The Human Rights Commission of Malaysia (Suhakam) revealed that the right to healthcare in prison is still lacking, based on a nationwide survey and report on the right to health in prison conducted in 2017.

According to the report, all survey respondents were selected by the Prisons Department, citing security reasons. 6,420 randomly selected individuals comprising 5,482 prisoners, 886 prison staff and 52 prison medical staff from 18 prisons in the country participated in the survey.

The report noted that it is still the responsibility of the Home Ministry for prison health and medical services, instead of the Ministry of Health (MOH); therefore, Malaysian prison health services are still not yet fully integrated into the national public health service.

"The main objective of such a move is to ensure that prisoners would receive the same health services as the general population with all expenses for primary health being covered by the health ministry," said Suhakam in the report.

It called for full cooperation from various stakeholders, mainly the health ministry, home ministry and Prisons Department to ensure that Malaysian prison conditions are "constitutional and consistent with health, safety and human dignity in order to achieve a criminal justice system that respects individual rights".

Lack of medical staff and facilities in prison

Other problems Suhakam outlined in the report was the lack of medical staff, and their lack of training.

The number of doctors placed at prisons was severely disproportionate to the number of prisoners, for instance a prison with 4,612 prisons only had two doctors available.

Suhakam found that most prison doctors were inadequate as they were only trained in the delivery of primary healthcare without sufficient experience in diagnosing and treating communicable diseases, drug abuse and mental health.

It warned that the failure to employ sufficient and qualified doctors in prisons would mean that many health problems may be left attended leading to unnecessary suffering, sometimes with fatal consequences.

More assistance from the MOH is needed

Recently, Deputy Home Minister Datuk Nur Jazlan Mohamed also highlighted the limited facilities in prisons, therefore many convicts suffering from tuberculosis infections could not be treated immediately.

Prison authorities have implemented a standard operating procedure to curb the disease but more cooperation and assistance from the MOH is still needed.

Currently TB-infected inmates are sent to the nearest government hospital in addition to MOH officials who visit prisons from time to time.

There was also a lack of female doctors to treat female prisoners, especially those who are pregnant and breastfeeding. Additionally, prisons are also not medically equipped to safely provide birth services ̶ instead pregnant women are transported to the nearest general hospital.

"Pregnant prisoners should (also) have access to female medical practitioners if requested," it said.

In majority of cases, mothers also faced nutritional challenges in jail which makes breastfeeding challenging. Suhakam highlighted that breastfeeding women have specific health and nutrition needs that are unmet in prison.

Suhakam reminds that prisoners are also entitled to healthcare

Suhakam also pointed out that there was a conflicting "dual loyalty" that prison doctors had to their patients and as subordinates to the prison director.

“If the prison doctor serves dual roles, functioning as both medical specialist and at the same time is directly subordinated to the prison director rather than being part of a civil healthcare structure, he or she will have a very difficult and sensitive role to fulfill," it reported.

It advised that doctors should never be involved in security or disciplinary matters of any kind in accordance to being medically ethical.

The lack of prison sick bays was also highlighted as this would mean prisoners remained in their cells, risking disease exposure to other prisoners.

Suhakam reminded that the Constitution of the World Health Organisation (WHO) affirms that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being regardless of race, religion, political belief, economic or social condition.

In addition, article 8(1) of the Federal Constitution states that all persons are equal before the law and entitled to the equal protection of the law. However, Suhakam failed to see equal treatment for prisoners. MIMS

Read more:
Malaysian MOH proposes initiatives to improve healthcare
MOH says Malaysian hospitals will not be affected by global cyberattack
Malaysia's MOH launches central health database aimed at cutting wastage