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It is well-established that prevalence of Hepatitis C (HCV) infection in prisoners is disproportionately higher than in the general population. While developments in screening and treatment for HCV have enabled greater detection and treatment in prison, release is a high-risk time for HCV infected prisoners returning to the challenges of community living. A scoping review was conducted to examine the evidence on individual, provider and system level factors that influence compliance with HCV treatment in patients transitioning from prison to community. Retrieved articles were screened and those eligible were selected for data extraction. Quantitative and qualitative studies were included. Electronic peer-reviewed databases were searched in February 2022: 140 articles were initially identified of which seven were included in the final review. Six key themes characterized the literature: education, case management and discharge planning, hepatology in-reach nurses, transition clinics, primary care providers and system wide approach. This summary scoping review highlights the paucity of research in this area. There is a need for experimental research to investigate specific interventions, and to understand HCV care-specific barriers and facilitators. A multi-pronged approach is needed to address barriers to healthcare services in general but also specific barriers relating to HCV. Factors that facilitate compliance should also be recognized and amplified across regional HCV elimination strategies.
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Hepatitis C , Prisioneros , Humanos , Prisiones , Hepatitis C/epidemiología , Hepacivirus , Cooperación del PacienteRESUMEN
PURPOSE: Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners' mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). METHODS: APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England's household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. RESULTS: One participant in seventy had been in prison (1.4%; 95% CI 1.1-1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02-3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. CONCLUSIONS: Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.
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Trastornos Mentales , Prisioneros , Adulto , Estudios Transversales , Humanos , Trastornos Mentales/epidemiología , Salud Mental , Morbilidad , PrisionesRESUMEN
BACKGROUND: People held in immigration removal centres have a range of vulnerabilities relating both to disappointment at imminent removal from the country of hoped-for residence and various antecedent difficulties. An important subgroup in the UK is of foreign national ex-prisoners who have served a period of incarceration there. Prisoners generally have higher rates of mental disorders than the general population. It is, however, not clear whether foreign national ex-prisoners in UK immigration removal centres have higher rates of mental disorders than other detainees. AIMS: To compare the screened prevalence of mental disorders, levels of unmet needs and time in detention between foreign national ex-prisoners and others in Immigration Removal Centres in England. METHODS: We conducted a secondary analysis of cross-sectional survey data from a previously published study in one Immigration Removal Centre. RESULTS: The 28 foreign national ex-prisoners had been in immigration detention for longer and reported greater levels of unmet needs than the other 66 detainees. The highest levels of unmet needs among the foreign national ex-prisoners were in the areas of psychological distress and intimate relationships. After adjusting for time spent in detention, there was evidence to suggest that foreign national ex-prisoners had a higher screened prevalence of substance use disorders, autism spectrum disorders and attention-deficit hyperactivity disorder than the other detainees. CONCLUSIONS/IMPLICATIONS FOR CLINICAL PRACTICE: This study supports the view that foreign national ex-prisoners are a vulnerable group within immigration detention who have needs for enhanced and specialist service provision, including appropriate arrangements for health screening and active consideration to alternatives to their detention.
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Trastornos Mentales , Prisioneros , Estudios Transversales , Emigración e Inmigración , Humanos , Trastornos Mentales/epidemiología , Salud MentalRESUMEN
BACKGROUND: Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. METHOD: The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. RESULTS: We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. CONCLUSIONS: For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.
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Prisioneros/psicología , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Servicios de Salud Mental , Prisiones , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Queensland , Factores de RiesgoRESUMEN
Risk-taking tendencies and environmental opportunities to commit crime are two key features in understanding criminal behavior. Upon release from prison, ex-prisoners have a much greater opportunity to engage in risky activity and to commit criminal acts. We hypothesized that ex-prisoners would exhibit greater risk-taking tendencies compared to prisoners who have fewer opportunities to engage in risky activity and who are monitored constantly by prison authorities. Using cumulative prospect theory to compare the risky choices of prisoners and ex-prisoners our study revealed that ex-prisoners who were within 16 weeks of their prison release made riskier choices than prisoners. Our data indicate that previous studies comparing prisoners behind bars with nonoffenders may have underestimated the risk-taking tendencies of offenders. The present findings emphasize the central role played by risk-taking attitudes in criminal offending and highlight a need to examine offenders after release from prison.
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Actitud , Prisioneros/psicología , Asunción de Riesgos , Adulto , Humanos , MasculinoRESUMEN
Background: The number of ex-prisoners worldwide has constantly been increasing in recent years. Currently, little is known about post-release daily adaptation, not to mention valid and reliable instruments for post-release daily routines pertinent to mental health. Objective: This study aims to develop and validate a self-report instrument, hereafter referred to as Post Release Living Inventory for Ex-prisoners (PORLI-ex). Methods: Three separate samples of ex-prisoners were recruited to complete an online survey (N=1,277, age range=17-89 years, 53.2% male, 72% white). Results: The final model evidenced acceptable goodness-of-fit and consisted of 45 items on nine dimensions, which loaded on three second-order factors: Consolidation (three dimensions; e.g., Institutional Routines), Replacement (two dimensions; e.g., Maladaptive Behaviors), and Addition (four dimensions; e.g., Socializing with Ex-prisoner Friends) (α=.695-.915). Convergent validity was demonstrated in the positive correlations with IADL, SOLI, MLQ, GSE-6, and MSPSS. Discriminant validity was demonstrated in the weak correlations with the LEC-5 and perceived social and personal cost of punishment. Criterion-related validity was demonstrated in the correlations with psychiatric symptoms and crime-related outcomes and incremental validity in the correlations with these measures independent of the scores on IADL, SOLI, MLQ, GSE-6, and MSPSS. Conclusion: This study calls for more resources on fostering psychological strengths and resilience through regularizing basic daily life experiences on top of traditional interventions for risk management among the ex-prisoners.
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Crime rates in Australia have declined or been steady over the past decade yet prison populations are at all-time highs. Similarly, unemployment rates have been low but unemployment for those ex-prisoners seeking work is very high. In this paper, we draw on the findings of an Australia-wide survey of government-funded employment service providers who support working-aged Australians including ex-prisoners in their search for work. We find that the heterogeneity of the needs of ex-prisoners coupled with the frugality and inflexibility of government policies and practices frustrates the abilities of these agencies to provide services to this target group.
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The literature on white-collar crimes committed by women is sparse, dealing mostly with their motivations, the incidence of the phenomenon, and differences between the women who commit them and those who commit other types of offenses. This qualitative study maps factors leading women to commit such crimes, with particular focus on their family and personal histories, and on the various roles they played as children and adults, which prepared and "trained" them for future illegal behavior. Data were collected using semi-structured interviews with 18 women convicted and imprisoned for white-collar crimes. A relationship was found between problematic family background and difficulty in help seeking and a nearly obsessive need for love in adulthood, and between the latter and white-collar crime. Theoretical and practical conclusions are discussed and future directions proposed.
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RATIONALE: It has been recognized that exposure to mass trauma tends to increase the time spent watching television (TV) news. Yet, research on the effects of this tendency on individuals' well-being yielded inconclusive findings. OBJECTIVE: The aim of this longitudinal study is to examine the effects of prior trauma and posttraumatic stress disorder (PTSD) on changes in the amount of TV news watching and its effect on subsequent PTSD. More specifically, we examined the interrelations of prior exposure to war captivity, long-term PTSD trajectories, and amount of change TV news watching with PTSD severity during the COVID-19 pandemic, among aging Israeli combat veterans. METHODS: One-hundred-and-twenty Israeli ex-prisoners of war (ex-POWs) from 1973 Yom Kippur War and 65 matched controls (combat veterans from the same war) were followed up at five points of time: 1991 (T1), 2003 (T2), 2008 (T3), 2015 (T4), and in April-May 2020 (T5), during the outbreak of the COVID-19 pandemic. RESULTS: Ex-POWs had higher odds of COVID-19 related increase in TV news watching, which, in turn, contributed to PTSD severity at T5. In addition, delayed PTSD trajectory was associated with COVID-19 related increase in TV news watching, which, in turn, contributed to more severe PTSD at T5. CONCLUSIONS: These findings highlight the negative implications of TV news watching during a mass trauma for traumatized individuals. More specifically, they demonstrate its potential pathogenic role in exacerbating prior PTSD among trauma survivors.
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COVID-19 , Prisioneros de Guerra , Trastornos por Estrés Postraumático , Veteranos , Humanos , Israel/epidemiología , Estudios Longitudinales , Pandemias , SARS-CoV-2 , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/etiologíaRESUMEN
The present meta-analytic review examined the associations between different forms of trauma and mental disorders among prisoners and ex-prisoners. Studies published from 1998 to March 31 2021 were identified by searching PsycINFO, PubMed, Medline and Web of Science. Data were meta-analyzed using a random-effect model. Moderator and mediator analyses were conducted. The protocol was registered in PROSPERO (CRD42020181587). We identified 62 studies (50 non-duplicated samples) with 15,115 (97.86%) prisoners and 330 (2.14%) ex-prisoners in 16 countries. A multi-level meta-analysis found that overall trauma was positively associated with more diagnoses or symptoms of mental disorders (Zr = 0.198, 95% CI = [0.167, 0.229], p < 0.001). Stronger effect sizes were found between childhood trauma (Zr = 0.357, 95% CI = [0.147, 0.568], p < 0.01) and sexual trauma (Zr = 0.326, 95% CI = [0.216, 0.435], p < 0.001) and stress-related disorders. Multilevel moderator analysis showed that effect size was stronger in imprisonment trauma (ß = 0.247, 95% CI = [0.177, 0.316], p < 0.01), mixed trauma (ß = 0.234, 95% CI = [0.196, 0.272], p < 0.001), and stress-related disorders (ß = 0.261, 95% CI = [0.214, 0.307], p < 0.01). Associations between trauma and mental disorders were mediated by social support but not coping. Our findings provide an evidence base for future research on the impact of trauma and inform assessments and interventions in correctional settings.
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Trastornos Mentales , Prisioneros , Adaptación Psicológica , Humanos , Trastornos Mentales/epidemiología , Salud MentalRESUMEN
BACKGROUND: Patient and Public Involvement (PPI) in health and social care research is increasingly prevalent and is promoted in policy as a means of improving the validity of research. This also applies to people living in prison and using social care services. Whilst evidence for the effectiveness of PPI was limited and reviews of its application in prisons were not found, the infancy of the evidence base and moral and ethical reasons for involvement mean that PPI continues to be advocated in the community and in prisons. OBJECTIVES: To conduct a review of the literature regarding the involvement of people or persons living in prison (PLiP) in health and social care research focused on: (i) aims; (ii) types of involvement; (iii) evaluations and findings; (iv) barriers and solutions; and (v) feasibility of undertaking a systematic review. METHODS: A systematic scoping review was undertaken following Arksey and O'Malley's (International Journal of Social Research Methodology 8: 19-32, 2005) five-stage framework. A comprehensive search was conducted involving ten electronic databases up until December 2020 using patient involvement and context related search terms. A review-specific spreadsheet was created following the PICO formula, and a narrative synthesis approach was taken to answer the research questions. PRISMA guidelines were followed in reporting. RESULTS: 39 papers were selected for inclusion in the review. The majority of these took a 'participatory' approach to prisoner involvement, which occurred at most stages during the research process except for more 'higher' level research operations (funding applications and project management), and only one study was led by PLiPs. Few studies involved an evaluation of the involvement of PLiP, and this was mostly PLiP or researcher reflections without formal or independent analysis, and largely reported a positive impact. Barriers to the involvement of PLiP coalesced around power differences and prison bureaucracy. CONCLUSION: Given the very high risk of bias arising from the available 'evaluations', it was not possible to derive firm conclusions about the effectiveness of PLiP involvement in the research process. In addition, given the state of the evidence base, it was felt that a systematic review would not be feasible until more evaluations were undertaken using a range of methodologies to develop the field further.
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This original and ground-breaking interdisciplinary article brings together perspectives from gerontology, criminology, penology, and social policy to explore critically the nature and consequences of the lack of visibility of prisons, prisoners, and ex-prisoners within global research, policy and practice on age-friendly cities and communities (AFCC), at a time when increasing numbers of people are ageing in prison settings in many countries. In addition, the COVID-19 pandemic continues to pose challenges in the contexts both of older peoples' lives, wellbeing, and health, and also within prison settings, and thus it is timely to reflect on the links between older people, prisons, and cities, at a time of ongoing change. Just as there is an extensive body of ongoing research exploring age-friendly cities and communities, there is extensive published research on older people's experiences of imprisonment, and a growing body of research on ageing in the prison setting. However, these two research and policy fields have evolved largely independently and separately, leading to a lack of visibility of prisons and prisoners within AFCC research and policy and, similarly, the omission of consideration of the relevance of AFCC research and policy to older prisoners and ex-prisoners. Existing checklists and tools for assessing and measuring the age-friendliness of cities and communities may be of limited relevance in the context of prisons and prisoners. This article identifies the potential for integration and for cross-disciplinary research in this context, concluding with recommendations for developing inclusive research, policies, and evaluation frameworks which recognise and include prisons and older prisoners, both during and after incarceration.
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Planificación de Ciudades , Planificación Ambiental , Prisiones , Anciano , Anciano de 80 o más Años , COVID-19 , Ciudades , Humanos , Pandemias , PrisionerosRESUMEN
This study aims to establish the effect of self-perceived social support on the intensity of Post-Traumatic Stress Disorder (PTSD) symptoms and Mental Health-Related Quality of Life (MHRQoL) in veterans more than two decades after exposure to trauma in the Homeland War in Croatia, which took place from 1990 to 1995. The sample comprised 259 Croatian Homeland War veterans diagnosed with PTSD, with at least 6 months of combat experience. Among them, 90 subjects had also experienced imprisonment in enemy prison camps (at least 1 month of captivity). The subjects were evaluated using the questionnaire on self-perceived social support, sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. A general regression model analysis was performed to determine whether social support affected patients' MHRQoL and intensity of the PTSD symptoms. The obtained results showed that veterans who had a more positive perception of social support after the events of the war had less intense PTSD symptoms and better MHRQoL. Furthermore, captivity and socioeconomic status were shown to be important predictors of PTSD and MHRQoL. The nonimprisoned veteran group was more likely to develop more severe PTSD symptoms and have poorer MHRQoL compared to the group of former prisoners of war (ex-POWs). This could be due to better post-war care and social support, which ex-POWs received after their release from captivity.
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The present research examines the integration into employment of prisoners on parole who had been under the supervision of the Prisoner Rehabilitation Authority during the period 2007-2010. The supervision program included rehabilitation in the community, with the emphasis on employment. The research compares integration in employment and rates of reincarceration for the supervised group with prisoners who had been released from prison after serving their full sentences. The findings indicate that among prisoners who had participated in the supervision program, there is better integration into employment, a higher wage level, and lower rate of reincarceration. Based on these results, it may be tentatively inferred that the supervision program possesses a high potential for reintegrating released prisoners into the community.
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Empleo/estadística & datos numéricos , Prisioneros/estadística & datos numéricos , Rehabilitación Vocacional/estadística & datos numéricos , Apoyo Social , Adulto , Humanos , Israel , Masculino , Ocupaciones , Prisiones , Reincidencia , Prevención Secundaria/organización & administración , Factores SocioeconómicosRESUMEN
Based on an ethnographic study with 58 participants released from a Romanian prison, this study revisits the pains of release and illustrates the complexity of the reentry process. Some of the pains of reentry seem universal while others seem to be context dependent. In the same time, some pains of release are personal, others social, while others are structural. Concepts of intersectionality and the multi-level model of reentry are discussed, and further suggestions for research are advanced.
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Integración a la Comunidad , Prisioneros , Adulto , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Romaní , Rumanía , Aislamiento Social , Estigma Social , Adulto JovenRESUMEN
Objetivo: Relatar o desenvolvimento do trabalho de campo com uso do método história de vida com mulheres egressas do sistema prisional do Distrito Federal e RIDE (Região Integrada de Desenvolvimento Econômico). Método: Trata-se de relato de experiência enfatizando os aspectos dessa vivência por meio de ferramentas originárias de estudos do método história de vida. Apresentam-se os caminhos adotados ao longo do desenvolvimento da coleta, registro e análise das informações, utilizando a observação participante e entrevista clínica. Seguiu-se o padrão cíclico do método proposto por Gaulejac, no qual os dados obtidos foram repetidamente aprofundados por outras observações e análises. Resultado: As técnicas utilizadas mostraramse valiosas para a revelação psicológica. Conclusão: As vivências na entrevista clínica foram momentos ricos em aprendizado e investigação, percebendo a amplitude da influência que as dimensões psicossociais têm no cotidiano e comportamentos humanos. O desenvolvimento da habilidade do olhar da psicologia social pode aperfeiçoar as práticas de saúde.
Objective: To report the development of fieldwork using the life history method with women from the prison system of the Federal District and RIDE (Integrated Region of Economic Development). Method: This is an experience report emphasizing the aspects of this experience through tools originating from studies of the life history method. The paths adopted throughout the development of information collection, recording and analysis are presented, using participant observation and clinical interview. The cyclic pattern of the method proposed by Gaulejac was followed, in which the obtained data were repeatedly deepened by other observations and analyses. Results: The techniques used proved to be valuable for psychological revelation. Conclusion: The experiences in the clinical interview were moments rich in learning and research, realizing the extent of the influence that psychosocial dimensions have on daily life and human behaviors. The development of the ability of the social psychology look can improve health practices.
Objetivo: Informar sobre el desarrollo del trabajo de campo utilizando el método de historia de vida con mujeres del sistema penitenciario del Distrito Federal y RIDE (Región Integrada de Desarrollo Económico). Método: Este es un informe de experiencia que enfatiza los aspectos de esta experiencia a través de herramientas que se originan en estudios del método de historia de vida. Se presentan los caminos adoptados a lo largo del desarrollo de la recolección, registro y análisis de la información, utilizando la observación participante y la entrevista clínica. Se siguió el patrón cíclico del método propuesto por Gaulejac, en el que los datos obtenidos fueron profundizados repetidamente por otras observaciones y análisis. Resultados: Las técnicas utilizadas demostraron ser valiosas para la revelación psicológica. Conclusión: Las experiencias en la entrevista clínica fueron momentos ricos en aprendizaje e investigación, dándose cuenta del alcance de la influencia que las dimensiones psicosociales tienen en la vida cotidiana y los comportamientos humanos. El desarrollo de la capacidad de la mirada de psicología social puede mejorar las prácticas de salud.
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Prisioneros , Psicología , Investigación , MujeresRESUMEN
BACKGROUND: This study aimed to assess the predictive validity of the Alcohol Use Disorders Identification Test (AUDIT) among adult prisoners with respect to hazardous drinking following release, and identify predictors of post-release hazardous drinking among prisoners screening positive for risk of alcohol-related harm on the AUDIT. METHODS: Data came from a survey-based longitudinal study of 1325 sentenced adult prisoners in Queensland, Australia. Baseline interviews were conducted pre-release with follow-up at 3 and 6 months post-release. We calculated sensitivity, specificity and area under the receiver operating characteristic (AUROC) to quantify the predictive validity of the AUDIT administered at baseline with respect to post-release hazardous drinking. Other potential predictors of hazardous drinking were measured by self-report and their association with the outcome was examined using logistic regression. RESULTS: At a cut-point of 8 or above, sensitivity of the AUDIT with respect to hazardous drinking at 3-month follow-up was 81.0% (95%CI: 77.9-84.6%) and specificity was 65.6% (95%CI: 60.6-70.3%). The AUROC was 0.78 (95%CI: 0.75-0.81), indicating moderate accuracy. Among those scoring 8 or above, high expectations to drink post-release (AOR: 2.49; 95%CI: 1.57-3.94) and past amphetamine-type stimulant (ATS) use (AOR: 1.64; 95%CI: 1.06-2.56) were significantly associated with hazardous drinking at 3 months post-release. Results were similar at 6 months. CONCLUSIONS: Among adult prisoners in our sample, pre-release AUDIT scores predicted hazardous drinking six months after release with acceptable accuracy, sensitivity and specificity. Among prisoners screening positive on the AUDIT, expectations of post-release drinking and ATS use are potential targets for intervention to reduce future hazardous drinking.
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Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/tendencias , Recolección de Datos/normas , Prisioneros , Adulto , Consumo de Bebidas Alcohólicas/psicología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Valor Predictivo de las Pruebas , Prisioneros/psicología , Queensland/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
Twenty years after the 1994 genocide, Rwanda shows all indications of moving quickly towards socio-economic prosperity. Rwanda's community justice system, Gacaca, was to complement this prosperity by establishing peace and stability through justice, reconciliation and healing. Evaluations of the Gacaca courts' achievements from 2002 to 2012 have had widely differing conclusions. This article adds to previous evaluations by drawing attention to specific forms of relatively neglected suffering (in literature and public space) that have emerged from the Gacaca courts or were amplified by these courts and jeopardize Gacaca's objectives. The ethnographic study that informs the article was conducted in southeastern Rwanda from September 2008-December 2012 among 19 ex-prisoners and 24 women with husbands in prison including their family members, friends and neighbors. Study findings suggest that large scale imprisonment of genocide suspects coupled with Gacaca court proceedings have tainted the suffering of ex-prisoners and women with imprisoned husbands in unique ways, which makes their plight unparalleled in other countries. We argue that the nature and scale of this suffering and the potentially detrimental impact on families and communities require humanitarian action. However, in Rwanda's post-genocide reality, the suffering of these two groups is overwhelmed by that of other vulnerable groups, such as genocide survivors and orphaned children; hence it is rarely acknowledged.