A quarter of the prison population at Westgate recently took part in an innovative new programme aimed at improving self esteem, self respect and discipline.

Some 53 inmates at the prison participated in a six-week, three-phase Dental Health Education Programme aiming at providing an awareness of dental hygiene and promoting the need for accountability of one's dental health.

By all accounts the programme was very successful and already other inmates have expressed interest in being a part of the programme when it resumes next summer.

The qualifying criteria was that only those serving long prison sentences of two years or more were eligible. Otherwise they had to be referred by the Government Dentist to the Dental Hygienist Brenda Harris-Scott who facilitated the programme along with Dental Assistant Joy Smith.

Those inmates participating were split into classes of six to eight each and for four days a week during the summer they were involved in classroom education regarding dental hygiene; oral hygiene instruction in dental surgery and treatment which included scaling and polishing. They got the chance to watch closely as a patient's teeth were examined.

It is a comprehensive programme that will be offered on an annual basis, but Senior Nursing Officer at Westgate, Russ Ford, pointed out that it is also a strict programme with rules for continued participation.

"In six months' time they will come back for reviews and the persons who have done everything they are supposed to do, such as cutting down or quitting smoking, will be eligible to have their teeth cleaned at that time or they will be taken off the programme," said Ford.

Other requirements are that the participants must floss daily, dress properly, abstain from foul or abusive language and show the appropriate respect for the programme staff, prison staff and other inmates.

"The whole purpose of the programme is to ensure that the guys take responsibility for their own dental hygiene," said Mr. Ford who pointed out that the special type of floss used by the inmates does not pose a security risk.

"The philosophy is that if they can apply the effort and determination in taking care of their teeth, then they can apply it to other areas of their lives which require discipline. It's not just about cleaning teeth, it's about improving self esteem, self discipline and self respect.

"There is peer support and peer pressure in that they will monitor each other to ensure they are doing the right things. And when they leave prison, because of what they have learned, they can teach it to their significant others.

"Any programme that we do, whether it's medical or other areas of the prison, it has to be geared with one end in mind ... to ensure that when people leave here their way of thinking is different. So that we can have more productive citizens."

Mrs. Harris-Scott first discussed the programme with Senior Dental Officer, Dr. Celia Nzabalinda, and Ford and decided summer would be better as the Hygienist also had responsibilities for the Government schools.

"In my first meeting with Dr. Nzabalinda regarding my treatment with the prisoners she said 'I would like for you to do 18 hours a year minimum'," said Mrs. Harris-Scott.

"Russ was getting on my back about it and I told him 'you know I always give you extra hours during the summer' and then something sparked and I said why not do an educational programme along with the treatment, which we had never done before."

They were all surprised at the response as the inmates showed great enthusiasm for the new programme.

"I thought it was going to be 25 to 30 prisoners and when we started bringing them in and explained to them that we were doing an educational programme and that there was going to be a test at the end, the response was very good," explained Mrs. Harris-Scott.

"They were very enthusiastic, showed a lot of attention and then we decided to extend it to 35 which went to 40 and we ended up with over 50 patients. That was not my intention but it was chiefly because of the fact they showed a lot of enthusiasm.

"A lot of the young men here have a lot of tobacco stains because they do a lot of smoking and they have a lot of calculus which is the hardening of the plaque.

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What I would do with the prisoners with a lot of calculus and stains is do only a few teeth at a time to let them see the difference when they were cleaned up.

"They were so overwhelmed with what their teeth looked like they were blown away. Russ said he noticed they were brushing all the time. They felt good knowing that their teeth looked as good as they did.

"I had a few that came with attitudes but at the end of the day I noticed a change in the way they talked and walked. Some didn't even talk much and then they became very, very talkative. I think it helped to give them a bit of self esteem as well."

Despite the large number, the hygienists made it a point of establishing a rapport with the prisoners.

"I made sure to try to remember their names because I felt that was also important," said Mrs. Harris-Scott.

"If you remember someone's name it makes them feel special. When they come in they are called by name and if they do well I let them know how proud I am of them."

Dr. Nzabalinda explained that two dental officers and their assistants provide care to the entire prison population.

"The dental officer in St. George's provides care for those at the Prison Farm and Co-ed Facility and the dental officer for the Somerset clinic provides care for the prisoners at Westgate," she said.

"We have a little bit more than a half a day per week that is devoted to care here at the (Westgate) prison and at times find it is insufficient, but with the present staffing that is as much as we can do."

She added: "The prisoners who have been incarcerated for more than two years are eligible for comprehensive care, and prisoners who are incarcerated for less than two years are generally eligible for emergency care only. However we have the discretion to provide some comprehensive care if we feel that they are likely to have a significant number of emergencies within that period of time.

"One of the problems we encounter with the population of inmates that we have, and the time we have available, is that sometimes we are so busy dealing with emergencies that we can't get enough time to render the kind of comprehensive care that some of the prisoners need.

Showing the longer term prisoners how to care for their teeth can be beneficial for both the prisoners and the prison department in the long long run, believes Dr. Nzabalinda.

"One of my long term objectives for this programme is that with this programme being conducted on a regular basis we will eventually see fewer emergencies amongst the long term prisoners," she stressed.

"It's more beneficial that we render the comprehensive care than constantly be dealing with one emergency after another."

Said Mr. Ford: "Currently we only have a dentist coming in one morning out of the week which is totally inadequate for what our needs are. The prison population has changed over the years, you have a younger population and a population that has not taken care of their dental hygiene.

"Of the 53 people who participated only half a dozen of those persons were doing sentences under two years. The rest were doing anywhere from two years to 33 years.

"And of the 53 in the programme, only four were putting in (requesting) for regular dental floss."

Mrs. Harris-Scott put the percentage of those participating in the programme at "about 20 or 25 per cent" who had good oral hygiene from the start.

"I remember one guy here who has never had a cavity," recalled Mrs. Smith.

"I don't know what the morale was like before we started this programme but when they walked out of here their spirits were very high and they were interested in spreading the word and wanted to come back."

Mr. Ford recently attended a conference put on by the American Correctional Association in Philadelphia which attracted some 6,000 delegates from prisons all over the world that has a dental hygiene programme.

"I asked around and there isn't any prison that I know of that has a programme set up like this that is so comprehensive," said Mr. Ford.

"I hoping, and this would be a long term goal, that we can use this as a model programme for other prisons across the waters. I think that can happen, because this programme is pretty well structured."

Mr. Ford has an answer to those who have their doubts about the programme.

"There may be people out there who will say 'these guys come to jail, why are we doing this for these murderers and rapists?'

"We're doing it simply because at the end of the day we hope to return people back into the community who feel a bit better about themselves prior to when they came in.

"It will have a knock-on effect as it relates to the recidivism level and also the overall crime. If I felt this programme was only about cleaning teeth it (programme) wouldn't happen.

"The end result of this programme is to have a person return back to society as being more responsible, more productive and more disciplined, with enhanced self esteem and self respect."