Bay Area Reporter - October 19, 2000
Katie Szymanski

The prison guards were polite and welcoming. The visiting room was adorned with a multicultural mural. And rumors even circulated that some prisoners who had previously been denied medical care were coincidentally beginning treatment that very same day.

But the charade was unsuccessful.

From the onset, the corrections department was clearly on the defensive. Testimony from more than a dozen prisoners described healthcare scenarios worse than "something the Three Stooges would do on Saturday Night Live," as one woman's husband summarized for the eight-member legislative panel.

The hearing in Chowchilla - home of the state's two largest women's facilities - was the first of two called by state Senator Richard Polanco (D-Los Angeles); it was followed by a hearing in Los Angeles that focused on sexual abuse by prison guards. Others presiding were state Senator Cathie Wright (R-Simi Valley) and Assemblyman Carl Washington (D-Paramount), and representatives of additional legislators including state Senator John Burton (D-San Francisco).

The testimony from prisoners and advocates was enough to evoke bipartisan disgust, prompting lawmakers to comment, "What I heard today curdled my stomach," (Wright) and "It seems as though most cats and dogs are treated better" (Washington).

Personal stories indicated that the moment women enter the correctional system - mostly for nonviolent offenses or crimes of self-defense - they become throwaways, not worthy of the most basic acts of humanity.

Compounding this stigma is the fact that the women's Medical Technical Assistants are also trained prison guards and responsible for their punishment, a duality not practiced in any other large state, according to Dr. Corey Weinstein, a consultant to many Bay Area prisoners' rights groups.

Thus, treatable illnesses become terminal and HIV regimens are sometimes prescribed without any thought to how they might interact with other medications or health conditions. Women often have to walk across prison grounds to get back to their cells after major surgery. Pain medication is not available to them should they happen to return from surgery between the hours of 8 p.m. and 6 a.m., testified the prison's own doctor.

Breast lumps and vaginal tumors are left untreated for months, often addressed only when survival is no longer an option. A typical HIV-positive woman has no confidentiality because she must stand in a public medicine line, and if she is like many prisoners with HIV, she is co-infected with the liver-damaging hepatitis C, a condition that can be fatal in the company of the prison's liver-toxic AIDS formulary. At least two women died last year when they were given tuberculosis medicines despite the fact that they did not have the disease; the meds killed their livers, their waist sizes bloating to over 60 inches in the months before they passed away. A woman with cancer was dropped post-surgery, causing her stitches to tear open. Many women discovered by accident that they tested positive for certain diseases and never were told. Others are still waiting to be retested four years after the prison discovered that its contracted laboratory faked hundreds of HIV, hepatitis, and cancer results. And these examples are just a sampling of conditions that lawmakers during the hearing frequently validated as outrageous.

"What I'm hearing from these women is that they're willing to do their time," said Washington. "Just treat them like human beings."

"We're not asking for Kaiser to come set themselves up in here," said prisoner Ellen Richardson.

In fact most women are just hoping to get out alive.

Recommendations made to the legislators included separating prison guard duties from medical duties, considering that an attitude of punishment is in direct opposition to the cooperative relationship required by medicine.

Other issues to be examined are whether women's prisons are modeled too closely after men's for everything from diet to preventative care; how to ensure healthcare access to women who can't speak English or justify in writing why they believe they have an emergency; and if perhaps, considering the high HIV and hepatitis C rates in prison, it might make sense to hire a few specialists.

Dying alone

The need for compassionate release was also emphasized for women prisoners with less than six months to live. Doctors are often reluctant to declare the women as "dying," and even when they do, the law - meant to allow prisoners to die among loved ones - is extremely hard to implement. Some legislators and prison officials had been pointing to the prison's new hospice as a step in the right direction, but attorney Cynthia Chandler, co-director of the Oakland-based Justice Network On Women, said the facility was being used as an excuse not to grant compassionate release. "They still die alone," said Chandler.

But even making it into the hospice, skilled nursing facility, or outside hospital for treatment is nearly impossible.

"Nothing qualifies as an emergency condition in here," testified prisoner Beverly Henry, "except maybe seizures à and what's the other emergency condition? Oh yeah, death." She and her fellow prisoners on the women with HIV/hep C panel burst into laughter over the ridiculous situations they endure.

Additionally, advocates from San Francisco's Legal Services for Prisoners with Children emphasized that in order for rehabilitation to occur and society to function, children of prisoners cannot be permanently taken away from their mothers.

The Department of Corrections had a chance to defend itself at the end of the hearing, and all but one of the medical staff members were notably absent from the two rows of chairs reserved for them. Dr. Susann Steinberg, deputy director of healthcare services, addressed the accusations by telling the legislators and crowd of prisoners' rights advocates, "I am the person with the greatest compassion for these prisoners in this room." Steinberg also claimed that most women refuse follow-up care, that many of them were used to being victims, and that much of the day's testimony was false. Perhaps she forgot that she was speaking at the very prison where a doctor recently told Ted Koppel's Nightline that he gave women Pap smears for their headaches because they enjoyed excessive pelvic exams; after all "It is the only male contact they get."

But neither the crowd nor the legislators were inclined to let the department off easy last Wednesday. In fact state officials made it very clear that they believed the women's horror stories, and warned the prison staff that they would suffer consequences if any retaliation should be directed toward those who testified.

It is a shaky time for prison healthcare reform, as certain provisions provided by the 1995 class-action lawsuit Shumate v. Department of Corrections case have expired, and many are worried that with less supervision, California prisons will become even worse than they were before the Shumate suit. Despite policy changes over the past several years, "What you see on paper, and what actually happens, are two different stories," said Judy Greenspan of the HIV in Prison Committee of California Prison Focus. People inside and outside alike, therefore, are cautiously optimistic about how much the legislature can do for an environment that is nearly immune to the law.

"You have in effect received two sentences," said Senator Wright to the prisoners. "One from the courts and another from the institution."

"What they've done to my daughter in here," echoed one mother, "they'd be arrested for on the street. And yet the state of California pays them for it."

There's barely a woman in this country who hasn't, at some point during her life, realized that she must make major changes in order to be free of burdens and look to the future. For many, a decent salary, non-abusive relationship, and good education makes these changes relatively easy. But for other women, the only chance for survival may be punishable by law.

Some call it a tough break, others call it rightful punishment, but few can dispute that it's the people without privilege who are doing 20 years for carrying $3 worth of heroin. Still, that sentence is a dream, say the prisoners, compared to the death sentence they feel surely awaits them should they ever need medical attention.

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