1. Three series of cases of oedema in an internment camp are described.
2. The first series of cases consisted of those diagnosed as beriberi. They were much less common than cases of oedema from other nutritional causes. Most of the beriberi cases occurred in a period when the supply of vitamin B1 was low. The other patients developed their disease while outside the camp. The clinical features are described and the diagnosis discussed.
3. The second series of cases occurred at the same time as the beriberi, but the olinical appearances were sufficiently different from beriberi to lead to the diagnosis of nutritional oedema from some unknown cause.
4. The third series occurred towards the end of internment and were probably due to hypoproteinaemia.
1.This paper records the treatment by a continuous intravenous quinine drip technique of fifteen cases of heavy P. falciparum infection in malnourished prisoners of war in a Singapore camp. These cases were selected from a series of approximately 1,000.2.The efficiency of the method, its simplicity, and the ease with which it can be combined with blood transfusion or the slow administration of thiamin are stressed.3.Recovery by this method of treatment is recorded of three cases with a peripheral intensity of infection higher than has hitherto been reported in Malaya with survival.4.The author is of the opinion that this is a safe and effective method for the treatment of pernicious falciparum infections.
The incidence of HBsAg in random blood donors was found to be twice that of the prisoner population. The anti-HBe however, was about twice that in the prisoners when compared with the random blood donors. Both the random blood donors and the prisoners had similar incidence of HBeAg. The percentage frequency of HBsAg positivity with anti-HBe positivity was also similar in both groups. The 18 normal non-blood donors did not have HBsAg, HBeAg or anti-HBe.
The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens.
Twenty-seven inmates from a detention centre in Perak were evaluated for possible causes of their ankle oedema. Physical examination and biochemical evaluation did not show any evidence of renal or hepatic dysfunction. The cardiac origin of their problem was suggested by the presence of other signs of heart failure in three of them and by radiological evidence of cardiomegaly in 40% of them. All the patients who returned for review demonstrated a prompt clinical response to thiamine replacement therapy.
The invasion of Singapore and Malaya was delayed because of the reduction in the period of service in the Far East. The atom bombs were then dropped and plans for all services including medical ones had to be altered, their main aim becoming the treatment and repatriation of surviving prisoners of war. The ending of the war did not occur abruptly on V-J day; many Japanese troops had to be convinced that the war was over. Meantime the treatment of diseases in British and other service men continued; reference is made to some experiences in Rangoon. The morale of personnel who now were anxious to return to their homes was low and efforts were made to raise their spirits. In India it was accepted that the days of British rule were over.
In Part 1 of her war diary, Brenda MacDuff, a nurse with the Colonial Nursing Service in Malaya, tells of her early experiences in the country at the outbreak of war in the East and of her subsequent capture by the Japanese Army.
In the concluding part of her war diary, Brenda MacDuff, a nurse with the Colonial Nursing Service in Malaya, tells of her final incarceration, eventual freedom and reunion with her husband.
Rapid participatory research and project development is possible within a tightly controlled social context such as a prison. Having gained access, based on trust and mutual respect, external agents may then facilitate significant change. Given adequate support, incarcerated people with HIV/AIDS and limited medical access may be able to develop mutual care, social support and income-generating activities. In the Malaysian context, we estimated in 1998 that up to one-quarter of prisoners with HIV had indicators of significant disease. We estimated that significant indicators remained unrevealed among between one-half and two-thirds of these. Given prevailing conditions, these would probably only be amenable to peer-based care.
Human Rights traditionally refer to rights and freedom that are inherent to every human being. They are based on Human Rights Law and concern the respect for dignity and worth of a person. These rights are universal, inalienable, indivisible, inter-related and interdependent. Members of Societies are detained for varied reasons and are made up of different age groups and gender. The United Nations through its numerous agencies, associated Conventions, Treaties and Resolutions have laid down guidelines that govern the rights of those under detention. Article 5 of General Assembly Resolution 45/111 clearly stipulates that except for those limitations that are demonstrably necessitated by the fact of incarceration, all prisoners shall retain the human rights and fundamental freedom set out in the Universal Declaration of Human Rights. As such, the Medical and Health Care of People under Detention should not be any different from the other members of societies. The Right to Health and Medical Care is stipulated under various Articles contained in the UN Bill of Human Rights (UDHR, ICCPCR and ICESCR) as well as other Conventions, e.g. Convention against Torture (CAT), Convention on Rights of the Child (CRC) and Convention for the Extinction of all Forms of Discrimination against Women (CEDAW). The United Nations have also developed specific guidelines and instruments for Treatment of People under Detention. These include the General Assembly Resolution 45/111 December 1990 elucidating the Basic Principles for Treatment of Prisoners, ECOSOG resolution 663C and 2076 regarding the Standard Minimum Rules for the Treatment of Prisoners which covers rules pertaining to accommodation and Medical Services, General Assembly Resolution 37/194 on Principles of Medical Ethics relevant to the role of health personnel, particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.
The people who are in detention are screened by the Medical Officer of the Prison and if they are found to be unwell, these prisoners will be accommodated in the sickbay and medical treatment will be provided. If their sickness needs further investigations and management, they will be sent to the Government Hospital. If the prisoners are found to have infectious or contagious diseases, steps will be taken to prevent the spread of these diseases to other prisoners in the prison. Prisoners are given time to exercise to maintain good health and their clothing are regularly washed to make sure that they will not contract skin diseases, e.g. scabies, ringworm, etc. The Prison Department since 1989 has increasing numbers of HIV positive prisoners. The Department complies with this problem by sending staff for courses, lectures and seminars so that they will be able to handle these prisoners more efficiently in the prison. When these HIV/AIDS prisoners' condition turns bad, they are usually transferred to a Government Hospital. Another of the Prison Department's prominent medical problem among the prisoners is drug addiction. Staff trained with skill and techniques are counselors for the drug related prisoners. Realizing and in anticipation that the sickbays in the prisons are going to be full of HIV/AIDS prisoners and drug related prisoners, special attention will be given to more allocation to upgrade the sickbays in the prison. White attires will be provided to the sick prisoners in the sickbays so that they will look neat and clean. More doctors, medical assistants and nurses will be employed so that appropriate medical care or rather more appropriate medical care can be provided to the sick prisoners in the prisons. The Prison Department is in the process of privatizing medical care for prisoners in the prison and the Department is also trying to convert some prisons to be medical prisons so that adequate medical care can be given to the sick prisoners.
A case is presented where confusion arose about skin lesions and whether they were diabetic or electrical in origin. The deceased was a known diabetic and hypertensive man. A middle-aged person in early fifties was found unconscious in the cell and judicial autopsy was performed. He was facing trial for capital punishment of being allegedly involved in drug trafficking and money laundering. He had few marks over his fingers and foot which were considered to be electric marks produced in electric torture. also had fracture of skull and ischemic necrosis of right side of cerebrum; and contrecoup lesions. Findings are documented with photographs of the lesions. The article also depicts photographs of the scene where the victim had fallen and sustained skull fracture.
To examine the association between HIV infection and psychiatric disorders among prisoners, where mental illness, substance abuse, and HIV are disproportionately represented.
We review evidence for effectiveness, cost-effectiveness, and coverage of antiretroviral therapy (ART) for injecting drug users (IDUs) infected with HIV, with particular attention to low-income and middle-income countries. In these countries, nearly half (47%) of all IDUs infected with HIV are in five nations--China, Vietnam, Russia, Ukraine, and Malaysia. In all five countries, IDU access to ART is disproportionately low, and systemic and structural obstacles restrict treatment access. IDUs are 67% of cumulative HIV cases in these countries, but only 25% of those receiving ART. Integration of ART with opioid substitution and tuberculosis treatment, increased peer engagement in treatment delivery, and reform of harmful policies--including police use of drug-user registries, detention of drug users in centres offering no evidence-based treatment, and imprisonment for possession of drugs for personal use--are needed to improve ART coverage of IDUs.