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The ICRC recently held their first ever Asian Pacific Conference on prison health in Bangkok, Thailand. Having arrived the previous evening and suffering badly from jetlag, I was delighted to taste some strong coffee on the first morning of the conference – this, I thought, would get me through the next three days. But the caffeine really wasn’t needed at all – it was such an exceptional event: well organised, stimulating and enlightening. No one, not even the most sleep-deprived of travellers, would have countenanced dozing off!
 
The participants came from a broad range of professions working in prison health and from many countries in the region – Australia, Bangladesh, Cambodia, India, Indonesia, Japan, Myanmar, Malaysia, Pakistan, Papua New Guinea, Philippines, Sri Lanka and, of course, Thailand. There was also a scattering of us from across the globe, for example Colombia, Rwanda, Spain, the UK and USA. Each session was themed and there was breadth here too with themes covering many important topics from health management information systems to healthy prison design. We enjoyed some fantastic presentations; without exception they were eye-opening, edifying and enlightening. As with the best conferences, the questions and discussion following the presentations were also illuminating and interesting, providing an opportunity for participants who perhaps did not have a formal presentation, to speak about their experience and practise.
 
All presentations were of such a high standard that it is hard to single out any one in particular. However, given that there is limited space here in this blog, two in particular stand out. The first was a candid account of the issues faced delivering health care to people in prison in the Papua New Guinea from Ms Napina Yumb, Medical Services of PNG Correctional Services. There are only about 5,000 people in prison in PNG but there are considerable challenges such as financing and a lack of health information systems. Whilst health care might be equivalent to the care provided for the majority of the population in PNG, this was far from ideal as the majority of people in PNG have poor access to health services. The second was from Dr Zulma Rueda from Pontifica Bolivarian University in Medellin, Colombia in South America. She presented a clear account of her work on active and latent TB in prisons in Medellin, questioning some aspects of WHO guidelines for the management of TB in prisons. We hope to hear more from Dr Rueda and WHO in March 2018, when TB will be the theme of the month for WEPHREN.
 
Despite the variety of speakers, topics and locations, there were clear themes that recurred throughout the three days. Almost all speakers highlighted the financial constraints that they encountered; these limited their ability to provide the high quality health care that they aspired to provide. Not unrelated to this were issues of inadequate health information systems in prisons and the difficulties with human resources, particularly recruiting and retaining sufficient staff. Two key issues that have been considered carefully by organisations such as WHO Health in Prisons Programme, were also were raised many times: the concept of equivalence of care for people in prison and issues around prison health governance. However, many speakers also emphasised the importance of good communication. Whether between staff and those detained in prison, or between different professional groups with competing priorities, good interpersonal relations were an important aspect of ensuring good health care in prison.
 
The conference provided a great opportunity for all of us who feel passionately about the health of people in prison to meet with like-minded professionals and share and exchange information and ideas. There was a huge energy amongst participants but I was struck that so many of us, whether practitioners, researchers or policy makers, feel isolated in our work and want to share experiences and learn from others. WEPHREN of course has an important role to play in linking professionals together and we hope to engage more with this region in the future. But I am also sure that there are many of us hope that this will be just the first of many ICRC Asian Pacific conferences on prison health!