Dear Sir/Madame:
I understand that you have been asked to do an accreditation evaluation of Alderson Federal Prison in Alderson, WV, and are particularly looking at the medical care provided there.
I have been a registered nurse and practiced professionally for many years until I retired in 1998, licensed in Connecticut, New York, Kentucky, and North Carolina. In addition to my nursing skills, I hold two masters degrees, an M.A. from Columbia University in Religion and Sociology, and a Masters in Public Health Administration from the University of North Carolina. I was also an inmate at Alderson Federal Prison for three months this year (April to early July) because of an act of civil disobedience I did at a military facility, protesting the School of the Americas (now known as the Western Hemisphere Institute for Security Cooperation). This was a class B misdemeanor trespass charge, and in no way detracts from my medical competence as used throughout my professional career.
I would like to alert you to problems I saw or experienced while a prisoner at Alderson.
1. The neglect of glaring health problems. For example, a woman in my housing unit was provided surgery (an A and P repair) at the nearby hospital. According to her,the prison staff insisted on her discharge before her surgeon was ready to release her. Since no meals or pain medicines are provided to inmates in their housing units, this meant the woman had to walk around the compound as a fresh post-operative patient to obtain her medicines and meals. Within days, she developed a fever and began bleeding badly. For almost two weeks, she repeatedly tried to get the medical staff to pay attention to her symptoms without results. Finally, when I convinced her to use the word “hemorrhaging” to describe her bleeding, they finally did an exam and rehospitalized her for blood transfusions and treatment of the post-op infection.
In a second case, another prisoner and I alerted the psychiatric staff about a woman who was severely depressed (we had met her while waiting in line for dental screening and the next day went for our initial psychiatric appointments). Both of us, independently, told the staff that this woman was suicidal and needed evaluation and medication (she had told us that she had been taken off of all her psychiatric medications on transfer from the medical facility in Carswell, Texas the week before). Ten days later, on April 30th, the woman did attempt suicide and the prison went into lock-down.
2.The deliberate falsification of test results. I saw tuberculosis skin tests that were positive and learned that the medical staff had read and recorded the results as negative. I experienced this at least three different times, and know from a letter from a physician friend of mine who is still an inmate at Alderson that she has seen this happen also. Not only is this terrible medical practice, but it exposes the prisoners and society in general to exposure to tuberculosis. I also saw health center staff re-administer tuberculosis skin tests to inmates with known positive ones—why? In the hopes that they would suddenly become negative? This is an area where I have considerable experience, having worked with health departments throughout Appalachia doing tuberculosis skin testing during the 1960's and 1970's, in attempt to reduce the high incident rate in that region. I also assisted one local health department in NC in treating the many cases of tuberculosis among Southeast Asia refugees during the 1980's.
3.The disregard for simple public health precautions when housing and feeding a large population in limited space. I can give many examples:
Allowing an inmate with known diagnosis of Hepatitis C to work in food service.
Letting the housing units run out of bar soap for hand washing and showers. The result of this is that days go by without hand soap in the lavatories where hundreds of women use the toilets without washing hands afterward.
Supplies of Comet and Lysol are also allowed to run out, preventing thorough cleaning of lavatories and showers.
The guards use as many latex gloves as they need to touch anything connected to an inmate, but many inmates share a single pair of rubber gloves to do the dirtiest cleaning jobs in a housing unit. Just sharing the gloves could allow the transfer of HIV or Hepatitis.
When the falsification of tuberculosis skin test results is combined with the lack of ventilation and air-conditioning in half the Alderson units, the use of the fans in the closed space could just spread the bacteria.
4.The exposure of inmates to work hazards that would be unacceptable to OSHA in any work setting outside of prison. While I was at Alderson, one of the prisoners lost a portion of her finger, which was cut off by the metal of a steel cabinet she was required to move. She should have been provided and required to wear protective gloves. Light cotton garden gloves, such as I saw among some of the working inmates, would have been inadequate protection.
The moving of the metal cabinets occurred during the cleaning out of the older cottage dormitories which are reputed to have asbestos. From my friends who are still at Alderson, I understand that there have been numerous respiratory complaints among the inmates who did that work of cleaning out the cottages. If asbestos was present, proper precautions should have been taken to prevent inmate contact and illness.
I have limited myself to telling you about problems that I directly saw, experienced, or where I personally knew the person affected. I have not reported the many problems that I heard about second or third hand, of cancer symptoms ignored until metastases cost the person her life, of broken bones not x-rayed for weeks, or of other problems incorrectly diagnosed. However, I have worked my entire professional career among medically under-served people—in an Indian mission hospital for two years, in founding a rural primary health program in Appalachia, in doing emergency medical work in Central America following Hurricane Mitch, and among the public housing residents of Statesville, NC. Never have I seen a poorer quality of health care provided to a population. Frankly, I would recommend a Congressional hearing to evaluate all the inadequacies.
I sincerely hope you will refuse accreditation and give Alderson Federal Prison a list of deficiencies they need to correct. Sincerely yours,
Linda O. Mashburn, MPH, Brevard, NC