A journey of change behind bars: promoting health and empowerment in Irish prisons

Published: 2 December 2013 15:15 CET

In ten of 14 prisons in Ireland, a small group of special-status Irish Red Cross volunteers combines an innovative community-based health approach with the Red Cross Red Crescent Fundamental Principles to change the lives of troubled men, transform prison culture, reduce violence and improve the physical and psychological health of inmates.

Since the Community Based Health and First Aid (CBHFA) programme was put in place, the percentage of fights involving an illicit, handmade blade has gone down from 97 per cent to 10 per cent in one year. The result has been fewer injuries and reduced prison health-care costs.

But the real beauty of the programme is that the volunteers don’t come from outside the prison. They are the inmates themselves.

Sporting black T-shirts with the seven Fundamental Principles listed on the back, the prisoners run a range of projects — from hygiene promotion and HIV counselling to violence prevention — with positive results that no previous attempts have ever achieved.

In one prison, the uptake of the HIV testing was raised from less than 10 per cent to over 72 per cent. There is less tension in the jail and issues like HIV stigma and discrimination are openly discussed.

“It’s especially satisfying to help other inmates overcome the kind of addictions I once faced. I feel like I am giving the other lads some hope,” says Ryan, an Irish Red Cross volunteer in Wheatfield Prison. “I was dependent on drugs and alcohol when I came in. I know how it feels. This was the help I really needed.”

The programme started in 2009, when Graham Betts-Symonds, CBHFA programme manager at the Irish Prison Service, began looking for a way to improve access to health care within Wheatfield Prison. He says there were problems with hygiene and many prisoners were apathetic about their own health. “The prison health care was very reactive. Prisoners went into the infirmary when they were sick, and nobody was looking at how to live a better and healthier life,” he says.

Lydia O’Holloran, CBHFA manager at the Irish Red Cross, said the organization put forward its unique programme idea and the prison service was receptive. “The Irish Red Cross came up with the idea that we would have volunteers within the prisons – that has never happened before.” she says. The Red Cross decided to apply the CBHFA approach, originally designed to help local communities in developing countries create systems for managing and improving their own health.

“The local community in a prison is the prisoners themselves,” O’Holloran says. “So what we needed was something that created action and empowerment within that community.” In the prison setting, that meant creating community health committees, made up of prison health staff, teaching staff and volunteers.

But being a volunteer in the prison means much more than just health to them. “I see this programme as empowering people, giving people the skills to believe in themselves, in doing ordinary everyday activities that actually make them feel and look good,” says Michael Donnellan, Director of the Irish Prison Service. “You don’t call them prisoners anymore, you call them volunteers. They are on the journey to reform and to change.”

“Sometimes I feel like I’ve never achieved or done anything in my life,” says Eddie, another volunteer. “But I’ve never said that since I joined the Red Cross. I have so much potential in life and that’s the thing I like to say most, my outlook in life and where I can go from here.”

The programme is active in 10 prisons in Ireland, and is due to be extended to all 14 prisons. It has recruited 326 inmates as Irish Red Cross special-status volunteers who have helped to improve the lives of more than 3,279 of their fellow prisoners and the prison staff.

The CBHFA approach and volunteering has provided a unique opportunity to develop and implement innovative health care projects and make Universal Health Coverage  possible.

Read the full story in Red Cross Red Crescent Magazine.