Nirmal Hriday

September 1, 2003 7:39 PM

Sick on the Inside. Published in Harper's August 2003 issue but not online, the full text of Wil S. Hylton's exposure of the medical conditions in United States prisons has been put on the web by the Wrongful Death Institute with the author's permission. The gravity of the situation for more than 2 million people behind bars can hardly be exaggerated.

"We have almost 30 percent of our prison population in Texas infected with hepatitis. That’s not so different from the numbers you see in the Dark Ages with the plague."
...
"[Correctional Medical Services] is an HMO with a captive audience," says David Santacroce, the professor who is spearheading the Michigan lawsuit. "The fewer patients they treat, the more money they make."

[more inside]
posted by Eloquence (11 comments total)

As the author notes, the conditions in prisons are generally ignored and all too many people feel that prisoners deserve whatever they get, be it rape and violence or all the diseases that can be cultivated in a rich ecosystem like ours. An attitude which, of course, ignores the hundreds of thousands of non-violent criminals, many of them the victims of the war on drugs and idiotic minimum sentencing laws (often passed with wide support from foaming-at-the-mouth voters).

The people who stand out in Hylton's article are those trying to make a difference, like Karen Russo. Action matters - this mess is not going to clean itself up. If only smart ideas like flash mobs were put to good use to put organizations like CMS, and the politicians who support them, under real public pressure -- but right now the web seems to be primarily used for the distribution of Flash cartoons.

Doing a search on the author's name, I found two other articles which you may find interesting:

• Who Owns This Body? about patents on genes
• Nancy Reagan's campaign for stem cell research (another of those issues where braindead fundamentalists have done their best to increase the suffering in the world)

posted by Eloquence at 7:47 PM on September 1, 2003

You can find a ton of statistics from the government itself.

I'll try to be the first in this thread to make woe about the astonishingly high imprisonment rate in the USA and the absurd number of people incarcerated for victimless crimes. Even if we feel no compassion for those who commit violent crimes, surely we should feel bad for Mr. Joe-next-door, imprisoned for possession and now stuck with hepatitis.
posted by five fresh fish at 7:49 PM on September 1, 2003

Even if people don't care about Joe, they have a personal stake in this issue. Most of the residents of those illness incubators eventually are let out.
posted by rcade at 7:57 PM on September 1, 2003

An attitude which, of course, ignores the hundreds of thousands of non-violent criminals

I've always thought this was one of the weaker arguments for better prison conditions; the strongest one being that the prisoners haven't been sentenced to be raped, and I think if you asked most people point blank if that should be part of a prisoners sentence, most of them would tell you no (although I'm sure that some would make the possible exception of rapists and child molesters). It's not part of their sentence. Hepatitis or other illnesses are not part of their sentence. Incarceration and the associated loss of freedom are. Labor might be. Solitary confinement might be. Illness and rape and being subject to experimentation, and mutilation are not.

It *is* sometimes a bitter pill to swallow that prisoners get benefits that the working poor struggle for: shelter, food, education, and... health care? But unless you effectively want to execute them, you have to provide these basics.
posted by namespan at 9:47 PM on September 1, 2003

This is really frightening. I recently saw a presentation by some doctors who had studied the circle of disease that brings about health crises when poor people continuously move between prisons and bad neighborhoods. It's amazing how much it costs us not to improve the health conditions of the incarcerated.

I guess it's mainly the poor in bad neighborhoods who get sick though, so who cares.
posted by crazy finger at 11:10 PM on September 1, 2003

The thing is that it could happen to you, me and anybody - not just to Joe. All you need is a bit of bad luck.

Overall change usually comes when there is an overwhelming majority of reasons for it. It sure seems like the US justice system is bent on creating more and more reasons. But when is too much *too much*?
posted by magullo at 3:36 AM on September 2, 2003

Thanks for the post Eloquence.

Harper's is a wonderful magazine and should be read religiously.

For those who don't care about the conditions prisoners suffer they should at least look at the point made by crazy finger: It's amazing how much it costs us not to improve the health conditions of the incarcerated.

The profit motive is a sorry reason for these conditions and this suffering.
posted by nofundy at 7:14 AM on September 2, 2003

Question:

What about the men and women paid to guard these prisoners? They're in close quarters with these folks eight hours a day, and I don't imagine that the health plans of these aforementioned (low) wage slaves (embarrasingly low, given the very unpleasant job they do, which creates opportunities for both corruption and brutality) is too terrific.

These people are susceptible to the ailments as well....and they walk among us every day. Just sayin'.
posted by jonmc at 10:14 AM on September 2, 2003

Wow. What an amazing article.

As a person who is pretty "sick" and has regular access to doctors, and who just went through a pretty awful process with a doctor who mis-treated me, I can't imagine the terror and anger that these sick inmates must feel. And the helplessness.

While it's hard to argue that inmates deserve free medical care while we all have to pay, it really is inhumane and cruel to deny them care. I mean, they don't have anywhere else to go. And the lack of oversight on the medical companies that provide them "care" is astounding.

This article is very frightening. Medical care is so important and critical, I can't imagine not being able to get the care I need. I would be frantic and terrified. I"m not usually very pro-inmate rights, but this goes beyond the pale.

Great story.
posted by aacheson at 10:48 AM on September 2, 2003

Excellent article, Eloquence...thanks.

Another fine example of the "efficacy" of "market forces" (greed) in providing for human needs. Gosh, one wonders what new triumph unfettered capitalism will bring us next.

However, prisons of all types often hire physicians (or even physician assistants) who don't have full residency training, or are otherwise non-board certified. It's not uncommon for a prison or correctional medical facility to ask an overworked generalist (instead of an infectious disease specialist) to manage prisoners with complicated chronic illnesses like HIV and/or hep-C infection. The results can be tragic.

The conditions in our prisons say more about the humanity of we who walk freely....than it does the humanity of those held within them.
posted by fold_and_mutilate at 10:58 AM on September 2, 2003

And this post got half as many comments as the WKRP post just above... you're right, foldy, the whole issue says a lot about who we are.
posted by orange swan at 12:26 PM on September 2, 2003