Health profile of the inmates at women prisoner ward, Ranchi: findings of a health camp

INTRODUCTION

Prison is an institution where a heterogeneous group of population, in terms of age, place of birth, education level and of different religion and ethnicity, resides for variable duration. More over there is continuous turnover of unpredictable number of inmates and the prisoner authority had to adjust with the current limited resources.

The hon’ble supreme court has affirmed the basic rights of prisoners – “there could be several factors that lead a prisoner to commit a crime but nevertheless a prisoner is required to be treated as a human being entitled to all the basic human rights, human dignity and human sympathy.”¹

In India, an analysis of prison statistics at five-year intervals reveals an increasing trend in the number of women prisoners – 3.3% of all prisoners in 2000, 3.9% in 2005, 4.1% in 2010 and 4.3% in 2015 were women.² In 2016, over 3 lakh women were arrested for crimes under the Indian penal code (IPC) and special and local laws (SLL).³ As jails were primarily designed to cater to male inmates, female inmates often face difficulty with prison infrastructure and administrative systems, which are largely oblivious to their gender - specific needs. In addition, they also need a special attention of their general health as well as reproductive health care. Special steps need to be taken to evaluate the exact situation and then to ensure adequate conditions for women as well. In this regard, our health team was given the responsibility for the general health assessment of the women residing in the central jail Hotwar, Ranchi.

The objectives of the current study were to obtain the socio-demographic information of the inmates of the women prisoner ward and to assess their health status.

METHODS

This was an institution based cross sectional study conducted among the inmates of female prisoner ward, Central Jail Hotwar, Ranchi. A convenience sampling technique was used to collect data, during a health camp organized by District Legal Services Authority (DLSA) within the campus of female prisoner ward, held on 28th of February 2020. The study population was all the inmates residing in the prisoner ward. All the inmates were collectively briefed about the purpose and steps of the study. Those inmates who were willing to participate and were ready to undergo physical examination were included in this study. Those inmates who were hesitant or not providing required information and refused for physical examination were excluded from the study. Out of total 102 females residing there, only 59 females were enrolled in the study after getting their consent.

Data collection and analysis

A pretested, semi-structured questionnaire was used for face to face interview of the participants. The questionnaire was designed to collect information on socio-demographic characteristics (age, gender, birth place, types of family, education, marital status, duration of stay at prison, reason for staying there, current employment, engaged in any educational or any vocational training etc) and health status (presenting complaints, any previous morbidity).The questionnaire were administered in the participants’ mother tongue. The participants also underwent general examination that was conducted after interview. The collected data was entered in MS Excel sheet and was analyzed using SPSS software version 20. Frequencies and percentages were determined for categorical variables. Means and standard deviations were calculated for continuous variables.

RESULTS

Of the total 102 females enlisted there only 59 females agreed to participate in the study, so the response rate was 57.84%. The study population was of age group 15-68 years more than three fourth (94.9%) were residents from Jharkhand and rests were from different states (Kolkata and Delhi). Majority (84.7%) the participants were married. More than half (59.5%) participants had no formal education. The details of socio-demographic profile are presented in Table 1.

*participants had multiple responses

Regarding health status, it was found that 91.52% of the study participants had no previous co morbidity. The main presenting complaint was dental problem (bleeding gums & bad breath) among 44.06% participants, followed by diminished vision (cataract & refractive errors) in 16.94% of the participants. Other health complaints of the participants were generalized weakness (10.16%) and body ache (5.08%). Table 2 is depicting the details of the health status of the study population.

On physical examination, we found that more than one third (37.28%) participants were having mild to moderate pallor and (5.08%) were found to be underweight.

DISCUSSION

Prison being the closed institution where an individual cannot move out anywhere to fulfill their personal need no matter how alarming the health issue is. One is completely dependent on jail administration initiatives.

The current study revealed that 58.06% population fall within the age bracket of 15-40 years, that is productive as well as reproductive group they need special attention as after getting released from prison they should be able to contribute society with their productive work as also for producing healthy generation. It was found that 59.5% of the study participants had no formal education and 49.15% were belonged to broken family. In Indian context females are still considered as burden and that’s why their education is not getting priority. In Jharkhand, the female literacy rate in rural population is 49.75%.⁴ The percentage of broken family somehow also draws our attention towards the social problem that too needs proper treatment.

Regarding health status, the main presenting complaint was dental problem (gum bleed and bad breath) in 44.06% of the study participants. The population was provided Datun (twig of neem tree) for their dental cleansing, which is a common practice in Jharkhand. In the year 2016, a study conducted by Gunjan et al at Dhanbad district of Jharkhand, revealed that 74.2% of the study populations were using twigs of sakhua tree (Shorearobusta) to clean their mouth.⁵ In addition, provision of fresh seasonal fruits was not sufficient.

Second health issue was found to be diminished vision in 16.94% participants. Refractive error and cataract were the main possible reason. In India, cataract (62.6%) continued to be the major cause of blindness whereas uncorrected refractive error is responsible for 19.7% cases of blindness.^6,7

On general examination, 37.28 % participants were found to have mild to moderate pallor and 5.08% populations were found to be the underweight. According to WHO, highest number of individuals affected with anaemia is observed in non-pregnant females aged 15-49 years.⁸ Anaemia is considered to be public health significance or problem if the population studies find the anemia prevalence of 5.0% or higher.⁹ In the prison one has to adjust with the cooked meal catered in the institution so underlying cause may be predicted as nutritional insufficiency.

However, our study had several limitations. First and the most compelling limitation was time constraint, data was collected during a health camp and our result prepared was solely dependent on the response of the participants and physical examination by the medical team. No laboratory test was done to assess the hemoglobin percentage. In order to get clearer picture, more time to be invested by the researcher and longitudinal study can be the better option.

CONCLUSION

Based on the results we can conclude that our study population is facing common health problem that is prevalent in general population as well. The prevailing health issue, i.e anemia which leads to wide range of health problems, such as impaired working capacity, weakness, malaise, headaches, cognitive impairment, decreased concentration etc. Similarly, vision problem again restricts one’s regular activities and in the worst case increases dependency and may lead to accidents. Fortunately, these issues can be addressed with little effort from the jail administrator. The health camp by the specialists (Ophthalmologist, Dentist and Gynecologist), can be organized at a regular interval within the campus. Iron and folic acid can be used to curtail anemia. Health of the prison population is of utmost importance as good health will help them to make a good start and further contribution in economic growth, after they come out of the prison.

ACKNOWLEDGEMENTS

The authors thank the women for participating in this study and the jail administration for the permission to conduct this study. The authors would also like to thank the entire medical team for supporting in data collection.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. SC Order in Re - Inhuman Conditions in 1382 Prisons dated 5th February 2016. W.P.(C) No.406 of 2013.
2. 2. Prison Statistics India 2015, NCRB
3. 3. Crime in India 2016, NCRB
4. 4. www.jharenvis.nic.in/Database/DEMOGRAPHYJHARKHAND_2323.aspx?
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6. 6. GOI. Present status of national program for control of blindness (NPCB). New Delhi: Ophthalmology section DGHS, MOH and FW, GOI; 1993
7. 7. GOI. National Survey on blindness 2001-02. NPCB Quarterly Newsletter 2002;1(2)
8. 8. WHO Report. World Prevalence of Anaemia 1993-2005. WHO Global Database on Anaemia. Geneva, Switzerland: World Health Organozation; 2008. Available at: http://www.WHO.Int/hinari/en/. Accessed on 25 August 2020.
9. 9. World Health Organization, worldwide prevalence of anemia 1993-2005: WHO global data base on anaemia. 2008.