A Cancer Grows
Gruesome stories roll out across the country:
§ In New Jersey, Margaret De Luca, 52, was sentenced to prison in April 2000 after having received a diagnosis of stage 3A breast cancer and a left-breast mastectomy. She endured eleven-to-fifteen-hour trips, sometimes without food, for radiation and chemotherapy. "Whenever I returned to this facility or needed medication for my pain, nausea, whatever--even though it was prescribed by the medical oncologist--I have to battle this staff to get it," she wrote in a letter. Her cancer has spread to vital bone areas, De Luca says. Lawyer Bonnie Kerness has sent thirty letters complaining about De Luca's treatment to Correctional Medical Services, the private corporation that has an annual $89 million contract for New Jersey's correctional healthcare. The company has contracts with more than 300 prisons and jails in thirty-one states.
§ In Chicago, Rochelle Bowles, former director of the transitional program Grace House, tried to sort out the medical records of a 52-year-old resident diagnosed with breast cancer shortly before her incarceration in fall 2000. Zero treatment or care had been provided in her six-month incarceration, and her condition worsened. "It boggles the mind," says Bowles.
§ After a review of more than 1,200 medical complaints of California women prisoners, professor Nancy Stoller of the University of California, Santa Cruz, reported scores of calamities. They included a woman with cancerous cells in her reproductive system who was denied a hysterectomy because of cost; a prisoner who underwent removal of a breast lump but had not received results; a doctor who broke a speculum inside a woman during a biopsy and used unsterilized pliers to remove it.
Recourse for the women is, unfortunately, limited. Copies of records are difficult to secure. Prisoners must file a formal grievance to appeal a medical decision, since healthcare is intertwined with strictly correctional functions.
To navigate the bureaucracy, lawyers are as necessary as doctors, but they too are handicapped. Prisoner advocates feel that judges let prisons off the hook, prematurely releasing them from complying with hard-won improvements in women's healthcare after legal settlements were obtained in Washington in 1995 and in California in 1997. Attorney Patricia Arthur in Washington says issues of inadequate care and chaotic staffing remain, and an appeal is pending.
In any case, under rulings of the US Supreme Court, no remedies are available unless prisoners can meet the monumental standard of showing that there was "deliberate indifference to serious medical needs." As the health concerns for women intensified with the prisoner influx of the 1990s, the federal government further closed courtroom doors through stiff hurdles to lawsuits via the Prison Litigation Reform Act of 1996, inscribing onerous pre-filing requirements, placing time limits on remedies and jacking up costs.
Advocates want to see women prisoners treated by the standards of acceptable medical care in the outside community. The mainstream National Commission on Correctional Health Care agrees, and even adopted the guidelines of the American Cancer Society and American College of Obstetricians and Gynecologists for breast and reproductive cancer testing and treatment.
Prisons, however, seem unwilling or unable to meet those standards. "If there is no means of redress, what would motivate them to want to treat you?" Fink asks. Deprived of adequate legal or medical recourse, and with hardly a nod from the flourishing and powerful women's health or breast cancer organizations, incarcerated women with health problems seem to have bleak prospects. "Part of me wants to see the silver lining, and it's hard these days," says Ellen Barry.
Cloistered inside the walls, Sherrie Chapman presses hard to send a message: "There are women with serious medical conditions, and they are scared to approach medical, scared of the repercussions. They'll tell you they have lumps in their breasts, in their thighs, all kinds of things. I've seen so many women die. It's really sad, you know?"