Supporting "special" patients

(Baonghean) - “To others, they are prisoners, they may have been stripped of their citizenship rights, they are suffering legal punishment, but to us, they are patients like any other, needing a hand to soothe their pain, needing a companion in the fight against illness. That is the mindset of the prison doctors...”

Lieutenant Colonel - Doctor Dau Duc Dung, after obtaining permission from the Supervisory Board of the Nghe An Provincial Police Detention Center, led us down to the unit's infirmary located behind the rows of detention buildings. It was already 11 a.m., and the doctors at the infirmary were still working diligently. Some were checking the list of inmates to be transferred for treatment that day, while others were examining patients in each room. If it weren't for the closed doors of the infirmary rooms and the striped uniforms, one might have found this place truly peaceful, with roses of various colors blooming brightly in the small garden in front.

Lieutenant Colonel - Doctor Dau Duc Dung examines a prisoner.

With only 6 medical staff members, including 1 doctor, they have to care for and treat 10-15 patients daily at the infirmary, dispense medication, and monitor the health of approximately 70-80 other patients, including about 60-70 HIV-infected patients. The prison doctors have many additional responsibilities, such as coordinating with on-duty officers to check and report on the health status of all newly admitted inmates for classification: whether they use drugs (if so, they must undergo rehabilitation first), monitoring and managing those with chronic illnesses, treating those with acute illnesses on-site, and advising on maternity leave for pregnant inmates who are still incarcerated. Furthermore, the doctors must accompany inmates to court hearings to provide healthcare and follow them when they are transferred between prisons. And it's not just about treating illnesses with medicine; the doctors and nurses at the detention center also volunteer to provide psychological "treatment" for the detainees.

For over 30 years in the profession, Dr. Dau Duc Dung has spent 20 years providing healthcare to detainees. In 1979, after graduating from a medical vocational school, he joined the police force and was assigned to the Nam Can Border Gate Post (Ky Son). Later, he worked at the Detention Center, then transferred to the Provincial Police Clinic, pursued further studies at Hue University of Medicine, and finally returned to the Detention Center to provide healthcare for detainees. We asked him: “So, during your career, you've cared for two groups of people: police officers and soldiers, and detainees. Do you see any difference in your work?” Dũng replied, "When standing before a doctor, everyone is just a patient. There is no status or distance between patients. To society, they may be prisoners or dangerous individuals, but before a doctor, they are still vulnerable people who need a comforting hand, a trustworthy companion in their fight for survival. That is something we doctors here deeply cherish and remember."

If there is any difference, according to Dr. Dung, it is the way patients behave towards their doctors. Ordinary patients, or officers and soldiers, honestly describe the progression of their illness and cooperate with doctors to find the root cause and treatment. However, many patients who are inmates are uncooperative, even defiant, or try to "deceive" the medical staff. Hundreds of thousands of ways to deal with the tricks of these patients have been accumulated by prison doctors over time. "No book teaches this; we have to become psychologists ourselves," Dr. Dung shared. The prison holds thousands of inmates, most of whom are notorious criminals with a history of wrongdoing outside of prison, many of them awaiting execution. Therefore, the psychology of these individuals is extremely complex.

Mr. Dung told us about cases of inmates trying every possible way to evade forced labor or escape from prison. Some prisoners burned plastic bags, dripped the ashes into their stomachs, causing burns, and then poured dirty water on the wounds to infect them. Others tried to swallow hard objects they obtained from work tools or personal belongings: razor blades, broken pieces of pottery, or even toothbrushes, toothpaste, or dish soap to… feign illness and be taken to the hospital. Sometimes, inmates would claim to have swallowed something, but it was often a lie, so doctors had to psychologically assess whether the statement was truthful.

There are also inmates who come here and feign mental illness to evade legal punishment. These are truly "difficult cases" for prison doctors. The assessment must be sent to a psychiatric hospital. Besides that, there are inmates who constantly try to end their lives. The majority of these are those with heavy sentences or serious illnesses, including HIV infection. Some try to bang their heads against the wall, others try to cut the veins in their arms. Dung vividly remembers the time inmate T, convicted of drug offenses and infected with HIV, attempted suicide by banging his head against the wall. The prison officers were at a loss as to how to handle the situation because the inmate was extremely aggressive, and blood was gushing from his head. At that moment, Dung had to intervene. Standing in the cell, he used every word to persuade him: "I am Dr. Dung. You are in so much pain right now, and as doctors, we have a responsibility to save lives, so I'm here to be with you. The law will determine what is right and wrong in your case, but please remain calm so I can bandage your wounds and fulfill my duty as a doctor to my patient."

Finally, Dr. Dung managed to persuade the individual to allow him to receive bandaging and treatment. On another occasion, Nguyen Van L., a dangerous individual with late-stage HIV and pulmonary tuberculosis, was brought to the Nghe An Tuberculosis and Lung Disease Hospital for treatment. There, in a moment of carelessness on the part of the staff and doctors, the individual used a hard object to cut a vein in his arm. The doctors at the hospital hesitated to intervene due to the individual's attitude and the severity of his illness. Ultimately, Dr. Dung was called in to encourage and provide emergency treatment to the individual.

Perhaps most notably, are those arrested while pregnant. As special cases, they are not allowed bail and are forced into detention. The children born in prison have brought a glimmer of goodness to the lives of these mothers. The prison doctors are the ones who see this most clearly, and they feel the most sorrow. “We look at these innocent children. Their eyes are as clear as any other child in the world. They don’t know how special and difficult the circumstances of their birth were. The more we look at them, the more we blame their parents. They have deprived them of the most beautiful childhood. All regrets, at that moment, feel so too late.”

Dr. Dung himself had assisted in a childbirth in a prison cell many years ago. It was an unavoidable situation, and in the unexpected labor pains of a female inmate, he was forced to act as an obstetrician. Many inmates who gave birth in the prison asked the doctors to name their children. The children of inmates Vi Thi N. and Vi Thi M. were given names imbued with hope and a desire for goodness, with the hope that they would follow a different path than their mothers had mistakenly taken. Currently, there is one inmate raising a young child in the prison, and two others are awaiting childbirth. When we arrived, we could hear the soft lullaby of female inmate Vi Thi M. in a room in the infirmary.

The lullaby was indistinct, just the low, rising sounds in the chest of the young, guilty mother. Mr. Dung explained that preparing for a child's birth in the camp required meticulous preparation, followed by the responsibility of caring for the child until the mother's sentence took effect. The children still had their "full-month" anniversaries, holidays, and Children's Day celebrations, all thanks to the doctors' kindness. Previously, the doctors themselves handled the birth certificates for the children. Nurse Ngo Thi Hoan, with 30 years of experience (currently awaiting retirement), has welcomed nearly 20 children into the camp and personally processed birth certificates for more than half of them.

It's probably unnecessary to elaborate, but it's clear that prison doctors face numerous dangers. However, what's remarkable is the quietude and joy they find within themselves. It's not simply orders from superiors or organizational assignments that keep them in this perilous profession, but a higher purpose stemming from the heart of a doctor. Like Dr. Dung, who is the head of the logistics department and the head of the infirmary, but first and foremost a doctor with many concerns: “Before, equipment was scarce; the only equipment for caring for inmates was a stethoscope. Now we have ultrasound machines and laboratory equipment, so the care has improved, and we doctors feel more at ease!”

Working in this environment, one might expect to have a heart of steel, but the doctors at the Provincial Police Detention Center think differently. They need to be "softer," to soothe the wounds not only on the patients' bodies. Every day, they witness inmates facing death sentences, see them suffering from tuberculosis, HIV, and even those who have wished to die, but at all costs, they fulfill their sacred duty of "saving lives." They collaborate with leading specialists in Nghe An province and the provincial hospital to care for critically ill patients, such as the case of LC, a notorious criminal (arrested for assault), who suffered from heart failure and received intensive treatment from the doctors for eight months.

"When patients are close to death, we realize just how intense the desire to live is in each person. It is here that we see even more clearly the sacredness of the work we do," Dr. Dung said before we left with a firm handshake...

Post:T.Vinh;Image:T. Son