Prisoners are enriching the lives of fellow inmates suffering from Aids, thanks to an enlightened programme
Story by Aphaluck Bhatiasevi and picture by Somkid Chaijitvanit
Uwes Dambermann, 32, slowly wipes the body of his weak fellow inmate, who lies on a bed in the special ward of Lat Yao prison's central hospital. He does this very carefully, making sure that the moist hand towel causes no further pain to this new-found friend, whose body is covered with blisters. Dambermann is a volunteer for the hospital's special hospice programme to provide the best possible care a prisoner can get in the last days of life.
Somchai (not his real name) is in his 40s, and has been in bed for over a month now. He suffers from Aids and has been frequenting the hospital for the past 10 years _ since he was imprisoned. Somchai has three more years to go on his sentence, but does not know if he will survive that long.
Beside him lies 26-year-old Keng (also an alias) who looks much older than his age. Keng was moved to this ward three weeks ago. He also has three years left behind bars.
Somchai and Keng are among the nine patients who receive treatment at the prison hospital's special Aids ward, which opened three months ago.
The ward is not fancy. But it is where patients can feel the atmosphere of loving care, and receive a range of alternative medical services such as foot and body massage and meditation.
"We try our best to provide holistic treatment to look into a person's well-being physically and mentally," said Vuthinan Promnil, a male nurse who has been working in the hospital for 15 years. "We also try to make people on their death bed feel they are being cared for and are not left alone."
A little-used ward at the hospital's medical unit needed repair, and so was transformed into the hospice centre. Twenty new beds were fitted in. The financial support comes from a former British prison service officer, Shan Biswas, who regularly visits Thailand.
"These patients will not live very long and we try within our limitations to help them feel as comfortable as possible during their last days," said Dr John Lerwitworapong, the hospital director. He has worked at Lat Yao Prison's Central Hospital for the past 26 years.
Thailand does not have special amnesty or compassionate release of prisoners who are in their last days of life, to allow them to spend their remaining time with relatives. The hospice can at least give some comfort to the patients in their last days, said Dr John.
The aims of the hospice programme are multi-fold, he said. Since the hospital has limited manpower and budget, the programme trains a number of prisoners to become volunteers who can assist the staff in taking care of the large number of patients there.
"Unlike the general public health sector, we can't make demands because we're dealing with prisoners, who have committed crimes. This programme will at least enable the patients in critical condition to feel better, so that they are able to die with dignity.
"We also hope this programme would enable other prisoners, many of whom I believe are good at heart and realise their mistakes, to be able to make merit by helping others. I believe that by doing so, they will be encouraged to do good deeds after they are released from prison," said Dr John.
The hospice programme also helps to eliminate discrimination against inmates with HIV and Aids by educating other prisoners on how they can live alongside the patients without fear of contracting the virus, he added.
Dambermann, a South American inmate, said he never imagined he would be able to do voluntary work behind bars.
"I was glad to join because I want to do whatever I can to help others. I want to make up for the things I did," he said.
The volunteer work gave him the opportunity to talk to and listen to fellow inmates who cannot help themselves, he said. It also gives him more time to himself to reflect than he would have in other prison zones.
Dembermann has already served nine years out of the 30-years imprisonment term for trying to smuggle drugs out of the country after his 17-day vacation here. He learned of the hospice programme after being treated for lupus infection at the hospital.
"I came here as a patient. I saw that the others in the same ward as me were in more serious condition and needed help, and since I was well enough to help them, I did what I could," he said.
When Dr John asked him if he wanted to stay on as a volunteer, he said he did not think twice before accepting the offer.
"It's a chance to do good," he said. Giving care to others in need has also surprisingly eased his homesickness.
Dembermann and other volunteers are responsible for regularly visiting and taking care of the patients on a 24-hour basis, particularly when they are in critical condition. Volunteers are also trained in counselling so they can give moral support and help the patients feel good about themselves in their final hours.
The help is timely. With an increase in the number of prisoners from 40,000 to 250,000 persons in recent years, the number of patients has dramatically increased. The hospital has to treat some 250 in-patients each day and half of all the patients are HIV positive, said the doctor.
Each year, about 1,500 prisoners die due to illnesses related to HIV and Aids.
Though HIV/Aids is a serious problem at the hospital, neither prison inmates nor hospital patients are forced to take mandatory blood tests to find out whether they are infected with HIV or not. "It's a human rights violation," said Dr John flatly.
When prisoners are admitted to the hospital, their blood is tested for medical purposes, and HIV testing will be carried out only with consent, he explained.
What the patients need most is a chance to see loved ones. The hospice is trying to work out plans to give family members the opportunity for regular visits within the hospital. Usually, relatives of prison inmates are not allowed to enter the hospital, which is behind three layers of the fully secured prison gates.
For the time being, the volunteers fill a gap as surrogate relatives because they can be with the patients all the time, he said.
"Actually, relatives or even officials can't be with them throughout the day. So the prison inmates who are our volunteers can take better care of the patients," Dr John said.
Initially, few prisoners wanted to volunteer to work for the hospital, even though the area is cleaner and allows more freedom of movement than other prison zones.
But the job provides no income, and many prisoners fear infection with illnesses such as tuberculosis. The volunteers are mostly ex-patients of the hospital, who come to believe such fears are ungrounded after being treated.
Take Pichetchai Tothaya, 24. He has been in the prison for almost two years. "At first I was afraid and I was not interested in joining. But now I'm not afraid any more."
Pichetchai spends his time by feeding and talking to other weak prisoners like Keng, who can barely help themselves.
Attitudes like his have given the volunteer programme the right to be a little more picky about members, compared to when it was starting up.
"Many prisoners want to volunteer [now] to help out at the hospital, but we are not able to accommodate all of them," said Dr John. Besides, the hospital can take only inmates with good records as volunteers, due to security reasons, he added.
The hospice programme currently has three full-time volunteers who reside in the ward along with the patients. Other volunteers come to help at the hospital only on a day-to-day basis.
The hospital's biggest obstacle remains the lack of financial support. The central hospital receives an annual budget of only six million baht while its real expenditure exceeds 10 million each year, he said. Consequently, the hospital is often short of medicines and basic medical products which are required for daily use for the patients.
But for the bed-ridden Aids patients like Keng and Somchai, what makes the agonies in their last days tolerable is the friendship from their inmate friends who have overcome fear of Aids to care for them. "I am deeply touched," said Keng. "My own relatives do not visit me, you know."
He paused. "You can't imagine how wonderful it is just to have someone to talk to when we are feeling so down and so all alone."
Central Correctional Hospital is a correctional referral center for
sick inmates from various prisons in Bangkok and vicinity. Its
newly constructed nine-storey building is designed to accommodate 500
inmate-patients and fully equipped with medical facilities such as 4 major operating rooms, 4
dental units, medical and dental film less digital X-ray system,
tele-medicine (psychiatry and radiology), etc.
