in 2005 when the government reportedly demanded ICRC officials to be accompanied by members of government-funded organizations during each prison visit.
The ICRC stopped supplying medicines to prisons, but it still provides financial support to prison families, according to the Assistance Association for Political Prisoners in Burma (AAPP).
As with many problems in Burma, it is difficult to get an accurate picture of the overall prison health issue. Conditions differ from one prison to another and from one prison superintendent to another, according to Bo Kyi, the joint AAPP secretary. "Emotions and personalities of jail chiefs matter more than policies," he said.
Bo Kyi said that political prisoners generally get better health care in a prison than ordinary prisoners, but it can be more challenging for them to get treatment when faced with a major health issue. Ordinary prisoners can usually bribe officials and easily get outside treatment, but the decision for a political prisoner to get outside treatment would require approval of a high-level military official and that process can be frustrating and slow.
"One political prisoner, Hla Myo Naung, lost his sight in one eye," Bo Kyi said.
When his family requested further medical treatment for his other eye, which was getting worse, he was denied treatment and transferred to Myitkyina Prison, which was 1,470 km from Rangoon."
According to the AAPP, tuberculosis, malaria, diarrhea, HIV and heart problems are common diseases in prisons. There are no preventative measures taken to reduce infections among prisoners. Ordinary prisoners who lack funds bear the brunt of the failing prison health service. Many never receive visits from family members, do not receive enough food, and are forced to work even in times of sickness.
In 2000, the World Health Organization ranked Burma 190 out of 191 member countries for poor medical services – the second worst country in the world. In 2006, the military government spent 2.3 percent of GDP on the national health care system.
With so little attention given to the health care system, there will be more ill prisoners in Burmese jails screaming for a guard to relieve their illness – usually in vain.
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