Pubdate: Sat, 04 Aug 2007
Source: Chronicle Herald (CN NS)
Copyright: 2007 The Halifax Herald Limited
Author: John Gillis
Bookmark: (Incarceration)
Bookmark: (Needle Exchange)
Bookmark: (Hepatitis)


Nearly one-third of federal prison inmates in Atlantic Canada have 
hepatitis C, prompting officials to hire a hepatologist to manage their care.

Documents from Correctional Service Canada say about 29 per cent of 
inmates in this region are known to be infected with the hepatitis C 
virus, which can lead to chronic liver infection, cirrhosis and even 
liver failure.

That rate compares to 0.31 per cent of the Nova Scotia population who 
were infected with hepatitis C between 1997 and 2006, according to 
the provincial Health Promotion and Protection Department.

Dr. Kevork Peltekian, who works in the gastroenterology division at 
the Queen Elizabeth II Health Sciences Centre in Halifax, is listed 
as the proposed hepatologist who may manage the care of federal prison inmates.

He would provide care to inmates at Atlantic Institution in Renous, 
N.B., Westmoreland Institution, Dorchester Penitentiary and Shepody 
Healing Centre in Dorchester, N.B., and Springhill Institution in Springhill.

The contract calls for him to provide up to 15 in-person, video or 
telephone consultations per month of at least six hours each, working 
with offenders and assisting and training prison staff.

The contract is worth $427,500 for one year, plus four option years.

Neither Dr. Peltekian nor officials from Correctional Service Canada 
could be reached on Friday.

People concerned with the spread of infectious diseases in prisons 
say the move is a good one but not enough is being done to address the problem.

"It's a welcome initiative," said Richard Pearshouse, senior policy 
analyst with the Canadian HIV/AIDS Legal Network in Toronto. "I think 
as well as the concern for treatment and medical care of people who 
are already infected, we should also be encouraging (Correctional 
Service Canada) to look to the prevention of hepatitis C and HIV as well."

Earlier this week, studies published in the Canadian Medical 
Association Journal found the prevalence of HIV and hepatitis C 
infection among inmates in Ontario remand facilities and Quebec 
provincial prisons was many times that of the general population.

Correctional Service Canada has said the sharing of needles for drug 
use and unsafe tattooing practices are the primary means of 
transmission inside prisons.

A commentary accompanying the journal articles condemns correctional 
and government officials for failing to take measures that would 
reduce the chance of transmitting the viruses.

Last year, Public Safety Minister Stockwell Day axed a year-old 
program that offered prisoners tattoos with sterile equipment for a 
nominal fee.

The federal government has also failed to implement any kind of 
needle-exchange program for imprisoned drug users, despite being 
advised by an expert committee in 1994 that such measures would 
inevitably be needed to control the spread of viruses in prisons. The 
commentary by Richard Elliott, deputy director of the Canadian 
HIV/AIDS Legal Network, calls this a "deadly disregard" for 
prisoners' health, noting Correctional Service Canada itself found 
the cost of the tattoo program was low related to the costs of caring 
for prisoners with HIV or hepatitis C.

It costs $29,000 a year to treat a prisoner with HIV and $26,000 to 
treat a prisoner with hepatitis C.

Mr. Pearshouse said the failure to support ways to prevent disease 
transmission seems to reflect a sense of denial about drug use in 
prisons by administrators and politicians.

"We are labouring under the misconception that it's possible to 
prevent drugs from entering prisons, where we know from studies 
within Canada and also international studies that drug use is very 
prevalent inside correctional facilities," he said.

"Because of a misguided zero-tolerance approach to drug use inside 
prisons, we're not looking out for the health of those prisoners."

He said people who are incarcerated do not give up their right to good health.

Mr. Elliott's commentary suggests the lack of preventative programs 
could form the basis for legal action.

"If the political will cannot be mustered to implement evidence-based 
measures to protect the health of those in the state's custody, it 
may be time to put the evidence of this ongoing denial of human 
rights before the courts."
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MAP posted-by: Jay Bergstrom