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Caring for criminals

 Surprise (Switzerland) 16 May 2019

Drug dealers, rapists, murderers - in the Bewa, a special ward in the Bern University Hospital, in Switzerland, they are all patients. The unique security prison takes care of inmates with medical or psychological problems. A day in the only Swiss high-risk prison with high-end medical treatment. (1753 Words) - By Mena Kost

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Therese Bangartner, deputy chief warden. Photo: Annette Boutellier

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Hospital cell. Photo: Annette Boutellier

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A warden looking into the cell. Photo: Annette Boutellier

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Outside of the hospital where prisoners get their daily dose of fresh air. Photo: Annette Boutellier


"Before we enter the prison cell, we will talk about who does what: left arm, right arm, left leg, right leg, head. Then we enter the cell, lay the inmate on the floor and hold him down."

The woman wearing the light-blue polo shirt with a name tag and deep blue trousers looks serious, but not unfriendly. Her voice is calm, her words are carefully chosen. She explains the procedure when somebody loses his temper. "If the inmate doesn't calm down, he has to go into the safety cell. There are neither lamps nor TV, no glass with which he could hurt himself. But you can still destroy things, for example, tear out the lavabo from the wall. Depending on their state, people can develop immense strength."

Therese Bangerter, 46, sits at the meeting table in her office; the sun shines through the window and makes her blond hair shine. Outside the snowdrops are blooming. At the beginning of the conversation the director of the Berne Inselspital (Bewa) is a little reserved; he had too many bad experiences with the media. The Bewa for example, discretely located in one of the many clinics of the hospital, is a security prison, where inmates with medical or psychological problems are treated. Because the institution is unique in Switzerland, they all come here: Murderers, rapists, child abusers- criminals, about which the tabloids like to report. That's also why journalists have camped in front of the entrance, hoping to get a statement from the staff.

At the Bewa not only violent criminals are taken care of: here there are men and women in the penitentiary system, in imprisonment on remand or about to be deported- or not tolerable anymore in the psychiatry.

At first glance, the Bewa seems a normal ward. At the second glance: the metal doors have a closable window hatch, the so-called "Suppentörli"; in the hallway a security guard sits in front of surveillance monitors, and on the inside of the door there are no handles installed. "The only ones getting in here are the ones we let in and out anyway," said Bangerter, with her her Bernese dialect which makes everything sound a little softer and rounder. Currently, not all rooms - or "Zäuä" as Bangerter calls it - are occupied. You can spot the occupied ones because the Suppentörli is closed, meaning the inmates are in bed. In Switzerland, more men than women are in prison and therefore often on the Bewa. Nevertheless, "There are some very dangerous women in Switzerland."

Two beds, a table, a TV and a toilet, which is separated by a curtain from the rest room: at the Bewa there are only double rooms, one has no privacy here. "It is sometimes very difficult for people who have been in prison for over 20 or 25 years. They are often solitary people", says Bangerter and shrugs her shoulders: "We would experience the same: with a stranger in the room and the toilet is separated only by a curtain ... that's not nice. "

The work of the Bewa-staff - the team consists of 24 people, three of them are women - has two parts: "In the past you have called us guardians, but that is obsolete. Today, we are carers and supervisors", explains Bangerter. In addition to her job as a deputy chief she is also the head of service. On one hand, she has to provide security and order, but on the other hand she needs to care for the inmates, for example helping when someone receives a letter that they do not understand. This dichotomy is a challenge: it may be that Bangerter explains the content of a long-awaited letter from the authorities in the morning. Later that day, the inmate becomes aggressive and wrecks the room to pieces. Then Bangerter has to overpower him and take him to the safety cell. "On a personal level is not easy, we walk on a narrow bridge".

No monsters

Cancer, appendix, dental problems, an accident during sport activities in prison - the reasons why prisoners are on the Bewa are very different. "I have the impression that many people primarily end up in prison because they are mentally ill," said Bangerter. Who had a schizophrenic psychosis, often sees no limits anymore. It happens easily that boundaries are overstepped. "If drugs, such as cocaine, are involved it becomes easily to commit a crime."

Older inmates come frequently to the Bewa. First, a check and later a hospital stay. "And at some point they come to us to die," said Bangerter, shrugging her shoulders. Normally, visitors can only be received in the visiting room once a week for one hour. "But we are no monsters. If someone is very weak we decide, for example, that the sister is allowed to make an open visit to her brother."

"For me it does not matter what someone has done, I treat them all equally," clarifies senior physician Bidisha Chatterjee. The specialist in internal medicine, who in addition to the Bewa also looks after the women's prison Hindelbank, doesn't talk about inmates, but about "patients." Her office is not as Therese Bangerter's office in the administrative wing of the station, but goes off the corridor with the hospital rooms. The window is barred; across the office is a shower room, next to it a toilet and a bath. "Back pain," explains the doctor, " is a typical health problem for prisoners, just like digestive problems, weight increase and insomnia, too." It is difficult to sleep after sitting 23 hours in a cell after something terrible has happened.

"I have the impression that many people primarily end up in prison because they are mentally ill"

Even if the same medical principles are applied, the work here is different from that in other wards. When the senior physician visits the room of a patient, the supervisors need to let her out again and she always has a safety button in case a patient becomes aggressive.

Chatterjee was never scared to see a patient. The 40-year-old shakes her head smiling. "We provide care to the patients; we do not have to negotiate with them about whether they should call again or something. Many are happy to be treated "Some patients send the nurses Christmas wishes, on the grey prison paper."

Handcuffs and pepper spray

The cooperation between medical and prison staff in a confined space is not easy. Medical treatment and security conflict every day. "Of course people come to us because they are in prison. First and foremost, they are here because they are ill. That is why medicine is a priority", says the deputy head of department Bangerter. "The security must be organized around it."

For certain tests - neurological or dentistry - the inmates need to be transferred to other departments. For this, handcuffs are compulsory. "Depending on the impression we have of someone, we also put fetters, too," Bangerter says.

Despite the high security standards, there are prison inmates who want to be moved to the Bewa because they believe it will be easier to escape. Once they realise, however, that this will probably not work, they want to return to prison. "Yes... we would probably try it, too", Bangerter thoughtfully says. Since 2000, only one inmate has managed to escape, and he fortunately wasn't dangerous.

"I do not want to be quoted with my real name in the text. Maybe someone doesn't like me and will search for me." The tall man with dark hair has been working for almost four years at Bewa. He was actually trained to be a painter. "Everyone working in prison is newcomer.  Proper training is required to work in the prison", he explains.

At first he was skeptical about how he would cope with the patients, but he soon stopped worrying. "We have a wrong picture of prisoners, which probably comes from the jailbirds on TV. The cliché about the tattoos is true perhaps - but otherwise the people are like you and me. What you learn here is that the way to prison is not a far one. There are enough people who are imprisoned for minor offenses. "

A constant issue at the Bewa is privacy: "The security staff is always present during the medical examinations - whether it is at the dentist or the urologist. We see everything, even the diagnosis. Indeed, we try to stay in the background. But of course, the inmates can't forget that someone is there. "

Like dogs

"Those who work here must be philanthropists", Therese Bangerter thinks. She and her colleague, who asked to remain anonymous, make a tour of the department: waiting room, quarantine rooms, drug toilet. The latter is for body packers, people who have drugs hidden in the digestive tract. The toilet is designed so that everything that comes out of the body is immediately sucked. "Couriers from overseas have up to 100 drugs packages, called fingerlings, in the stomach. Thumb sized portions, usually packed in several layers of condoms ".

"The most difficult for me are the women imprisoned pending deportation" Bangerter says, striking her hair behind her ear. "I go with them to the hospital to do the ultrasound examinations and talk to them about the babies to come. Even at birth I am present, these women have no one else. We had a woman here who was suppose to give birth on April 20. But recently a fax has arrived from the Foreign Service. It said the woman had been deported. Now I think, of course, about how she's doing in her country of origin."

Her co-worker shares a story: "Right now we have somebody here who is violent and tied to the couch. Whenever the care staff is doing their job, I have to be there and hold him. He looks into my eyes and says: 'I'll kill you, I'll kill you, I'll kill you'. When you have a bad day you go home with an apprehensive feeling."

And yet, they don't feel fear. Bangerter says: "It's the same with dogs. They also realise when you're afraid".

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