When Palm Beach County, Fla., Jail inmate Onyx Ramos approached Susan Dean at the jail's annual health fair two weeks ago, he was looking for more than just a few hygiene pamphlets.

"He came up to me and said, 'I get out in 10 days, and I'm homeless. I've got places to go, but they all involve crack houses. I want somewhere else to go,'" recounted Dean, who single-handedly coordinated the 600-inmate event that attracted almost 30 health-related organizations.

One of these organizations, United Deliverance, specializes in assisting HIV-infected victims but offered to find shelter for Ramos, 35, after his release even though he wasn't HIV-positive.

"If the guy is homeless, we want to make sure that the information is in his hands," said Dean, who stressed that, though primarily a health effort, the fair assisted prisoners in several aspects of reentry. "Just giving him that one business card could have given him a choice between calling the wrong person and the right person."

Based on the theory of continuity of care, Palm County Jail's health fairs aim to educate inmates on the health resources that are available to them after release.

Over the last six years of hosting the event, Dean said, "Of course, the clientele has changed since last year. But the message is still the same, tried and true: live healthy lifestyles."

More Than Just the Usual Fair

Still, due to recent outbreaks of the antibiotic-resistant infection Methicillin-Resistant Staphylococcus aureus (MRSA) in correctional facilities across the country, Dean said it has been a much more intense, "political year" for the jail's health administration. The Palm Beach Sheriff's Office wanted this year's fair to demonstrate the jail's proactive approach to their inmates' health and hygiene. 

As opposed to a once-a-year event, Dean said the fair is part of a larger campaign to increase health awareness in the county jail. Another aspect of the effort involves Prison Health Services, the jail's medical provider. For example, PHS just recently produced videos that provide inmates with basic hygiene advice, such as hand washing and disease transmission prevention.

"We've also started to post signs around the jail that remind the prisoners to take care of themselves," Dean said. "It's definitely an ongoing thing."

Beyond Jail Walls

Though the jail's health campaign increases inmate awareness, Dean said it is also important to note that the services provided to prisoners can only travel as far as the jail's walls.

"Let's say you're already getting treatment in jail for substance abuse issues, or anger management," she said. "Once you step out of these walls, you must be able to connect with an agency or even an individual out there who understand what your needs are."

Dean said this continuity of care is not only important for the prisoners, but it is also vital for the health of the surrounding community.

"These people are coming into our communities," she said. "The healthier the individuals who come into the community are, the healthier all of us are [and] the better life is for all of us."

County Health Department Becomes Highlight of Fair

In the meantime, prisoners are able to sift through outside health services each year at the fair.

Dorm by dorm, 600 inmates from the county's medium-security facility, Stockade, were guided through booths for nation-wide, statewide and local services, from the American Lung Association to the Palm Beach County Health Department.

Human services program specialist Linda Warren, who hosted the booth for the county health department, focused her efforts on STD prevention. While demonstrating the use of a female condom, Warren handed out 10-minute phone cards to inmates who provided the best answers to HIV-related questions.

Warren said inmates were, for the most part, uninformed about the detection and prevention of the disease.

"Out of all the inmates who came through my booth, only 30 percent of them could actually give me the answers I wanted to hear," she said. "Though I'm sure sex education is being offered to them, I'm not sure that their comprehension is up to par."

Warren said she hoped that, by providing inmates with the facts on HIV, she is saving their lives and the lives of those they are close to.

"I try to keep the message of AIDS prevention broad, so that I get the message across to everyone," she said. " That way, if they understand and are concerned about it, then they will help me pass the message on."
 
Indeed, Dean noted that Warren "spoke the language of the people."

"She was very effective in talking to them, very straight-shooting about STDs and other health issues," Dean said.
Fair Promotes AIDS Testing

Warren was so effective that, by the end of the fair, she had convinced almost 270 inmates to get tested for AIDS.

Dean said the inmates would travel to the health department in groups of 50 to obtain their free AIDS tests. At the department, they will also receive pre-test counseling and become a part of the health department's database for future contact.

If inmates change their minds about being tested, Dean said they are welcome to decline, their refusal would not mean defeat.

"If they refuse, at least they now know that there is a place where they can get tested at no charge later," she said. "The message is still getting out."

But just to make sure inmates won't forget the message, they complete individual forms after the fair, requesting information from the organizations that may be able to meet their healthcare needs. Using these forms, Dean collects pamphlets, business cards and brochures from participating booths to place in the inmates' property pouches that are given to them upon release.

Dean doesn't have a way of knowing how many released offenders actually take advantage of the services that she presents each year. However, she is hopeful that those released from the jail are minding their health.

"We spend time talking to so many inmates, I don't even know if I'm making a difference," Dean said. "But if these folks aren't coming back, then maybe I am."

Resources:

To learn more about the benefits of hosting a health fair, e-mail Susan Dean at: deans@pbso.org.