Deadly Health Care at California Women's Prisons

Revolutionary Worker #1090, February 11, 2001, posted at

"As an advocate for women prisoners for almost 25 years, I have interviewed thousands of incarcerated women, and their stories paint a consistent picture of systematic medical neglect that would horrify the average citizen if he or she knew it were happening in the 'free world.' "

Ellen Barry, attorney, Legal Services
for Prisoners with Children

Pamela Coffey was from Los Angeles. She was 46 years old. Her sentence for narcotic sales turned into a death sentence. Pamela died Dec. 2 in front of her cellmates after complaining for weeks about a large knot in her side. Inmates say the only treatment she received from prison medical staff was an antihistamine Benadryl. The inmates say one of the prison's medical technical assistants, or MTAs--guards with minimal training who are responsible for determining whether prisoners have access to other medical staff--disregarded Coffey's complaints less than an hour before her death. "I looked at her stomach and it had blown up, like she was pregnant nine months with twins," said Rhonda Smith, Coffey's cellmate. By the time an MTA arrived 45 minutes later, Smith said, Coffey could barely speak and could not sit up. After examining Coffey, the MTA said he couldn't understand what she was saying, Smith said. "He said, 'You could do more for her than I can.' He just laughed and walked away." After her death it was determined that Coffey's tongue had swollen, making it difficult for the medical assistant to understand her. The cause of her death is not yet known.

Two days later, at the same prison in Chowchilla in California's central valley, Michelle Wilson, 36, died four months after brain surgery for a tumor. She had served five years of a 10-year sentence for credit card fraud. Prisoner advocates say that Wilson was not given timely or proper treatment and that this contributed to her death.

Five days after Wilson's death, Stephanie Hardie, 34, of Pomona, died in her cell. Inmates say the prison's MTAs took about 15 minutes to respond after Stephanie collapsed in her cell. A fellow inmate administered CPR until medical help arrived. Bobbie Smith, a cellmate, said Stephanie had been complaining of chest pains for weeks, saying "that it felt like someone was squeezing her heart."

Five days after Stephanie died in her cell Carolina Paredes, 67, who was in prison for real estate fraud, died of cancer. Prisoner advocates also claim that Carolina's death was caused by late and improper care.

The very next day prison activists were visiting the prison, conducting interviews with prisoners about treatment for HIV and hepatitis C. Suddenly, just outside the visiting area, prisoner Eva Vallario, 33 years old, collapsed and died after being strip-searched and complaining to staff that she was having difficulty breathing. A report by a professor at the University of California at San Francisco revealed that better treatment might have saved her life. The report by Dr. Kathleen Clanon, released on January 30, concluded, "There is a substantial likelihood that she could have been resuscitated if she had been ventilated earlier." The report contradicts an earlier version of Vallario's death given by prison officials.

In the last two months, there have been nine deaths at Central California Women's Facility (CCWF) in Chowchilla. CCWF and Valley State Prison for Women (VSP), also in Chowchilla, make up the largest prison complex for women in the world. They imprison 60% of California's women prisoners. Together they hold over 7,000 women. These deaths are part of a systematic denial of even minimal health care to prisoners.

Amnesty International issued a statement on December 20 raising concern about the deaths at CCWF and calling for an independent investigation. "The recent deaths of seven women prisoners [two women have died since the AI statement was released--RW] in a California prison points to the pressing need for independent scrutiny of medical care," Amnesty International said. "For several years we have received complaints about the inadequacy of medical care--and delays in treatment--in women's prisons in California. What is particularly alarming now is that these deaths have come just weeks after state legislative hearingsÊraised concerns about medical neglect in these facilities."Ê

Pattern of Medical Neglect

"Nothing qualifies as an emergency condition in here except maybe a seizure and what's the other emergency condition? Oh yeah, death."

A woman prisoner testifying
in front of a State Senate Panel at
Valley State Prison, October 2000

Prison authorities have tried to claim that there is nothing wrong with health care at the prison and that the prisoners would have died anyway. They claim that the women are lying about the medical treatment at the prison and that they create the problems themselves. They have even circulated rumors that the deaths were caused by bad drugs at the prison--a claim for which there is absolutely no evidence.

The truth is that there is a long and shocking history of inhumane medical care for women prisoners. In 1995, 24 women prisoners, many with life-threatening illnesses, filed a suit against California Governor Pete Wilson and the Department of Corrections charging them with systematic denial of necessary medical care. Clarisse Shumate, the lead plaintiff in the lawsuit, suffers from sickle cell anemia and was denied basic medical care, forcing her to go into repeated health emergencies. The case was settled conditionally in 1997 and the state promised to improve the medical care given to women prisoners. As part of the settlement the court ordered audits of medical services at two women's prisons. The suit did not cover CCWF, which had not yet opened in 1995 when the suit was filed. On December 20, just as the death toll at CCWF was mounting, the court auditor released a favorable report on health care at the two prisons. If the judge approves the report then the lawsuit will not go forward. This report is a green light to prison authorities to continue their inhumane treatment of women prisoners.

In 1999 Amnesty International released its own report based on an investigation of conditions at Valley State Prison. The report documents:

Women patients in the secure ward at a local hospital are routinely shackled to their beds. A terminally ill woman could be allowed to die in shackles.

Male guards are allowed in the reception area where women are strip-searched. Male guards are allowed to observe the area where women prisoners shower. Male guards are allowed to pat search women prisoners.

MTAs disrespect women prisoners. "Let's let in the geese," an MTA commented as he unlocked the door from the yard to let in women waiting to see a doctor or nurse during the Amnesty International visit.

As is the case throughout California's prisons a medical co-payment system is in effect which restricts access to healthcare. A $5 co-payment is required before patients can see a doctor unless a prisoner is indigent. Indigent is defined by the prison as a prisoner's account having less than $5 for 30 days. Maximum wages in the prison are 30 cents an hour and many women make as little as 5 cents per hour, meaning that they have to work 100 hours to afford a visit to the doctor.

Women interviewed by Amnesty International at VSP reported having to wait 4 to 6 weeks to be seen by a doctor in prison and months to be seen by an outside specialist.

Women suffering from persistent painful conditions were just given ibuprofen. In October 1998 a woman prisoner had a miscarriage after having bled for two weeks without adequate medical attention. Another woman told Amnesty International that she did not get an annual check-up despite having received a hysterectomy due to cancer.

In 1999, ABC Nightline ran an investigative series on conditions of women in prison focusing on VSP. "I have a heart condition and I've gone for weeks at a time without my heart medication, " said an inmate at Valley State Prison interviewed for the series. Another inmate told Nightline that the lump she discovered in her breast was not treated for seven months. By the time the lump was removed the cancer had spread to her lymph nodes. Laurie McClary told Nightline that it's not unusual for an inmate to request ibuprofen from the prison pharmacy and receive something like heart medication instead.

According to Nightline, prisoners at VSP filed, on the average, 400 medical complaints each month in 1999. One common complaint was unnecessary and unwanted cervical exams and PAP smears. "I went to see [the prison doctor] to ask him if he could give me a blood test to see if I have arthritis. He wanted to give me a PAP smear and I didn't understand. What's that have to do with it?" one prisoner asked.

Dr. Anthony DiDimenico, at the time Chief Medical Officer at Valley State Prison, told Ted Koppel: "This is a group of women that are isolated. And I've heard women tell me that they would deliberately like to get examined - it's the only male contact they get." DiDimenico's shocking taped comments provoked a storm of outrage and he was reassigned within the California Department of Corrections.

On October 11, a State Senate Panel conducted a hearing at Valley State Prison and many women prisoners courageously stepped forward to give testimony about conditions at the prison. Among the facts brought out by the women:

HIV drug regimens are prescribed without thought of how they might interact with other medications or conditions.

Women have to walk across prison grounds to get back to their cells after major surgery. No pain medication is available to them should they return to their cells between 8 p.m. and 6 a.m.

Breast lumps and vaginal tumors are left untreated for months until they become a death sentence.

At least two women died in 1999 when they were given tuberculosis medicine despite the fact that they did not have the disease; the meds killed their livers, and their waists bloated to over 60 inches before their deaths.

The prison's contracted laboratory faked hundreds of HIV, hepatitis and cancer tests. Some women are still waiting to be tested four years later.

Earlier Deaths at CCWF

There is a history to this murderous health care at CCWF. A 1999 Op-Ed piece in the Los Angeles Times by Ellen Barry, Founding Director of Legal Services for Prisoners with Children, exposed some previous cases:

In the spring of 1997, Mia Doiron entered the CCWF to serve a one-year sentence for drug possession. By Feb. 20, 1999, she was dead. Mia first requested medical attention in September 1997 for severe pain in her leg. She did not obtain the correct diagnosis of bone cancer for another five months. Had she been diagnosed and treated properly in the early stages of her illness, her survival rate was estimated by a medical report to be about 90%. By the time she left prison, however, and was able to seek treatment on her own, her cancer was so aggressive that her chances for survival were just 10%. She suffered the amputation of her leg, trying to save her life, but it was too late.

Tina Balagno was sentenced to four years in prison on drug charges in June 1998. While in custody at CCWF, she discovered breast lumps and was diagnosed with breast cancer. As with Mia Doiron's case, a series of delays in medical care resulted in receiving no treatment for five months. Balagno had a mastectomy, but it was too late for her as well. The cancer had metastasized to her bones, leaving her in excruciating pain. While in the prison system's Skilled Nursing Facility, Tina was never given sufficient pain medication to keep her comfortable. She received no assistance with eating or bathing, even though she was too ill to move. In February 1990, she was granted "compassionate release." She died one week later.

Gloria Johnson, a 45-year-old grandmother, recently was released from CCWF. She suffers from multiple sclerosis, and while under the care of prison doctors, lost the use of both arms and legs. Housed in the Skilled Nursing Facility, a facility condemned by the California Department of Health Services for its failure "to treat each patient as an individual with dignity and respect," Johnson was denied assistance with her food and personal hygiene. She described needing to "eat my food like a dog when it was put in front of me." Staff left her to lie in menstrual blood for up to eight hours at a time.

Standing with Our Sisters

On January 27, over 100 protesters, many driving many hours from the San Francisco Bay Area and Los Angeles, held a protest rally and memorial at the gates of CCWF and VSP. At the rally sponsored by California Prison Focus and Legal Services for Prisoners with Children, many protesters carried signs with pictures of women who died in the prison. A memorial ceremony was held around a small table.

Several relatives of women who died in the prison spoke at the rally. Pamela Coffey, who shares her name with her mother who died at the prison, said that her mother should not have died the way she did and vowed to not stop challenging her death. "I'm just doing what my mother would have done for me," Coffey said.

Grace Ortega also spoke at the rally. Her daughter, Gina, died on November 29, a week after she was granted a "compassionate release." She said that her daughter was never properly treated for cancer at the prison.

Speaking at the gate of CCWF, Donna Christopher of San Diego, mother of Eva Vallario, said, "We are here for one reason --and that reason is: this place has to be shut down."

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