No holds barred

@THAILAND

The Medical Correctional Institution has been providing anti-retroviral drugs to inmates with HIV/Aids since 2004, thanks to a budget from the National Health Security Office and the Global Fund to Fight Aids, Tuberculosis and Malaria.

The MCI, widely known as the "Prison Hospital," is regarded overseas as a model of best practice for treating HIV/Aids patients who are behind bars.

Sick inmates are sent from all seven prisons based in and around Bangkok, including the maximum-security Klong Prem prison where the hospital is located.

The hospital also accepts terminally ill inmates from prisons in other provinces.

Ordinary prison medical units are inadequately equipped and too short of staff to take care of severe cases.

John Lerwitworapong, director of the Medical Correctional Institution, worked at the hospital for 30 years until his retirement this month.

Thanks to him, medical facilities in Thai prisons have become a learning centre for other countries.

But he and his team _ 14 doctors and a few dozen nurses and other medical staff _ cannot rest on their laurels as the fight to prevent HIV/Aids continues.

Weerakit Harnpariphan, a Prison Hospital doctor, said as many as 5,000 inmates around the country are infected with the Aids virus. About 40% of them are receiving treatment.

At the Prison Hospital, the inmates being treated include convicted foreign nationals, said Dr Weerakit, who started working there after he graduated from Chiang Mai University two decades ago.

The MCI runs with a 6 million baht budget from the government and financial assistance from the Global Fund.

Each inmate with Aids also gets financial help of 1,200 baht per year.

The hospital provides blood tests and psychological evaluations.

The patients are treated with the same amount of respect and dignity as any other sick person, say the MCI staff.

For inmate patients, having Aids is an added stigma.

"It's not easy for us to get a job and I can't tell anyone I have Aids," said a 42-year-old former prisoner who earns a living from making cloth bags and helping the Corrections Department improve the living condition of inmates.

For those still in jail, the treatment they get from the hospital can help keep them alive.

Saengla Palanan, 31, from Phayao who was convicted seven years ago for trafficking drugs, said she contracted Aids from her first husband 14 years ago.

On a doctor's advice, she took a drug which prevented her from passing the virus to her baby.

Her son has tested negative for Aids and is living under her sister's care.

Normally, relatives have enough difficulty accommodating former prisoners back into mainstream society.

But those looking after former inmates with HIV/Aids take on a double burden, said Vuttinone Promnil, head of the ward which treats final-stage Aids patients.

For inmates about to be released who are in the final stage of the illness, the Prison Hospital will issue them with a paper which entitles them to medical welfare services from state-run agencies.