Last update - 00:00 08/03/2007
TB patients declining treatment forcibly hospitalized in prisons
By Jonathan Lis, Haaretz Correspondent
In the past five years, five tuberculosis patients who declined treatment have been forcibly hospitalized in prisons for several months, even though they were not convicted of anything.
In all five cases the health authorities petitioned the court to remove the patients from the hospitals they had been in for fear they would infect others.
"The health authorities petition the court, which issues a quarantine order," said Dr. Alex Adler, the Prison Service's head doctor. "The order remains in power until the patient agrees to receive medical treatment and until the treatment is proved effective."
The Prison Service medical center is part of the Ramle prison compound, intended to provide prisoners with medical services. The TB patients were placed for several months in the special quarantine wing set up in the 1990s for prisoners who contracted tuberculosis. The last of the five civilians was released a few months ago.
"The order issued by the judge stipulates holding the patient in quarantine until he agrees to receive treatment. As time goes on, some of them are persuaded to do so," Adler said.
Even after they agree to treatment, constant medical surveillance is required to make sure they take their medicines and are improving.
"The treatment continues until the cultures show the patient ceases to be contagious. It takes more than a week or two. Finally, after their medical condition improves, the court orders their release," he said.
Tuberculosis is a bacterial disease transmitted through the air. Some 80 percent of the patients suffer from TB in the respiratory system and only they can infect others. Usually prolonged contact with a bacteria-spreading patient is needed to contract the disease.
Only one of 20 people who contract pulmonary TB will contract it within five years of exposure, unless he receives preventative treatment. A complete recovery requires continuous administration of several antibiotic medicines for at least six months.
In the past five years three to five prisoners have been interned in the prison's TB wing. Every new prisoner is tested for TB. In some cases veteran prisoners were found to have TB.
The TB wing has 12 isolated cells and an advanced air purification system. Each cell is separated from the entrance corridor by two heavy iron doors.
A prisoner suffering from TB is now hospitalized in one of the cells.
"If we discover TB in the prison we immediately open an epidemiological investigation together with the Health Ministry," Adler said.
"The ministry decides which prisoners to examine from among those who live close to the prisoner that has TB and the wardens who have been in contact with him."
The TB wing was built after a forecast that the mass immigration from the former Soviet Union would lead to an increase in the number of prisoners with TB. The wing is one of the four TB quarantine facilities in Israel.