http://www.activedayton.com/ddn/news/daily/0204skininfection.html

By David Tuller
New York Times

SAN FRANCISCO | More than 1,000 jail inmates in Los Angeles County have suffered painful and aggressive skin infections caused by a bacterium resistant to many antibiotics, medical authorities say. The unusual outbreak over the last year is still not contained.

The same pathogen, which causes fast-growing boils and unsightly abscesses, also appears to have infected dozens of gay men, many of them HIV patients, in Los Angeles and San Francisco, health officials say.

Epidemiologists say the outbreaks stem from Staphylococcus aureus, a bacterium that causes many infections in hospitals and nursing homes.

But the experts are worried because this strain — resistant to methicillin, penicillin and other standard antibiotics — is spreading outside its traditional setting.

The ability of this bacterium to cause sudden and dangerous lesions on apparently healthy skin concerns health officials because it differs from other strains of methicillin-resistant Staphylococcus aureus, or MRSA, which generally attack the skin only at weak points, like surgical incisions or open wounds.

And epidemiologists are concerned that the bacterium may develop resistance to the handful of antibiotics that still work against it.

They are also worried that it may be spreading to other groups. Dr. Elizabeth Bancroft, an epidemiologist with the Los Angeles County Department of Health Services, said she had received a growing number of reports of comparable ailments from people who were neither gay nor in prison.

‘‘My voice mail and e-mail are overflowing from people saying they’ve had similar infections in the past few months,’’ said Bancroft, who is overseeing an investigation to pinpoint risk factors and routes of transmission.

In the Los Angeles jail system, the authorities at first believed that the infections were from spider bites, but no spider was ever identified. As the number of cases grew and the lesions failed to respond to standard antibiotics, officials realized they were facing a more serious problem.

The standard antibiotic-resistant bacterium — which can be spread during skin-to-skin contact or indirectly through shared hospital equipment and other items — has been increasingly common in hospitals and other health care centers since the 1980s.

In recent years, health officials around the country have reported scattered outbreaks, apparently acquired through social contact outside hospitals and in various groups of children, injection drug users, athletes, American Indians and prisoners.

No one has a clear idea how widespread the skin disorder actually is outside hospitals, because states do not require doctors to report cases of drug-resistant staph infection, unlike diseases such as AIDS and tuberculosis.

But, said Dr. Matthew Kuehnert, an epidemiologist with the Centers for Disease Control and Prevention: ‘‘This is the largest cluster of infections that we’ve heard about in prison or jail. And we haven’t previously seen MRSA specifically being associated with gay men.

The agency plans to compare samples of the staph strain from California with those found in previous MRSA outbreaks elsewhere.

Staph infections can be fatal if antibiotics fail to control them. In the current wave, no one identified as having the ailment is believed to have died, but in some cases doctors have had to cut away diseased tissue and administer intravenous antibiotics for weeks. Dozens of infected patients have been hospitalized.

Epidemiologists have told the jail authorities in Los Angeles that increasing inmate access to showers, clean laundry and medical treatment can help bring the outbreak under control.
The exact number of cases in the parallel outbreak among gay men is unknown. But doctors in Los Angeles say they have identified more than three dozen gay patients with the skin infections. Many, but not all, have HIV.

Dr. Peter Ruane, who treats many gay men and people with HIV at Tower Infectious Disease Medical Associates in Los Angeles, said the boils and abscesses appeared suddenly, grew rapidly and were far more virulent than previous staph infections he had seen. ‘‘This is a nasty bug,’’ he said. ‘‘Some of these infections take your breath away.’’
While the outbreaks were first publicly reported in Los Angeles, doctors who treat gay patients in San Francisco say they have seen similar infections.

‘‘It’s really rampant,’’ said Dr. Bill Owen, a primary care physician in San Francisco with a gay and HIV practice. ‘‘We’ve seen 10 or 15 cases in the last couple of months.’’

Owen said he knew of other doctors in the area who had also noticed an increase in the unusual skin infections.
Health officials in San Francisco said they were aware of the reports and were considering ways to assess the scope of the problem.

Medical authorities speculate that gay men could be contracting the infections through sexual encounters or in shared facilities like gyms and steam rooms.

Through a technology known as molecular fingerprinting, health officials have already determined that the staph strain found in the jails and among gay men was virtually identical with one implicated in two much smaller outbreaks last year in Los Angeles, one among newborns and the other in young adult athletes.

The staph strain has proved resistant to a host of commonly used antibiotics besides methicillin and penicillin. But it appears to respond to some other lesser-known oral antibiotics and to vancomycin, an intravenous antibiotic.
Health officials say that even if an infection appears to have abated, it is critical that patients complete their entire course of antibiotic treatment, which helps prevent the pathogen from mutating and developing further resistance.

‘‘We don’t want the bacteria to become resistant to the antibiotics that it’s still sensitive to,’’ Bancroft said, ‘‘because that would really be a nightmare.’’

[From the Dayton Daily News: 02.04.2003]

http://www.theadvocate.com/stories/020803/new_spider001.shtml

Inmates allege spider bites; jailers say it's an infection

By ADRIAN ANGELETTE
aangelette@theadvocate.com
Advocate staff writer

More than 30 Parish Prison inmates claim in lawsuits that they were bitten by venomous brown recluse spiders.

The two suits say the East Baton Rouge Parish Sheriff's Office, which operates the prison, has not worked to eliminate the hazard.

"Either no steps were taken to control the spider problem or the steps taken were wholly inadequate," one suit says.

Defendants named in the suits are East Baton Rouge Parish Prison Warden Joe Sabella, the Sheriff's Office and the city-parish.

However, attorneys for the city-parish said a state expert found that the inmates are suffering from a staph infection, not spider bites.

None of the inmates who sued has produced a spider, one lawyer said.

"No one has ever come up with a single brown recluse spider," said Leu Anne Greco, an attorney for the Sheriff's Office.

The lawsuits contend that after a spider bites, the area around the bite turns red and swells, leaving a red ulcerous sore that causes a scar.

Some of the inmates claim to have been bitten multiple times.

Greco said the city-parish and Sheriff's Office had Raoul Ratard, the state epidemiologist, review the inmates' medical files. Epidemiology is the study of disease and its distribution within a population.

Ratard determined that the health problems were caused by a staph infection called methicillin resistant Staphylococcus aureus, Greco said.

The strain of the infection is the same one that has been reported in prisons in other states, she said.

The Centers for Disease Control and Prevention says that since 1999, the Staphylococcus aureus has been found in prisons in Mississippi, Tennessee, California, Texas, Georgia and Pennsylvania.

MRSA is spread through physical contact, most often to people with weak immune systems, the CDC reports.
To stop the spread, patients are often isolated and antibiotics are used for treatment. Surgery is sometimes necessary at the source of the infection, the CDC says.
The infection can cause oozing boils, infections or pneumonia.

James Hilburn, an assistant parish attorney, said the staph infection is common throughout the nation and is often found in hospitals.

He also said the staph infection spreads easily. "It only needs broken skin to spread," Hilburn said.

Hilburn said Ratard found nothing wrong with the way the prison is operated. It is sprayed twice each month to kill harmful insects, including spiders.

Greco said the city-parish also had an entomologist inspect the prison, and that he found no spider problem. Entomology is the study of insects.

Brown recluse spiders are common in Louisiana, Mississippi, and the section of the United States between Dallas and Atlanta, from the Gulf of Mexico to the northern boundary of Missouri.

printed it out and mailed it to Clinton!n Thank you Teb! he is always very gratefull for information like this...you know they don't tell these men anything. If they don't hear it from us they just don't know. I know that whenever I sent something like this to Clinton, he gives the papers around all over prison to make sure many people know and can do something in time.

Hey Teb~ When Eric went to san quentin, he started getting what the co's were
calling a brown recluse spider bite, Eric has had many of these types of infections. I
know that from being in nursing for many years (LVN) that these are not spider bites,
they are Staph Infection. Eric has had them on his buttocks, hip and now on one of
his legs. I am very concerned about this outbreak at San Quentin, and have gone as far to speak to the Director of Medicine At the prison, who says it is a spider bite. B.S.!
A spider bite would respond to antiboctics, Staph Infection ususally doesn't do very
well with antiboctics. Eric has had to have daily dressings applied. He told me that he
had 4 separate doses of anitboctics in a 4 week time frame, and finally the 4th dose
cleared it up. Then he got two more, and now the one on his leg. It totally freaks me
out, as Staph Infection at San Quentin is running out of control at this prison. And the
prison is doing nothing to bring it under control. Eric will be home in 5 days and a wake
up and he will be going to our health care specialist to get this infection under control
and gone. I saw his hip one day in visiting, and I knew the minute that I saw it with
the discolor of the skin, it wasn't a spider bite. Just another "cover up" brought to you
in part of the State Prisons here in California.

I've just been informed by someone that this staph infection is rampant in a prison and nothing is being done about. Prisoners are walking around with oozing sores among the general inmate population. Sharing the same bathrooms and showers, no isolation at all.

Don't understand how they can do nothing about it. What is wrong with the people in charge?? After all the guards and workers there are being exposed as well. They in turn if infected are bringing it home to their families, who then bring it out to the general public.

Will it take a major epedimic to the general public for the people in charge to do something?? A very scary thought. After all many of these guys are being released on a daily basis.

What or whom can we contact to help in this matter??

Thank for any leads as to where I can turn to.

OTRA, I don't know who you are "supposed" to contact with something like this but you could start with the health department. Whether you get a response or not just keep ringing someone's phone at every office that might have even the slightest impact on what is going on. Nothing gets to the "higher ups" like phone calls pouring in from citizens.

That's exactly what was happening at Parchman in camp 30. Guys kept getting "spider bites" and had awful pussy sore. It took them forever to get to the doctor to get treated. Some guys actually pretended to pass out so they could get faster treatment. They were led to believe they were spider bites until one doctor finally told an inmate that it was a staph infection. This was several months ago and I don't think it's going around there anymore.

I know this sounds awful too but my husband and I both ended up with scabies which we think we got from the conjugal visit room perhaps. Anyway I kept calling and calling to get him to medical and they wouldn't see him. Finally I talked to a couple of different people and told them that if they didn't get my husband treated they would all end up with parasites and they sent him to medical that night.

Hey Teb~ When Eric went to san quentin, he started getting what the co's were
calling a brown recluse spider bite, Eric has had many of these types of infections. I
know that from being in nursing for many years (LVN) that these are not spider bites,
they are Staph Infection. Eric has had them on his buttocks, hip and now on one of
his legs. I am very concerned about this outbreak at San Quentin, and have gone as far to speak to the Director of Medicine At the prison, who says it is a spider bite. B.S.!
A spider bite would respond to antiboctics, Staph Infection ususally doesn't do very
well with antiboctics. Eric has had to have daily dressings applied. He told me that he
had 4 separate doses of anitboctics in a 4 week time frame, and finally the 4th dose
cleared it up. Then he got two more, and now the one on his leg. It totally freaks me
out, as Staph Infection at San Quentin is running out of control at this prison. And the
prison is doing nothing to bring it under control. Eric will be home in 5 days and a wake
up and he will be going to our health care specialist to get this infection under control
and gone. I saw his hip one day in visiting, and I knew the minute that I saw it with
the discolor of the skin, it wasn't a spider bite. Just another "cover up" brought to you
in part of the State Prisons here in California.

Just a few days ago an inmate at FCC Coleman Low died of a acute Staph infection which was not properly cured. He started vomiting blood and died on his way to the hospital. They burnt his matress and all his belongings.
LP

My son who was in Halawa Corr. Facility here in Hawaii complained to me 6 months ago about this problem. Evidently there were a minimum of 30 guys that had which he described as very painful, huge boils. The only treatment they received was an iodine wipe. Reading this information makes me furious as my son is a heart patient and has to really watch any type of infection. Thank you so much for posting this as tomorrow I will be faxing a copy of the article to the warden over there and let him know he better take immediate action and do something for these guys.

Aloha,
MomofJosh

My fiance is in an ALabama prison and has experienced the same problem! He was given Penicillin for a couple of weeks but the "boil" is still there!!! What can be done???

That skin infection is call a staff infection and that is in the blood. It is from dirty everything..It has another name and I can't think of it..I had a article from the LA times but don't know where I put it..minnie:cool: .

I have attached a copy of a recent article that appeared in the NYTimes. The recent increase of women contracting the AIDS virus has prompted much interest, talk and research into men "on the down low". It is quite unfortunate but the prison environment has helped to perpetuate this because of the married men who have intimate relations with their wives and also with men on the inside. I think it is a great idea to issue condoms in the prisons to help prevent the spread of this deadly virus to the unsuspecting wives of inmates.

I hope you find this article educational, informative and enlightening!

-----------------
Fighting the AIDS Epidemic by Issuing Condoms in the Prisons

September 7, 2004
By BRENT STAPLES

The novelist E. Lynn Harris has become a fixture on the
best-seller list and a favorite among black women by
writing steamy books about men who live "on the down low" -
men who cheat on wives and girlfriends by having sex with
other men. The fear of men "on the down low" is now
palpable among black women, who are more than 20 times as
likely to contract AIDS as white women and are
understandably anxious about protecting themselves. This
fixation has also become a cottage industry, dealt with in
books, lectures, plays and an episode of the popular
television series "Law & Order."

The hyperbole and exaggeration surrounding the "down low"
has taken the public health debate in a counterproductive
direction. It has spread paranoia and pushed a much-needed
discussion about bisexual behavior further underground.
Moreover, it has kept the country from focusing on the
long-neglected connection between H.I.V. and the prison
system, where infection rates are high and unprotected sex
among male inmates is far more common than prison officials
care to admit. Men who have sex with men in prison pose an
enormous threat to women when they return to the outside
world and heterosexual behavior.

In any given year, 35 percent of the people with
tuberculosis, nearly a third of those with hepatitis C and
17 percent of the people with AIDS pass through jails and
prisons. Faced with budget crises, many correctional
facilities back away from testing inmates, fearing they
will be required to pay for expensive treatments.

Condoms are banned or simply unavailable in more than 95
percent of the nation's prisons. The corrections system
processes nearly 12 million people a year. It is especially
vulnerable to AIDS and other blood-borne diseases that
spread easily through risky, unprotected sex acts.

Congress was forced to confront the issue in legislation
after a series of reports suggested that
prisoner-against-prisoner rape, often accompanied by
horrific violence, was commonplace. Concern over the
problem led to the federal Prison Rape Elimination Act of
2003, a groundbreaking law that requires the Justice
Department to collect data on prisoner-against-prisoner
rape and act to prevent it.

Research on sex in prison is limited. But a much-cited
study of California prisoners in the 1980's found that 65
percent of them participated in sex acts behind bars. The
data, though sketchy, suggests that men who regard
themselves as heterosexuals are more likely to have sex
with other men the longer they remain in jail. Starved for
intimacy, many inmates apparently enter relationships that
they would never have considered in the world outside.

In an article published two years ago in The Prison Journal
by Christopher Krebs of the Research Triangle Institute,
inmates reported that 44 percent of the people they knew
participated in sex acts in prison.

The Krebs study disputes the standard hypothesis that sex
acts behind bars mainly involve men who were already active
homosexuals. Indeed, fewer than one-third of the people
mentioned in the study seem to fit that category, which
suggests that about 70 percent experienced their first
same-sex encounters only after landing behind bars. The
infections these men pick up in prison cycle back into the
community once they are released.

The prison data cries out for an AIDS-prevention strategy
that would encompass all of the nation's jails and prisons.
At a minimum, the program would give inmates free and open
access to condoms. The American prison system is now
dominated by the dangerous notion that distributing condoms
would encourage prisoners to break the rules by having sex.
As a result, condoms are unavailable in an overwhelming
majority of jails and prisons.

Prison authorities have resisted condom distribution
despite intense criticism from public health officials, who
have pointed out time and again that condoms are freely
distributed in prisons in many countries, including Canada.


The Canadian model is commendable in that it applies clear,
specific rules throughout the prison system and leaves
little to the judgment of local prison officials. The
directive requires that condoms be made "easily and
discreetly available" in gyms, libraries, schools, laundry
rooms and other areas where inmates can get them without
having to interact with guards. The point is to ensure that
inmates do not bypass condoms out of fear or embarrassment.


The connection between the prison experience and the spread
of AIDS outside prison is especially clear in poor
communities, where a great many men spend time behind bars
at some point in their lives. But with millions of people
regularly exposed to H.I.V. in the prison system, the
entire country has both a moral and a medical obligation to
confront the sexual realities of prison life.

Until then, lives will be lost and prison-borne diseases
will continue to spread from the corrections system into
the community at large.

http://www.nytimes.com/2004/09/07/opinion/07tues4.html?ex=1095869630&ei=1&en=59d803e25527a705

Cant say I agree


The American prison system is now
dominated by the dangerous notion that distributing condoms
would encourage prisoners to break the rules by having sex.
As a result, condoms are unavailable in an overwhelming
majority of jails and prisons.


This I agree with

Well it is about time that they realize that inmates have sex...Now they are giving condoms out..Better late than never...minnie:cool:

In South African prisons it has been the norm that when an inmate gets put into custody he gets given a box of condoms. It is not a fact that they condone the sex that happens there, but AIDS is rife in SA and any prevention is better than no cure. I cant say that i condone any sexual interaction between inmates, but it does happen and it will happen, no matter what. So i say, give them the condoms and prevent them from being another statistic.

Tony told me one guy where he is got in trouble for having condoms. He got a trip to the "hole" as condoms are contraband there

You don't have to condone the activity - but if sex is taking place in prison and diseases are spreading becasue of it then it is obviously happening even if it is against the rules or policies of the prison. Is it not better to offer 'protection' to eliminate or reduce the spread of deadly disease than to ignore it and say that sex in prison does not happen becasue it is against the rules?

I recently read an article that suggested that 25% of men that leave prison with a potentially deadly and spreadable disease did not enter prison with this disease.

One of the major factors is what is the collateral damage of ignoring or not addressing this situation. Your man comes home from prison. Your man went to prison disease free. Your man now has either AIDS or Hep C. He is not exhibiting any symptoms yet. Through sexual contact you are now in danger of contracting either of these diseases. How did he get either one of these diseases? Either through sexual contact or tattoos. He may have been forced into the sexual situation or he may have entered it willingly. I think one of the main reasons that this issue is ignored is because it brings up the discussion of homosexuality - no one wants to think that their guy goes to prison straight and is gay inside the prison. This issue of 'physical contact' goes far deeper than 'am I gay or straight' - physical contact is a basic human need - some people deal with the absence of this better than others. For the straight men in prison that may engage in sexual contact with another man - they are not all of a sudden gay - they are using sex as a means to get the physical contact that they so need and desire. They are not now gay.

I am Canadian - we consider ourselves more liberal with this kind of thinking and these kinds of solutions. We offer condoms to our Inmates. We are now considering tattoo parlors in prisons so that tattoos are done in a sterile environment. We offer needle exchanges for addicts. Sometimes you can lessen the damage of the bigger issue by offering a solution or a band aid to a smaller part of the problem. We don't condone drug use, but if you get a clean needle each time you use drugs then you may be an addict but not an addict with AIDS or HepC. When you are ready to go into rehab we can clean you of the drug addiction and we don't have to treat you for another problem.

Offering condoms in prison is just good sense. Closing your eyes to the spread of disease in a prison - no matter how it is spread - is not good sense.

I agree totaly.COndoms should be passed out in prisons.and tattos should be legal in there with a sanitary place to do them. They also need to do manditory testing every year in prison.alot of people with the diseases dont tell for fear of ridicule and then they knowingly spread this to others in there thru sexual contact and needles.I also agree that it is a basic human need to touch and doesn't mean a man is gay because he has needs.they should have visits for coulples to engage in sexual contact. This would help the spread of disease tremendously.Its unfair to families on the outside to aquire these diseases from their men when they are released.Society and the goverment need to adress this problem with realistic solutions.My man has been down for almost 10 yrs and 3 more to go. The thought scares me to death that he might catch something and bring it home. They need to test test test and PREVENT... Im sure thats just wishful thinking.This is a very important topic.

Is the World Finally Waking up to HIV/AIDS in Prisons? A Report from the International AIDS Conference.

U.S. appeals for flu vaccine rationing

Officials ask healthy people to defer to those at risk




WASHINGTON (AP) -- A top federal health official, lamenting "a very fragile vaccine production system," urged healthy people Wednesday to defer getting their influenza shots so medication will be available for those most at risk.

"We really need a long-term solution so we don't end up in this year-to-year situation where we don't have a reliable supply," Dr. Julie Gerberding said, after the supply of vaccine to the United States was abruptly cut in half.

Gerberding, head of the federal Centers for Disease Control and Prevention in Atlanta, and other government officials appealed for voluntary rationing in the wake of a major supply interruption.

British regulators unexpectedly shut down a major flu-shot supplier Tuesday, citing manufacturing problems at the Chiron Corp. factory in England where roughly 46 million doses destined for the United States had been made.

That means only about 54 million flu shots will be available this year from a competing firm, and the U.S. government decided quickly that most healthy adults should delay or skip them to leave enough vaccine for the elderly and other high-risk patients.

Vaccine should be reserved for babies and toddlers ages 6-23 months; people 65 or older; anyone with a chronic condition such as heart or lung disease; pregnant women; nursing home residents; children on aspirin therapy; health care workers who care for high-risk groups; and anyone who cares for or lives with babies younger than 6 months.

For everyone else, "Take a deep breath. This is not an emergency," Gerberding said Tuesday. "We don't want people to rush out and look for a vaccine today."

The government has urged voluntary rationing before, during a shortage in 2000. This year, however, will mark a record shortage just before flu season begins.

"We will need the help of the public," said Health and Human Services Secretary Tommy Thompson.

Gerberding, appearing Wednesday on CBS News' "The Early Show," said that if officials "prioritize" the disbursement of available flu vaccine, "we will make it possible for people to get vaccine if they really need it."

Chiron's problem began in August, when it discovered contamination in a small amount of vaccine that delayed its U.S. shipments. Still, top U.S. health officials assured the public less than two weeks ago that close monitoring showed the rest of Chiron's supply was fine, and plenty of vaccine would be available.

Tuesday, British regulators disagreed and suspended Chiron's license for three months, officially prohibiting export of the Fluvirin brand that Chiron manufactures in Liverpool. The sanction means more than a delay, Chiron officials said. The company will ship no Fluvirin anywhere this year.

The move took U.S. regulators by surprise. Food and Drug Administration officials headed to Britain Tuesday night to investigate but wouldn't say if they would ask British regulators for a special release of shots for use here if the flu season proves a bad one.

Chiron had brought more than 1 million doses to this country before its license was suspended but hasn't released the batch, Thompson said. He would not say if those doses were potentially usable.

Thompson asked the maker of the remaining 54 million flu shots to try to make more. Aventis Pasteur plans to try, but can't increase production until it meets existing orders in November.

High-risk patients depend on flu shots because the injections are made of killed influenza virus. Other people have another option: About 1 million doses of an inhaled flu vaccine, MedImmune Inc.'s FluMist, will be available for healthy 5- to 49-year-olds. It's made from live but weakened influenza virus.

A flu treatment called Tamiflu also can protect against infection if swallowed daily during an outbreak. Manufacturer Roche Pharmaceuticals said Tuesday it would step up production in anticipation of greater demand this winter.

Flu vaccine is made using chicken eggs and takes months to brew, meaning manufacturers cannot suddenly produce more. Yet vaccine shortages and delays have plagued the country for several years, and Tuesday's debacle prompted scientists to urge that the system be modernized.

"This points up the vulnerability of our influenza vaccine supply," said Dr. William Schaffner of Vanderbilt University, a government vaccine adviser.

Congress allocated $50 million in the 2004 budget to begin making such changes, half the amount federal health officials had requested. Thompson urged Tuesday that lawmakers provide $100 million next year.

The government is taking other steps to ease the shortage:




CDC is working with Aventis to alter its flu-shot distribution so that shipments also go to parts of the country that had depended on Chiron's supplies.

FDA and NIH are studying whether Aventis' vaccine could be diluted to get two doses out of each original shot. A small NIH study several years ago suggested doing so could provide enough protection for healthy people, said Dr. Anthony Fauci, infectious disease chief for the National Institutes of Health.

Another Unnecessary Death in D.C.

The Washington Post; 10/9/2004; Colbert I. King

10-09-2004

Too bad that 27-year-old Jonathan Magbie, at this late stage, didn't
know the right people. If he did, he might still be alive today. But Magbie
had no ties to this town's rich, famous or influential. As his life drew
to a close, everyone who wanted to could exercise veto power over him.
It had been that way ever since he was hit by a car at age 4 and left paralyzed from the chin down.

Magbie's story was told a week ago in The Post by reporter Henri Cauvin.
It was a sad tale about a quadriplegic, unable to breathe on his own since
childhood (and mobile only with the help of a chin-operated, motorized
wheelchair), who was arrested, convicted and sent to the city's jail for
10 days for marijuana possession. His five days in custody of the D.C.
Department of Corrections -- interrupted by a one-night stay at Greater
Southeast Community Hospital -- ended in death. Questions concerning the
quality of care provided by the hospital and the Corrections Department
to Magbie are still unanswered. Unless his mother, Mary Scott, and his
lawyer kick up a fuss, the late Magbie will be another closed chapter in
the city's long and sickening history of dumping on the least among us.

The last five days of Magbie's life, as pieced together this week through
e-mail exchanges and interviews conducted with court and corrections officials, paint a picture of a kind of official treatment that would never be accorded a senator's son or someone with friends in city hall.

Let's begin with the office of Judge Judith Retchin. On Friday, Sept. 17,
three days before Magbie appeared in court for sentencing, Retchin directed
her law clerk to check with the person in the chief judge's office who
serves as a liaison with the D.C. Corrections Department to determine whether the department would be able to accommodate a "paralyzed, wheelchair-bound defendant." The clerk was told that the jail could handle such an inmate.

But did the clerk discuss Magbie's reliance on a ventilator? The court's
e-mail response: "No. The law clerk did not inquire about a ventilator.
Mr. Magbie had never used a ventilator in the courtroom during any of his
court appearances."

A serious omission indeed. Corrections Department Director Odie Washington
told me that if his department had known Magbie needed a ventilator, it
would have advised the court that on-site ventilator care was not available
in corrections facilities. Contrary to Retchin's announcement at the time
of Magbie's sentencing, the Corrections Department could not attend to
his needs.

Let's consider other matters that have turned up since The Post's story.

The article stated that what happened between Magbie's arrival at the jail
on Sept. 20 at 2 p.m. and his being taken to the hospital at 9 p.m. was
not explained.

An Oct. 7 e-mail response from the Corrections Department to my inquiry
indicated that Magbie went through medical and mental health processing
through the afternoon of Sept. 20 and was awaiting transfer from the jail
to the jail's annex, the Correctional Treatment Facility (CTF), when he
started having difficulty breathing at 9 p.m. A registered nurse on duty
asked if he used oxygen at home and Magbie stated that he did not use oxygen at home but he needs continuous breathing ventilator treatment at night. "This is the first time that [the Corrections Department] learns of Mr.
Magbie's need for a ventilator," the e-mail stated.

The nurse told CTF doctors, and after a second medical evaluation and finding
that Magbie needed acute medical care, they decided at 9:15 p.m. to transport him as an emergency patient to Greater Southeast Community Hospital.

The Post story reported that a court official, speaking on condition of
anonymity, said that Greater Southeast discharged Magbie back to the Corrections Department the following day, and when a senior CTF doctor who believed Magbie belonged in a hospital asked Greater Southeast to take him back, the hospital refused.

"That is absolutely not true," Joan Phillips, chief executive officer of
Greater Southeast, told me on Thursday. "They did not ask us to take the
patient back."

Bill Meeks, public information officer for the Corrections Department,
concurred. No Corrections Department medical personnel asked the hospital
to re-admit Magbie, he said.

So where did that story about Greater Southeast's refusal come from? Court
spokeswoman Leah Gurowitz said she and those she spoke with didn't know.

Another query: Why did the Corrections Department retain custody of a ventilator-dependent inmate for three nights when it knew that neither the jail nor the CTF provided on-site ventilator care?

"That was not our decision," said corrections chief Washington when I asked
him for an explanation. "We provided the care directed to us by Greater
Southeast Community Hospital," he said, and cited his department's e-mail
to me: "Magbie was returned to the CTF from Greater Southeast with a patient discharge form with instructions for nasal oxygen at night as needed. No ventilator was ordered."

But does Washington's finger-pointing hold up?

According to a Superior Court e-mail reply, on Sept. 21 -- the day after
Magbie's sentencing and overnight stay in the hospital -- a CTF doctor
contacted Judge Retchin's law clerk, informed her that Magbie needed a
ventilator when he slept and inquired about procedures to transfer him
to Greater Southeast. The clerk consulted with the chief judge's liaison
to corrections and was told that the doctor should speak with the Corrections
Department's medical administrator, because the court cannot direct medical
placements.

Washington acknowledged that a CTF physician, "acting on his own," discussed the ventilator situation with Magbie's attorney and that the two reached an agreement to have Magbie's mother bring her son's ventilator to the CTF on the morning of Sept. 24. Unfortunately, by the time she arrived,
at approximately 10 a.m., her son, having difficulty breathing, had already
been taken to Greater Southeast, where he later died.

Court, corrections and hospital bureaucrats have now scurried to their
bunkers.

Jonathan Magbie wasn't always so little thought of.

Twenty-two years ago this month, a chipper 5-year old Jonathan "John-John"
Magbie was invited to take part in a White House ceremony commemorating
National Respiratory Therapy Week. He had suffered the paralyzing injury
a year earlier and was breathing with the help of a mechanical device inserted
in his neck and speaking through a battery-powered device that he operated
with a flick of his tongue.

On the way to the White House, "John-John" told his doctor, Dean Sterling,
director of respiratory care services at Children's Hospital, and nurse
Nancy Rivers that he wanted to ask President Reagan something. After the
ceremony, and as Reagan was saying hello to "John-John," the doctor said:

" 'John-John,' you had something you wanted to ask the president, didn't
you?"

"Yes," said the boy. "What are you going to be for Halloween?"

Startled, the president replied: "I think I'll just keep being me. That's
been tough enough recently" [Bob Levey's Washington, Oct. 29, 1982].

This Halloween, both are gone.

(For the record: I have never met Judge Retchin. I did, however -- along
with other family and friends -- write a letter of recommendation last
year to the judge in behalf of a jailed relative who was being sentenced
on a felony conviction. At sentencing, Retchin credited him with time served
in jail, ordered him into drug treatment and called for a subsequent assignment to a halfway house. He is now on probation and employed. As noted in an earlier column, the King family tree includes members who have attended Penn State and the state pen.)

kingc@washpost.com

Keywords: ED

Copyright 2004, The Washington Post Co. All Rights Reserved.

WHY AREN'T WE TALKING ABOUT JUVENILE ADDICTIONS?

Wisconsin State Journal; 10/8/2004; William Wineke

This report ought to form the basis of tonight's presidential debate - but it most likely won't even be mentioned.

The National Center on Addiction and Substance Abuse at Columbia University reported Thursday that four of every five young people in the juvenile justice system either was drunk or high when committing a crime or has a long-term history of substance abuse. Of an estimated 1.9 million juveniles who are arrested for crimes and who have substance abuse and addiction problems, about 68,000 - or 3.6 percent - receive some kind of treatment for those addictions.

That's pretty shocking, isn't it? Here's an estimate that's even more shocking:
The center suggests that if we spent an average of $5,000 in treatment programs for each of the 120,000 juveniles who are now incarcerated in out-of-home facilities, those programs would pay for themselves within a year.

And those programs wouldn't have to be "successful."

All it would take, the CASA report estimates, is that just 12 percent of those children treated remain free of drugs and alcohol and commit no further crimes in order for the treatment program to break even.

By "break even" the agency means save the system the costs incurred by the juveniles in terms of committing crimes, being arrested and being incarcerated.

The report is 200 pages long and I can't really substantiate those figures here - but you can read the whole thing online at the National Center for Addiction and Substance Abuse Web site.

What's important here is that we have a national scandal that could not only be addressed but that, by addressing it, we could save society billions of dollars a year and, at the same time, save thousands of lives.

I have a feeling that, if we were to do the job right, it would cost more than $5,000 a year per child. The research agency also estimates that up to 75 percent of all incarcerated juveniles suffer from "diagnosable mental health disorders" that also need treatment.

But the potential payoff is staggering. We save the productive lives of the kids we treat - at least, we save many of them. We protect the lives of the people those kids prey upon if they're not treated. And, since a very large percentage of adult inmates were originally juvenile offenders, we reduce our adult crime rate as well.

And, are we doing it? Nationally, not very well. Dane County, it must be said, has long had fairly humane juvenile policies, at least compared to the rest of the country. But county officials have trouble just holding the line on spending for social services, let alone increase funding.

Nationally, our answer to juvenile crime seems to be to get tough with the kids. As Dr. Phil would ask, "How's that working for ya?"

The CASA study makes the point another way: "Public policy for juvenile crime has focused increasingly on accountability from the juvenile offender. But accountability is a two-way street. Demanding accountability from children while refusing to be accountable to them is criminal neglect."

Isn't this issue worthy of attention from the men seeking the highest office in the land?

(Copyright (c) Madison Newspapers, Inc. 2004)

Providing HELP to HIV-Positive Offenders in the Community
By Michelle Gaseau (http://www.corrections.com/news/staff.html), Managing Editor

The transition from prison cell to the community can be a bleak one for many ex-offenders: jobs are scarce, money is tight and housing is non-existent. These challenges are multiplied for offenders who are HIV positive.

A new program supported by a grant from the Minnesota Department of Health aims to address some of those problems and, in particular, help rectify health care disparities among offenders of color.

"When the inmates are being released, it's already difficult for them when they come back into society. It's even more difficult if they have a health disparity," said Agustina Martinez, Manager of Projects for the Minneapolis-based Council on Crime and Justice, the non-profit that is managing the new program.

The Healthy Educational Lifestyles Project (HELP) is designed to identify HIV positive and hepatitis C positive inmates who are released from Minnesota prisons to residences in Hennepin and Ramsay Counties. The goal, once identified, is to help these offenders develop new attitudes that will help them remain crime-free, become self-sufficient and live a healthier lifestyle. It began working with offenders last fall.

To get to this point, the council received a planning grant in 2002 that it used to create a service plan for a particular group of HIV-positive and hepatitis C-positive offenders - men and women of color.

According to Martinez, the council realized through information from AIDS-related service providers that this group of offenders had the most difficult time transitioning back into the community.

So HELP uses a two-pronged approach to assist these offenders: education and advocacy.

Education About Behaviors

The council sends staff members into two Minnesota prisons to conduct health education classes and then provide advocacy services both pre and post-release to offenders.

HELP's health educator, Willie Wessley conducts 10-week course at Lino Lakes and Rush City prisons teaching inmates about sexually transmitted diseases, HIV, hepatitis C and other health issues.

The courses have been ongoing since 2003, but this year HELP changed its curriculum to also include information and suggestions for changing high-risk behaviors that affect health.

"It's not only that they are learning the knowledge of HIV, but also what could happen if they have unprotected sex, for example," said Martinez.

In the courses, inmates are given a pre-test to determine what their knowledge base is and then a post-test to determine what they have learned. In addition, the courses offer an open forum for questions and discussion, which the council believes is an important part of learning and behavior change.

"We want to make sure they have an open place where they can discuss their issues," said Martinez.

The courses are open to all inmates with the hope of educating those who even refuse to be tested for HIV or even those who do not have HIV at all.

"Let's say they probably know they are positive and they are about to be released. What we do is as soon as they are released, within two weeks, we make them have a full medical check up -to see if they are positive or not," said Martinez.

The medical check-up is just the start of the services after release.

Post-Release Connections

HELP's advocacy services begin with staff member Eric McCoy who works with offenders pre-release to provide on-on-one counseling based on need.

The advocacy part of the program includes interactions with community clinics, doctors as well as housing program and services and employment services.

"If there's any need that we cannot provide them, we make sure that we [get] them to the right agency so they get their [needs met]," said Martinez.

And, even though the program is fairly new, it has an idea that it has made a difference.

One recent success story has given council staff the feeling that he programming is right on track.

Martinez said that one offender who began the HELP classes earlier this year was at the end of a two-year sentence and wanted to make life better for himself. He attended classes faithfully and contacted his case advocate from prison and began meeting with his advocate.

Then in March 2004, he was released and began receiving services outside. Today he works in the construction field and lives successfully in the community. Martinez believes that small success stories like this one will make a cumulative difference in the long run for many.

"He has changed his outlook on life and has a strong will to support his family," she said.

By connecting these offenders to employment and giving them a leg up in starting a new life, HELP hopes to show offenders how changes in behavior can benefit them and their loved ones.

"The hope for this program is that we can reduce recidivism and we teach them we can change their behavior," she said.

And, the more that HELP produces success stories, the more word will come back to offenders on the inside that education and asking for help is worth the effort.

"They [get] employment and they [get] housing and they have changed their ways because they have worked with a case advocate," Martinez said. "I think it's important because there is a huge stigma out there and there's not many programs that are doing what we're doing."

Resources:

Council on Crime and Justice www.crimeandjustice.org (http://www.crimeandjustice.org/)

Martinez - martineza@crimeandjustice.org (martineza@crimeandjustice.org)

HIV inmates to be desegregated
The Press-Enterprise

Some inmates at the California Institution for Men in Chino are fighting a proposal to move them into a housing unit for prisoners infected with the virus that causes AIDS. Many say they are afraid of contracting HIV themselves, but prison officials say the change is needed to keep dorms from overcrowding. Sgt. Arioma Sams said inmates in the prison's east yard permanent work crew have raised concerns about the proposed transfer into Del Norte, a two-story facility built in the 1980s to treat inmates who are HIV positive. The transfer will take place next month. Prison officials said the move is needed to save money and prevent housing units at the prison from becoming overcrowded. The Del Norte facility has space available, now that the number of inmates with HIV has gone down, officials said. AIDS is not an airborne virus and living together will not spread the disease, said Sams. The work crew and HIV-positive inmates already coexist in the yard, attending classes and visiting hours together, he said. Prisoners with HIV are already integrated with the general population at many of California's 32 other prisons, said Terry Thornton, spokeswoman for the state Department of Corrections. In 2002, the California Department of Corrections estimated that about 1.4 percent of the state's 160,000 inmates are infected with HIV. Thornton said her department encourages testing and education because inmates often lead lifestyles that can lead to a higher risk of transmitting the disease, such as unprotected sex and drug use.

Bill would establish mental health standards for prisons
Associated Press

The beating of a man with mental problems at a Lincoln, Neb. prison demonstrates the need for setting standards for treating inmates with mental illness, a legislative committee was told Thursday. "Because a significant number of inmates have psychological, mental, drug, alcohol and other problems, it's necessary that the system recognize these problems and address them," Sen. Ernie Chambers of Omaha told the Judiciary Committee about his bill. Chambers said the recent beating of Daniel Luethke at the prison system's Diagnostic and Evaluation Center illustrates the need for setting such standards. Luethke, 32, has a history of mental health problems. He was booked into the Seward County Jail early on Dec. 5 on suspicion of making terroristic threats. Sheriff's deputies later took Luethke to the evaluation center after he threatened jail staff and broke a window in his cell. His aunt said Luethke had failed to take the medication he needs for his bipolar disorder. One hour after being placed in a holding cell at the center, Luethke was severely beaten, apparently by another inmate. Chambers said his plan, which would cost more than $5 million a year, is especially critical because of a plan being pushed by Gov. Mike Johanns to close two of the state's three mental health hospitals. That, Chambers said, means that more people with serious mental illness could wind up in the prison system. A report issued in December by the American Civil Liberties Union said health care for inmates in Nebraska prisons and county jails is dangerously close to cruel and unusual punishment. Although the Department of Correctional Services now provides mental health care and some substance abuse counseling and treatment, Chambers' bill would set standards for providing such treatment.

Dying inmates seek release
Press-Enterprise

Lonnie Creech is dying. So is Helen Loheac. Both sit behind razor wire and iron bars at California prisons. Both are waiting for a compassionate release. Creech, 52, has lung cancer and has been given less than three months to live. Loheac, 81, has a chronic kidney ailment and goes to dialysis three times a week. Their chances of going home to die, though, are slim. Legislation passed in 1991 allows some sick inmates with fewer than six months to live and who are not threats to society to die at home. Last year, only 17 inmates out of 48 who applied won a compassionate release from the California Department of Corrections. Seven more applied to the Board of Prison Terms. One was denied and three more are being considered by the board. Last year, Vidilla Spragin of San Bernardino was granted her request and was released from the California Institution for Women in Chino. Spragin, who had killed her husband by setting him on fire, died last month from liver cancer. Creech was sentenced six years ago to 14 years for assaulting a Riverside police officer and making terrorist threats. He spends his days in the infirmary at the California Rehabilitation Center in Norco, said Lt. Tim Shirlock. In July he was diagnosed with small cell lung cancer and a tumor in his stomach, according to Sarv M. Grover, California Rehabilitation Center Chief Medical Officer. A compassionate release request with the California Department of Corrections was denied in September by then-director Edward Alameida. Two weeks ago, a second request was denied by acting director Richard Rimmer. Spokeswoman Terry Thornton said the decision was based on Creech's criminal history and current medical condition. "He is still ambulatory," Thornton said. Creech's family plans to appeal the decision to the Youth and Adult Correctional Agency and legislators.

Profile: State of prison health care in California

All Things Considered (NPR)

10-14-2004

Profile: State of prison health care in California

Host: MICHELE NORRIS
Time: 8:00-9:00 PM

MICHELE NORRIS, host:

In California, lawmakers are lamenting the state of health care in the state's huge prison system, and they want to know why a health-care system that costs a billion dollars a year is plagued with incompetent doctors and unexplained deaths. NPR's Mandalit del Barco reports.

(Soundbite of ambient noise in exercise yard)

Unidentified Woman: Yard recall.

MANDALIT DEL BARCO reporting:

In the exercise yard at Corcoran State Prison, Broderick Crawford(ph) daydreams about life after he serves his sentence for attempted murder. But right now he has a more pressing problem: a cracked tooth that he's afraid to let the prison dentist work on.

Mr. BRODERICK CRAWFORD (Inmate): I have two more years left.

DEL BARCO: You have to wait two years to get your tooth looked at?

Mr. CRAWFORD: Right. Unless, of course, I want to just pull it all the way out.

DEL BARCO: Does it hurt you right now?

Mr. CRAWFORD: I don't eat on that side. I just eat over here and wait.

DEL BARCO: You hear similar worries and worse from inmates throughout the California prison system. Many doctors and medical staff have been hit with charges of incompetence and medical neglect. And in recent days, the case of an inmate who died after having his wisdom teeth pulled has generated more negative headlines. Forty-one-year-old Anthony Shumake suffered a complication that eventually led to heart failure. His family is suing the state for wrongful death. And there's the ongoing class-action lawsuit against the California Department of Corrections, the CDC.

State Senator JACKIE SPEIER (Democrat, California): To put it very bluntly, the health-care system at CDC is sick.

DEL BARCO: During a recent public hearing in Sacramento, state Senator Jackie Speier painted a grim picture of how prison doctors have been responsible for costly lawsuits and unnecessary deaths.

State Sen. SPEIER: Twenty percent of the physicians have either a bad mark on their record or a series of malpractice lawsuits, a figure that is four to five times higher than the general population of physicians in California.

DEL BARCO: A new state report spells out the details, such as prison doctors who themselves have criminal convictions, others who have a history of alcohol or drug addiction, and some prison physicians who've lost the privilege of working at outside hospitals. Senator Gloria Romero says the system is broken.

State Senator GLORIA ROMERO (Democrat, California): The problem is much like our correctional system itself, we haven't quite rehabilitated our behavior, and this must stop.

DEL BARCO: The allegations are not new. One inmate lawsuit recently labeled California's prison medical care as `cruel and unusual punishment.' But some doctors bristle at charges of incompetence.

Dr. JUAN TORR(ph) (Prison Doctor): We are as good as anybody out there doing medicine.

DEL BARCO: Dr. Juan Torr practices medicine in Chowchilla, at the country's largest women's prison. At 73 years old, he's worked for the prison system for the past decade.

Dr. TORR: There's no doctor that I know of that hasn't had a lawsuit against him, OK? We all have them, but if they're dismissed, they're dismissed.

DEL BARCO: So in other words, you're saying that doctors here are no different from any doctor anywhere?

Dr. TORR: No. I believe we're more scrutinized, to check our license completely.

DEL BARCO: Doctors complain about not having up-to-date equipment and adequate staffs.

Dr. JOE BICK (California Medical Facility): Hi, gentlemen.

DEL BARCO: At the California Medical Facility in Vacaville, the state's largest prison hospital, Dr. Joe Bick says his staff could use twice as many nurses, more examination tables and even something as basic as chairs. And the patients themselves are a challenge.

Dr. BICK: For many of them, when they were on the street, health care was not their priority, so they've never seen a dentist; their teeth are rotting out. They've got terrible feet because they've been living on the street. They've been shot; they've been stabbed. They've jumped out of buildings. They've had car crashes. They've ignored their diabetes and their hypertension. And now they have a moment of clarity where they can focus on their medical care, and they want it all done now.

DEL BARCO: As for why California spends a billion dollars a year on this troubled system, Dr. Bick blames it mostly on costly drugs for treating inmates with chronic problems: HIV, AIDS, hepatitis C and mental illness. And because of the aging inmate population, many of the prisons in California have become de facto nursing homes. Clyde Hoffman is 80 years old and dying of emphysema and lung cancer. He's spending the remainder of his life sentence for murder at the prison in Vacaville. He's one inmate who says he's grateful for the hospice care he's getting.

Mr. CLYDE HOFFMAN (Inmate): Everybody that works up here is excellent. This was far beyond my hopes and dreams that there'd be a place like that in prison.

DEL BARCO: Hoffman's doctor, Joe Bick, the chief medical officer, admits some of the prison doctors probably should have their licenses removed. But the majority, he says, are doing their best to heal the sickest of the sick in California's prisons.

Dr. BICK: Many of us who are here are not here because this is the only choice we have. We didn't come here because we're running away from something. We came here because this is something we care deeply about.

DEL BARCO: Dr. Bick says, in a strange way, prison doctors have a lot in common with the inmate. They sometimes feel just as isolated as their patients, spending their days behind bars.

(Soundbite of prison door)

DEL BARCO: Mandalit del Barco, NPR News, Los Angeles.

(Soundbite of prison door)

NORRIS: You can see photos of the conditions in some of California's health-care systems at our Web site, npr.org.

Content and Programming copyright © 2004 National Public Radio, Inc. All rights reserved.

MALPRACTICE AT THE JAIL

The Palm Beach Post

10-13-2004

Providing health care at jails and prisons is a tough business. Inmates often are uncooperative and sometimes hostile. Medical records are hard to find. Substance abuse complicates treatment efforts.

But none of this excuses the manner in which the Palm Beach County Jail's private medical provider, Prison Health Services, ignored Patrick Bilello in the weeks before his death last year. Bilello, who had a history of heroin abuse, also had HIV, hepatitis C, anemia, abnormally low blood pressure, pneumonia and heart problems. Yet he was in jail for 53 days without seeing a doctor. By the time he was examined, it was too late. PHS transferred the 47-year-old man to the emergency room at Columbia Hospital as a non-emergency patient. Bilello died there after his heart stopped five times.

His widow, Rosanne Bilello of Palm Springs, is suing PHS and its corporate parent, America Service Group Inc., as well as two doctors - jail medical director Erin Cody and her interim replacement, Edgar Escobar - and Sheriff Ed Bieluch. PHS has fired Dr. Escobar but announced no disciplinary action. Sheriff Bieluch has fired PHS and hired its rival, Correctional Medical Services, the lowest bidder for a two-year contract that began Oct. 1.

The case for firing PHS went beyond Bilello. Several inmates had died after receiving questionable care; judges ordered other inmates released to receive private care; and PHS was slow to respond to a persistent staph infection at the jail. PHS has contracts in 22 Florida counties, including St. Lucie, where the firm also provides health care at the jail.

Palm Beach County prosecutors considered pursuing criminal charges and presenting the Bilello case to a grand jury. They pulled back, saying investigators had not uncovered sufficient evidence. Boynton Beach lawyer Gary Susser, who represents Ms. Bilello, said he was pleased with the depth of the PBSO's internal investigation, which confirmed that none of the jail's doctors saw Bilello. In statements to lawyers, Dr. Escobar admitted that he only stamped his name, initialed and dated a critical lab report that showed a dangerously low level of oxygen in the blood. Ms. Bilello and Mr. Susser repeatedly sent PHS letters, imploring the company to give Bilello all his medication. It took an order from Circuit Judge Kenneth Stern to force PHS to give him his medication three weeks before his death.

Prosecutors may be waiting until the civil case uncovers more evidence to consider filing charges. But if 53 days of neglect, indifference and intransigence aren't enough to suggest criminal behavior, how many days does it take?


Copyright © Palm Beach Newspapers, Inc., 2004

Legionnaires bacteria found in women's prison

AAP General News (Australia)

10-15-2004

Qld: Legionnaires bacteria found in women's prison

By Alex Murdoch

BRISBANE, Oct 15 AAP - Bacteria that causes the deadly legionnaires' disease has been found in an airconditioning system at Brisbane Women's Prison, authorities said today.

Corrective Services spokesman Ron Watson said the bacteria was picked up on Wednesday as part of the service's regular screening process at the prison and was eradicated yesterday.

He said the unit was in one of the prison's kitchens, and as such was not in an area frequented by children who visit the facility.

"It's also not a unit that has a full thoroughfare of all staff and prisoners," Mr Watson said.

Legionnaires' disease is a potentially fatal form of bronchopneumonia (lung infection), with an incubation rate of two to 10 days.

The water coolant systems of some air conditioning systems have been found to be an ideal breeding environment for the bacterium.

Mr Watson said a maximum of 10 staff and 16 inmates had been exposed to the disease and had been offered free medical checks.

He said anyone who displayed the symptoms of legionnaires' disease would be immediately tested.

"Delegates of the Queensland Public Sector Union, which represents custodial staff, were briefed this morning on the find and eradication," Mr Watson said.

"The prison was locked down at 10am to enable all staff to be briefed by Workplace Health and Safety, health and air-conditioning experts."

Mr Watson said legionnaires' disease was not contagious; it cannot be spread from person to person or from contaminated food. It can only be spread by breathing in the bacteria from a contaminated air supply.

AAP am/sc/cdh/was/de

KEYWORD: LEGIONNAIRES

© 2004 AAP Information Services Pty Limited (AAP) or its Licensors.

Reports: Over 80 percent of Russian prison inmates sick

AP Worldstream

10-15-2004

Dateline: MOSCOW
More than 80 percent of Russia's prison inmates have health problems, Russian news agencies reported Friday, quoting the country's human rights ombudsman calling the situation catastrophic.

Of the 615,000 people currently in prisons in the nation of 144 million, nearly 500,000 have some kind of illness, the Interfax news agency quoted Justice Ministry spokesman Oleg Filimonov as saying.

About 36,000 inmates are HIV-positive, 56,000 have tuberculosis and many are suffering from the effects of previous drug use, Filimonov was quoted as saying.

Human rights commissioner Vladimir Lukin called the state of medical facilities in Russian prisons "wild and catastrophic." Lukin said only half of the nation's correctional facilities have been certified by doctors.

Russia has one of the largest per capita prison populations in the world, and its jails and labor colonies have become severely overcrowded. Cells intended for eight people are sometimes packed with up to 30, forcing inmates to sleep in shifts.

Copyright 2004, AP News All Rights Reserved

PRISONER LEFT BRAIN-DEAD He gave help, but got beaten Inmate was allegedly attacked by another he had just been assisting with legal matters at a Bronx courthouse


Newsday

10-17-2004

BY GRAHAM RAYMAN, LUIS PEREZ AND ROCCO PARASCANDOLA. STAFF WRITERS



An inmate at a jail barge could face murder or manslaughter
charges in a Bronx courthouse beating that left a prisoner comatose and
brain-dead, police said yesterday.

Kenny Taylor, 27, was charged yesterday with assault in the Tuesday beating
of Ronald Fesce, 54, inside a holding pen at Bronx Criminal Court, on East
161st Street.

A law enforcement source familiar with the incident said Fesce has a
working knowledge of the legal system and was helping Taylor with his pending assault case.

But the two got into an argument, possibly regarding the assistance Fesce
was providing Taylor, and Taylor attacked Fesce, the source said.

Fesce fell, hitting his head on a bench, then on the concrete floor, police
said. He was aided by prisoners and regained consciousness, police said. The
city's Correction Department said correction officers did not witness the
assault. The agency and police also said Fesce did not tell anyone in authority what had happened.

On Thursday, Fesce, back in his cell at the Vernon C. Bain Center, a jail
barge in Hunts Point, complained of body and head pain - both of his eyes were black, the source said - and he was taken to Lincoln Medical and Mental Health Center.

He later lapsed into a coma and is brain-dead, police and the source said.

Fesce, who was in custody for allegedly selling drugs near a school, is
divorced and has a 16-year-old son.

Many of Fesce's neighbors, on Dawson Street in Morrisania, were unaware of
the alleged assault but said it was characteristic of Fesce to want to provide
legal assistance. He had a keen interest in the law, fueled in part, they
acknowledged, by his arrests, mostly for drug offenses. Often, they said, he
would retreat to the quiet of the library on nearby Kelly Street and research
legal matters, sometimes for friends.

"He loved the law a lot," said neighbor Jamie Baker, 24. "That was his main
subject."

Neighbor Vivian Torres, 41, said that when her son was arrested on a
marijuana charge, Fesce provided legal counsel that helped her son avoid jail.

"If he wasn't the way he was, trying to help everybody, maybe he wouldn't
have ended up the way he did," said a third neighbor, Lisa Joyce, 28. "He was a real good person."

Copyright 2004, Newsday Inc.

That is a shame - actually that is so sad.:(

My prayes go out to his family and loved ones. That is a horrible way to go - trying to help someone who didn't appreciate him or his efforts.:mad:

Gosh that is terrible :(

Posted 10/19/2004 8:06 PM Updated 10/19/2004 8:11 PM

Some inmates will get flu shots

The Associated Press

Norman Cooper has been unable to find a flu shot for his wife who takes daily oxygen treatments for asthma, emphysema and bronchitis. So he was incensed to learn that some inmates in the state prison 30 miles down the road were getting flu shots. (Related story: U.S. to get more flu vaccine in January (http://www.usatoday.com/news/health/2004-10-19-flu-vaccine_x.htm))
"This deal with the prisons has got me so upset," said Cooper, who also hoped to help an 80-year-old friend who was on oxygen for a chronic lung illness. "I don't think they should get flu shots over citizens who are at high risk. They're being treated like first-class citizens, and we are second-class citizens."

Federal and state prison officials say the inmates getting the shots are also high-risk — either 65 and over or suffering from a chronic medical condition. They say it's the surest way to fend off a flu epidemic inside the prisons that could be costly to taxpayers.

But Cooper's distress over the situation is just one example of the difficulty of fairly distributing the nation's short supply of flu vaccine.

The government estimates there are 98 million people at high risk of flu complications, and expects to have a little more than half of that number of flu shots.

The Missouri prison system's medical services contractor, Correctional Medical Services, got 8,780 of the 9,460 doses it had requested, said spokesman Ken Fields. And he said all of those shots have already been given to high-risk inmates as well as some high-risk staffers who have direct contact with them.

"By being proactive about this, we hope to keep inmates from having to be housed in outside hospitals," said John Fougere, corrections spokesman.

Meanwhile, Cooper and thousands of others have spent countless hours calling doctors and health departments seeking flu shots. Cooper, who lives in Scott City in southeast Missouri, says his 64-year-old wife was hospitalized in June and was warned that a cold or the flu could be fatal.

But prison officials argue that inmates also need protection. Even though they are confined, they are susceptible to flu through contact with staff, visitors and turnover among inmates, said Joe Weedon, spokesman for American Correctional Association, a trade group that accredits jails and prisons. A large number of inmates also suffer from alcohol and drug addictions, which can compromise their immunity.

"You've got an environment where inmates are living in close quarters, coming into contact with each other and not necessarily in the most sanitary conditions because they don't wash their hands," Weedon said. "The inmates throw fecal matter at other inmates or at officers, things like that do happen, and they lead to the spread of disease."

Even so, while prison populations often have infectious outbreaks like staph infections or hepatitis, no corrections officials could recall a serious outbreak of flu among an inmates.

Like the rest of the country, prison officials have been told not to expect all of the vaccine they ordered.

While Missouri had enough vaccine for nearly a third of its inmates, Texas, with one of the nation's largest prison populations, is mapping plans for doling out 1,100 flu shots among 150,000 inmates — or less than 1%.

"Our infection control policy is to give a flu vaccine to chronic disease patients, HIV/AIDS patients, offenders 65 years of age and older and pregnant females," said Texas prisons spokesman Mike Viesca.

As part of its infection control policy, health officials with the Texas corrections system also vaccinate to protect against pneumococcal bacteria, a common flu complication, and Hepatitis B, measles-mumps-rubella and tetanus and diphtheria.

In Kansas, the Department of Corrections doesn't have any flu vaccine for its 9,000-plus inmates. Officials hoped to learn later this week whether it would get some, spokesman Bill Miskell said. Last year, 5,500 flu shots were given to inmates and employees, he said.

Dan Dunne, a spokesman for the Federal Bureau of Prisons, which has 152,811 inmates across the country, said the system didn't expect to use a disproportionate amount of vaccine.

He said he didn't know how many flu shots were available for federal prisoners. Shots to employees will be limited to those at greatest risk of getting the flu and spreading it to prisoners, he said.

Article found here: http://www.usatoday.com/news/nation/2004-10-19-inmates-flu-shots_x.htm (http://www.usatoday.com/news/nation/2004-10-19-inmates-flu-shots_x.htm)

BRONX CRIMINAL COURT HOLDING FACILITY Inmate death under investigation Man was released from clinic after being injured during fight; second local jail death in two weeks

Newsday

10-19-2004

BY GRAHAM RAYMAN. STAFF WRITER

The wife and son of an inmate who was fatally assaulted in a city holding pen on Oct. 12 demanded answers yesterday.

Ronald Fesce, 54, of the Bronx, was removed from life support Sunday at
Lincoln Medical and Mental Health Center, five days after police said he struck
his head on a bench and a concrete floor in a fight with another inmate in the
pen at Bronx Criminal Court.

"He was under the city's care, and somebody has to be held accountable,"
Fesce's wife, Carmen Cerezo, 50, said yesterday.

Assemb. Ruben Diaz Jr. (D-Bronx), noted that the Fesce case followed the
Oct. 3 beating death of Tyrrell Abney at another jail facility.

"The mayor was outraged at one killing in Rikers, and now we have another,"
he said. "Nobody deserves to die this way. The family is not getting answers."

Thomas Antenen, a Correction Department spokesman, said an investigation by police and prosecutors is ongoing.

"The answers will be forthcoming as the investigation continues," he said.

Ellen Borakove, spokeswoman for the city medical examiner's office, said an
autopsy is pending.

Cerezo said Fesce, who faces drug charges, was known as "the street
lawyer," often representing himself in court. "He learned a lot about the law,
and he would try to advise people of their rights," she said.

Fesce had a close relationship with his son, Ronald Jr., 17, a high school
senior. "He was a guy who tried to make friends with everybody," his son said.
"It's a shock."

The extent of Fesce's injuries was not discovered until more than 24 hours
after the incident.

Cerezo said Fesce had scratches, bruises and black eyes, when she saw him
in a comatose state at Lincoln Friday night. "It was like he had been in a
fight with a truck," she said. "How is it that no one noticed?"

Cerezo said she questions why Fesce was sent back to his cell after a visit
to a jail clinic a day after the assault.

Police said inmate Kenny Taylor, 27, who was facing assault charges, pushed
or struck Fesce on Oct. 12 during an argument, possibly over legal advice.
Antenen said the altercation wasn't witnessed by correction staff. After the
assault, Fesce was transferred back to the Vernon C. Bain Center.

On Oct. 13, an officer noticed a bruise on Fesce's face and sent him to a
clinic for treatment, a correction source said. Fesce told doctors he was OK,
the source said. That same day, he was transported to the criminal court, where he pleaded not guilty, and was returned to the Bain center.

Just after 5 a.m. on Oct. 14, Antenen said, Fesce complained that he felt
ill, triggering a trip to the clinic and then a transfer to Lincoln.

Cerezo said she was told an officer saw Fesce passed out in his cell, and
took him to the clinic. Another inmate, she said, also reported that Fesce
seemed sick.

Once at Lincoln, Cerezo said, doctors noted he was already in poor
condition, with visible injuries on the front and rear of his head. They did a
CT scan and operated to try to relieve brain swelling.

Fesce was moved to intensive care Friday, she said. She did not learn that
Fesce had been taken to the hospital until that night, when she found a note
from a correction chaplain taped to her door.

Copyright 2004, Newsday Inc.

California Blasted for Poor Prison Health Care

Mandalit del Barco, NPR

The HIV ward at Vacaville State Prison in California.

“To put it very bluntly, the health care system at (the California Department of Corrections) is sick. Twenty percent of the physicians that work at the CDC have either a bad mark on their record or a series of malpractice lawsuits -- a figure that is four to five times higher than the general population of physicians in California. ”
California state Sen. Jackie Speier (D-San Mateo/San Francisco)





All Things Considered (http://www.npr.org/programs/atc/), October 14, 2004 · California spends $1 billion each year to provide medical services for inmates of the state's 32 prisons. But the quality of that care is being scrutinized. NPR's Mandalit del Barco (http://www.npr.org/about/people/bios/mbarco.html) reports on accusations of medical incompetence, lax staffing and outdated equipment, and the challenge of treating patients who often ignore their health until their illness is all but untreatable.

Broderick Crawford, an inmate serving time for attempted murder at Corcoran State Prison, is typical of many prisoners who simply don't trust the quality of care behind bars. He's got a cracked tooth, but he's afraid to let the prison dentist fix it. He's willing to wait until his sentence is served -- two years and counting -- and get it fixed on the outside.

Many California prison doctors and medical staff have been hit with charges of incompetence and medical neglect. A recent case involving an inmate who died after having his wisdom tooth pulled has generated more negative headlines. There's also an ongoing class-action lawsuit against the California Department of Corrections( CDC).

"To put it very bluntly, the healthcare system at CDC is sick," says state Sen. Jackie Speier (D-San Mateo/San Francisco). "Twenty percent of the physicians that work at CDC have either a bad mark on their record or a series of malpractice lawsuits -- a figure that is four to five times higher than the general population of physicians in California."

One inmate lawsuit recently labeled California's prison medical care as "cruel and unusual punishment."

But some prison doctors bristle at charges of incompetence. "We are as good as anybody out there doing medicine," says 73-year-old Dr. Juan Tur, who practices medicine at Chowchilla, the nation's largest women's prison. "I believe we're more scrutinized, to check our license completely."

Other prison doctors complain of outdated equipment and inadequate staffing. And the patients themselves can be a huge challenge to treat.

"When they were on the streets, health care was never a priority, says Dr. Joe Bick, who works at the California Medical Facility in Vacaville -- the state's largest prison hospital. "So they've never seen a dentist, their teeth are rotting out, they've got terrible feet cause they've been living on the street, they've been shot, they've been stabbed, they've jumped out of buildings, they've had car crashes, they've got diabetes and hypertension.

"They're first diagnosed with HIV when their immune systems are shot. And now they have a moment of clarity, where they can focus on their medical care, and they want it all done now," Bick says.

Peace....HIV is real in all communities. Given this reality it only makes sense to have condoms available to cease, as much as possible, the spread of the disease. I work in a hospital. Have seen too many patients who have this disease. As I have told people, one can not look at a person and tell whether he/she has the disease...if you were able to simply look...no one would have it. Its real! Everyone should have access to all tools to fight it and to protect themselves from it. It another arena that folk need to organize around. Thanks for the inforamtion. Blessings...

Did anyone read the article in the most recent issue of READERS DIGEST about prison health care? I only got a chance to glance at it, but it talked about how GOOD the inmate's medical care was & that they get better health care than people in the community. I don't have the magazine with me, but maybe I can get it & read the whole thing & post more on the article.

No, I haven't had a chance to read it. Please do post it if you can get it. I will look for it also.

Nutrition: A Proactive Approach to Inmate Health
By Kelen Tuttle (http://www.corrections.com/news/staff.html), Internet Reporter

Nutrition in correctional facilities has come a long way in the past two decades. While in the 1980s the recommended dietary allowances published by the Food and Nutrition Board sought to meet the needs of healthy people, they now endeavor to help people stay healthy by preventing nutritional deficiency diseases and chronic disease. According to Barbara Wakeen, a registered licensed dietitian, correctional systems are beginning to successfully incorporate these nationally recognized standards into correctional menus.

Wakeen, who plans correctional menus and researches the standards upon which they are based, believes that correctional systems are generally in compliance with both national standards and the often more stringent statewide standards. Yet Wakeen also said that if more states and jails instituted a "heart healthy" menu, it could lead to fewer specialized diets and healthier inmates overall.

"It's important to take the proactive approach to prevention instead of just maintaining health," Wakeen said. By providing more nutrition education and serving heart healthy meals, Wakeen believes prisons will "prevent disease down the road instead of just treating it later."

A heart healthy diet as promoted by the American Heart Association consists of foods high in fiber and low in saturated fat, sodium, and cholesterol. While many states already serve healthy heart meals to inmates, Wakeen advocates the use of these kinds of diets in all correctional facilities.

"By streamlining the process using these nationally recognized standards and offering a healthy heart menu to all inmates, we can optimize nutritional care to ensure that all inmates get adequate nutrients," Wakeen said.

Although Wakeen expresses satisfaction with the overall nationwide compliance with dietary regulations, she also said that the accuracy of medical meals is an ongoing concern. "If medical diets for inmates with health conditions such as diabetes, hypertension, or cardiovascular disease are not followed, serious consequences can result," she said. Wakeen indicated that varying monitoring systems are used nationwide to ensure that those who need special diets receive them consistently.

Universal Diet Cards

A new program in Washington State addresses this concern with the Universal Diet Card, a system that ensures consistency in the diets of offenders. According to Cheryl Johnson, Registered Dietitian and Food Program Manager for the Washington State Department of Corrections, the program "successfully reduces costs while also ensuring the dietary health of offenders."

The program requires that a medical provider or religious chaplain screen new inmates for special nutritional requirements when they first enter the prison system. As usual, inmates with special dietary needs receive a card listing their dietary requirements. Yet, by laminating this card to the back of the offender's identification badge and marking the front of the badge with a red stripe to indicate the presence of a dietary requirement, prison officials ensure that the inmate's diet remains consistent no matter how often he is transferred from prison to prison.

"Before we had to repeat the screening process at every institution, reissuing dietary cards every time," said Johnson. This allowed inmates to change their dietary requests frequently, often without cause. "Even then," Johnson said, "inmates could take their dietary requirement badge off or put it on depending on the meal, [leading to a lack of dietary consistency and effectiveness]."

By issuing permanent cards that are consistent throughout the prison system, Washington State increased offender accountability and compliance. According to Johnson, inmates now receive the right meal every time they come through the chow line, which helps to maintain the inmates' health.

It has also decreased the number of confrontations between inmates and food service staff, which is good news for Johnson. Inmates can no longer claim false dietary needs because staff can confidently determine an offender's dietary status with a glance at his identification badge.

"There are much fewer arguments over meals because the dietary cards are always right there on the inmate's badge," she said.

Another benefit of the Universal Dietary Card is lowered operating costs in Washington prisons, according to Johnson. Although prisons continue to screen inmates at regular intervals to reevaluate dietary needs, administrative costs have declined because prisons no longer conduct a new screening every time an offender transfers. The program also saves money in the kitchen, reducing waste by ensuring that all special meals are eaten. "If we make 10 vegetarian meals because there are 10 inmates registered as vegetarians, all 10 will be eaten," said Johnson. "This way, we make only as many meals as we need."

Johnson recommends the program to prison systems across the nation. "It has real medical implications, especially with the cost of healthcare on the rise," she said.

Wakeen and Johnson will present their work in a joint presentation at the NCCHC Conference in November.

Prison system fails female inmates


Kristin Kelley (kellykri@bvu.edu), Editorial Board

Mammograms, pap smears and chemotherapy are not often words one would associate with prisons, but in recent years, many women have died because the prison system is refusing to grant women proper medical care. Prison officials are denying medical treatment for women inmates because they feel the women are either faking illness or just want drugs to feed an addiction.


Women represent fewer than 10 percent of the total prison population, but this does not excuse our system for failing our women. While it is true most women are in prison on drug-related charges, granting them a mammogram when they find a lump on their breast or a regular pap smear to prevent against cervical cancer has nothing to do with an addiction to drugs.

"Deadly Health Care at California's Prisons," published in Revolutionary Worker, recounts the story of Pamela Coffey. Coffey, 46, was sent to prison after being convicted of selling drugs.

While in prison, Coffey complained about a large knot in her stomach, which other inmates described as being so large it looked as though she was pregnant with twins. The only medical attention Coffey received was a few tablets of Benadryl.

In December 2000, Coffey died in front of her fellow inmates. Coffey had collapsed on the floor of her cell. Her cellmates called for medical assistance which did not arrive until approximately 45 minutes later.

By the time the medical officials arrived, Coffey could barely speak and could no longer sit up. The medical official on the scene, upon arriving and finding that Coffey could no longer talk because her tongue was so swollen, told the other inmates that they could do more for her than he could and walked away laughing. Minutes later, Coffey died without receiving any help from the medical staff on duty within her prison.

Coffey's story is one of many horrendous stories of women who died in prison because they did not receive proper medical attention.

In 1999, two women were given tuberculosis medicine when they did not have the disease, which caused their livers to fail, their waists to bloat to over 60 inches and eventually led to their deaths. In many cases, women are not allowed to receive needed medication such as chemotherapy to battle cancer or AIDS-related drugs to keep them alive. Some are even forced to walk back to their cells after major surgeries.

Often when comparing the United States to the world, we see this nation as superior, but with regards to our treatment of women in the prison system this is not the case.

Internationally, shackles are only used when absolutely necessary, but in the U.S. these are a common sight. In fact, women giving birth are often shackled, which can cause some serious complications for the babies being born as well as for the mothers themselves.

While we are sending these women to jail to teach them a lesson, are we really trying to kill them? The U.S. sends individuals to prison for murder, but each day this nation is killing or advancing women within the prison system toward their deaths.

Women should not be dying from preventable causes within our prisons. It may cost a few extra taxpayer dollars, but in the end is not the life of a human worth it? Yes, these are criminals, but we send them to jail to become reformed, and we should give them that chance. They should especially be given the chance to live through their sentence.

Article found here: http://web.bvu.edu/organizations/tack/asp/story.asp?id=3200 (http://web.bvu.edu/organizations/tack/asp/story.asp?id=3200)

Great article! The correctional health care system is making strides in some areas and has so much room to grow in other areas. Keeping these issues out in the forefront should guide continued progress, we hope!

:eek:
THAT'S OUTRAGEOUS!
Reader's Digest October 2004

I got a hold of the Reader's Digest article that I was talking about earlier that's about "health care in prisons". The article is written by Michael Crowley, a regular columnist for READER'S DIGEST , also a senior editor at the New Republic magazine. Write to him at outrageous@rd.com

I think this writer needs to get in touch with the "real world" of prison healthcare!
CRIME PAYS......... if you need top-notch medical care

The article starts out.........
"James Wolfe was doing hard time in Pennsylvania for raping an eight-year-old girl when he discovered that prison can be a pretty good deal. It seems James had always wanted to be a woman (he had even changed his name to Jessica). and a doctor labeled his condition "gender identity disorder." That made James eligible for hormone treatments to help change his gender---at taxpayer expense. The state says these treatments don't cost much, but according to an estimate by the Pittsburgh Tribune-Review, they can run up to $8,000 per year."

"Here's the really bitter medicine: That amount could go a long way toward providing health insurance for a family. With an estimated 44 million peple in America lacking health coverage, one million of them in Pennsylvania alone, you'd think inmates would be the last to receive elective procedures."

".....It gets worse because the problem goes well beyond these sorts of unusual treatments. Around the country, hardened criminals of every stripe receive top-notch care that many average families don't get, including expensive dental surgery......."

"In Oregon, which has recently cut public health benefits, the state is spending about $120,000 per year on dialysis treatments for a convicted murderer on death row. In other words, it's shelling out big bucks to keep him alive until it's time to kill him. True, there's always the chance he'll get his death sentence revoked, but why are his costly treatments guaranteed and fully covered when plenty of law-abiding people can't affor the care they need?"

"Something to think about. So is the fact that other hugely expensive treatments, like bone marrow transplants and heart-bypass surgery, have been provided to prisoners, courtesy of your wallet and mine."

"Convicts sometimes even qualify for precious organ transplants. Two years ago in California, a twice-convicted felon serving time for armed robbery got a new "ticker", at an initial cost to the state of $900,000. At the time, 3.900 people were on the national waiting list for a new heart, and hundreds of them eventually died waiting."

Meanwhile, a person without health insurance might never have made the list in the first place. Unlike an inmate with guaranteed coverage from the government, an uninsured individual may be judged too financially risky by many hospitals."

"It's all startling evidence of a little-known quirk of american life:
the only class of people with a constitutional right to health care in the United states are prison inmates."
For the roughly one in seven Americans living without coverage, their best hope of seeing a doctor for free might be getting thrown behind bars."

"....At times, the inmates even get top-dollar treatment. ...The California state prison system spent $11 million for dermatology services in just one budget year---including services performed by a Beverly Hills dermatologist. The state has also spent millions on hearing aids for prisoners, even thought many private health plans don't cover them. It's no wonder, then, that California's prison health care costs soared 11% over the past year...."

"....Sure, this can be a tricky issue. Should we just let inmates die of illness without treatment? Does anyone want to deny a jailed shoplifter an emergency room visit? Of course not. But maybe it's time to ration care behind bars more carefully."

"Maybe a violent criminal who needs a liver should be bumped down the long waiting list. And surely criminals shouldn't be rewarded with better coverage than law-abiding people, who deal with ever-stricter managed-care plans. The bottom line, though, is simply this: Premium health care shouldn't be the reward for robbing a bank."

Well, what do you think? Myself, I'm OUTRAGED at his view of how health care is in US prisons! I think we should write to him at the email address above and tell him some of the true stories of health care behind bars!
I think he should write a retraction to HIS outrageous opinions.
For instance the issue about transplants: Not everyone who is on an organ receipient list gets the next available organ! They might not be a match. My boss just died suddenly (at age 57). She was able to donate her liver & kidneys, but not her heart, because there wasn't a match on the list that could receive it.

Well, anyway, as you can see, I'm passionate about this issue. I hope we'll all give this writer an ear-full!

November 27, 2004

EDITORIAL OBSERVER

The Federal Government Gets Real About Sex Behind Bars

By BRENT STAPLES


Thirteen million Americans have been convicted of felonies and spent time in prison. The prison system now releases an astonishing 650,000 people each year - more than the population of Boston or Washington. In city after city, newly released felons return to a handful of neighborhoods where many households have some prison connection.

The so-called prison ZIP codes have more in common than large populations of felons or children who grow up visiting their mothers and fathers in jail. These neighborhoods are also public health disaster areas and epicenters of blood borne diseases like hepatitis C and AIDS. Infection rates in these areas are many times higher than in neighborhoods short distances away.

No one can say how many infections begin in prison. But the proportion could be high given the enormous concentrations of disease behind bars and the risky behaviors that inmates commonly practice. They carve tattoos in themselves using contaminated tools borrowed from other inmates.

They inject themselves with drugs using dirty syringes.

The most common source of infection could easily be risky, unprotected sex, which, despite denials by prison officials, is clearly a regular occurrence behind bars. A recent study of male inmates in several prisons, for example, found that more than 40 percent had participated in sexual encounters with another man. Most of these inmates, by the way, viewed themselves as heterosexual and planned to resume sex with women once they got out of prison.

Prison systems in Canada and Europe have tried to cut down infection by making condoms available to inmates. Prompted by research showing that sterile syringes slow the spread of AIDS among intravenous drug users, several countries have actually moved programs that supply clean needles right into the prisons.

Public health officials who favor needle exchanges in the United States are fully aware that this country has just emerged from a presidential election that witnessed heightened activism by conservative Christians. Indeed, even nonreligious Americans would prefer to see prisons shut off the flow of illegal drugs and provide addicts with treatment instead of syringes.

The condom issue, however, seems somehow less explosive. But as of now, condoms are banned or unavailable in 48 of 50 state prison systems, on the theory that distributing them would condone illicit sex. When confronted with public health data from abroad, American prison officials have blithely suggested that all the fuss is overblown - because there is little sex to speak of in jail.

Congress seemed comfortable with this fiction until 2001, when the Human Rights Watch organization issued a grisly report titled "No Escape: Male Rape in U.S. Prisons." The study suggested that rape accompanied by horrific violence was a regular aspect of American prison life. Based partly on the accounts of more than 200 prisoners in nearly 40 states, the report told of prison officials who stood by while sexual predators raped fellow inmates and sometimes sold them - as sex slaves - to gangs and other inmates.

The study led directly to the Prison Rape Elimination Act of 2003, which sailed through Congress and was signed into law by President Bush. The law, which requires the Justice Department to collect data on prison rape and develop a national strategy for combating it, provided a much needed mechanism for weeding out sexual predators behind bars.

But this law is, at its heart, a public health law. It provides for grants that could be used to underwrite public health initiatives - including sorely needed studies of disease transmission in the criminal justice system. The law has already resulted in fruitful discussions about expanding disease testing and prevention behind bars.

Lawmakers find it easy to discuss prison sex in the context of rape because everyone agrees that sexual assault is horrible and needs to be rooted out. The conversation about consensual sex among inmates will be trickier to handle. Even so, the law will inevitably force prison officials to confront all the varieties of sexual contact that public health researchers have known about for a long time.

The commission created by Congress to oversee the new law is just getting started. But it has already brought some honesty to the historically dishonest conversation about sexual behavior in prison. Commission members who have spent time in the public health world, for example, are well aware that people who participate in sex behind bars do so for a variety of reasons. Some barter their bodies - and risk disease - in exchange for protection from marauding gangs. Others perform sex acts in exchange for necessities like soap, food and access to telephone calls.

Not all sex in prison, however, can be attributed to rape or bartering. Recent research suggests that some of it is consensual among lonely inmates who experience same-sex encounters for the first time - and for many of them, the only time - while in prison.

The new law is pushing some states to create new strategies for dealing with sexual assault in prison. But common sense tells us that sex among inmates will not disappear even if rape and coercion are taken out of the equation. That said, prison officials need to revisit rules that outlaw condoms behind bars. These rules aid the spread of diseases that flourish in prison - and then make the leap to the world outside.

Copyright 2004 (http://query.nytimes.com/ref/membercenter/help/copyright.html) The New York Times Company (http://www.nytco.com/)

I totally disagree with the Readers Digest writter, I wonder if he visited any of the prisons in California to really get an idea about how poor the medical and especially the mental health care is. I think it is a disgrace to the people of California. Inmates are dying from lack of care, the mentally ill are being brutalized by guards and other inmates. Inmates are taken off their medications and left to die. The mentally ill are taken off their meds, and when they get to the state when they start to get out of control, they are handled brutally, and the acts of these sick are then reported to the media to make the citizens turn against any help for inmates. But in the reports to the media, the reason for the sick to get out of control isn't mentioned, removal from necessary meds. A bill was passed by our Govenor which said that any inmate not diagonised by a prison doctor will not be medicated or illness recognised regardless if he or she was diagonised by a civilian doctor. And we pay for this medical abuse as tax payers. Sure hope I never find myself having to go to prison.

Let me tell you a little story about a inmate in a womens prison in Ca. This inmate went to get her tooth fixed or pulled either one. They told her to come back in two weeks. In the mean time I caleld as I felt this was a little long to have to wait for tooth repair. When she did see the dentist they told he because I called she would have to wait and was going to the bottom of the list. They said this in front of witnesses and then began to share person history with the other inmates about this patient with her sitting right there to hear the whole conversation. When she did finally get her tooth fixed the doctor told her I put you to the bottom of the list TWICE because your husband called and bothered me. They then deadened the tooth and proceeded to drill before the anesthesia set in. Now you tell me where any of this fulfills any of the hippocratic oath that a doctor swears to. Also tell me what part of this was legal, humane, or ethical. You cannot. These fine doctors in these fine institutions need to spend a little time behind bars themselves. This is my loved one they did this to, I am not done. They violated Title 15 and Title 24 of the BOC regs. I worry about retribution which is rampant, so I wait.

Hospital Faulted In Death Of Inmate; Quadriplegic's Care Lacking, Probe Finds

The Washington Post

12-04-2004

The D.C. Department of Health has found that Greater Southeast Community
Hospital failed to provide adequate care to a quadriplegic jail inmate
who died in September after he was taken to the emergency room for severe
breathing problems.

The inmate, Jonathan Magbie, died Sept. 24 of acute respiratory failure,
raising questions about his medical care as well as why he was incarcerated
in the first place. Magbie, 27, of Mitchellville, was serving a 10-day
sentence after pleading guilty in D.C. Superior Court to possession of
marijuana, an offense that rarely carries jail time for a first-time offender.

The Health Department's investigation focused on what happened after Magbie arrived at the D.C. jail Sept. 20 and primarily on his treatment at the
hospital. The findings, released late yesterday in response to a Freedom
of Information Act request, represent the most comprehensive official accounting of his death.

The hospital will be cited for violating local and federal regulations.
Last year, Greater Southeast was faulted by District hospital inspectors
for persistent problems with the quality of medical care. The city later
determined that the hospital had addressed deficiencies.

"This was a tragic incident," Gregg A. Pane, director of the Health Department, said in a statement released with the report.

Magbie's mother, Mary Scott, said last night that she was pleased to see
Greater Southeast held accountable but that others shared in the blame
for her son's death. All knew, she said, that he had serious medical problems.
"It's misconduct on everyone's part," Scott said. "I still hold the judge
responsible, the jail responsible and the hospital responsible."

Hospital officials issued a statement saying they had not received an advance
copy of the report, but they defended the care they gave Magbie.

"We are confident that appropriate care was provided in this case, but
privacy rules prevent us from talking about specifics," the hospital statement
said. "We would welcome a fair and impartial review, but question whether
the District's conflict of interest in this matter allows it to be fair
and impartial."

Magbie, who was struck by a drunk driver at age 4, was paralyzed from the
neck down and his growth stunted. But, helped by a settlement that paid
him $30,000 a month, he tried to make the most of his life. He traveled
frequently, wore what he said was a $7,000 watch and lived in what he called
a mansion.

Although he had never before been accused of criminal wrongdoing, Magbie
was known to keep rough company, according to prosecutors, who said his
name came up on a wiretap of a suspect in a major drug-trafficking investigation.

He was arrested in April 2003 while riding with a cousin in his family's
Hummer in Southeast Washington. Police found cocaine, marijuana and a gun
in the vehicle.

Magbie pleaded guilty to possession of marijuana, and probation seemed
to be the likely sentence. But the judge, Judith E. Retchin, noting the
gun in the car and Magbie's insistence that he would continue to smoke
marijuana because it made him feel better, sentenced him to jail.

Hours after he arrived at the D.C. jail Sept. 20, he began having difficulty
breathing. Magbie told a jail nurse that he used a ventilator to help him
breathe at night, according to the Health Department's investigation, but
the jail did not have the equipment. The jail's doctor had Magbie taken
to Greater Southeast.

William Vaughn, a doctor in the hospital's emergency room, told Health
Department investigators that Magbie was brought to Greater Southeast because
he might need a ventilator. Vaughn initially planned to admit Magbie but
changed his mind after Magbie's condition improved, the investigation found.
He discharged Magbie back to the jail the next day with instructions that
Magbie could need nasal oxygen.

The Health Department said that the doctor erred by releasing Magbie without
addressing his ventilator needs at night. Magbie never got a ventilator
while at the jail.

The staff at the Correctional Treatment Facility, the medical jail annex
where Magbie was being held, was concerned when Magbie reappeared at the
jail, the Health Department investigation found. Its chief medical officer,
Malek Malekghasemi, told investigators that the facility "should not have
a patient that required a vent."

Malekghasemi said he called Retchin's chambers to find out why someone
in Magbie's condition would be in jail. The doctor wanted a court order
to have Magbie sent to the hospital but told investigators that the judge
said she could not take that action.

Magbie was returned to Greater Southeast on the morning of Sept. 24, again
with breathing problems. The Health Department said it found "no documentation"
that the nursing staff kept doctors informed as his condition worsened.

Medical records show that a doctor was brought in at 5:40 p.m. when Magbie
was in respiratory distress; his breathing tube had become disconnected.
Doctors reattached the tube, but Magbie died within an hour.

Staff writers Nicole Fuller and Cheryl W. Thompson contributed to this
report.

Copyright 2004, The Washington Post Co. All Rights Reserved.

Dealing with Meth in Michigan: Allegan County Targets Addicted Inmates for Treatment
By Meghan Mandeville (http://www.corrections.com/news/staff.html), News Research Reporter

Tucked away, hidden within the rural landscape of Allegan County, Michigan, lie methamphetamine laboratories - breeding grounds for a drug that has left a portion of the population there addicted, and oftentimes incarcerated, for meth-related crimes. While the county has been grappling with the issue for the past few years, a new treatment program aimed at helping meth-addicted offenders kick the habit has criminal justice officials optimistic that they can reduce the number of people who are returning to the county jail as a result of their substance abuse problem.

Modeled after treatment programs like Alcoholics Anonymous and Narcotics Anonymous, the Allegan County meth treatment program is designed to both reduce overcrowding at the jail by diverting offenders before their sentences are complete and help addicts to recover so they will not reoffend.

"In Michigan, Allegan County, unfortunately, is the hotbed for meth labs and meth activity," said Sergeant Mike Larsen, who coordinates the programs division of the Allegan County Sheriff's Department. "We are a rural county [and] we have a lot of state game areas that are conducive to setting up labs and cooking the drug."

According to Larsen, since Allegan County has many farming communities, anhydrous ammonia, a form of nitrogen fertilizer that is a main ingredient of the drug, is readily available for people to steal and transform into meth. In fact, he said, meth has become such a problem in the southwestern Michigan county that roughly 15-20 percent of the jail's inmate population is incarcerated for crimes related to it.

With the problem growing, the county realized that it needed to take steps to address meth addiction and crime.

"The sheriff had obviously noted it as a problem [and] we took great lengths on the law enforcement side to curb the problem," Larsen said.

But with so many offenders returning to jail time and time again for meth-related crimes, the county decided that corrections needed to get involved.

"We realized that the law enforcement and corrections community needed to do what it could to help these people get over the addiction," Larsen said. "The level of addiction is so high that we [know] most people are not capable of defeating the drug or the activities that go with it on their own."

Finding Solutions

To assess this problem and brainstorm possible solutions, in 2002, the county created a task force, which included corrections and law enforcement personnel, drug treatment providers, circuit and district court staff and citizens.

"We pooled everyone together to get a general perspective on what and how we could offer treatment that would, hopefully, [help offenders] defeat the addiction," Larsen said.

From the task force's research and ideas, a five-phase, cognitive behavioral and substance abuse treatment program emerged at the Allegan County Jail in June of 2004. According to Larsen, it's essentially a variety of elements from different treatment models bundled together and geared specifically towards people who are addicted to meth.

"Basically, what we have done is we have stolen from every semi-successful or very successful program and assembled it all into one," said Larsen.

Offenders are identified for the program by a circuit court probation agent, who handles every meth-related felony case, according to Larsen. After considering an offender's offense and background, the probation officer decides whether or not to recommend people to the program.

If an offender is recommended for the program, a judge must agree to his placement in it. Then a review team, which, according to Larsen, is a smaller