HIV spreads in Insein Prison

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The Medical Care system that failed to prevent HIV spreads in Insein Prison
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1. The Medical Care System in Insein Prison
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There is only one approximately 100 bed hospital in Insein Prison for ten
thousand prisoners.  The hospital is governed by Dr. Soe Kyi, the officer
in-charge of
the prison hospital and the two assistant surgeons, Dr. Tun Tun and Dr. Aung
Than
Myint, who are under his supervision. Dr. Soe Kyi was honored by the
military junta with the title of Kyaw Thura for his approval signature on the
death certificate of (41) demonstrators who suffocated to death in a prison
van on the way to the prison in March, 1988. The prison hospital is governed
directly by the prison department of the Home Ministry. 

The out-patient clinic is only open one a day for the prisoners in each
prison hall (different days for different halls). The procedure to get a
medical check up is lengthy because of the bureaucratic red tape system
inside the prison. The ill prisoner must
present himself first to the A Khan Lu Gyi ( the head prisoner of the cell
who is
selected by the warden to monitor regulations), then if he approves the need
for a
medical check up, he must next present himself to Tan Si (a long-term
serving head prisoner who is selected to monitor the prison regulations for
a whole building- 8 cells or 16 cells). Then another approval from the
assistant warden and the warden is needed for registration on the list of
out-patients, who have the right to receive medical check up on the assigned
day of the week. Most of the prisoners failed to receive proper
medical treatment during the lengthy process of the prison system. Usually the
out-patients only received drugs like Asprin, Paracetamol, Buspro, and
Sodamint without properly treating their underlying illness. The prison doctors
give prescriptions and medics usually follow with injections and medications
later.
Most of the medics do not have background medical knowledge and are selected
and appointed from the criminals who are jailed for drug abuse. They have
tacit license to keep a syringe. 

Fourth-fifths of the in-patients who are admitted to the jail hospital
are not really ill patients, but they have paid a bribe to the medical
officers so as to
enjoy special favors granted by the authorities and to be free from having
to do hard labor. Some drug-addicted criminals pay money to the prison
doctors to stay in the
hospitals so that they can have access to needles and syringes and use drugs
freely.

Prison medical care system that drives the spread of AIDS
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The medics use the same needle to inject several patients. One of my own
experiences is that, in late July 1990, because I was seriously ill, I lied
down on a thin sheet in my prison Block for 4 or 5 days. I didn't have any
proper medical treatment during those days. Although my fellow political
prisoners reported my illness to the authorities, later I had to go through
many different authorities to get permission to be admitted to the hospital, 
even though I blacked out frequently.

The next morning after I arrived at the hospital, Dr. Soe Kyi and two other
criminal medics came and examined me. They gave me some medicine such as
Tetracycline, Paracetamol and Burmeton. After the doctor checked me, a
drug-addicted medic came to me with a syringe filled with some sort of liquid
medicine. Then he asked my name and he said he had to give me an
injection.  Being injected by a fellow prisoner is an ordinary prison
routine, and I didn't want to make any complaint, but I wondered what kind
of medicine I was going to receive, so I asked him. He replied " Are you a
doctor or a patient? If you are a patient, you must follow the doctor's
prescription. You don't need to ask anything at all. Otherwise you don't
need to come here and you can get out of here! " The medic who I met was a
criminal
who had been sentenced to a five-year term in prison, and he bribed Dr. Soe Kyi
to let him stay in the hospital to avoid hard labor in outside camps. He
could use drugs freely.

(1. HOW DO YOU KNOW HE WAS A DRUG ADDICT?  DID YOU SEE HIM USING DRUGS?)

Although his words made me very angry, my 104' F temperature kept me quiet.
He tapped my hip three times and poked the needle-point into my flesh. Later
he pulled it out and fixed the tube of the syringe and called another
patient to inject him with the same needle. When I asked the person in the
bed beside me about this, he replied " this is the routine since a long time
ago in prison". The ill
prisoners have no other choice.  They know the risk of becoming infected
with HIV from injections is great, but if they don't get an injection, they
might die from their illness. So first and foremost is to overcome their
illness.

Two weeks later when I was at the hospital, the medic attempted to inject me
again. There was a quarrel between him and me. Then Dr. Soe Kyi arrived and
asked us what had happened. When I explained to him what was going on, he
replied to me rudely that "this is a jail hospital, we can't use a
disposable needle. If you want to be injected by your own single-use needle,
you can do whatever you want when you are outside jail ( when you are
released). But this is jail and you must accept our rules, whatever they
are." He
turned his head to the medic and gave the order " Don't give him any more
injections".

Blood transfusions in a jail hospital are rare though minor surgery for
boils and skin infections are common and the practice is also very risky for
the transmission of HIV because the same instruments are used without enough
disinfection first.


HIV IN INSEIN PRISON

Drugs in Prison

In the cell blocks, prison halls, and prison hospital, drug use is rampant.
Drugs can be found in the halls for detainees who are under trial and the
halls for prisoners who have been sentenced, especially hall #5.  It is easy
to buy heroin, sedatives, marijuana, and opium in Insein Prison.  

There are three ways to smuggle drugs into Insein: first with the warders,
second prisoners who go to trial and come back can carry drugs with them,
and third hidden in the food sent by visitors.  

The drugs which are smuggled into Insein are then used by the recipients or
sold to other prisoners.

>From 1990 to 1992 when I was in prison, the main drug dealers were Maung
Maung Gyi, Thein Htun, Clark, Soe Soe in Hall #1, and Ko Thein and Raju in
Hall #5.

The prisoners who were imprisoned for drug abuse always continued to use
drugs.  These prisoners bribed the doctor in the prison hospital so that
they were able to stay in the prison hospital.  They tried to get needles
and syringes in the hospital.  Some prisoners sold these needles and
syringes to the prisoners in other cell blocks and halls.  Sometimes they
made their own syringes.  If the needle points got dull, they sharpened them
on the floor and used them again, up to 70 times.  

In mid 1991, two criminal prisoners, Nga Shin and Kyaw Thu, overdosed from
their own drug injections.  Nga Shin died.  Although Kyaw Thu recovered, he
wasn't punished at all.

Homosexuals in Prison

In Insein Prison, some criminal prisoners try to rape other prisoners by
using force and threats.  Many of  most senior prisoners in each cell or
hall try to persuade or threaten young and good-looking prisoners to have
homosexual relations with them.  This includes children under 14.  The cell
leaders even dare to rape other men in the daytime.  

For example, Aung Htun, the hall leader in Hall #5, coerced a fourteen year
old boy into having sex with him every night.  That boy was sentenced to
three years in prison for stealing his parents' belongings.  Some prisoners
reported to the prison authorities what the hall leader had done, but they
didn't do anything about it.

Mya Maung, hall leader in Hall #4, raped a child, and told the child not to
talk to any other prisoners.  One day, Nga Shin and Moe Thu were talking to
that boy, and after that Mya Maung killed them (because of jealousy).

Soe Myat, the hall leader of Hall #1, threatened a political prisoner with a
knife and tried to rape him.  Kyaw Thu interfered to stop the rape, and then
Soe Myat quarrelled with him.

Clark, from one of the dog cells, threatened  another political prisoner
with a knife and tried to rape him, but other political prisoners got angry
and stopped him.

No Education about STDs including AIDS transmission
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No education about sexually transmitted diseases including AIDS, and the
negligence of the prison authorities has caused  HIV infection
in Insein Prison to become widespread. Tattooing, having limited access to
shaving materials, and genital reshaping (inserting metal balls) by illegal
minor surgery are also common causes for HIV transmission.