Health Care Services

Health Care Services in Correctional Centres promote the health of inmates and awaiting trial detainees, identify inmates with health problems, assess their needs and deliver treatment or refer to specialist services as appropriate.

It also continues any care that has been started in the community contributing to a seamless service and facilitates after care on release.

The majority of the health care services and programmes in Correctional Centres are of a primary care nature.

However, healthcare delivery in Correctional Centres faces a significant number of challenges not experienced by primary care in the wider community.

All inmates are entitled to health care at State expense except for treatment for cosmetic purposes.

An inmate may be granted permission to be treated by his or her private medical practitioner or dentist at own cost and risk.

Purpose of the Directorate

To establish an effective system for the provision of comprehensive primary health care services (which include nutrition, personal and environmental hygiene services) to all categories of inmates including awaiting trial detainees and babies incarcerated with their mothers based on the stipulations of the Constitution of RSA, all applicable legislation, international and national policies, guidelines and protocols.

Core Functions of the Directorate

Provide legislative policy guidelines regarding the provision of health care, pharmaceutical, nutrition, personal and environmental hygiene services in Correctional Centres (policies, standards and procedures formulation, monitoring and evaluation).
Design the minimum health care package for Correctional Centres guided by the principles of primary health care and the district health model
Establishment of Correctional clinics, in-patient facilities, pharmacies and kitchens
Ensure the delivery of a comprehensive package of primary health care services
Resource management and mobilization
Liaison with relevant internal and external stakeholders with regard to health care provision, nutrition, personal and environmental hygiene issues
Advice the Department on health care, nutrition, personal and environmental hygiene matters

Aim of Primary Health Care

Early detection and treatment of illnesses
To move health care closer to the patient wherever possible
Shift the emphasis away from the hospital-based treatment (curative care)
Emphasize more on promotive and preventive measures
Better health education, self awareness and chronic disease management in the correctional environment

Benefits of Primary Health Care in DCS

Health care needs of inmates are better met
Recruitment and retention levels of key staff are increased
Increased opportunities to achieve value for money
Greater flexibility in the provision of services
Better integration with the wider health care system including mental health services, secondary care and specialist services
Improved interface with the rest of the correctional centre

Primary Health Care Programmes and Services

Preventive and promotive health
Acute and chronic care
Communicable and non-communicable disease management
Reproductive health
Youth health
Substance abuse
Mental health
Basic rehabilitation
Counselling
Specialists
Pharmaceutical services
Dental(oral)
Referral
Nutrition
Personal hygiene
Environmental hygiene
Infection control (including bio-hazardous waste management)
Information management

Level of Health Care Provision

Initial reception assessment:

This involves the immediate assessment of the inmates after admission prior to being allocated to their accommodation cells, to determine any needs that may require immediate attention

Induction

This entails the process where information on the following is provided to the newly admitted inmates :

Health care services and programs available to inmates and how these programs and services can be accessed
Patients’ rights
High risk behaviours that must be avoided
Medicine administration times
And any other relevant information

Health education ( health promotion and disease prevention):

Presentation and/or implementation of programs for specific programs for example, fitness and exercise, substance abuse, living healthy life style, self-care, self – medication, prevention of high risk behaviours, etc

Health promotion programmes
Periodic assessments of food-handlers
Periodic review of meal plans
Pre-release planning and liaison with the relevant stakeholders
Primary health care services
Screening of all newly admitted inmates
Comprehensive health assessment of all new admissions
Daily sorting of inmates complaints to determine those who require urgent attention
Daily health assessment of inmates complaining of being ill, those who are on voluntary food refusal and those kept in isolation
In –patient care management
Distribution and administration of prescribed medication
Consultations by nurses, medical practitioners, psychiatrists and dentists
Referrals for supplementary health care and specialists consultations where applicable

Secondary and tertiary health care services

This refers to treatment provided by specialists either on-site or externally at tertiary and / or academic hospitals by the following:

Orthopaedic surgeons
Ophthalmologists
Psychiatrists
Ear, Nose and throat specialists
Dermatologists
Surgeons
Gynaecologists
Urologist
Physicians
And relevant others

Nutrition, Personal and Environmental Hygiene Services

Introduction

In addition to the Department’s function of safe custody and humane incarceration, the Department has the responsibility to maintain the wellbeing of those entrusted into its care by satisfying their nutritional, environmental and personal hygiene needs.

The Department has a statutory obligation to comply with the stipulations of the Constitution that, every person has the right to

Have their dignity respected and protected
adequate water and food
clean and healthy environment.

The Correctional Services Act 111 of 1998 also prescribes how the provisioning of meals should be managed in the Department. Nutrition, personal and environmental hygiene services are managed as prescribed by international and national legislations, policies, norms and standards

Services and Programmes

All Inmates and awaiting trial detainees are entitled to three nutritious meals per day including children and Babies with their incarcerated Mothers

Offenders are also provided with therapeutic diets that are prescribed by a medical doctor based on health reasons. Religious and cultural diets are also provided to those offenders whom eating of certain food items are prohibited by their respective religion or cultures.

On admission, all sentenced offenders including children and babies with their incarcerated mothers are provided with suitable clothing, bedding and toiletry to maintain their basic hygienic standards. Awaiting trial detainees are issued with bedding and toiletry items only.

All incarcerated are detained in conditions that are conducive to rehabilitation and the promotion of human dignity.

Every offender is responsible for keeping his/her person and living environment including accommodation cell in a clean and healthy condition.

Inmates have access to clean drinking water, sanitary and bathing/shower and laundering facilities.

The following programmes are offered under the sub-Directorate:

Personal Hygiene Services

Capacity building of officials.
Lice, pest and rodent control (Vector and Vermin Control).
Provision of adequate clothing.
Provision of bedding to all offenders.
Provision of toiletry to all offenders.
Provision of personal protective equipment (PPE's).
Facilitate the establishment of hair saloons.
Facilitate the establishment and management of laundering facilities in Correctional Centres.
Provision of SABS compliant cleaning material, detergents and disinfectants for hygiene promotion.
Facilitate the establishment and provisioning of bathing and sanitation facilities.

Environmental Hygiene Services

Hygiene management in diaries and abattoirs.
Waste Management (Dry and Wet, Health Care, biochemical).
Food hygiene and safety in Food Service Units Management.
Hygiene and safety in corridors, stairs, accommodation cells, recreation areas, offices, laundries, storerooms and sanitary facilities.
Capacity building of assistant environmental hygiene officials.
Conducting education sessions on Health and Hygiene of sanitation.
Monitoring of water and food quality to ensure compliance to the set standards.
Conduct investigation in the event of an outbreak.
Proper disposal of sewage from Correctional Centres.
Control of tobacco and smoking in Correctional Centres.
Control of environmental pollution.
Ensuring provision of clean and safe water in Correctional Centres.
Ensuring safe handling and storage of chemicals including agricultural pesticides.

Nutritional Services

Capacity building of food service officials and food handlers
Cleaning and maintenance of hygiene on the food services units and equipments
Food preparation and serving to all inmates including children and babies with their incarcerated mothers (Good Preparation Practices)
Proper transportation and storage of food (stock) and equipment
Record keeping and control of food items, stored, prepared, served and on equipments utilized in the units.