Corrections_Today_Fall_2025_Vol.87_No.3

COMMITTEES

for support. After that, I had to give him a few minutes to recover before the next patient. Immediately after ‘operation her nia plop’ Ivan, the CEO of Health through Walls, found me and was proud to announce he had found crutches in a local pharmacy for the amputee we saw yesterday. They cost a little more than we thought they would, around $60, but I was happy to pay. The plan was to go back inside the prison and pres ent them to him. I was hesitant at first regarding this, as I didn’t feel I wanted any recognition for it, but I also did want a chance to see the inside of the prison again. The director escorted a few of us inside the prison into the main atrium. As before, a sea of men crowded the main living area. The man in question was called front and center, and out of the fog of bod ies he hopped his way to us. Words were said in their local language as I took the crutches out of the new wrapper and presented them to him. The room was silent as the director said some words and the inmates clapped in appreciation. At one point, as we were helping him adjust them, there was a moment of quiet in the entire facility. That quiet and small moment gave birth to a sense of shared humanity. This feeling was ever-present the entire trip, but somehow always felt just out of reach as it sat below a layer of control that clearly separated the incarcerated from the free. In that moment, if only for an instant, the veil of that layer was lifted, and we all felt, in one way or another, the weight of being able to connect with these fellow humans.

After this experience, there was little time to recalibrate as patients were stacking up back at my station. Part of the art of medicine is to walk through profound situations, be able to absorb, appreciate, and even learn from the lesson, but then to quickly fall back into stride. It’s easy to do this and be cold, or jaded; it’s much more difficult to switch this fast and maintain compassion and empathy. We were now well into the wom en’s prison, and my first patient was a kind lady who had been complain ing of chest pain for several weeks. I did a double take when looking at her blood pressure, and had to find another cuff to confirm it, as it read 235/154. I immediately handed her over to Dr. M, thinking that the ap propriate intervention would be to send her straight to the hospital. He spoke little English and I didn’t have my translator with me, but watched him take a few pills from his bag and give them to her, say some words, and send her on her way. As the day went on, I kept worrying about this woman, waiting for someone to report back that she was having an active stroke somewhere. About an hour later, I saw her with all of her things being escorted out of the compound. I asked Dr. M with relief if she was going to the hospital. He responded that today just happened to be the day she was released. So, with that, she was on her own. Around 3 p.m. on day three, we had finished screening all the inmates, and to my surprise, we had been requested to now also screen staff. This was mostly a surprise be cause, as in the U.S. and many parts of the world, the local guards are not interested in being seen by the

prison healthcare system. However, we learned that in Xai-Xai, many of the staff also see the prison nurse and doctor on a regular basis, so this stigma did not exist. There were about 40 staff members in all. We used the same screening protocol for TB, HIV, and any other concerns they wished to discuss, but it quickly became more of a general primary care wellness check. I was able to provide some education on stress management, headaches and food journaling for IBS, and I also did some motivation al interviewing to encourage a few staff members to consistently take their blood pressure medications. Day 4 Our mission at the prison in Xai-Xai was complete, and now we were going to run a quick operation on the last day at a more remote, smaller facility outside of town. At this point, I was feeling a bit run down from the last few days, the 43 hours of travel to get here, and whatever sickness or wood smoke had settled into my sinuses, so I was just surfing the wave. We drove for about 30 minutes, the last portion of which was a small dirt road. This was an open-air prison that was maybe 200 feet long and looked like an old barracks out of a long-forgotten war. We set up shop and recalibrated our workflow amongst the papaya trees and soft sand. Once again, the machine of our operation cycled on as we churned out another 100 or so exams. We finished the day around noon and, in the lightly falling rain, stood in a circle giving thanks to all the

Fall 2025 | Corrections Today

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