I have corresponded for twenty years with a woman in the country's largest prison for women, the Central California Women's Facility (CCWF), which houses nearly 7,000 inmates. I know she is honest, intelligent and a model prisoner. She is also an "in-house" advocate who knows her stuff when it comes to holding the prison accountable for misdeeds and maltreatment.
When she wrote me that there could be a measles outbreak in the prison, which is near the heart of the California outbreak, I took her seriously. She had been told by medical staff that despite the risks inherent in proximity, overcrowding and contact with people from "outside," inmates could not be tested for immunity or be vaccinated. I began trying to find out what was going on.
After a run-around with California's bureaucracy, I reached a public information officer at the California Department of Corrections and Rehabilitation (CDCR) who informed me that "anyone who requests a measles check or vaccine will receive one." This was verified by a memo from the Chief Medical Executive. However, inmates continued to be denied immunity testing or vaccination. My friend filed a formal complaint. My contact at CDCR said that according to staff, "no complaints had been filed" despite a document I have which affirms that my friend's complaint was received. Two letters I've written to the warden remain unanswered. I have turned the matter over to the ABC affiliate in Fresno in hopes they will do some investigative reporting.
So far there has been no measles outbreak in the prison. But the matter prompted me to look further into health care in America's prisons. What I found wasn't pretty. In 2011, for example, CCWF was singled out in a report cited in the Huffington Post. Over the course of 12 years, according to a former inmate, hundreds of untreated women had died in CCWF. One woman with liver disease was told at the prison clinic to return to work despite profuse bleeding. "Within a week the woman was dead." Another morbidly obese diabetic woman, denied adequate treatment, lapsed into a coma and nearly died.
In 2011 the Supreme Court ruled that overcrowding in California's prison system constituted cruel and unusual treatment and violated the 8th Amendment. Oddly, the Court's ruling largely ignored what was going on in California's three female facilities where about 12,000 women lived in crowded, unsanitary conditions. In addition to sexual abuse by guards and increasing levels of violence among women because of overcrowding, these women navigated a world of insufficient and often dangerous medical care, neglect and mistreatment.
Women's health needs are often gender-specific causing them to require medical attention more than men. Beyond care for acute and chronic illnesses, they have specific reproductive health needs. And in prison, because of overcrowding and sparse allotments of menstrual supplies, they are exposed to blood that can put them at risk for HIV and Hepatitis-C. According to the United Nations Special Rapporteur on Violence Against Women, "female-specific care has been absent in the California system for decades"illustrating the 'invisible' state of women inmates."
Between 2006 and 2010 more than 100 women were unknowingly sterilized after giving birth, a practice that violates federal and California state law. California Prison Health Care Services, which has been under federal receivership since 2006, acknowledges this claim. In addition, women have been shackled during labor and deliver, even when an epidural renders them incapable of moving. Perhaps most insidiously, medical rape is a common occurrence.
"At the core of these health concerns is an inadequate system which is insufficiently responsive to gender-specific needs, including the reproductive health needs of women," the UN report concluded.
Here's how some women at CCWF put it in a newsletter published by the California Coalition for Women Prisoners:
"I had to 'prove' that I was incontinent. They made me urinate in bed. They would not give me enough catheters."
"There are rules about being seen for only one issue at a time. It means a lot of issues are never dealt with. It takes 4-6 months to be seen if you need medications for more than one problem."
"I have been given a diagnosis of six months to live. It's horrible fighting cancer and not being able to do full treatment."
Madelon Finkel, Ph.D., professor of clinical public health at Cornell Medical Center, points out that the 1929 Geneva Convention and more recently Amnesty International, the International Red Cross, and the Council of Europe have directed that "prisoners should have the same access to health care as the non-incarcerated population and that health care provided to prisoners should be equivalent to that provided to the non-incarcerated population."
Given broken systems like California's, that mandate seems a prison pipe dream. Until it is real vs. rhetorical, women will die unnecessarily, have their reproductive rights ignored, and possibly suffer a massive measles outbreak that never had to happen.