key: cord-0921344-kpx73ki2
authors: Van Hout, Marie Claire
title: "COVID-19, health rights of prison staff and the bridge between prison and public health in Africa "
date: 2020-06-25
journal: Public Health
DOI: 10.1016/j.puhe.2020.06.037
sha: c7bb4e801190c1b9de7804f75bdd77d4723c51b7
doc_id: 921344
cord_uid: kpx73ki2

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Title: "COVID-19, health rights of prison staff and the bridge between prison and public health in Africa ".

Despite a range of international instruments designed to protect human and health rights of people deprived of their liberty, many African prisons are still not meeting minimum conditions and standards of care [1] . Human rights violations, systemic abuse and deplorable environmental determinants of health continue. African prisons are generally operating over capacity and are characterized by old physical infrastructure, insufficient sanitation, ventilation and hygiene, severe congestion caused by high pre-trial detention rates, and fragile prison health systems [1] [2] [3] .

Prison health research in Africa is historically of low priority and remains underdeveloped [4] . This Letter is intended to draw attention to the concerning lack of academic activity in this field and the particular lack of representation of the voices of people who work in prisons and their occupational health situation. The wellbeing, working conditions, health and safety concerns and experiences of prison staff in the African prison environment is understudied and ill understood. Extant empirical literature has generally focused on stakeholder perspectives on the situation of incarcerated people, and not that of prison staff. Where prison staff have been consulted on the environmental determinants of health in prisons, they voice a deep concern for their health and that of their families, and anxiety around bio-hazard risks (particularly airborne diseases such as TB) [5] . Given the current COVID-19 pandemic, and its devastating impact on African prisons and local communities, it is imperative that greater investment in occupational health research occurs.

The academic discourse on prison staff and their health situation in Africa is inadequate. This Letter advocates not only for research into prison health determinants, but also for greater academic research into existing prison health policies related to prison staff to assess gaps and inform policymaking efforts. Prison staff and prisoners are exposed to the same pathogens, the same hygiene and sanitation; the same congested space; air for breathing; and water for washing, drinking and cooking. They are also exposed to generally Research is warranted to enhance our understanding of the prison determinants of health and cultures which shape prison staff responsiveness to threat of contagious and infectious diseases, the impact of prison conditions in terms of congestion, hygiene, ventilation and sanitation, navigation of health risks and work-related stress [2] [3] [4] [5] . Information garnered can help to reduce future risks, tackle occupational health deficits, and identify what policies, practices, interventions and mechanisms could be best employed by authorities to improve prison occupational health standards, outbreak preparedness and ensure safe working conditions in African prisons. This focused attention on the health and well-being of prison staff through research could also contribute to greater social accountability and buy-in from government and prison officials, and fuel the upscaling of holistic prison health initiatives. Such a concerted and strategic research effort can support a positive shift to reforming African prison health operations and systems.

Marie Claire Van Hout, Professor of Public Health Policy and Practice,

HIV and tuberculosis in prisons in sub-Saharan Africa

Prison health situation and rights of juveniles incarcerated in Sub Saharan African prisons

Contemporary female prisoners health experiences, unique prison health care needs and health care outcomes in Sub Saharan Africa: A scoping review of extant literature

Challenges in ensuring robust and ethical health research and the reporting of health outcomes and standards in sub-Saharan African prisons

Prison facilities were not built with a woman in mind': An exploratory multi-stakeholder study on women's situation when incarcerated in contemporary Malawi prisons