Incarcerated and Incapacitated: The Failing State of Healthcare in Our Prison System

(c) Don Gomez – September 2015

This is a guest post by Don Gomez, a progressive political writer who will be starting his own blog in the near future.

Renowned author and journalist Fyodor Dostoevsky once wrote, “The degree of civilization in a society can be judged by entering its prisons.” Given his history, few can attest to this more keenly than he.

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Dostoevsky, once a prisoner himself, was jailed for merely associating with the wrong crowd and reading the wrong books. Still however, his captors, agents of the Imperial Russian Tsar labeled him “one of the most dangerous convicts” and due to this assessment Dostoyevsky had his hands and feet shackled for the entirety of his almost six year prison term. He described the deplorable conditions he was forced to live in while incarcerated in his later works as: “In summer, intolerable closeness; in winter, unendurable cold. All the floors were rotten. Filth on the floors an inch thick… From dusk to dawn it was impossible not to behave like pigs … Fleas, lice, and black beetles by the bushel …”

What then would Dostoevsky think of modern prisons?

To be sure he would find them incomparably cleaner and slightly less crowded. What remains in question is how he would view their tendency to provide inmates adequate healthcare in comparison to their 19th century counterparts.

During the course of his imprisonment in the contemporary equivalent of today’s federal prison system Dostoevsky was afflicted with seizures, hemorrhoids, intense fever, and malnutrition and was only occasionally treated in a nearby military clinic which was a far cry from the often inadequate facilities provided even  to today’s military personnel.

That top shelf care and facilities are not as yet being provided to our nation’s best and bravest, only underscores the likelihood of the lack of suitable medical care available to inmates in modern penitentiaries.

Few know what goes on behind closed doors, and fewer still are affected by the plight of those interred by our criminal justice system. Many upstanding Americans figure that most prisoners, having been convicted beyond the shadow of a doubt by our courts deserve to be where they are, and perhaps the higher percentage of them do. What is often forgotten, however, is the fact that though they are inmates, these men and women still retain constitutional protections provided in the eighth amendment of the U.S. Constitution against cruel and unusual punishment.

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The Supreme Court in Estelle v. Gamble held that these protections extend to inadequate medical treatment as well because the 8th Amendment “proscribes more than physically barbarous punishments[.]” In the court’s opinion Justice Thurgood Marshall wrote that “[t]hese elementary principles establish the government’s obligation to provide medical care for those whom it is punishing by incarceration. An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical “torture or a lingering death”… In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose.”

The opinion of the court in Gamble also stated that, “[t]he [8th] Amendment embodies “broad and idealistic concepts of dignity” and “the evolving standards of decency that mark the progress of a maturing society[.]” It is safe to say that Dostoevsky would concur with the court’s opinion in this case.

One hundred years after Dostoevsky’s release from his Siberian prison camp, on the other side of the planet, a young man named Wesley Cook was born in Philadelphia, Pennsylvania, USA.

Though Dostoevsky’s father was a doctor he dedicated his career to treating those at the lower end of the social scale. Therefore, Dostoevsky and Cook were raised in similar (read: poor) economic settings. As with Dostoevsky, Cook developed an early fascination with the literature of fantasy and a fixation with religion.

For both young men, these early circumstances and preoccupations soon developed into an interest in the world at large which was colored by a passion for social justice.

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Both men entered the literary and journalistic world early in life. For Dostoevsky his literary career began with the publishing of his first novel entitled Poor Folk, which is hailed as the first social novel in Russian history. For Cook his introduction came with his appointment at the tender age of 14 as the Lieutenant of Information for the Philadelphia branch of the Black Panther Party where he was responsible for writing information and news communications. His involvement with the group came on the coattails of a beating by Philadelphia police for his role in the disruption of a ‘George Wallace for President’ rally. In 1970 Cook legally changed his name to Mumia Abu Jamal to more properly reflect his African heritage and solidarity with the Civil Rights Movement.

Through his work with the Panthers, Abu Jamal was introduced to the ideas of socialism as Dostoevsky had similarly been introduced by friends in literary circles he frequented. By the early 1980’s Abu Jamal was the President of the Philadelphia Association of Black Journalists and was outspoken in his criticism of the conduct and practices of local law enforcement which he saw as being especially prejudiced against African Americans and people of low socioeconomic standing.

Just as Dostoevsky was denounced to authorities for reading banned literature and allying himself with suspected radicals, Abu-Jamal also saw his budding career come crashing down in one fell swoop.

For Abu-Jamal his fate was sealed by being in the wrong place at the wrong time. Because the particulars of the trial are so spotty and the evidence for his guilt so minimal that to this day the fairness of his trial remains hotly contested by the ACLU, Human Rights Watch, and Amnesty International I will not begin to deliberate about his guilt or innocence. Suffice it to say that Philly’s Best were elated to name their most vociferous critic as the chief suspect in the shooting death of Officer Daniel Faulkner in December of 1981.

Fast forward 34 years to 2015 and my digression from the topic of prisoner’s rights to adequate medical care will begin to make sense.

On March 30th of this year Abu-Jamal fell unconscious due to an undiagnosed diabetic condition that is the result not only of subpar nutritional intake from a prisoner’s diet which is high in carbohydrates, sugars, and sodium but also systemic neglect by privatized healthcare providers contracted to provide health services to the SCI Mahanoy correctional institution where he is currently incarcerated.

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The diabetic shock suffered by Abu-Jamal came only weeks after a series of blood tests administered by prison healthcare staff failed to acknowledge the presence of this life threatening condition. Blood glucose levels which were as high as those suffered by Abu-Jamal are known to regularly lead to diabetic coma and even death.

Abu-Jamal’s diabetic shock, however severe, was only a part of escalating health problems that has begun to plague him as far back as August 2014 when he developed a painful rash that eventually grew to cover most of his body and proved resistant to conventional treatments. The symptoms of the rash which plagued Abu-Jamal are characteristic of Urticaria, a type of rash common to sufferers of strains of Hepatitis. At the insistence of Abu-Jamal, his lawyers, and consulting physicians blood tests were finally provided in July of 2015 that have confirmed that Abu-Jamal has active Hepatitis C. Despite the undeniable medical evidence that he is in need of treatment for this condition, prison medical staff is refusing to provide any. This is likely due to the high cost of proprietary remedies that are patented by leading pharmaceutical manufacturers.

Despite the prohibitive cost of these remedies it should come as no surprise that prison health care authorities under the employ of Corizon Prison Health Management, have refused the treatment.

Formerly known as Prison Health Services, Corizon PHM, provides health care and mental health services to correctional departments in 27 states and has been sued for malpractice a staggering 660 times. Corizon has faced accusations of failure to provide constitutionally adequate health care to inmates across the nation, resulting in illness, injury, and death. The privately held corporation has settled countless lawsuits alleging wrongful death and deliberate indifference to inmates’ serious medical needs. States and counties have threatened to withhold payments due to Corizon’s failure to meet its contractual obligations. The company has also been cited for multiple labor violations.

It is clear that Abu Jamal has been subject to gross mistreatment by authorities who have denied the aged and ailing man proper medical care and who have violated his rights in a multitude of other ways during the course of his incarceration. His supporters believe this abuse stems from his outspoken criticism of capital punishment and law enforcement practices which he continues  to do within his constitutionally protected rights through mediums such as prisonradio.org (albeit with occasional interruption due to disciplinary actions for engaging in “entrepreneurship contrary to prison regulations”).

What is truly appalling however is not that such deplorable maltreatment has been heaped upon one individual but rather, if a model prisoner who is as articulate and well connected to the outside world as Abu Jamal is still being so heinously disregarded it is not hard to imagine that other inmates are also being denied the very care that our prison systems are legally bound to provide. The true number of those forsaken by unsympathetic prison authorities and forced to suffer a slow and excruciating death may never be known. How then can we possibly begin to gauge the degree of civilization within our society when by Dostoevsky’s standards our pulse is so weak and thready?

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