Community Based Health and First Aid

In 2009, the Irish Red Cross pioneered an innovative healthcare management solution to improve health awareness and education within Ireland’s prison community. It currently serves as an International Federation of Red Cross and Red Crescent Societies (IFRC) best practice example on Community Based Health in Prisons.

The Community Based Health and First Aid (CBHFA) programme is a unique approach to improving community health, hygiene awareness and first aid skills in prisons, using groups of Irish Red Cross volunteer inmates as peer-to-peer educators. The programme has grown from strength to strength and has been running in all fourteen of Ireland’s prisons since 2014. CBHFA is run in partnership by the Irish Prison Service, the Irish Red Cross and the National Education and Training Board.

Since the CBHFA programme was introduced, there has been a measurable decrease in the percentage of fights involving illicit, handmade blades, down from 97% to 10%. Assaults have also dropped by 50%, resulting in fewer injuries and reduced prison healthcare costs.

“Governors are saying that their prisons are cleaner, more hygienic and safer places. Volunteers are passing what they have learned on to the wider community through visits from their families” said Graham Betts Symonds, CBHFA Programme Director.

Within the CBHFA programme, Irish Red Cross inmates implement prison cleaning routines and advise others on good hand washing techniques, healthy lifestyles and mental health. They also facilitate overdose prevention programmes and help people to stop smoking, as well as running accredited first aid courses. In addition, awareness raising and screening campaigns are carried out for Hepatitis C and HIV/AIDS, and the inmates promote anti-bullying and weapons amnesty projects.

Over the years, the CBHFA programme has continued to expand its services, including by training its volunteers in psychosocial care with help from the IFRC Reference Centre for Psychosocial Support. This served as a pilot for a psychosocial support training module which is being added to the eCBHFA manual – an online tool to help volunteers worldwide to build a sense of community and identify existing problems that can affect people’s health.

The CBHFA programme started by proposing the concept of “Red Cross volunteering” directly to prison inmates, promoting an alternative way to experience life in prison. Prison blocks are seen as if they were neighbourhoods; with each landing representing a street and each prison cell a household. The formal prison healthcare units are viewed as the community health centres serving these neighbourhoods. Each Irish Red Cross volunteer inmate is connected to a nurse within these health centres, ensuring quality control and linking operational health risks to all of the volunteer health and wellbeing awareness projects.

The CBHFA programme has not only achieved greater health awareness in prisons, but has also had significant impact on the personal development, agency and confidence of the Irish Red Cross volunteer inmates themselves, many of whom have changed both their behaviour and outlook. Being a part of the programme has helped to give them a sense of hope, worth and purpose.

“I didn’t appreciate life… I was hanging out on street corners taking drugs, robbing cars, doing everything I shouldn’t be doing. There were two things that changed my life… One of them was the [prison] psychologist and the other was joining the Irish Red Cross”, says Eddie, an Irish Red Cross volunteer inmate.

The Irish Red Cross and its partners are now focusing on institutionalising the CBHFA programme in Ireland and implementing it abroad so that prisons continue to be healthier and safer places, where prisoners have more opportunities for personal development. At the same time, it is hoped that this initiative will help provide a steady direction for volunteer inmates beyond the prison walls; contributing to reduced recidivism and improving overall community safety.

"Since I have been an Irish Red Cross volunteer in prison, I have friends who are drug-free and I am keeping fit. I am a caring person and not violent anymore”, shared one Irish Red Cross volunteer inmate.