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One of my jobs with the BOP (Bureau of Prisons) was to be one of two “town drivers” who would drive women off-site as the occasions came up. One was for their monthly mammograms when their number came up. I dubbed these “Mammogram Thursday’s. “I tried to make this a fun road trip. Many of these women hadn’t been outside the camp for three to five years without a guard. I would take them in groups of 4 to 8 at a time for these exams. They were everything from nervous to terrified. I felt my part was to calm them and walk them through this process, letting them know I would be by them throughout the experience. I could not imagine being that afraid to go outside the camp. It was the beginning of my understanding of what being institutionalized meant. I began to wonder how I was changing? 

Getting a follow-up exam, when recommended, was a completely different story. I watched these women wait for months to see if their lump or spot was cancerous. One woman waited for her test results for 6 months. During this time, we all watched her breast grow to four times their average size. Even the guards could see there was a problem. Instead of going for a follow-up, the BOP opened a new women’s facility, and instead of a follow-up, she was transferred to the new facility. Once there, she started with an initial breast exam again and, after some time, learned she had advanced breast cancer. Though not in our camp, so many knew her that we followed her progress closely. She continued to wait for the medical staff’s advice for a treatment plan as she continued to grow ill. After another six months at this facility, the camp decided to send her to Carswell, Texas, where the BOP had a women’s hospital. No treatment or information was provided. Upon arrival at the woman’s hospital, she continued to wait several months to learn about a treatment plan, and when it would start. Eventually, She got one round of chemotherapy before she passed away. It’s hard to explain the anger that welled in those of us who knew her. It’s even harder to cope with the fear we all head that something like that might happen to anyone of us. How dare they let her die like this! Pain and anxiety were only underscored with anger.

I listened to many sad stories while in camp. I watched while so many of them remained ill and poorly treated or untreated. When going to an off-site facility, these women asked me to sign a Hippa form so the doctor could share their information with me. They wanted help in understanding what was going on with their health. Once returning to camp, the medical facility did not have to agree with or follow the specialist orders. Let me give you an example. I took a woman to a specialist off-site whose kidneys were failing. I signed the Hippa form to be in the room with her. The specialist advised us that her organs were shutting down. He told us it was because of the medicines she was put on in the camp. She had not been on these before coming here. The doctor wrote orders for her to be taken to a hospital where he could flush these meds from her system. He believed that within 24 to 48 hours, she should be much better. I made copies of the order. One for her and one for me with her consent. The camp chose to ignore these orders. They left her on the medications, and after many weeks, they transferred her to Carswell, Texas. No further or different treatment was being provided. She just got more ill as time passed and continued to swell up like a balloon. This is one of those clarifying moments for me where I knew I would be an advocate for these women. This kind of medical malpractice could not remain untold and hidden behind the veil of the BOP. 

I was terrified of any health care I might receive while stuck in the camp, entering as a 67-year-old woman. Quickly learning about the lack of care available, one of my goals was to stay away from the medical facility. During my first interview, the doctor told me I was diabetic and that I would die of a heart attack. I left feeling visibly shaken, trying not to cry as I worked my way as far away from this facility as I could get. I found myself crying a lot here when things stunned me, feeling momentarily out of control. But my problems were small compared to many of these ladies. Many of them had been doing drugs before arriving. They go cold turkey once incarcerated. Many of them will require medical attention while here.

Medical care for anyone in prison is borderline when provided on-site, but the situation is worse for women. Because the prison health care systems were created for men. Like everything else that happens in your life here as women, you are not an afterthought, you haven’t been thought about. Routine gynecological care, such as pap smears and breast exams are scarce. Most gynecological needs are delayed or worse ignored. Some of these women arrived while still high on drugs or so drunk they had alcohol poisoning. Both dangerous circumstances. They were just put in a bus stop to sleep it off and recover on their own. 

 Treatment is frequently administered once the situation becomes an emergency. Once treated, you can wait forever for results. Too many women become chronically ill or worse. How much more do we spend on medical care because we failed to provide timely care and follow-up when needed? If you got sick, you could be put on medical hold and were not eligible to be released from prison. We all prayed for good health.