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:

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

Keywords: Healthcare delivery, Trustees

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.

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Provincial Jail: Basis for Health Care Enhancement

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

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.

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

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 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,

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Provincial Jail: Basis for Health Care Enhancement

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 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

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

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

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Provincial Jail: Basis for Health Care Enhancement

4.3 Disease Prevention

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

delivery?

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

Chapter IV
RESULTS AND DISCUSSION

I. Profile of Respondents

A total of 30 trustees as respondents for this study. 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

Table 1
Physical Structure
Weighted
PHYSICAL STRUCTURE Always Sometimes Never Description
Mean

1. Prison cell well lighted 17 13 0 2.57 Always

2. Prison cell well ventilated 7 23 0 2.23 Sometimes

3. Crowded prison cell 26 3 1 2.83 Always

4. Availability of bed per

5 16 9 1.87 Sometimes
detainee

5. Availability of shower and

12 16 2 2.33 Sometimes
comfort rooms

General weighted mean 2.37 Sometimes

Table 1 shows the response of trustees on the physical structure of TPJ. The

respondents believe that prison cells are always well lighted, with a mean value of

2.57, in contrast to the cells being always crowded (2.83). Prison cells, however, are

sometimes well ventilated (2.23), having available bed per detainee (1.87), and

shower and comfort rooms are sometimes available (2.33). Hence, the physical

structure of TPJ sometimes (2.37) met the quality standard set for all provincial jails;

all but crowdedness of prison cells.

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Provincial Jail: Basis for Health Care Enhancement

Table 2
Nutrition
Weighted
NUTRITION Always Sometimes Never Description
Mean

1. Eat at least 3-5 times a day. 25 5 0 2.83 Always

2. Equal servings of meat and

10 16 4 2.20 Sometimes
vegetables per meal.

3. Diet serving according to

4 20 6 1.93 Sometimes
reported health condition.

4. Drink water at least 8-10

28 2 0 2.93 Always
glasses a day.

5. Meal serves on time. 16 13 1 2.50 Always

General weighted mean 2.48 Always

Table 2 shows the response of trustees on nutrition inside TPJ. The detainees

always eat at least 3-5 times a day (2.83), drink waters at least 8-10 glasses a day

(2.93), and meals being served on time (2.50). Equal servings of meat and vegetables

per meal are sometimes being served (2.20), which are sometimes in accordance to

reported health condition. In general, nutrition at TPJ always conforms to standards.

Table 3, as shown below, described the nutrition at TPJ as perceived by the

respondents. TPJ always has clean comfort rooms and shower rooms (2.77) and

prison cell (2.63). Detainees always change bed linens (2.53). However, there are

occasional presence of hazard such as rats, cockroaches, and cobwebs (1.97). The

segregation of waste materials is sometimes satisfactory. Hence, Sanitation condition

at TPJ is always met according to standards (2.41).

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Provincial Jail: Basis for Health Care Enhancement

Table 3
Sanitation
Weighted
SANITATION Always Sometimes Never Description
Mean

1. Clean comfort rooms and

19 13 0 2.77 Always
shower rooms.

2. Clean area within the cell. 19 11 0 2.63 Always

3. Presence of hazard (rats,

3 23 4 1.97 Sometimes
coackroach, cobwebs, etc.)

4. Segregation of waste
13 8 9 2.13 Sometimes
materials.

5. Change bed linens. 17 12 1 2.53 Always

General weighted mean 2.41 Always

The table below shows the health promotion programs being implemented at

TPJ.

Table 4
Health Promotion
Weighted
HEALTH PROMOTION Always Sometimes Never Description
Mean

1. Nutritional Programs
(Feeding Programs) 5 18 7 1.93 Sometimes

2. Exercise (zumba, taebo,

etc.) 13 17 0 2.43 Always

3. Mental Health Programs

(Mental Awareness
Celebration) 5 19 6 1.97 Sometimes

4. Smoking Cessation
Programs 4 22 4 2.00 Sometimes

5. Healthy Lifestyle Programs 9 21 0 2.30 Sometimes

General weighted mean 2.13 Sometimes

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Table 4 describes the health promotion being implemented at TPJ.

Exercises such as Zumba and taebo are always being practiced (2.43). Nevertheless,

definite programs such as nutritional programs (1.93), mental health programs (1.97),

smoking cessation programs (2.00), and healthy lifestyle programs (2.30) are

sometimes implemented. However, in general, health promotions program at TPJ is

sometimes implemented, with a general weighted mean of 2.13.

Table 5
Health Protection
Weighted
HEALTH PROTECTION Always Sometimes Never Description
Mean

1. Medical screening 11 18 1 2.33 Sometimes

2. Healthcare waste
management programs 10 16 4 2.20 Sometimes

3. Oral hygiene and dental

care programs 8 21 1 2.23 Sometimes

4. Occupational health hazard

programs 6 20 4 2.07 Sometimes

5. Water and sanitation

programs 7 17 6 2.03 Sometimes

General weighted mean 2.17 Sometimes

Table 5 shows the health protection being practiced at TPJ. In general,

these health protection services are sometimes being practiced, with a general

weighted mean of 2.17. These include medical screening (2.33), healthcare waste

management programs (2.20), oral hygiene and dental care programs (2.23),

occupational health hazard programs (2.07), and water and sanitation programs.

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Table 6
Disease Prevention
Weighted
DISEASE PREVENTION Always Sometimes Never Description
Mean

1. Flu Vaccine
Immunization 3 12 15 1.60 Never

2. Tuberculosis control
and testing program 19 11 0 2.63 Sometimes

3. Educational and Social

services (STD services, risk
reduction services, etc.) 12 17 1 2.37 Sometimes

4. HIV Screening 6 24 0 2.20 Sometimes

5. Hepatitis B vaccine 5 11 14 1.70 Sometimes

General weighted mean 2.10 Sometimes

Table 6 shows the manner in which TPJ prevents the onset and spread of

diseases, as described by the respondents. In general, these health protection services

are often being practiced, with a general weighted mean of 2.04. These include

tuberculosis control and testing program (2.67), educational and social services

(2.33), HIV screening (2.67), and hepatitis B vaccine (1.70). However, according to

the respondents, flu vaccine immunization (1.60) has never been performed at TPJ.

The table below shows the reported common communicable diseases transpired

at TPJ.

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Provincial Jail: Basis for Health Care Enhancement

Table 7
Common reported communicable diseases
COMMUNICABLE Weighted
Always Often Sometimes Description
DISEASES Mean

1. Influenza 5 12 13 1.73 Often

2. Tuberculosis 12 7 6 1.87 Often

3. Acute Respiratory
Tract Infection 7 13 10 1.90 Often

4. Pneumonia 3 8 19 1.47 Sometimes

5. Dengue fever 2 4 24 1.27 Sometimes

General weighted mean 1.65 Sometimes

Table 7 shows the common reported communicable diseases at TPJ.

Generally, the occurrence of communicable diseases sometimes happen, with a

general weighted mean of 1.65, which has very low probability of which it occurs.

However, influenza (1.73), tuberculosis (1.87), and acute respiratory tract infection

(1.90) often occur. Luckily, pneumonia (1.47) and dengue fever (1.27) sometimes

occur.

Table 8 shows the common reported non-communicable diseases at TPJ.

Generally, the occurrence of communicable diseases often happens, with a general

weighted mean of 2.09, which has higher probability of occurrence. Diabetes mellitus

(1.80), asthma (2.27), rheumatoid arthritis (1.97), and heart diseases (1.90) often

occur at TPJ. However, hypertension (2.53) always occur among detainees.

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Provincial Jail: Basis for Health Care Enhancement

Table 8
Common reported non-communicable diseases
NON-COMMUNICABLE Weighted
Always Often Sometimes Description
DISEASES Mean

1. Hypertension 19 8 3 2.53 Always

2. Diabetes Mellitus 5 14 11 1.80 Often

3. Asthma 13 12 5 2.27 Often

4. Rheumatoid Arthritis 7 15 8 1.97 Often

5. Heart Diseases 5 17 8 1.90 Often

General weighted mean 2.09 Often

The table below shows the food and water-borne diseases that occurred at

TPJ

Table 9
Common reported food and water-borne diseases
FOOD AND WATER- Weighted
Always Often Sometimes Description
BORNE DISEASES Mean

1. Acute Watery Diarrhea 6 13 11 1.83 Often

2. Food poisoning 1 6 23 1.27 Sometimes

3. Typhoid fever 2 8 20 1.40 Sometimes

4. Hepatitis A and C 1 9 20 1.37 Sometimes

5. Amoebiasis 1 7 22 1.30 Sometimes

General weighted mean 1.43 Sometimes

Table 9 shows the common reported food and water-borne diseases at TPJ.

Generally, low occurrences these diseases has been observed by the respondents, with

a general weighted mean of 1.43. Food poisoning (1.27), typhoid fever (1.40),

hepatitis A and C (1.37), and amoebiasis (1.30) have very low occurrences because

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Provincial Jail: Basis for Health Care Enhancement

they only sometimes arise. However, acute watery diarrhea (1.83) often occurs, which

is probably attributed to the source, storage, and transport of water supplies at TPJ via

their water system.

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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
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Provincial Jail: Basis for Health Care Enhancement

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