Dedication

Norrita Jeanette Wynder (Baby Girl) died on February 7, 2006 as a result of a preventable and treatable asthma attack. She was 28 years old. The guards on her unit helped trigger an attack when they upset her by denying her a phone call for which she was signed up. They made the attack fatal by refusing to let her get help once the attack was triggered.
While several individual guards are complicit in her needless and untimely death, it indicts the whole prison system. We hold the prison and the prison system responsible for the prevailing attitude that prisoners are “faking” any time they report their health issues.
We dedicate this issue of The Fire Inside to Norrita Wynder, her death throws a spotlight on the non-delivery of health care in prison.

It’s Your Health: The New Prison Scourge

by Prisoner, CCWF
Note: In the last issue of The Fire Inside we printed an article from a sister at VSPW about the denial of sufficient soap and water for basic hygiene and the spread of antibiotic resistant staph infections and hepatitis. Here is a detailed follow-up from a sister at CCWF.
Methicillin resistant Staphylococcus aureus (MRSA) is a very serious and sometimes fatal infection that is causing great concern in hospitals and other institutional settings, such as prisons. MRSA can kill and is very difficult to treat once it gets established. How many cases we?ve had at CCWF is hard to measure, partly because the infection has been misdiagnosed as “spider bites” or skin rashes. But several women have developed life-threatening episodes of this infection requiring hospitalization at Madera Community Hospital and intravenous antibiotic therapy.
History
MRSA has been around for a while, but in the last 4 years there has been an exponential increase of this disease in county jails and prison systems throughout the US. For example, L.A. County jails reported increases from 921 cases of MRSA in 2002 to 2,480 cases in 2004. A well-drafted lawsuit on behalf of all current and former L.A. county jail residents alleges 8th and 14th Amendment violations for improper conditions of confinement, cruel and unusual punishment, and failure of duty to care for prisoners.
Even the guards? union (CCPOA) has expressed concern for the risks the disease presents to prison guards (COs). E. Fitzgerald, president of Santa Clara CCPOA said, “MRSA is spiraling out of control.” Two COs are suing for being exposed to MRSA and carrying this infection home to their infants.
What does MRSA look like?
MRSA usually starts with a skin boil, pimple or sore. These sores are often just “tip of the iceberg” as the infection is festering underneath. Redness, swelling, chills and fever are common symptoms.
What can I do if I think I have it?
1. Seek help immediately. Waiting even for one day can make you a lot sicker and place your friends and roommates at risk.
2. Go to the MTA or preferably the RN. Tell them you think you have MRSA. Write a co-pay using the words “suspected MRSA,” hand carry the co-pay and keep the back copy. Ask for a culture if the sore is open and draining. You cannot be charged for this co-pay as this is a communicable disease outbreak that the prison health department has a responsibility to monitor.
3. Do what you can to help your body heal. How you view your health and wellness has a profound effect on your body’s ability to heal itself. Drink lots of water, eat healthy foods, rest more than usual and envision the MRSA germs being devoured by your own infection-fighting white blood cells.
4. Take the full course of antibiotic exactly as it has been prescribed.
5. Don’t share medicine or take anyone else’s medications. It is partly the indiscriminate use of antibiotics that has caused MRSA to be so virulent. When you take just a few antibiotic pills you do more harm than good and actually increase MRSA’s resistance to treatment.
What can I do to prevent infecting others?
1. First of all, don’t feel ashamed or “unclean” because you have it. Anyone can get it, and coming down with MRSA is not necessarily a reflection of poor hygiene.
2. Wash your hands, wash your hands, and wash your hands again! Seriously, hand washing is the single best way to prevent the spread of infection ? more effective than all the chemical sprays, germicides, etc.
3. Spray citricide frequently on surfaces you commonly touch. Don’t forget doorknobs, chair backs, and other places that many people touch. Dilute the citricide as recommended, stronger is not necessarily better and undiluted citricide has its own side effects.
4. Wash you towels, bedding and clothes more frequently. With 3 washers and dryers in all housing units now, hopefully this will be a little easier to do.
5. If you have had MRSA once, there is some research that shows you may be more susceptible to repeat infections. Tell the RN or MTA that you’ve had it before and suspect you are getting it again. After all, you know your own body better than anyone else.
This serious infection is difficult to control in overcrowded prisons, but everything you do to help yourself and prevent transmission helps you stay healthy and promotes wellness for everyone.

Legal Corner: Custody interference in healthcare

In the October 2005, Findings of Fact and Conclusions of Law Re Appointment of Receiver (Plata v. Schwarzenegger), Judge Henderson addressed several areas of concern in which the court found the CDCR woefully inadequate in its provision of health care services. The court?s findings received much needed publicity and a receiver was appointed. However, one area of concern addressed by the court but not been given much publicity was that custodial staff often interfered with the prisoner?s medical care. The court found that, ?[T]oo frequently medical care decisions are preempted by custodial staff who have been given improper managerial responsibility over medical decision-making.? The court pointed to a lack of respect by custodial staff for medical staff. In addition, the court found that custodial staff often raised the issue of ?custody concerns? to explain why they needed to actively interfere with medical decisions. However, in the court?s opinion, the reasons relied on had little to do with legitimate custody concerns.
How exactly does custodial staff interfere with medical? Examples include the following:
(1) A correctional officer (C/O) who confiscated a ?short-walk chrono? because the prisoner used a cane and could ?stop and rest.?
(2) A C/O who confiscated a prisoner?s wheelchair that was parked outside the cell while the prisoner was sleeping. The prisoner had been ordered by medical to avoid putting any weight on her surgically repaired foot for four months. It took the prisoner three days to get her wheelchair back.
(3) Another C/O who refused a prisoner access to the medical clinic despite the fact that the prisoner had a valid pass and scheduled medical visit.
(4) A prisoner denied access to emergency care for a swollen and discolored hand. Two different C/Os looked at the hand and said it wasn?t an emergency. (Later the same day the prisoner was finally able to get the hand x-rayed and found out that the hand was broken).
(5) Another ?short-walk chrono? that was confiscated because it appeared to be a ?forgery? despite the fact that the same C/O had checked the same chrono a few days earlier and found it was valid.
(6) C/Os who wrote expiration dates on ?lower bunk? chronos and then moved prisoners out of their lower bunks.
All of the above incidents occurred at one prison during March and April 2006, and were reported to CCWP. Fortunately, all were resolved and the prisoners were able to regain their respective chronos or access the care they needed. However, one can only imagine the number of incidents that went unreported by prisoners because they were fearful of getting ?written up? by staff.
The unfortunate truth is that the CDCR is incapable of providing medical care and the receiver is aware of the problem and is taking steps to make things right. If you are experiencing difficulty in accessing appropriate health care in prison you should immediately file a 602 appeal. If the problem persists, then you should contact the attorneys at the Prison Law Office, General Delivery, San Quentin, CA 94964. You can also contact Robert Sillen, California Prison Receivership, 1731 Technology Dr., Suite 700, San Jose, Ca. 95110.

The Coalition for Accountable Healthcare

by Colby and Robin
This spring, California Coalition for Women Prisoners met with members of other anti-prison organizations to talk about prison healthcare and the newly appointed federal receiver. The receiver, Robert Sillen, is in charge of ?fixing? healthcare in prisons across California following the decision by Judge Henderson to take control of prison healthcare away from the State.
This new Coalition for Accountable Healthcare includes people from Justice Now, Legal Services for Prisoners With Children, Free Battered Women, The Transgender, Gender Variant and Intersex Justice Project, All of Us or None, The Family Advocacy Network, A New Way of Life, and The CCWF Inmate Family Council. We met to strategize on how to ensure the receiver is accountable to incarcerated people, their families and the community based organizations that work with people inside of prisons.
We requested a meeting with Sillen to present our proposed solutions to the healthcare crisis. The list of solutions that CCWP brought to the table came from our conversations with people we visit at VSPW and CCWF, and from the results of the campaign surveys many people submitted last year. The solutions fall into three main categories: improving oversight, decarcerating (releasing people from prison) and improving health care administration. A few examples of the solutions we will pitch to Sillen are as follows:
1) Abolish the co-pay system as it imposes a barrier to accessing health care.
2) End the MTA position. The MTA position should be abolished, and measures should be taken to separate health care staff from custody staff. All CDCR staff positions should be either custody-related or health care-related ? no staff positions should combine these duties.
3) Improve preventative care. Provide access to better nutrition, opportunities for exercise, and information on preventative care. Also provide condoms, dental dams, and clean syringes to stem HIV and HCV infection rates. Partner with non-CDCR agencies and organizations to provide training curriculum for MACs, WACs and peer educators on preventative health care and nutrition. Provide regular medical care, elder-specific medical care, early-detection tests and monitoring.
4) Translation: provide information in multiple languages (verbally and in written form as part of prisoners? orientation packet) for prisoners in receiving at any prison on how to ask for a translator, post information on how to do this throughout prisons, and give to WAC/MACs, and peer educators.
We are excited to report that the receiver agreed to meet with the coalition soon. We are working together to prepare for this opportunity to express our collective concern about the horrific state of healthcare inside, and to stand behind the solutions for change that many of you have been voicing and organizing around for years. More news soon!

A letter to Receiver, Robert Sillen

June 2006
Dear Mr. Sillen,
I just wanted to welcome you, and I hope you are able to bear with all of our complaints. For the past few years we haven?t been able to have the help and understanding that we need, so we are looking forward to establishing a new working relationship under your guidance as the new Receiver.
So, with anticipation from our hearts ? WE THANK YOU!
Anna Bell
CCWF