COUNTRY REPORT BIRUTE SEMENAITE, MEDICAL DIVISION OF THE PRISON DEPARTMENT UNDER THE MINISTRY OF JUSTICE OF THE REPUBLIC OF LITHUANIA
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1 COUNTRY REPORT BIRUTE SEMENAITE, MEDICAL DIVISION OF THE PRISON DEPARTMENT UNDER THE MINISTRY OF JUSTICE OF THE REPUBLIC OF LITHUANIA Tallinn, 16 October 2012
2 LITHUANIA IN EUROPE area km2 population Population of country by year on 1st of January
3 LITHUANIAN PRISONS. BACKGROUND 11 PENITENTIARY INSTITUTIONS OFLITHUANIA: - 3 REMAND PRISONS FOR ADULT PRISONERS (including 1 institution combining a remand prison and a closed prison); - 5 CORRECTION HOUSES FOR ADULT SENTENCED MEN; - 1 CORRECTION HOUSE FOR SENTENCED WOMEN; - 1 CORRECTION HOUSE- REMAND PRISON FOR JUVENILES; - 1 CENTRAL PRISON HOSPITAL (with division for TB patients). PRISON POPULATION (as of ) PRISON POPULATION RATE PER NATIONAL POPULATION 310 AVERAGE NUMBER OF PRISONERS (in 2011) ANNUAL TURNOVER OF PRISONERS (in 2011)
4 PRISON POPULATION RATE ON 1 JANUARY BY YEAR
5 PRISON POPULATION RATE PER NATIONAL POPULATION, TURNOVER of August
6 POPULATION IN PENITENTIARY INSTITUTIONS on 31 August 2012 On 31 August offenders were placed in penitentiary institutions. Of them: 1213 detainees, awaiting court decision; 8665 sentenced prisoners (of them 109 life sentenced, 159 sentenced to arrest); 113 juveniles; 440 women; 147 foreigners.
7 DRUG USE IN PRISON SYSTEM OF LITHUANIA
8 DRUG USE IN PRISONS OF LITHUANIA: new and all cases 13,9% 86,1% other cases new cases
9 NUMBER OF DRUG USERS IN PRISONS OF LITHUANIA (total, on 1 January by year)
10 DRUG USE IN PRISONS OF LITHUANIA (% by Year, on 1 st of January 25,00% 20,00% 15,00% 13,3% 14,4% 15,6% 18,1% 18,4% 17.7% 20.1 % 19.0% 17,4% 15,0% 11,3% 10,00% 5,00% 6,6% 7,5% 8,8% 0,00%
11 CLINICAL FORMS OF DRUG SUBSTANCE USE (according to ICD-10) 8,2 % 1,7 % 17,8 % 72, 1 % 0,2 % harmful use unspecified mental and behavior disorders addiction syndrome and abstinence residual mental disorder abstinence with delyre
12 WAYS OF DRUG USE IN PRISONS ,4 % 1,7 % 12,7 % 80,2 % injection per os inhalation snuff
13 DRUG SUBSTANCES USED IN PRISON SYSTEM OF LITHUANIA (%) Opiates (F11) 75,6 66,7 57,1 42,0 36,0 44,2 40,8 46,8 49,6 52,7 Cannabis (F12) 1,0 0,8 1,6 2,6 4,4 3,4 4,0 3,8 3,5 3,1 Tranquilizers (F13) 3,2 6,2 3,9 1,5 1,5 1,1 0,9 0,9 1 0,5 Cocaine (F14) 0,1 0,1 0,2 0,2 0,3 0,1 0,1 0,1 0,06 0,06 Stimulants (F15) Haliucinogenes (F16) Inhalators (F18) Several drugs (F19) 2,6 4,5 9,7 11,9 8,7 8,1 8,2 8,2 8,5 7,9 0,1-0,1 0,2 0,5 0,2 0,5 0,3 0,3 0,4 3,0 3,6 2,4 2,0 1,5 1,2 1,0 0,5 0,3 0,5 14,4 18,1 25,0 39,6 47,0 41,7 44,7 39,4 36,6 34,9
14 MEASURES OF DRUG PREVENTION Main trends: development and improvement of rehabilitation activities for prisoners prisoner education and penitentiary staff qualification upgrading improvement of prevention of psychotropic substances in penitentiary institutions
15 SOCIO-PSYCHOLOGIC AL PROGRAMS emotional management development of skills for conflict resolution communication skills training Special attention is focused on motivation of psycoactive substance users to participate in psychological and occupational programs
16 HIV/AIDS EPIDEMIOLOGICAL SITUATION IN PRISON SYSTEM OF LITHUANIA
17 NEW HIV CASES AMONG LITHUANIAN AND PRISON POPULATION BY YEAR Total in Lithuania In penitentiary system
18 DETECTION OF HIV IN PRISON SYSTEM OF LITHUANIA Total Known cases New cases detected in pre-trial New cases detected in Correction Houses
19 CHRONOLOGY OF HIV/AIDS AND MEASURES TAKEN IN PRISONS OF LITHUANIA 2003 May HIV/AIDS Counseling Center established in Central Prison Hospital 2003 Local Zone 2002 HIV cancelled outbreak in Alytus CH 1997 several persons with HIV positive. Problem of their accommodation during their term of imprisonment opening of the Local Zone 1992 the first HIV infected person
20 One of the basic legal acts regulating the control of infections in penitentiary institutions is the PROCEDURE ON PREVENTIVE EXAMINATION FOR INFECTIONS QUALIFIED AS RISKY AND OF HIGH RISK OF PERSONS HELD IN THE INSTITUTIONS SUBORDINATE TO THE PRISON DEPARTMENT UNDER THE MINISTRY OF JUSTICE APPROVED BY THE JOINT ORDER No 343/191 OF THE MINISTER OF HEALTH OF THE REBUBLIC OF LITHUANIA AND THE MINISTER OF JUSTICE OF THE REPUBLIC OF LITHUANIA OF 2 July 2002.
21 Daily number of prisoners in penitentiary institutions who are HIV infected or ill with AIDS amounts to 400: on 1 st of October 2012 the number was 392. Currently all the patients in need of the treatment have access to it. However due to constant increase of HIV/AIDS infected persons in penitentiary institutions funding for the treatment may fall short.
22 INCIDENCE OF ACUTE VIRAL HEPATITIS IN PRISON SYSTEM OF LITHUANIA
23 PROBLEMS We don t know real epidemiological situation: - due to financial problems patients are not examined for chronic viral Hepatitis; - in many cases prison medical staff don t have information about patient s treatment before entry into prisons. Due to available budgets only a limited number of patients with chronic viral Hepatitis can get treatment - some of patients have to wait until the treatment is prescribed.
24 INCIDENCE OF VIRAL HEPATITIS IN PRISONS PER POPULATION Total 30 26,8 27,2 26,7 HVB ,1 21,6 15, ,9 18,6 15,1 14,9 15,3 22,5 16,2 HVC 15 11,3 12,3 11, ,7 5,8 6,6 6,6 4,6 5,6 6,2 8,8 3,7 7,6 5 4,6 7,7 5,5 4 1,
25 NUMBER OF ACUTE VIRAL HEPATITIS IN PRISONS OF LITHUANIA Total HVB 60 HVC
26 EPIDEMIOLOGY OF TUBERCULOSIS IN PRISON SYSTEM OF LITHUANIA
27 INCIDENCE OF TUBERCULOSIS IN PRISONS SYSTEM PER POPULATION , ,5 890,5 1017, ,4 815,4 1118,3 1067, , ,6 577,
28 INCIDENCE OF TUBERCULOSIS IN LITHUANIA PER POPULATION ,2 74,7 69,8 74,4 66,6 69,5 69,5 65,9 62, ,7 58,
29 REGISTERED CASES OF TUBERCULOSIS IN PRISON SYSTEM Total New cases Ralapses
30 INCIDENCE OF TUBERCULOSIS OF INVESTIGATED PERSONS AND CONVICTS (%) ,9 42,2 27,3 28,8 31,4 44,5 40,5 45,9 36,8 34,8 44, ,1 57,8 72,7 71,2 68,6 55,5 59,5 54,1 63,2 65,2 55, investigated convicts
31 PREVALENCE OF TUBERCULOSIS IN PRISONS OF LITHUANIA (total No)
32 SOCIO-DEMOGRAPHIC CHARACTERISTIC An inmate/detainee ill with tuberculosis is a young man: out of 59 new cases of tuberculosis in 2011 only 4 women; Men by age: years old years old years old years old years old 3 Use of alcohol: rarely 59,6 percent abused 40,7 percent
33 PRIMARY DRUG RESISTANCE ,1 0 95, ,5 31,3 12,5 43, ,8 47,1 11,8 19, ,5 29 6, ,8 17,6 2,9 70, ,6 17 4,3 68, ,9 17,2 13,8 62, ,3 12,5 6,3 74, ,3 18,2 2,6 73, ,3 13,9 11,1 66, ,4 18,8 18,8 53 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% mono resistance MDR poli resistance sensitive
34 DRUG RESISTANCE Combi - nation of drugs New cases Relapses Treatment failure Return after treatment interruptio n New cases Relapses Treatment failure Return after treatment interruptio n New cases Relapses Treatment failure Return after treatment interruption Mono H S MDR HRS HRSE HRZS HRZSE HRE Poli HS
35 RESULTS OF TB TREATMENT ,1 2,2 20,3 Treatment completed Cure 5,6 16,9 53,9 MDR Treatment interrupted (released) Died Untreated
36 RESULTS OF TB TREATMENT ,9 20,3 0 53,9 5,6 2,2 1, ,5 29,8 35,2 17,5 Cure ,9 25,7 1,4 33,8 18,9 1,4 Treatment interrupted (released) Failures Treatment completed MDR ,4 22,2 1,4 38,9 8,3 2,8 Untreated Died ,6 7,9 2 47, % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
37 CURRENT PROBLEMS 1. The level of TB morbidity in penitentiary institutions fluctuates either up or down, but the trend that percent of morbidity if viewed on the morbidity structural chart is comprised of TB brought in from the outside, i.e., a disease which is revealed only during preventive medical examination upon an offender s entrance to a remand prison, remains.
38 CURRENT PROBLEMS 2. Patients' succession is a pending problem (interinstitutional cooperation (MoJ, MoH, MoSSandL) possible joint programs or other measures) patients released from penitentiary institutions without accomplishing the complete course of treatment usually fail to continue the treatment outside. The problem gets deeper every year as more and more offenders are released without accomplishing their treatment due to a shorter period of sentencing.
39 CURRENT PROBLEMS 3. The problem of multidrug-resistant tuberculosis in penitentiary institutions increases year by year. More offenders keep returning to penitentiary institutions with previously diagnosed tuberculosis and having terminated the treatment that ensues multidrug-resistance.
40 CURRENT PROBLEMS 4. The problem of inter-institutional cooperation (MoJ and MoI) on the issue of continuous antituberculosis treatment for detainees and prisoners convoyed to the arrest houses of the police commissariats has not yet been settled.
41
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