Health Through Walls

HIV/AIDS Assistance for Prisons in Haiti objective is the control and prevention of the spread of contagious diseases in Haiti's prisons. Haiti's prisons do not have a sustainable system of care and HtW through funders help to fill in many gaps that exists to prevent neglect of care of the thousands of inmates incarcerated there and eventual death of those who are sick or who contract a deadly disease while incarcerated there. HtW has doctors, nurses, laboratory technicians, counselors, radiographers and psychiatrists who work at all 21 locations throughout the country. HtW is charged with setting up a sustainable system of care providing sanitation for all the prisons and creating a clean working environment for the officers and health care workers and a healthy living environment for the prisoners. We also ensure that there is clean water for consumption.

Klinik Solidarite was formed from an alliance with AIDS Healthcare Foundation to provide medical and laboratory services to released prisoners infected with HIV or TB, their affected family members, their sex partners and anyone else infected in the communities where they live. Klinik Solidarite also care for women who were physically abused and abandoned or orphaned children. The clinic has its own lab and clinicians, and it is located in Bourdon, Haiti.

Impact Against TB and HIV is a project formed in collaboration with the Global Fund. These funds allow us to increase and improve prevention, screening and testing of HIV/AIDS and TB in 5 additional prisons in Haiti. These prisons are located outside of the metropolitan area. We also provide and care treatment services for all prisoners indentified TB+ and HIV+. This program allows us to screen for MDRTB and negotiate and set up isolation areas for those identified. HtW is charged with renovation of prison medical offices and replacing destroyed equipment, development of a hospital ward at the PCPP-M, recruiting and training medical staff for facilities without staff, training Health Promoters and a peer education program in all the prisons.

The Strengthening Haitian Activities in the Prison Environment (SHAPE) is funded by International Narcotic Law Enforcement (INL). This Task Order is implemented by Health through Walls, Inc, with two (2) subcontractors University of Florida and Emory University. The project is to assist the Haitian National Police's capacity and ability to meet the health needs of persons in Haitian prisons; improve the HNP's capacity to meet the nutritional needs of the Haitian prison population; provide the HNP with the tools to sustain the improvements in structure, sanitation and facilities made as a result of this project.

Project ECHO: Ending HIV in Prisons is a collaboration with the Project Echo program, funded by Gilead Foundation that seeks to create a two-pronged Project ECHO learning platform in correctional settings of resource-poor countries to engage prisons systems to share best practices and learn strategies for managing, preventing, treating and ending the HIV epidemic in prisons. This free program will provide virtual training programs to both correctional clinicians and provide peer education programming to incarcerated persons with the objective to reduce new HIV infections and the eventual end to the HIV epidemic. Prisons in resource poor countries face many challenges in delivering adequate health services. The prisons often have extreme conditions of overcrowding, lack of sanitation, safety hazards, poor nutrition, and little access to health professionals. These are often the same countries with the highest prevalence of HIV infection. The ramifications of failing to identify or prevent or properly manage HIV infections pose a threat to the entire prison population, staff, visitors, and community. Incarcerated persons are a key population often missed by traditional HIV programs. HtW also has a joint program with Gilead Foundation to provide HIV management and care services in the prisons in Jamaica, Haiti and Dominican Republic.

Support on Health in Prisons is a collaboration with the United Nations Development Program for professional to provide Medical advice and expertise on the prevention, identification and treatment of communicable diseases, especially COVID-19, in low-resourced countries and overcrowded prison facilities. A joint venture to create a Rapid Assessment Tool for Prison Healthcare and the United Nations Supplemental User Guide for Prison Healthcare: The guide is composed of a self-assessment checklist and supplemental user guidance, which aims to assist an assessor of prison health services to evaluate some of the essential healthcare components within places of detention in low and middle resource countries. The tool is intended for use by staff who work in international development and humanitarian affairs, health care staff and/or custodial staff within a prison location, or by health and justice authorities at a national level. The assessment tool and accompanying supplemental user-guide is designed to provide a practical checklist that can be utilized to identify deficiencies within a prison-based healthcare system and guidance to begin addressing them. The tool and supplemental user guidance is intended to be a starting point to bridge the gap between best practice and the operational reality in any given country. Expenses: $16,260.00 Including grants of: $15,000.00 Revenue: $ 1,260.00 General Fund: Used to buy medication and provide support for delivery of food and other HIV/essential services in resource poor countries. Expenses: $46,283 Including grants of: $46,451.00 Revenue: $12,033.33

EMERGENCY CHOLERA RESPONSE IN PLACES OF DETENTION IN HAITI. On October 2, 2022, the national authorities reported two confirmed cases of Vibrio Cholerae Port-au-Prince. This was the beginning of the rapid spread of the disease throughout the country not unlike the first appearance a decade earlier. In less than a week there were more than 50 cases and 35 deaths in the West and Central Plateau. Two days after the first confirmed case, on October 4, 2022, cases of cholera were suspected at the Prison Civile of Port-au-Prince (PCPP), the country's the largest prison in Haiti holding an average of over 4000 prisoners daily. Within two weeks, there were 944 cases and 22 deaths at the PCPP. Haiti has 18 places of detention and approximately 11,697 inmates in its facilities. Because of this rapid spread HtW requested support from international agencies to stop the spread. Immediate programmatic, material, and financial support was provided to various degrees by AHF, ICRC, INL, and USAID. HtW worked with the MOH and the DAP to set up processes for identification, isolation, treatment, and care. It took some work to establish the treatment center (TCAD) since it was already being used for something else. The biggest obstacle was adequate space to house patients, there is no triage space in several prisons, and it was necessary to transform a prison cell into a triage room or erect tents to quarantine the infected. HtW, the DAP, the MOH, ICRC and INLE strategized weekly approaches to curb the spread of the disease and minimize deaths. The project began November 1st, 2022, and ended on March 31st, 2023, and was funded by the International Committee of the Red Cross.

General Fund: Used to buy medication and provide support for delivery of food and other HIV/essential services in resource poor countries.

UNDP supported work in Central African Republic: Deliver an integrated model of care that includes the strengthening of the TB identification, treatment and support and for those with concurrent or distinct health conditions in two Bangui prison locations. The integrated service will be delivered by Amici per il Centrafrica (Amici) in partnership with Health through Walls (HtW), and is enabled by embedding with existing health and prison administration services within the Central African Republic. We are build capacity in existing services offered to incarcerated persons and to provide additional health services. The newly commissioned services will be integrated within the TB program and include the identification, treatment, health promotion/education, and community referral (when discharge from prison occurs) for HIV/AIDS, malnutrition, fungal disease, skin conditions, hypertension, diabetes, chronic respiratory disease, cardio-vascular disease, and mental illness, among others.