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Sir, Dr.Richard Smith’s series of articles on the State of the prisons highlights a topic of genuine concern for the medical profession. Following an act of  civil disobedience as part of the Christian Peace Movement and my subsequent refusal to cooperate with a binding order to keep the “peace” I had occasion to experience at first hand, as a prisoner, conditions in Pentonville Prison for seven days. The lack of adequate hygiene exposes prisoners to potential medical risks as well as transgressing basic humane standards.

As a civil prisoner I had the right to wear my own clothes but once that right is taken association with with other prisoners is more restricted and no change of clothes or pyjamas is allowed.

I was offered one shower on the first night and another on the morning of release. Despite frequent requests I was unable to obtain a shower or bath during the five whole days of my imprisonment. This is merely a symptom of the gross lack of facilities and overcrowding in prisons and not due to any lack of correct behaviour on the of the prison officers, who did their best in diffcult conditions.

I was totally confined to my cell from 4 pm until 8 am the next day. A pot for urine is provided, and at 8 am the slopping out procedure is carried out. Although I was alone, most prisoners share two to a cell which is about six paces by three. The pots for urine to my knowledge were never cleaned. The room in which the slopping out procedure is carried out is a little larger than a cell and contains a sluice, a flush toilet, a washbasin, a urinal, and a hot and a cold water tap. The cold water tap is the water supply for the prisoners in that area. The hot water tap is generally the place for washing the plastic plates and mugs of the prisoners. The water runs directly into a drain in the floor, there is no sink, and washing detergent is not provided. Prisoners therefore often washed their plates and mugs by simply passing them through this stream of hot water a few times while at the same time and in close proximity urine was being slopped out; the urinal was being used, as was the toilet, which was separated from this area only by a door about five foot in height. There were often queues to use all amenities in this confined space. The hand basin was never used as there was no soap or towel there to wash one’s hands and the basin itself was often dirty. The collecting of clean water and the washing of plates and mugs are therefore carried out in an area of potential cross infection and in an atmosphere smelling of faeces and urine. Plates were sometimes washed in an adjoining room where there was hot water and a sink but it was left to the prison officers’ discretion as to whether this room was opened or not. Although it is obvious that many prisoners are from sections of the community that suffer major social deprivations, the prisoners often viewed their conditions in prison as outside normal human standards of our society. Major improvements in hygiene could be made without enormous financial investment if a policy was instituted to separate the facilities for washing plates and collecting water from the sluice and toilets and to improve handwashing facilities. Prison doctors themselves have raised doubts about basic hygiene in prisons (1), and the need for research on this topic is very pressing (14 January, p 129). It seems a small request that basic primary health care should be in our prisons; this would also go some little way towards making conditions for prisoners more humane.

London SW4

(1) Anonymous. Curb on jail protest doctor 1983 November 7 The Times