Title : Engaging red cross inmate volunteers to raise awareness and advocate for disease control in Irish prisons
Abstract:
The value of engaging prison inmates as Irish Red Cross peer-educators in all Irish Prisons over the last fourteen years for health promotion, awareness-raising, advocacy for testing, ‘case-finding’ and ‘seek and treat’ have been impressive. This successful recruiting technique has been successful in campaigns relating to case HIV, HCV and Latent TB in various Irish prisons (UWO 2024; Phillips 2024; Crowley et al 2018; 2019.
In addition, the pre-Covid 19 established and active teams of Red Cross inmate peer educator/advocates in every prison in Ireland, matched with state-of-the-art infection control systems, had a significant impact in Irish Prisons, reducing prisoner deaths to the lowest in Europe and boosting a 70% uptake of Covid 19 vaccines estate-wide.
Bannon et al (2016) report on voluntary mass ‘point of care’ testing for HIV with Irish Red Cros volunteer advocates in Irish Prisons. The role of inmate peer-educator IRC volunteers was to create community HIV awareness, stimulating discussion, reducing stigma and to advocate ‘knowing your status’ by participating in voluntary testing (UWO 2016; IRC 2018).
The outcome of the campaigns indicated an average of 50% test attendance - a level never previously realised through staff awareness-raising. Whilst no new cases were identified, the exercise raised awareness, reduced stigma and demonstrated the value of using peer education in stimulating greater recruitment for BBV testing in prisons (Bannon et al 2016).
In 2017, a coordinated a voluntary mass viral screening campaign was planned and implemented in Mountjoy Prison, reported in Crowley et al (2018); Crowley et al (2019). This was a working example of the WHO (2007) ‘Whole Prison Approach’ to health with the planned participation of prison healthcare, Prison Teachers, Mater Hospital, Irish Red Cross volunteers and staff, prison officers and prison management.
The outcome of the campaign indicated that 80% of prison inmates attended for testing and that 19 new cases of hepatitis C were identified and able to be entered into treatment (UWO 2024; Crowley et al 2018;2019). This included, where necessary, the continuation of treatment in the wider community on release.
Post-testing, qualitative data analysis indicated the importance that inmates placed on the role of the IRC inmate volunteers in securing their participation. It indicated a level of trust, different to that placed in professional staff and resulted in greater compliance (IRC 2028; UWO 2024).
The University of Bath (Ward et al 2021) undertook a cost-effectiveness study on this project. This compared the cost of the campaign versus the societal savings projected in terms of QALYS and chronic illness management indicated significant savings in societal costs compared with the investment.
This proven partnership between approach between national Red Cross/Red Crescent and Detention Services is a cost effective and replicable model that could be adopted in other European states to support the ECDC Toolbox for the Elimination of HCV in European Prisons Strategy 2030.
