America’s private prison system is a national disgrace


Jill Filipovic

An ACLU lawsuit against a prison in Mississippi is the latest to detail flagrant abuses at a private correctional facility

Jill Filipovic

Thursday 13 June 2013

guardian.co.uk

The privatization of traditional government functions – and big government payments to private contractors – isn’t limited to international intelligence operations like the National Security Agency. It’s happening with little oversight in dozens of areas once the province of government, from schools to airports to the military. The shifting of government responsibilities to private actors isn’t without consequence, as privatization often comes with a lack of oversight and a series of abuses. One particularly stunning example is the American prison system, the realities of which should be a national disgrace.

Some of those realities are highlighted in a recent lawsuit filed by the American Civil Liberties Union (ACLU) on behalf of prisoners at the East Mississippi Correctional Facility (EMCF). EMCF houses severely mentally ill prisoners, with the supposed intent of providing both incarceration and treatment. Instead, the ACLU contends, the facility, which is operated by private contractors, is rife with horrific abuses. As the ACLU states, it is

“an extremely dangerous facility operating in a perpetual state of crisis, where prisoners live in barbaric and horrific conditions and their basic human rights are violated daily.”

The complaint lists a litany of such horrors, but here are a few highlights: rampant rapes. Placing prisoners in solitary confinement for weeks, months or even years at a time, where the only way to get a guard’s attention in an emergency is to set a fire. Rat infestations so bad that vermin crawl over prisoners; sometimes, the rats are captured, put on leashes and sold as pets to the most severely mentally ill inmates. Many suicide attempts, some successful. The untreated mentally ill throw feces, scream, start fires, electrocute themselves and self-mutilate. Denying or delaying treatment for infections and even cancer. Stabbings, beatings and other acts of violence. Juveniles being housed with adults, including one 16-year-old who was sexually assaulted by his adult cell mate. Malnourishment and chronic hunger. Officers who deal with prisoners by using physical violence.

One prisoner allegedly attempted to hang himself. He was cut down by guards, given oxygen and put on supervision, but wasn’t taken to an emergency room, let alone given psychiatric care during the suicide watch. Without seeing a psychiatrist, his medication dosage was increased.

A severely ill 16-year-old with “a long history of being physically and sexually abused in addition to suffering from a traumatic brain injury, limited intellectual functioning, self-harm, and psychosis” was moved to EMCF from a juvenile detention center. His cell allegedly had a broken lock, and so other prisoners were able to enter. Five or six of them beat him. He was moved to a solitary confinement unit and, when he voiced his suicidal ideations and asked to see a psychiatrist, was deemed “manipulating to be moved”.

Another told prison mental health staff that he was depressed and thinking about about suicide. The treatment plan from the prison psychologist was reportedly three words: “encourage behavioral compliance”. After being asked to provide a urine specimen, which he could not give because of a health condition, the ACLU reports:

Mr. Roe began banging on his door, smeared blood on the cell door window, threatened to commit suicide, and tied a rope around his neck. Officers sprayed excessive amounts of Mace in his cell. According to witnesses, officers waited approximately 20 minutes before pulling Mr. Roe out of his cell. By that time, he was non-responsive and cyanotic. He was taken, his hands and feet bound by zip-ties, to the hospital where he was pronounced dead.

For several days after Mr. Roe’s death, medical staff continued to ‘document’ in the daily segregation log that Mr. Roe appeared to be ‘in good health and mood.'”

These kinds of abuses are not relegated to a single prison, but they also aren’t inherent in any detention system. In the United States, though, they’re business as usual. Our prison system is increasingly built and run by for-profit corporations, who have a financial interest in increasing the number of people in prison while decreasing the amount of money it costs to house them.

Since 1980, the US prison population has grown by 790%. We have the largest prison population of any nation in the history of the world. One in three African-American men will go to jail at some point in his life. Imprisoning that many people, most of them for non-violent offenses, doesn’t come cheap, especially when you’re paying private contractors. The United States now spends $50bn on our corrections system every year.

Much of that money goes to private contractors, who are doing quite well living off of American corporate welfare – at the expense of the American taxpayer, whose dollars are funding this mass incarceration project. Large-scale imprisonment isn’t making us any safer, either. But it is putting small-time non-violent individuals – drug users and dealers – in close contact with more hardened criminals and making it significantly more difficult for them to find decent work after their release. That’s a perfect recipe for recidivism, not rehabilitation.

Prisons, as demonstrated by the ACLU case, have also become de facto mass institutions for the mentally ill, except without the oversight that pure psychiatric facilities face. With states tightening their budgets, mental health care is being cut even further. While the mentally ill are more likely to be victims of crimes than victimizers, they are imprisoned at disproportionate rates, and often lack meaningful mental healthcare in prison and even face conditions that exacerbate their diseases, like solitary confinement and total squalor. We’re effectively taking some of the most vulnerable members of society and subjecting them to ongoing torture.

We have so demonized criminals in the United States that there’s widespread acceptance of the fact that jail in modern day America means rapes, beatings, vermin, filth and abuse. But to what end? “Criminals” are punished, yes – brutally, and in ways that should repel and shame us. But rehabilitation isn’t happening in these facilities. Crime isn’t being deterred; if anything, it’s being fostered.

The American public is losing out. The only winners are the private companies who are still awarded contracts to build and maintain more prisons, and who throw their weight behind politicians who promote the supposedly “tough on crime” measures that ensure those prisons are full.

There are many ways to punish crime and protect the public. Ceding our humanity doesn’t have to be one of them.

 

Child’s HIV cure won’t mean new treatments immediately #healthcare


Liz Szabo, USA TODAY6:38p.m.March 4, 2013

Doctors are thrilled with the cure of a 2½-year-girl infected with HIV at birth but say that extending that success to others will be a challenge.

More than 300,000 babies a year worldwide are born infected with HIV, the virus that causes AIDS.

As of this week, doctors appear to have cured exactly one.

And while the Mississippi child’s story has generated excitement in the medical community, researchers also note that it will likely take years before they’re able to extend that success to a broader community of patients, if ever.

“This is a really groundbreaking report,” says Diane Havlir, a professor and AIDS researcher at the University of California-San Francisco, who attended a presentation of the new study Monday at an Atlanta medical conference.

“This tells us a cure is possible,” says Havlir, who wasn’t involved in the new study, which reported on a 2½-year-old girl who was infected with HIV at birth but apparently cured after 18 months of triple-drug therapy. “That is thrilling news.”

Doctors credit the child’s cure to early treatment; her physicians began treatment soon after delivery, which is the standard of care for the child of an untreated, HIV-positive mother.

STORY: Doctors report first cure of HIV in a child

Most adults can’t benefit from such early therapy, because they typically don’t even learn that they’re infected for months or years, says Rana Chakraborty, an associate professor of pediatrics at Emory University School of Medicine. The only adult to have been definitively cured of HIV had a unique situation: He had a bone-marrow transplant to treat his leukemia from a donor with a genetic mutation that provided protection from HIV.

Scientists will first have to learn what exactly allowed the child to be cured before they can apply that knowledge to developing vaccines or new drugs, he says.

And Havlir notes that doctors are unlikely to make any changes to children’s care before they can verify the study’s results. She notes that, in developed countries, doctors focus far more on prevention than treatment. Giving women anti-HIV therapy while pregnant reduces the risk of mother-to-child transmission by 98%.

But if the results hold up and doctors can identify the best medications, they could start anti-AIDS therapy on high-risk newborns even before getting results of their HIV tests, Havlir says.

That could be important in developing countries, where many women — like the mother of this Mississippi child — don’t get recommended care. The girl’s mother had no prenatal care, let alone anti-HIV therapy, before delivery. Then, when the girl was 18 months old, the mother stopped bringing her to the doctor, which left the child with no anti-HIV treatment for five months.

While the child’s story has been hailed as a victory for science, Chakraborty says the case also illustrates the single greatest challenge in treating AIDS: actually getting care to patients.

Delivering on the promise of scientific breakthroughs has been a challenge not just in developing countries of Africa, but in the USA.

Only 28% of people of the 1.2 million HIV-positive Americans have been diagnosed and treated successfully so that their levels of virus are undetectable, according to the Centers for Disease Control and Prevention.

HIV has become entrenched among the poor in the USA. Many patients lack access to health care and grapple with other problems that keep them from getting the care they need, such as homelessness, drug addiction or mental illness, Chakraborty says.

“Many individuals fall out of care, especially in adolescence or young adulthood,” Chakraborty says. “Young people think they’re invincible.”

Yet Havlir says scientists are ready to confront such obstacles.

“There are daunting challenges,” Havlir says, “but they are challenges that the field is going to embrace, because many people think they are surmountable.”

 

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