Desmotology: A Black Hole in Health Care

Desmotology is a branch of medicine that addresses the health care needs of people detained in jails, juvenile detention centers, and prisons (1). Desmotology, the term is adopted from Greek word " Desmoterion " meaning prison. It deals with a unique population, with unusual health problems and distinct setting away from main stream of health care. More than 10.1 million people are held in penal institutions throughout the world, mostly as pre-trial detainees/remand prisoners or as sentenced prisoners. Prison population is growing in all five continents (2). Prisoners tend to have poorer physical, mental and social health than the population at large. Prisoners are at great risk of contracting diseases since they have no control over their environment. Many diseases among prisoners are infrequently seen in general population. Many inmates serve a short sentence and are imprisoned for non-violent, property or drug-related offences. Many imprisoned women are mothers and are usually the sole care taker for their children. In many countries, very young children can stay with their mother in prison. With the background evidence of lack of adequate health care services to the most disadvantaged people in prison throughout the world, World health organization published " Health in prisons-A WHO guide to the essentials in prison health " in 2007 and " Kyiv Declaration on women " s health in prison " during 2009 to improve the state of women " s health and criminal justice systems and prisons throughout the world (3-4). Harzke et al. in a study from Texas prison found out that nearly one quarter (24.5%) of the study population had at least one disease condition (5). Andrew et al in a study found that prevalence of chronic diseases were comparatively high among prison inmates than general population of United States (6). Mental health foundation found out that the suicide rate in prisons is almost 15 times higher than in the general population (7). Disease management in prisons can be organized at three levels namely individual level, institutional level and population level. At the individual level, clinical interventions for the management of illness as well as self-care are important in preventing and managing the disease. At the institutional level, searching and screening can prevent exposure to blood-borne diseases, screening for other chronic diseases, providing health education, stress management, art therapy, skill develop-ment(vocational training) or administrative arrangements for ventilating the indoor spaces can decrease the transmission of …