According to one nationally recognized expert in correctional medicine, medical care in Sheriff Joe Arpaio's vast incarceration complex is not just potentially hazardous to the health of pretrial detainees and jail staff, but to that of the general public.
Dr. Robert Cohen, a member of New York City's Board of Corrections and the Board of the National Commission on Health Care, is expected to testify in federal court today on behalf of the plaintiffs in Graves v. Arpaio, a jails-conditions lawsuit in federal court that stretches back decades, long before Arpaio came to power.
The basis for Cohen's testimony during a hearing at the Sandra Day O'Connor U.S. Courthouse in downtown Phoenix is to be his November 2013 report on the care provided by the county's Correctional Health Services, which is scarier than some horror flick by M. Night Shyamalan.
Not only do county inmates "not receive adequate care," according to Cohen, deficiencies in the jails' medical system "continue to place patients at a major risk of serious harm -- which includes pain, deterioration of health, unnecessary morbidity and death."
Also, inadequate screening for tuberculosis unnecessarily exposes inmates, staff, and those who come in contact with them -- potentially you and me -- to infection.
MCCHS is a separate entity from the MCSO, yet the two county departments obviously work hand-in-hand.
Cohen finds the problems with health care in our jails "endemic to the entire system," and faults both the MCSO and the MCCHS for knowing of these inadequacies "for years," while not taking adequate steps to correct them.
Inmates are not properly examined for various medical conditions, do not have proper access to medication and doctors for emergency and chronic conditions, and are not properly treated for alcohol and drug withdrawal, Cohen finds.
For a public that often regards Joe's jails as hellholes for the deserving, the situation regarding tuberculosis in Arpaio's gulags should be alarming.
Cohen knocks the jails' "poorly designed screening and treatment program" for the disease as a direct threat to jail staff and other prisoners.
"By design," Cohen writes, "tuberculosis screening...does not begin until the initial health assessment is performed. This rarely occurs before 12-14 days after admission, often takes longer, and sometimes does not occur at all."
This "failure of the tuberculosis control program" affects "everyone in the jail and everyone who has contact with the men and women who live and work in the jail," observes Cohen.
Cohen cites specific examples of patients who were not properly screened and treated for TB.
For example, "patient 49," received his screening 17 days after being booked into jail. He tested "very positive," and yet, he did not receive a follow-up chest x-ray to determine if he actually had the disease until four months later.
The x-ray showed "a right lower lobe pneumonia, consistent with active tuberculosis," according to Cohen.
"If this was tuberculosis," Cohen notes, "a person with active tuberculosis would have been living, and coughing, in the MCJ for over four months without treatment.
"Tuberculosis is spread through droplets injected into the air by coughing. Tuberculosis screening is a critical component of medical care in a large urban jail where tuberculosis is known to be present."
In addition to TB, there are horror stories aplenty regarding poor or nonexistent care: untreated septic infections, diabetics, heart patients denied proper meds, inmates given ibuprofen for terrible pain, mentally ill people allowed to become increasingly psychotic, and prisoners in alcohol withdrawal who are inadequately treated, in one case, leading to death.
Even if you are inured to the suffering of others, such conditions have been found in the past to violate the U.S. Constitution. They often become the basis of lawsuits that have cost the county scores of millions of dollars over the years.
One of the more recent lawsuits involved the death of Deborah Braillard, the diabetic mom denied her medication by MCSO gendarmes until she was so sick, she was vomiting and defecating on herself, ultimately falling into a diabetic coma from which she did not emerge.
Dan Pochoda, legal director of the ACLU of Arizona, which is representing the plaintiffs, explained that Graves v. Arpaio began in 1977 as the lawsuit Hart v. Hill (later Hart v. Arpaio), and it involved general jail conditions, including medical and mental health care.
In 2008, U.S. Circuit Judge Neil Wake ruled conditions in Arpaio's jails unconstitutional for pretrial inmates, ordering a series of remedies, which Arpaio appealed to the Ninth U.S. Circuit Court of Appeals.
Joe lost in 2010, with the Ninth U.S. Circuit's ordering Arpaio and the county to obey Wake's 2008 ruling.
Pochoda says the MCSO improved in the non-medical areas of the decree, and the court lifted those parts. Now the county is attempting to get out from under the court's 2008 order, regarding medical/mental health care.
The court has experts assigned to monitor the progress of medical care. During the ongoing hearings, both sides in the lawsuit are offering their own experts' assessments of the situation in the jails.
"There's other experts being put on the stand by each party," Pochoda said. "With one side, ours, saying...there's inadequate care, systemically inadequate, and the other side saying everything is rosy."
Only thing rosy about the health care in Arpaio's jails is the color of the phlegm from TB-infected inmates.
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Until that part of the equation is fixed, none of us is safe. Including those lucky enough to avoid doing time in Joe's dungeons.
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