Medical Care

One pressing issue for women prisoners is the lack of or poor medical care they receive. While all prisoners face poor medical care, prison administrations
often ignore or neglect the particular health care needs of women prisoners.
That the majority of lawsuits filed by or on behalf of women in prison are for
inadequate medical services testifies to the importance placed on health care
and treatment.1 Even prison wardens agree that several of the particular needs
of pregnant women "have yet to be dealt with in any of the facilities,"
including adequate resources to deal with false labors, premature births and
miscarriages; lack of maternity clothing; the requirement that pregnant inmates
wear belly chains when transported to the hospital; and the lack of a separate
area for mother and baby.2 Pregnant women are also not provided with the
proper diets or vitamin supplements, given the opportunity to exercise or
taught breathing and birthing techniques. The director of Legal Services for
Prisoners with Children, Ellen Barry, accused the prison system of a "shocking
disregard of basic humanity that I saw reflected in the type of treatment to
which pregnant women were subjected." One horrifying example is that of a
twenty-year-old woman who was almost five months pregnant when incarcerated.
Soon after, she began experiencing vaginal bleeding, cramping and severe pain.
She requested medical assistance numerous times over a three-week period, but
there was no obstetrician on contract with the prison. She was finally seen by
the chief medical officer, an orthopedist, who diagnosed her without examining
her physically or running any laboratory tests, and given Flagyl, a drug that
can induce labor. The next day, the woman went into labor. Her son lived
approximately two hours.3

Dr. Patricia Garcia, an obstetrician and gynecologist at Northwestern
Universitys Prentice Womens Hospital, has stated that shackling a laboring
mother "compromises the ability to manipulate her legs into the proper position
for necessary treatment. The mother and babys health could be compromised if
there were complications during delivery such as haemorrhage or decrease in
fetal heart tones."4 Despite these dangers, women continue to be shackled in
the name of security. In an interview with Amnesty International, one woman
described giving birth while an inmate in Chicago. Her legs were shackled
together during labor and, when she was ready to birth, "the doctor called for
the officer, but the officer had gone down the hall. No one else could unlock
the shackles, and my baby was coming but I couldnt open my legs."5

In addition to medical ignorance/neglect by staff, women who have given birth
are not only immediately separated from their newborns, but, in the name of
security, are sometimes subjected to vaginal exams despite the risk of
infection.6

Pregnancy is not the only specifically female medical concern ignored by prison
officials. Prevention, screening, diagnosis, care, pain alleviation and
rehabilitation for breast cancer are virtually non-existent in prisons. In
1998, a study at an unnamed Southern prison found that seventy percent of the
women who should have had mammograms under standard medical protocol had not
been tested. Although many of the women were at high risk because of family
histories, they were not provided with a clinical breast exam, information or
basic education on self-examination upon admittance.7

Not only are the particular health care needs of women ignored or dismissed,
but health care in general is often inadequate or life-threatening.8 In
February 2000, Wisconsin prisoner Michelle Greer suffered an asthma attack and
asked to go to the Health Services Unit (HSU). When the guard and captain on
duty contacted the nurse in charge, he did not look at Greer's medical file,
simply instructing her to use her inhaler (which was not working). Half an
hour later, Greer's second request to go to HSU was also ignored. After
another half hour, Greer was told to walk to HSU but collapsed en route. When
the nurse in charge arrived, it was without a medical emergency box or oxygen.
A second nurse arrived with the needed emergency box, but again with no oxygen.
Forty-five minutes after her collapse (and less than two hours after her
initial plea for medical help), Greer died.9

However, women have been active about trying to change their sometimes
life-threatening medical neglect. The most successful and well-known
prisoner-initiated project organized around health care is the AIDS Counseling
and Education Project (ACE) at Bedford Hills. AIDS is the leading cause of
death among U.S. prisoners, being five to ten times more prevalent in prison
than in the outside society.10 In 1999, the New York State Department of
Health found that the rate of HIV infection among women entering the New York
State Correctional Facilities was nearly twice that of their male
counterparts.11 In 1987, women at the maximum-security Bedford Hills
Correctional Facility in New York, motivated by watching their friends die of
AIDS and by the social ostracism and fear of people with AIDS, started ACE.12

ACE founders hoped to educate and counsel their fellow inmates about HIV/AIDS
as well as help to care for women with AIDS in the prison infirmary. While the
prison superintendent, Elaine Lord, gave the group permission for the project,
ACE continually faced staff harassment and administrative interference. For
instance, because both Kathy Boudin and Judith Clark, alleged members of the
Weather Underground, were active ACE members, the group was constantly
monitored and sometimes prevented from officially meeting. The fear that the
one-to-one peer counseling sessions would lead to inmate organizing and the
staff's own ignorance and fear of HIV/AIDS led to staff harassment and
interference. Educators from the Montefiore Hospital holding training sessions
were banned from the facility for suggesting that the Department of
Correctional Services lift its ban on dental dams and condoms.13 A year after
its formation, ACE members were prohibited from meeting at its regular time, to
use its meeting room, give educational presentations or to refer to themselves
as "counselors."14

Despite these setbacks, the members of ACE not only managed to implement and
continue their program, but also received a grant for a quarter million dollars
from the AIDS Institute and wrote and published a book detailing the groups
history and its positive impact on women with AIDS as a guide for other prison
AIDS programs. One interesting aspect is that despite ACE's success, male
prisoners attempting to set up similar programs at their facilities continue to
meet with administrative resistance and retaliation.

Other women political prisoners have also focused on the AIDS crisis behind
bars. Marilyn Buck, for example, started an AIDS education and prevention
program in California.15 However, with the exception of ACE at Bedford Hills,
researchers and scholars have either largely ignored these programs or
overlooked the difficulties and administrative harassment faced by those
organizing around HIV/AIDS issues in prison.

Women have also worked individually and without the auspices of administrative
approval to change their health care. Until her recent death, Charisse Shumate
worked with her fellow inmates with sickle-cell anemia to understand the
disease and the necessary treatments.16 She also advocated the right to
compassionate release for any prisoner with less than a year to live and was
the lead plaintiff in the class-action lawsuit Shumate v. Wilson.17
Unfortunately, Shumate herself died at CCWF, away from family and friends,
because the Board of Prison Terms recommended clemency rather than
compassionate release. Governor Gray Davis refused to approve the Board's
recommendation.18 Four years before her death, Shumate wrote : "I took on
[the battle] knowing the risk could mean my life in more ways than oneAnd yes,
I would do it all over again. If I can save one life from the medical
nightmare of CCWF Medical Department then its well worth it."19 Her work did
not cease with her death. Women who had worked with her continue the task of
teaching others how "to understand their labwork and how to chart their
results, keep a medical diary, hold these people accountable to what they say
and do to them."20 Sherrie Chapman, one of the twenty-six inmates who
testified in Shumate v. Wilson, became the primary plaintiff in a class-action
suit over medical conditions as well as filing a civil suit charging the CDC
with cruel and unusual punishment after waiting over a decade for cancer
treatment.21

Just as scholars and researchers have ignored women's organizing around
HIV/AIDS, they have also ignored the struggles of individual women for adequate
health services and support. The works of ACE, Marilyn Buck, Charisse Shumate
and other women may not be as dramatic as a work strike or a boycott, but they
nonetheless address crucial issues facing women in prison and contradict the
notion that women do not and cannot network and organize to change their
conditions.

CONTINUE

NOTES:

Medical Care

1 Belknap, Joanne. "Programming and Health Care Accessibility for
Incarcerated Women." States of Confinement: Policing, Detention and Prisons.
Joy James, ed. New York: St. Martins Press, 2000. 112.

2 Boudouris, James. PhD. Parents in Prison: Addressing the Needs of Families.
Lanham, MD: American Correctional Association, 1996. 11.

3 "Inside the Womens Prisons of California." Revolutionary Worker #911.
15 June 1997. http://www.rwor.org/a/v19/910-19/911/prison.htm. Cites Ellen
Barry's paper "Women Prisoners and Health Care: Locked Up and Locked Out."

4 Amnesty International. "Not Part of My Sentence : Violations of the
Human Rights of Women in Custody." March 1999. 11.

5 Ibid. 10.

6 Pollock-Byrne, Joycelyn. Women, Prison and Crime. Pacific Grove, CA:
Brooks/Cole Publishing Co., 1990. 147-152.

7 Cooper, Cynthia. "A Cancer Grows." The Nation. 6 May 2002.

8 In 1976, in Estelle v. Gamble, the Supreme Court ruled that deliberate
indifference to serious medical needs violates the Eighth Amendment. Despite
this ruing, prison health care continues to neglect and even jeopardize the
health of both its male and female inmates.

9 Pens, Dan. "Bag'm, Tag'm and Bury'm: Wisconsin Prisoners Dying for Health
Care." Prison Legal News, volume 12, #2. February 2001. 1-2.

10 The Women of the ACE Program of the Bedford Hills Correctional Facility.
Breaking the Walls of Silence: AIDS and Women in a New York State
Maximum-Security Prison. Woodstock, NY: The Overlook Press, 1998. 23.

11 Women in Prison Project of the Correctional Association of New York.
"Women Prisoners and HIV." Cites Laura Manuschaks HIV in Prisons and Jails,
1999. Bureau of Justice Statistics. July 2001, revised 25 October 2001.

12 ACE, 41-44.

13 ACE, 54.

14 ACE, 66-67.

15 Resistance in Brooklyn. Enemies of the State: A frank discussion of past
political movements, victories and errors, and the current political climate
for revolutionary struggle within the u.s.a. with european-american political
prisoners Marilyn Buck, David Gilbert and Laura Whitehorn. 1998. Marilyn Buck
is imprisoned for conspiracy to free Assata Shakur and armed bank robbery to
support the New Afrikan Independence Struggle. She is currently at FCI Dublin
in California.

16 The Fire Inside. (Newsletter of the California Coalition for Women
Prisoners) #4. May 1997.

17 Shumate v. Wilson was the class-action lawsuit filed by inmates at the
Central California Womens Facility and the California Institution for Women
against the state, alleging that those with cancer, heart disease and other
serious illnesses were being denied medical care and that the prisons medical
staff failed to protect the confidentiality of inmates with HIV and AIDS. In
August 1997, the California Department of Corrections agreed to a settlement in
which untrained prison employees would be barred from making judgments about
inmates medical care, the prisons would ensure medicines without undue lapses
or delays, and medical staff would offer preventive care, including pelvic and
breast exams, pap smears and mammograms. See "California Agrees to Settle
Inmates HIV Privacy Claims." AIDS Policy and Law; Prisons, Vol. 12, #17. 19
September 1997. On 31 July 2000, in light of evidence of tampering with
medical files in preparation for the assessors visits, the Department of
Health Services reports citing CCWFs failure to comply with regulations, and
the CDCs failure to retest prisoners who had received fraudulent lab results,
the plaintiffs attorneys submitted a motion to reopen discovery in the case.
The motion was denied by Judge Shubb and the case was dismissed in August 2000.
(See "Strategies for Change : Litigation."
http://www.prisonerswithchildren.org/litigation.ht m

18 Pierson, Cassie M. Memorial for Charisse Shumate. First Unitarian Church,
San Francisco, California. 23 September 2001.

19 Shumate, Charisse. "The Pros and Cons of Being a Lead Plaintiff." The
Fire Inside. December 1997.

20 Letter from Central California Womens Facility. Dated 3 March 2002.

21 Thompson, A. Clay. "Cancer in the Cells." San Francisco Bay Guardian. 24
February 1999.

CONTINUE