Surviving Hepatitis C in AZ Jails, State Prisons, and Federal Detention Centers.

Surviving Hepatitis C in AZ Jails, State Prisons, and Federal Detention Centers.
The "Hard Time" blogspot is a volunteer-run site for the political organization of people with Hepatitis C behind and beyond prison walls, their loved ones, and whomever cares to join us. We are neither legal nor medical professionals. Some of us may organize for support, but this site is primarily dedicated to education and activism; we are fighting for prevention, detection, treatment, and a cure for Hepatitis C, particularly down in the trenches where most people are dying - in prison or on the street... Join us.


Saturday, September 25, 2010

Remembering murdered prisoners and their families

Today is the National Day of Remembrance for Murder Victims. The victims' rights organizations that assured this day would be recognized and murder victims remembered have done a good job of representing families destroyed by homicide.

My job, however, is to remember those families of prisoners killed in the care of the state who don't even have the standing as "victims" under our state constitution. Marcia Powell didn't even earn standing as a "victim", for all the suffering she went through before her death. I imagine that's so the state doesn't admit liability for neglect by acknowledging the special class of victims they create through neglect and abuse. Maybe if our constitution inferred that the same level of humanity exists in "people in custody for an offense" they wouldn't be getting killed by the desert in outdoor cages or ignored when being mutilated by cellmates so often.

A couple of these men were themselves in prison for murder or had otherwise seriously harmed others, but not most of them. None were sentenced to be executed. I have heard from or read messages left by many of their traumatized loved ones - their families were destroyed once by their convictions and imprisonment, now again by their murders.

I've also read a bit by family members of their victims, and from the victims of others. These deaths often open wounds for them, as well, including those not yet healed. I hope this doesn't have that effect for any of them.

I'll put together a later piece with links to relevant documents or blog posts on each of the murders I've researched. Today I'm just remembering homicide victims in prison, not what they did to get there. On some level, the public has already bargained that most prisoners get what they have coming to them. They don't. Most of the truly evil criminals aren't even in prison - some are actually running this show. A lot of people go to prison who never should have because they're just too poor to fight it.

I've decided that I'm going to ask the victims' rights organizations for help on this issue. Prisoners deserve safety, too, and are far too vulnerable to victimization - especially those who have been abused and exploited already.

I need to run this final list by the AZ Department of Corrections Monday to see if they can give me any more information from their own investigations, as the media did almost no follow-up on any of the ADC reports. I have more posts following the Hawaiian prison homicides than I do on the Arizona ones. This is a high prison homicide rate (national average 4/100,000 state prisoners per year), regardless on how those suspicious deaths pan out. The Phoenix New Times did good coverage of this issue after the four in 2008 - I hope someone in the media picks it up again.

The prisoner homicides that have been reported by the Arizona Department of Corrections in the past nine months alone follow. Our condolences to their loved ones. Please contact me if you want to share your story, connect with other prisoners' families, or think there's anything else I might be able to do.

If you contact the Department of Justice about your loved one's homicide, address your correspondence (always keep a copy; I certify my mail them, too) to:

Judy Preston, Acting Director
US DOJ Civil Rights Division
Special Litigation Division
950 Pennsylvania Avenue, NW, PHB
Washington, D.C. 20530

Please specify that you want a CRIPA investigation into your loved one's death and the pattern of homicides and suicides at the AZ Department of Corrections, as well as into the death of Marcia Powell.

Anyone can write to them, by the way, and support a CRIPA investigation for us as easily as this:

1. Print out this blog post, and write "PLEASE CRIPA this state!" across the top. Also write in your own name and contact info.

2. Photocopy your final work, then put it in an envelope.

3. Address the envelope to the DOJ.

4. Put appropriate postage on the original and mail it.

It would be a big bonus if you send me a copy of your CRIPA request so I can post that here, too. All my contact info is in the column to the side.


- Peg


Prisoners Murdered in the Care of the State of Arizona, 2010.
National Day of Remembrance for Murder Victims (September 25, 2010).

Shannon Palmer, 40 (9/10/10) ASPC-Lewis/Buckley Transitional

Dana Seawright, 26 (7/7/2010) ASPC-Lewis/Stiner

Albert Tsosi, 35, (6/16/2010) ASPC-Lewis/Rast

Alexandru Usurelu, 23 (1/25/10) ASPC-Eyman/SMU

Ulises Rodriguez, 22 (1/25/2010) ASPC-Tucson/Cimmaron

Also reported as suspicious in that time with no media follow-up:

Carl Cresong, 49 (1/3/2010) ASPC-Lewis/Buckley

Christopher Francis, 39 (8/17/2010) -ASPC-Lewis/Stiner

Armando Lugo, 36 (3/26/2010) - ASPC-Lewis/Morey

Franklin Leverette 60 (9/15/2010) - Central Arizona Correctional Facility


This does not count the Hawaiian prisoners in the custody of CCA facilities in Arizona, as they are not prisoners of the AZ Department of Corrections. The people of Hawaii are welcome to contact me, however, if you're organizing to have some of your prisoners sent home - and all of them kept safe. You clearly can't count on your government officials to act in victimized prisoners' or their families best interests - though at least your media has been covering the murders more closely. There's also that little thing about subjecting your citizens to the death penalty - if it's okay in Arizona, why not bring it to the Islands?

I'd really like to hear from some of you out there. Contact me at (phone 480-580-6807).

Friday, September 24, 2010

Neglect at the ADC: Special Litigation needed.

Hey all,

Here's what I'm sending off to Judy Preston at the Department of Justice's Special Litigation Section in the
Civil Rights Division re: a couple of CRIPA complaints. Here's what they did recently about Erie County's jail and the suicide rate I put up that Mother Jones article on a couple of weeks ago.

If you want to print out any or all of the posts below and/or newspaper articles about what's been happening in the prisons and send them to the DOJ and the AZ ACLU (addresses below) it may help move things along.

I'm keeping the letter accompanying this confidential since it references specific prisoners, but I'm posting the rest of this packet up here so pretty much anyone can pick up wherever I leave off - I'm researching the ADC homicides now to send in.


Arizona DOC: Image is Job 1. Prisoners are expendable. 1/17/2010

Governor Brewer: Help Prisoner Tripati. 1/17/2010

Sanity, mental illness, and "crime". 9/17/2010

The restoration of Jerry Kulp. 9/23/2010

Shannon Palmer's murder: prisoners at risk. 9/13/2010

Prisoner Patrick Lee Ross' tragic death: more to the story 9/7/2010

Perryville SOS: Critical conditions for seriously ill women. 9/10/2010

ASPC-Tucson: Prisoners neglected in cages, again. 9/7/2010

ASPC-Tucson: The death of Tom Reed. 7/08/2010

Despair Behind Bars: Suicide in Arizona Prisons 9/10/2010


Judy Preston, Acting Chief
Special Litigation Section - DOJ, Civil Rights Division
950 Pennsylvania Avenue, NW, PHB
Washington, D.C. 20530

(877) 218-5228
(202) 514-6258

American Civil Liberties Union of Arizona
P.O. Box 17148
Phoenix, AZ 85011
(602) 650-1854

(re: Conditions of Confinement: 8th Amendment and health/mental health care)

Monday, September 20, 2010

Syringe Exchange: For all the right reasons.

Cleveland has Ohio's only legal syringe exchange program

Updated: Monday, September 20, 2010, 12:09 PM
Emmanuel Romero, The Plain Dealer  
Emmanuel Romero, The Cleveland Plain Dealer 
Clients of the Free Medical Clinic of Greater Cleveland can exchange one used syringe for one clean syringe.
CLEVELAND, Ohio -- The Free Medical Clinic of Greater Cleveland runs Ohio's only legal syringe exchange program.

Drug addicts, sex workers and white-collar professionals stop by The Free Clinic or its mobile van and exchange one used syringe for one clean one.

The premise is simple, say program advocates: By taking used syringes off the street, it decreases the chance someone in the community might be pricked by a needle tainted with blood-borne pathogens such as hepatitis C or HIV. The program also helps ensure that people in the community are less likely to have sexual contact with someone who shares dirty needles.

HIV prevention efforts nationwide received attention in mid-July when the Obama administration announced a national strategy to reduce the annual number of new HIV infections in the United States by 25 percent over the next five years.

President Barack Obama called for a coordinated national response to address the epidemic. The strategy he proposed would include intensifying HIV prevention efforts in communities where HIV is most heavily concentrated, expanding targeted efforts to prevent infection, and educating all Americans about the threat of HIV and how to prevent it, according to the executive summary of the National HIV/AIDS Strategy for the United States.

The strategy also calls for scientifically proven approaches to reducing HIV transmission, including syringe exchange programs, which while once banned from federal funding, are now eligible.

Cleveland first allowed syringe exchanges in 1995. At that time, more than 17 percent of new HIV infections were associated with intravenous drug use. Last year, that number had fallen to 3.4 percent, according to the Cleveland Department of Public Health.

By comparison, the Office of National AIDS Policy says the national rate of new HIV infections associated with intravenous drug use is 12 percent.

No one is claiming the syringe exchange alone is to credit for the decline. But the city's HIV surveillance report says that Cleveland's below average numbers, in combination with other HIV prevention efforts, may be associated to the exchange program.

"While we do not have direct evidence that needle exchange caused this decrease, the association appears to have timeliness, consistency and biological plausibility," David Bruckman, a biostatistician for the city's health department, said by email.

The syringe exchange -- which also helps addicts access services they either didn't know about or were too hesitant to look for, such as HIV and hepatitis testing, safer sex education and rehabilitation programs -- has strong support from public health officials and people in recovery.

"It's one of those public health interventions I really believe to be a no-brainer," said health department Director Matt Carroll, referring to the lower rates of HIV infections associated with intravenous drug use as reported by his department.

"If it wasn't for the needle exchange, I would have caught HIV," says Roy Vonderau Jr., a self-employed upholsterer and former client of the program who has been sober nine-and-a-half years.

Supporters also see syringe exchange programs as a financially sound way to tackle HIV.

"The health impact and costs that we incur as a result of HIV, hepatitis and other diseases transmitted through the use of shared or dirty needles is enormous," says Martin Flask, director of public safety for Cleveland.
According to the AIDS Taskforce of Greater Cleveland, the average lifetime cost of care without drug discounts for one HIV positive patient is $618,900. Syringes cost less than $1 each.

But critics of such programs have prevented them from becoming widespread. The government first banned federal funding for syringe exchange programs in 1988, an action fueled by widely held fears that such programs increased drug-related crime and implied the government supported drug use. Those fears did not pan out in Cleveland.

"I don't have any evidence to suggest any correlation at all between the needle exchange program and crime," says Flask, a former commander of police when the program started.

Advocates who credit the program for the decline in infections among intravenous drug users want to bring similar programs to other parts of Ohio. The AIDS Taskforce is advising city officials and advocacy groups, including people in Columbus and Cincinnati, that are interested in organizing syringe exchange programs.

"We need to make sure we have more talks and figure out -- is [Columbus] ready to support something like that?" says Peggy Anderson, president and CEO of the Columbus AIDS Task Force. The city and police department need to be on board to help ensure a successful program, she said.

David Merriman, project coordinator of the Office of HIV/AIDS Services for the Cleveland Department of Public Health, also has reached out and connected people from STOP AIDS Cincinnati to The Free Clinic.
"The biggest thing we learned was what they did before they even started a syringe exchange," says Adam Reilly, MSM outreach educator at STOP AIDS. Knowing which city officials to talk to and what data to collect are two important steps.

For the last year, Reilly's group has been conducting surveys with drug users and Cincinnati police to gauge their thoughts on a syringe exchange program.

Members of STOP AIDS, Cincinnati's public health department and Cincinnati police plan to present this data to Cincinnati's health commissioner in September, says Reilly, who believes that state law remains the biggest barrier to starting syringe exchange programs.
Under current Ohio laws, a syringe exchange program can only operate if a city's health department issues an emergency order, but that doesn't protect participants from state prosecution. With support from the MAC AIDS Fund, a charity affiliated with MAC Cosmetics, the AIDS Taskforce is working with state policymakers to amend laws that prohibit the possession of syringes by drug addicts or the distribution of syringes to drug addicts.

In 2009, then-state representative Tyrone Yates of Cincinnati sponsored House Bill 274, which would have allowed drug addicts to carry syringes from an exchange program for the purpose of preventing disease transmission. The bill died after Yates accepted a municipal judicial appointment in January.

Despite that setback, legislators have been willing to talk about proposing new bills, said Chris Krueger, syringe exchange policy coordinator for the AIDS Taskforce, though he declined to identify which legislators were talking to the AIDS Taskforce.

In December 2009, Congress passed and Obama signed an appropriations bill that included language to lift the two-decades-old ban on federal funding for syringe exchange programs. That was a big move on the national level, Krueger says.

In July, the Department of Health and Human Services released written guidance on using HIV prevention funds for syringe exchange programs. The guidance allows money from two existing national grants -- neither of which currently funds The Free Clinic -- to be used for syringe exchange programs. The move does not promise additional federal money.

"The budget environment is very tight right now," says Jennifer Kates, vice president and director of global health policy and HIV for the Kaiser Family Foundation, a non-profit, non-partisan foundation.

The Free Clinic's syringe exchange program is primarily funded by the George Gund Foundation and the AIDS Funding Collaborative. While the Free Clinic receives federal funds for HIV prevention, none of these funds are currently used for the syringe exchange. It is unclear when they can apply for federal grants that can be used for the program.

The program is only reaching about a third of the population it needs to, says Chico Lewis, outreach coordinator for The Free Clinic's syringe exchange program, who bases his assertion on his experience working as a resident assistant at Matt Talbot Inn, a residential treatment facility. Lewis said several clients there have told him they were not aware the syringe exchange program existed.

As for critics who feel Lewis is only supporting drug addiction, and ask why he works with the syringe exchange program, his answer comes quick and easy: "I'm saving lives."

© 2010 All rights reserved.

Hep C Epidemic: Harvard Health Letter

From the September 2010 Harvard Health Letter. 
Simple but good background on the HEP C EPIDEMIC.
No time like the present to put an end to it.


The smoldering epidemic

The number of new cases of hepatitis C is down, but millions are chronically infected and may not know it.

The identification of the virus that causes hepatitis C, a disease that affects the liver, has probably saved millions of lives. Before the discovery, two other hepatitis viruses — the hepatitis A and B viruses — had been identified, but neither was present in many cases of this disease. Patients were said to have "non-A, non-B hepatitis" — an awkward name that spoke of medicine's ignorance. In 1989, the mystery was solved. The viral culprit responsible for most cases of non-A, non-B hepatitis was found. Thereafter, those cases were called hepatitis C and their cause, the hepatitis C virus.

The hepatitis C virus is transmitted through blood, so before the virus was identified, the disease was spreading through blood transfusions, medical procedures such as kidney dialysis and organ transplantation, and needle sharing by intravenous drug users. The discovery of the virus meant that screening tests could be developed to find it in the blood supply. Diagnosis and treatment of the infection in people also became possible. Prior to the virus being discovered, about 200,000 Americans were newly infected with hepatitis C each year, according to federal government estimates. Today, it's estimated to be about a tenth of that number (and the number of confirmed cases is far fewer than that). Hepatitis C has also become a disease of middle age in the United States as people who were infected in the peak years in the 1980s have survived and gotten older. Hepatitis C is now more common among Americans in their 40s and 50s than in any other age group.

This isn't to say that hepatitis C is a conquered disease. Globally, as many as 170 million people are believed to be chronically infected with the virus. In the United States, it may be just over three million. Many infected people don't realize they have the disease because a lack of symptoms, or that they can unknowingly spread it to others. Hepatitis C can lead to liver cirrhosis and liver cancer, and about 10,000 American deaths each year are attributed to the disease. There's no vaccine, and the current treatments for chronic infection have bad side effects and aren't effective in many cases.

The A and the B of hepatitis

The hepatitis A virus is spread through the fecal-oral route. Fecal-oral transmission can occur if someone handles food after not washing his or her hands properly, or if the food (or water) came from tainted sources. The classic example is shellfish harvested from sewage-contaminated waters.

Roughly 25,000 Americans are estimated to get hepatitis A each year, but the incidence — the number of new cases — is at record lows. Perhaps the single most important reason for the decline is the hepatitis A vaccine, which was introduced in 1995 and is now one of the vaccines that young children routinely receive. An increasing proportion of American hepatitis A cases are the result of infections acquired overseas in countries where the illness is more common, such as Mexico.

The symptoms of hepatitis A include fever, nausea, abdominal pain, and the like. People can be sick for weeks, even months, but hepatitis A doesn't turn into a chronic infection like hepatitis B and C. Most people recover completely without treatment (except for symptom relief) and without liver damage.

Like the hepatitis C virus, the hepatitis B virus is transmitted in blood, although semen and saliva can also be infectious. In the United States and other parts of the world where hepatitis B is relatively rare, the virus is spread primarily through unprotected sexual intercourse and the sharing of contaminated needles during intravenous drug use.

Like the hepatitis C virus, the hepatitis B virus can survive outside the body for prolonged periods, so it's possible to get infected from sharing toothbrushes, razors, or other objects that might have blood on them.
Federal health officials estimated that 43,000 new cases of hepatitis B occurred in the United States in 2007, the latest year for which such an estimate has been made. Hepatitis B incidence has been in steady decline in this country since 1991, when children began to be vaccinated against the disease.

Symptoms and diagnosis

Frequently initial infection with the hepatitis C virus doesn't cause any notable symptoms. Some people (about 25%) may feel tired or feverish, lose their appetite, or have some pain in the upper right part of the abdomen, where the liver is located. When symptoms do occur, it's often one to three months after the exposure, so they may not prompt a visit to a doctor. Jaundice, the yellowing of the skin and whites of the eyes that's a classic sign of liver trouble, usually happens only when the disease gets more advanced.

Even when the infection persists and becomes a chronic condition, which happens about 80% of the time, hepatitis C often doesn't cause symptoms and can lurk undetected for decades. As a result, an infection is often discovered incidentally when a routine blood test shows a spike in certain liver-related enzymes. The doctor may follow up with more blood tests, like a special one that detects antibodies to the virus. Those tests aren't done routinely, but they are recommended for patients in the high-risk groups for hepatitis C, which in the United States includes, among others, those who received donated blood or organs before 1992 or blood clotting factors before 1987 and past or current users of intravenous drugs.

If the antibody test comes back positive, another test will probably be ordered to identify the genetic makeup of the virus. The hepatitis C virus has at least six different genotypes, which are referred to by numbers. In the United States, most people are infected with genotype 1, with most of the remaining infections being genotypes 2 and 3.

Avoiding cirrhosis

Even without symptoms, chronic hepatitis C can cause the liver to become inflamed as it fights the infection. Over time, the inflamed liver tissue can become scarred (this is called fibrosis) and replace healthy tissue. The liver is a resilient organ and can heal if the illness is caught and treated successfully. But if the scarring continues and becomes serious, the person is said to have cirrhosis (pronounced sir-ROW-sis). The most common causes of cirrhosis in the United States are alcohol abuse and chronic hepatitis B and C infections.

Once cirrhosis develops, a lot may go wrong and there's no shortage of symptoms. Fluids may accumulate in the legs (edema) or abdomen (ascites). Veins in other parts of the body may expand and bleed because blood doesn't flow properly through the liver. The blood itself can become laden with toxins that a healthy liver would normally filter out. Eventually the cirrhotic liver may fail altogether, which leaves a liver transplant as the only treatment option. Cirrhosis also greatly increases the risk for hepatocellular carcinoma, the most common type of liver cancer. A third of such cancers in the United States can be attributed to hepatitis C infections that led to cirrhosis.



illustration of liver showing damage from cirrhosis

The good news amid this gloom is that pretty much all of the serious consequences from chronic hepatitis C infection occur only after cirrhosis has developed, and that happens in a fraction of people with chronic hepatitis C infections. Studies have come up with different percentages, but 20% is a commonly cited figure.

Why some people get cirrhosis while others live with chronic hepatitis C infections that cause little, if any, harm to their livers isn't completely understood, but several factors have been identified. People are more likely to develop cirrhosis if they drink alcohol, for example, or if they're also infected with HIV or hepatitis B. Age may matter: the risk of cirrhosis seems to go up if you were infected between the ages of 40 and 55. Some evidence suggests that African Americans are less likely than whites to develop cirrhosis. Results from a few studies suggest coffee might be protective.

The uncertainty of whether a chronic hepatitis C infection is going to lead to cirrhosis, along with the gradual nature of the process, often makes starting treatment a bit of a judgment call. Some people with chronic hepatitis C choose to delay treatment if tests show that their livers are healthy. Blood tests, ultrasound exams, and biopsies can be used to monitor how the liver is doing, so treatment can start later if the virus starts to cause liver damage.

Naturally, there's great interest in anything that might reduce the chances of that liver damage happening. The standard advice is pretty limited, though. People are told to avoid alcohol entirely because it both encourages replication of the hepatitis C virus and damages the liver on its own. Most medicines are safe for people with hepatitis C, although acetaminophen (Tylenol) use should be limited.

Some people with chronic hepatitis C infections take silymarin, an extract of the milk thistle plant. Milk thistle has long been thought to promote liver health, and some lab experiments have shown that it might protect liver cells, but solid proof is lacking. Trials are under way that may provide more evidence.


The most effective current treatment for a chronic hepatitis C infection is a combination of pegylated interferon, taken as a weekly shot, and ribavirin (Copegus, Rebetol), taken as a pill. Eliminating the virus is the goal, so treatment is deemed successful if there's no evidence of the virus in the blood six months after therapy has stopped.

Interferon, a protein produced naturally by the body to fight viruses, is used to treat various cancers and other diseases. There are three major types of synthetic interferon, and the alfa variety has been used as a therapy for hepatitis C since the early 1990s. To help the interferon last longer in the body — and reduce the number of injections — it is "pegylated" by adding the chemical polyethylene glycol. Ribavirin, an antiviral medication, was approved as an add-on drug in 1998. The pairing of ribavirin with interferon has proved to be two or three times more effective than interferon alone.

The chances of successful treatment depend partly on the type of hepatitis C. About 80% of people in the United States infected with genotypes 2 and 3 respond well to pegylated interferon and ribavirin, but only about half of those infected with genotype 1 do.

Side effects are a problem: up to 80% of patients experience them. Generic "flu-like" symptoms, as well as fatigue, are common. But interferon-based therapy also has unusual effects on emotions and mood, and is associated with depression, emotional swings, or bouts of anger. Another drawback to the current regimen is that the medications need to be taken for a long time: six months for treatment of genotypes 2 and 3 and almost a year for genotype 1.

Doctors have tinkered with the interferon-based therapy with mixed results. One approach has been to combine it with novel compounds designed to interfere with replication of the hepatitis C virus, which mutates quickly inside cells. Two of the most promising drugs being tested in patients, telaprevir and boceprevir, inhibit protease enzymes, which is how many of the HIV drugs work.

Dr. Raymond Chung, a leading hepatitis C researcher at Massachusetts General Hospital, says scientists are looking at ways to attack the virus at different stages in its life cycle. One strategy is to prevent the hepatitis C virus from entering or exiting liver cells, so the virus can't assemble itself inside and then leave to infect other cells. Researchers are also looking for ways to boost the body's immune response to the hepatitis C virus. Dr. Chung heads a research consortium that received a $15 million federal grant to investigate how the virus manages to elude the immune system so well.

Viral Hepatitis and Liver Cancer Control and Prevention Act

By Julian Pecquet -  
The Hill - Blog
08/05/10 03:58 PM ET 

Sen. John Kerry (D-Mass.) on Thursday introduced a bill directing the Department of Health and Human Services to develop a national strategy to prevent and control viral hepatitis.

The bill would authorize funding of almost $600 million over five years to combat the disease. Some 5.3 million Americans are infected with hepatitis B or C, which disproportionately affects blacks and Asian and kills 12,000 to 15,000 Americans every year.

"Viral hepatitis is a silent killer," Kerry said in introducing the legislation. "Most people don’t even know they have hepatitis until it causes liver damage or even cancer years after the initial infection. We can easily avoid these needless tragedies with prevention, surveillance programs, and by educating Americans about this deadly disease."

Kerry's bill — the "Viral Hepatitis and Liver Cancer Control and Prevention Act" — has the support of 102 community-based organizations that provide viral hepatitis counseling, screening and treatment.

"Senator Kerry’s legislation is urgently needed to modernize our nation’s public health response to chronic viral hepatitis," Lorren Sandt, chair of the National Viral Hepatitis Roundtable, said in a statement. "Screening and early intervention are critical to achieving better outcomes for infected patients and must be a national priority. Otherwise, our system will incur — each and every year — thousands of avoidable deaths and billions of dollars in unnecessary costs."

Kerry's bill is sister legislation to the bill Rep. Mike Honda (D-Calif.) introduced in the House in October. That bill has 60 bipartisan co-sponsors.

The House oversight panel held a hearing on the issue in June and urged prompt passage of Honda's bill. The hearing came on the heels of an Institute of Medicine report that highlighted deficiencies with the federal government's response to the epidemic.

Expand Screening, early treatment for Hep C.

NVHR Responds to New York Times Article on Hepatitis C Testing

July 22, 2010

Washington, DC-In response to today's New York Times article, "Hope against Hepatitis C," Andrew Muir, M.D., M.H.S., Director, Gastroenterology/Hepatology Research, Duke Clinical Research Institute and Steering Committee Member of the National Viral Hepatitis Roundtable (NHVR) 
released the following statement:

Washington, DC—

"Today's New York Times article details potential promising new drug therapies that could significantly improve the way we treat individuals infected with hepatitis C. Regrettably, the article suggests that expanded screening for hepatitis C may not be warranted. This approach is wrong and contrary to the direction in which we should and must move our health care system, particularly through improved access to care under health care reform. More than 5 million Americans are estimated to be infected with viral hepatitis B or C - and most are unaware they are infected as there are often few symptoms. Our health care system misses most infected individuals, who only learn that they have hepatitis C once they have progressed to liver cancer, cirrhosis, or liver failure. At that juncture, treatment options are limited and success rates are lower.

"Precisely because we do not know which individuals with hepatitis C will advance to these terrible diseases, it is critical that our public health infrastructure be modernized to achieve early detection of new infections and also to screen for individuals within specific risk groups, such as baby boomers and disproportionately affected populations. Once individuals are aware of their status, they will be empowered with this information, not only to make treatment choices, but also lifestyle choices to decrease their likelihood of disease progression and not to spread this infectious disease to others. In our current health care system, there are far too few options for diagnosis, care, and treatment. Unless or until the health care system provides access to all persons in need of hepatitis C treatment, it is important for the pharmaceutical industry to provide comprehensive compassionate care programs for those who are un/under insured.

"We can't prevent or treat what we don't know, which is why screening is critical. Access to screening would capture more infected individuals who can respond favorably to early intervention, reduce transmission, avoid needless medical expenses, and ultimately save thousands of lives annually."
NVHR is a coalition of more than 150 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from chronic viral hepatitis that afflicts more than 5 million Americans.
Contact: Phil Blando,, 202-534-1772

New HCV Treatments overview.

This is a really good overview of the emerging treatment options for people who are HCV+. Now is the time to raise public awareness about this illness.


Hope Against Hepatitis C

July 21, 2010
New York Times
New medicines are being developed that are expected to transform the care of patients with hepatitis C, making treatment far more effective and far less grueling.

The new drugs, which could start reaching the market as early as next year, could help subdue a virus that infects roughly four million Americans, most of them baby boomers, and 170 million people worldwide.

“I almost think this will be revolutionary, to be honest,” said Dr. Fred Poordad, chief of hepatology at Cedars-Sinai Medical Center in Los Angeles. “We are chomping at the bit to try to treat as many patients as we can.”

About two dozen pharmaceutical companies are now pursuing drugs for hepatitis C, which an executive at Vertex Pharmaceuticals recently called “one of the largest pharmaceutical opportunities this decade.”

That is because the toll of the disease, which now kills about 12,000 Americans a year, is expected to rise in the coming decade. Although new cases have dropped sharply, hundreds of thousands of people who were infected decades ago are expected to start experiencing the effects of liver damage.

New cases of liver cancer are already rising year by year. And hepatitis C is the leading cause of liver transplants, like the one recently received by the rock musician Gregg Allman.

Hopes for new treatments were buoyed in May by the first results from a late-stage clinical trial of one of the new drugs, telaprevir from Vertex. When added to the existing treatment — a combination of alpha interferon and ribavirin — telaprevir effectively cured 75 percent of patients, compared with 44 percent of those treated with the existing drugs alone. And for many patients, the course of treatment could be halved to 24 weeks.
Dr. Poordad, who is a consultant to some of the pharmaceutical companies, said that one-fifth of his patients were being “warehoused,” meaning they were forgoing treatment now to wait for the new drugs.

But even if the drugs do work, some experts and doctors warn that this virus may be particularly tough to vanquish. Three-quarters of the people who are infected do not know it because they are not tested for the virus and because the infection can be asymptomatic for years while it stealthily attacks the liver.

And because this disease is transmitted by blood, those infected largely are former or current IV-drug users — a population that characteristically has little or no health insurance — who may not be the most able to stick to a lengthy treatment regimen that can cause brutal side effects.

Pharmaceutical companies “completely ignore the real face of hepatitis C,” said Dr. Diana L. Sylvestre, who runs a clinic in Oakland, Calif., that treats drug addicts and former addicts with hepatitis C. “A minority of patients who have hepatitis C will benefit from these drugs.”

When she gave a recent talk at Vertex, Dr. Sylvestre’s first slide showed a man in a suit, meant to be a Vertex executive, with his head in the sand.

Dr. Camilla Graham, a senior director of medical affairs at Vertex, said that addicts accounted for less than 10 percent of people with hepatitis C. While many people got infected by trying drugs in the 1960s and 1970s, they have long since kicked the habit, she said.

Hepatitis C can also be transmitted sexually, particularly when men have sex with other men. And many people got the virus from blood transfusions before 1992, when donated blood began being tested for the virus.

Nevertheless, pharmaceutical companies realize that difficulties getting patients screened and treated could limit the use of their drugs. So they are contributing to a groundswell of activism to raise awareness of what has long been known as a silent epidemic. Also contributing to the new advocacy is the highly organized H.I.V. community, since 15 to 30 percent of those with H.I.V. also have hepatitis C.

A report issued by the Institute of Medicine in January urged a new national strategy to improve prevention, detection and treatment of hepatitis C and hepatitis B, which also causes liver disease. A hepatitis task force created by the Department of Health and Human Services is preparing an action plan by October. The House Oversight and Government Reform Committee held a hearing on hepatitis last month.

Drug makers contribute to the National Viral Hepatitis Roundtable, which helped pay for the Institute of Medicine report, and several companies have banded together into the Corporate Hepatitis Alliance to lobby for more government funding. In January, several companies started the Viral Hepatitis Action Coalition, to help finance research at the Centers for Disease Control and Prevention.

Vertex has commissioned studies projecting a rising toll from hepatitis C. One such study, done by Milliman, a health insurance consulting firm, projected that the number of people with advanced liver disease from hepatitis C would quadruple in 20 years if treatment did not improve.

Screening people for hepatitis C should become easier. In June, the Food and Drug Administration approved a rapid blood test developed by OraSure Technologies that gives an answer in 20 minutes rather than several hours needed if the sample is sent to a lab. Future versions might use a mouth swab, allowing screening to be done at churches, street fairs and other gatherings.

There is a risk that increased screening could result in treatment for people who will never need it. Only 5 to 20 percent of people with chronic infection develop cirrhosis in about 20 to 30 years, and doctors cannot predict which patients those will be.

“I think the companies have done a superb job of marketing this disease,” said Dr. Ronald L. Koretz, emeritus professor of clinical medicine at the University of California, Los Angeles. Dr. Koretz said there was no good evidence that treatment made a difference since many patients cured by the drugs might never have developed serious problems anyway.

The current treatment for hepatitis C consists of weekly injections of alpha interferon — the leading brands are Roche’s Pegasys and Merck’s PegIntron — combined with ribavirin, a generic oral drug. It is not quite clear how these drugs work.

The regimen usually lasts either 24 or 48 weeks and costs more than $30,000. It can be rough, causing flulike symptoms, depression, anemia and other problems. And the treatment fails to cure the patient about half the time, either because it cannot clear the virus from the body or because the patient cannot tolerate the drugs.
The new drugs generally inhibit enzymes needed by the virus, a strategy that has worked well against H.I.V. The two drugs that could conceivably make it to the market by next year, Vertex’s telaprevir and Merck’s boceprevir, are both pills that inhibit the protease enzyme.

For a few years at least, the new drugs would have to be used along with interferon. But doctors are hopeful that starting perhaps in five years, combinations of the new pills will do away with the need for interferon.
The drugs could offer new hope to an estimated 300,000 people for whom the existing treatment has not worked. Some early data suggests that telaprevir, when combined with the existing drugs, could cure half of them.

“I was willing to try yesterday,” said Kenny C. Charles, 58, of Woodbourne, N.Y., who said he got hepatitis C from blood transfusions and had undergone four unsuccessful treatment attempts with the existing drugs. Now, he said, his liver was starting to show signs of cirrhosis, or scarring.

Some people with hemophilia, who were infected more than 25 years ago by blood-clotting drugs derived from human plasma, are pressing the Food and Drug Administration to allow them to be treated with combinations of the new drugs, without interferon, even before the new drugs are approved. The F.D.A. held a public hearing on the request in April and is now formulating a policy.

Mark Antell of Rosslyn, Va., one of the organizers of the petition, said he had to stop taking interferon because of flulike symptoms, loss of hair and creaking joints. “It was as though I was aging very rapidly,” he said.

Mr. Antell, 63, a retired Environmental Protection Agency employee, said hemophiliacs were typically not allowed into clinical trials to test the new drugs, so they needed another way to obtain them.

“I think there’s a lot of guys in my situation, and we don’t have a lot of time,” he said.

Needing Needle Exchange: California Bills

Good guest editorial from the Sacramento Bee on the need for more harm reduction approaches to stemming Hep C and HIV in the US. Arizona could learn something from them.

Viewpoints: Two bills key to curb HIV and hepatitis C

Special to The Sacramento Bee

Christopher Kennedy Lawford is an actor, lecturer and author. He is honorary chairman of California Hepatitis Alliance,

Published Saturday, Sep. 11, 2010

"I want to test you for hepatitis C and HIV," my doctor told me in 2000. I'd been in recovery for 15 years, but as a teenager and very young man I had been addicted to drugs and alcohol. I used needles and syringes. Among the people I knew, sharing needles was common back then – before HIV and hepatitis C were a reality.

The last time I put a needle in my arm was in 1981, just as the first cases of AIDS were being identified in the United States. I'd avoided getting tested out of sheer terror – fear that I'd gotten sober only to die of AIDS.
My doctor gave me the good news/bad news: I wasn't infected with HIV, but I was infected with hepatitis C.
I'd heard of hepatitis C – folks trudging alongside me on the recovery road were getting diagnosed with hep C, and it didn't sound good. My doctor gave me the whole cold truth – without treatment, I might face liver cancer, liver transplant. Maybe death.

A lot of things came together at that point in my life. The urgency created by the fact that I might die made the period revolutionary. I've died many, many times during my addiction, but I've never been confronted with the possibility of really dying in sobriety.

With the support of medical professionals, family and friends – particularly those in recovery – I survived hepatitis C and became an author and advocate for drug treatment, hepatitis C and HIV treatment, and better prevention policy.

In the 10 years since I was cured, I've met thousands of people confronting a diagnosis of HIV or hepatitis C, a cruel remnant of not only their past, but a public policy environment in the United States that differs from the rest of the industrialized world. Most of the world responded to AIDS by investing in addiction treatment and making sterile syringes available to those who would not, or could not, stop using drugs immediately. Those policies kept Western Europe from suffering a major outbreak of HIV among injection drug users, and a hepatitis C rate that is lower than in the United States.

There is absolutely no controversy among public health researchers and scientists on syringe access. More than 200 studies from around the world concur that allowing adults to legally access and possess syringes suppresses the spread of these diseases without contributing to any increase in drug use, crime or syringe litter.

It is time for California to catch up with the rest of the world. We have that option through two good bills that Gov. Arnold Schwarzenegger should sign.

• Senate Bill 1029 by Sen. Leland Yee, D-San Francisco, would allow physicians and pharmacists the discretion to furnish a limited number of syringes to adults without a prescription.

• Assembly Bill 1858 by Assemblymman Bob Blumenfield, D-Woodland Hills, would allow the state Department of Public Health to authorize syringe exchange services where the conditions exist for the rapid spread of HIV or hepatitis C through syringe sharing.

Neither bill costs much to implement and would save taxpayers billions, literally billions, by averting costly infections.

In politics, there are always those who propose half-measures, like allowing legal syringe access to be a decision of local government. That doesn't make sense – communicable diseases don't respect the county line, and Californians deserve equal access to a proven disease prevention strategy, no matter where they live. Furthermore, publicly funded programs pay for the health care of a low-income person, no matter where he or she lives – so taxpayers deserve a statewide standard, as well.

I trust the governor will respect the scientific consensus that supports legal syringe access. Those of us strong enough to recover from addiction deserve a chance to get better, and the taxpaying public deserves smart prevention policy. Governor, please sign SB 1029 and AB 1858.

© Copyright The Sacramento Bee. All rights reserved.

Saturday, September 11, 2010

the Desaparecidos of 9/11

A friend passed these lyrics on to me today in remembrance of those most forgotten from the tragedy on 9/11/2001. Grief was spoken in our country in many languages that day - and it was silenced by fear. Still is.

This is for the families of the Desaparecidos everywhere.
Liberty weeps for you, too. May you someday safely bring your loved ones into our light.

Peggy Plews
Arizona Prison Watch


If I Give Your Name

by Emmas Revolution

Mi esposa, my wife, worked on the 80th floor
The company had hired illegals before
She got the job by word of mouth
That’s the way in the north when you’re from the south
They say 3,000 but the counting’s not done
Mi esposa está muerta
Three thousand and one

I have no papers, I have no rights
All my days end in sleepless nights
Missing you, silently
If I give your name
Will they come after me?

Mi hermano, my brother, the elevator man
A doctor in our country but you take what you can
I saw the photos in Union Square
But I could not leave his picture there
They say 3,000 but that’s not true
Mi hermano no volverá
Three thousand and two

Mi hija, my daughter, went in early that day
She had always been that way
Her daughter asks, "Where did she go?"
How to tell her, I don’t know
They say 3,000 but that can’t be
Perdí a mi hija
Three thousand and three

Mi padre, my father, I have no words
I tried to find you when I heard
They gave some ashes to families
But I’ll only have the ones I breathe
They say 3,000 there’s so many more
Three thousand and four

Mi esposa, my wife. Will they come after me?
Mi hermano, my brother. Will they come after me?
Mi hija, my daughter. Will they come after me?
Mi padre, my father. If I give your name,
Will they come after me?

Youth on Fire: Heroin and Hep C everywhere.

I read this last night and wept. This thing is going after our kids with a vengeance. It's already bigger than AIDS. What's it going to take for us to step up the to fight with everything we've got? How will kids get help while they still have hope if they're too afraid of arrest?

We can't just keep throwing addicts into prison and leaving them to die there, but in America, chains and cages for our people seem to be all we're willing to invest our resources in. How is that either good public health policy or justice?


Hepatitis C Spikes Among Young Heroin Users

Sep. 9, 2010, 6:27 AM

BOSTON — Heroin, a drug that claims nearly two lives in Massachusetts every day, killed a young woman in Cambridge late last month. She had just turned 18 when she overdosed alone in a bathroom.

“It was a real tragedy, it always is,” says Michael May, the outreach coordinator at Youth on Fire, a teen drop-in center in Cambridge. “She was really young, had been using for a long time and was a pretty key fixture in the community around here.”

May worked with the girl he can’t name and worries that the epidemic he fights every day is gaining steam.
“This summer has been very intense for heroin use in this area,” May says. “And we’ve been getting a lot of kids who, rather than a slow progression into injection drug use, have kind of jumped right into it.”

Needle Use On The Rise

This signals trouble for diseases transmitted through needles, which are also on the rise. The Department of Public Health says infection rates for Hepatitis C in 15- to 25-year-olds have almost doubled since 2002. But there’s no money in this year’s budget for Hep C prevention or to treat new patients.

Hepatitis C is passed through blood in needles, on cotton and on other equipment drug users share. It is 10 times more infectious through a needle stick than HIV. If untreated, Hep C inflames, scars and can ruin your liver.

Dan Church, an epidemiologist at the Department of Public Health, says a spike in Hep C among young heroin users is an urgent matter.

“It’s very alarming to see these numbers of cases with a disease that we really have not seen in this age group for quite some time.” So I think it’s very important that we start thinking about how we can prevent Hepatitis C and provide them education so they will not continue to transmit this disease unknowingly to other people,” Church says.

That is happening. Heroin users and counselors say Hep C is everywhere.

“Once I found out about Hep C, it was just like, yeah, everyone has Hep C,” says Gabe, a 23-year-old who fears arrest if he gives his last name. He started shooting heroin nine years ago but says he only uses occasionally these days.

Gabe does not have Hep C. He tries to keep a few clean needles on him as he moves between Boston and his other home base, Chicago, hopping freight trains, but it doesn’t always work out.

“I’ve definitely gone back and grabbed my old needles off the ground; I don’t know if someone used them, or somebody else’s got dropped there,” Gabe says.

“I generally kept them hidden in one spot but sometimes, you know…”

In Cambridge, and in the the state’s three other needle exchange programs, counselors work Hep C into their prevention talks even though state funding was eliminated this year. May, from Youth on Fire, has a list of precautions he urges users to take. But he knows they may not stick to them in the heat of the moment.

“If somebody’s in a hurry, if they’re sick, it’s just now, now, now,” May says, “and then after they get well is when the rational thinking comes back into play.”

What’s also scary, May says, is that many users aren’t too worried about Hep C.

Johnny, a 24-year-old who also won’t give his last name because he worries about being apprehended by police, sleeps in the woods and hangs out at “Youth on Fire” during the day. He has Hep C.

“It just makes you tired, that’s it. I mean, people can live with it for the rest of their lives right and not die,” he says.

Johnny may be able to manage Hep C with a good diet, rest and no drugs or alcohol. But even if he gets worse, he says he won’t seek treatment because “I heard it makes people really sick and it can kill you.”

Treating Hep C

Hepatitis C is difficult to treat. The drugs won’t kill but they can make patients feel like they have the flu on and off for six months to a year and are only effective in 30 to 40 percent of cases. But on the medical side, things may be looking up.

“We’re really on the dawn of a new era of treatment for Hep C,” says John Ward, director of the division of viral hepatitis at the Centers for Disease Control. “The drugs we have now aren’t specific for the virus.”
Ward says new drugs that are specific to Hep C could be on the market next year.

“When those [new drugs] come on, it will probably double the likelihood of being cleared of this virus and having to go through about half the weeks of treatment,” Ward says.

Ward is understandably excited about better treatment options. In addition to the new wave of young people infected with Hep C, one in 30 Baby Boomers have it, according to the CDC. They could have been infected through a blood transfusion if it occurred before 1992 or in a non-licensed tattoo parlor, but the main way people get Hep C is through intravenous drug use. Cynthia Jorgesen, who runs education and training programs at the CDC, says many people don’t want to recall a past that might have included Hep C.

“Because of that association with negative connotations,” she says, “a lot of people don’t assume they’re at risk because they’re not ‘one of those people.’ ”

Baby Boomers And Hep C

Sixty-five to 75 percent of Baby Boomers who have Hep C don’t know it. Ward says that’s because “they call Hep C the silent epidemic. You can live for decades and don’t know you are infected. The liver doesn’t complain much until it is very, very ill. So you don’t get sick often until it’s too late to help the liver.”

The CDC says death rates are expected to triple in the next 10 to 20 years if the Boomers don’t find out they have Hep C before they get seriously ill.

Most health insurance plans cover a Hep C screening if there’s reason to think you need one. The Department of Public Health is hoping word about Hep C will spread faster than the virus until there’s money again for prevention and new treatment.

Friday, September 10, 2010

Perryville SOS: Critical conditions for seriously ill women.

The following comment was posted to my earlier piece about conditions out at Perryville prison for women - this is specifically referencing San Pedro, which is supposed to be the "medical yard". The concerns enumerated by her are serious and chronic. There are elderly and frail women there, including women with AIDS, cancer, Hep C, and a host of other illnesses and disabilities.

I can say with confidence that this woman's complaints aren't an exaggeration, nor are they unique to San Pedro (or even to Arizona). I also doubt that any of these issues were addressed when the women of Santa Cruz protested the recent lock-down. I've heard all these things from other women who were/are prisoners at Perryville - including two breast cancer survivors and one woman seeking a compassionate release who's now losing a battle with colon cancer (ironically, given the horrid conditions of her confinement, she was actually written up once for a "grooming violation").

Even the healthy women are at risk in that environment. The notion that people are "well taken care of" behind bars is a popular myth rooted in ignorance and self-serving politics that costs many vulnerable prisoners their lives. And no, they don't all "deserve" to be there in the first place - they certainly don't all need to be there for the sake of public safety - despite the absurd claim in the Fischer report that almost all of the ADC's prisoners are a danger to the rest of us (if you look at that link, check out Professor Mona Lynch's testimony in response, and note how Fischer doesn't differentiate between violent and repeat offenders for the legislature - they're just staving off budget cuts by preventing the early release of ANY prisoners, save a handful of "criminal aliens" the state had deported). My terminally ill friend is an example - she got 5 years from a Pinal County judge as a first time, non-violent offender on a controlled substances charge (she's an addict, of course). Hence the outrage of the author below about "bullshit charges" women are imprisoned for these days - our rate of incarceration has skyrocketed.

San Pedro is a minimum custody level yard - those are women who are low risk enough that they can move freely about the prison, share large dorm areas, and work in the community. When escorted outside of Perryville, they only need one guard to accompany them. So why do they need to be locked up at such an exorbitant expense at all? The average amount we pay per state prisoner in minimum custody in Arizona is about $21,500/year. That's more than twice what our federal government will afford for an elderly or disabled person in the community who is solely dependent on Supplemental Security Income (the state doesn't even supplement that).

Health care costs for prisoners are outrageous, but the quality of health care that prisoners get (if they get it at all) is worse than folks get on AHCCCS, believe it or not. Given that San Pedro is a "medical yard", the author's estimate of the cost of incarceration there may well be accurate, though - for some prisoners it's much higher. Once they finish doing their time (if they survive the experience), we're more than willing to leave them homeless, too, no matter how sick they may be. If they stay homeless too long on parole, they can get violated and thrown back in. That seems awfully twisted to me...

Thank you, to the former prisoner who took the time to send out this SOS for her sisters. She's absolutely right about women getting the worst deal in prison (most of the prisons are fire traps, but I don't hear nearly as much from the men about health hazards as I do from Perryville). Results will be hard to come by - God knows Middle Ground has been working on this for years - but if we can get some key legislators invested and build even a modicum of human rights' protections into Marcia's Law, it might help some of these conditions.

Please feel free to contact me - you or any other family members or former prisoners out there - if you want to work on these concerns with us. We need all the help and eyewitness testimony that we can get.
My number is 480-580-6807; call anytime.


September 10, 2010 12:41 PM

Anonymous said...

I want someone to fight for the women who are serving time in Perryville Prison. I just did a nine month stint on San Pedro Yard. The place is disgusting, none of the swamp coolers work, its 120 degrees in our cells. The K-9 dogs stays in cages in the air conditioning. We are treated like animals (worse than animals). The sewer systems on both yards over flow, right in front of the kitchens, YUCK! The swamp coolers are filled with pigeon poop, and we breathe that into our lungs. Every bathroom is covered with mold, the walls , the floors, the shower curtains. One of the kitchens on 8 yard has been condemed, and the prison is not supposed to house inmates in there. BUT THEY DO! As soon as the health inspectors come to check stuff out, they leave and they start housing girls back in there AGAIN!.

The medical services on San Pedro is a joke, more than one time I was told to take advil and drink alot of water, and I have blood clots, and fibromyalgia!!!! Ive Heard them tell the same exact thing to the girls right after they have a seizure! The prison is so over full that we are living in squaller, The smoking section is full of fleas, bugs, ROACHES. The Deputy Warden MUSE is useless, Im surprised she even has a job. IF we get lucky to have a community meeting, and ask her a question, she always puts it off on someone else, she is extremely rude, and inconsiderate. AND LLAAZZYY!!

San Pedro is supposed to be a medical yard and i have NEVER seen living conditions like that before.!, and Im not just taking someone elses word for it, I lived there. The prison is so broke , why do we continue to hold so many girls that they cant afford to take care of them. ITS your Tax money to hold girl in disgusting conditions, Why dont you let alot of them go home to there kids. Come on drug charges for there own personal use (GIVE ME A BREAK). It cost tax payers 30-40 thousand dollars a year to hold mothers, daughters, wifes sisters.... FOR SOME BULLSHIT CHARGES...... Dont any of you have better things to do with your money?

Push for the senate bill to lower the 85%, to the 65%, and Fire Deputy Muse, shes not doing one bit of good anyway. Illegal Immigrants had their 85% dropped down to 50%..... The Prison is condemned, and its filthy, if we were the men at the mens prison, wed riot for what we want, but because were women and were more passive , and we dont riot....WE GET THE SHITTY END OF THE DEAL!!!!!!!! HELP!!!!!HEALTH INSPECTORS ARE ALWAYS SHUTTING THINGS DOWN ON OUR YARD! we EAT DAYS OLD LUNCH MEAT EVERY SINGLE DAY FOR LUNCH! food poisoning is common!~

Thursday, September 9, 2010

300 American prisoners will be raped today.

Hey folks - read this article then please head over to sign the petition to Holder at

Leave an intelligent comment on the blog there, while you're at it. Too many idiots have done so already.

---From the New York Review of Books---

Prison Rape: Eric Holder's Unfinished Business

David Kaiser and Lovisa Stannow

A new report by the Bureau of Justice Statistics (BJS) provides grim reaffirmation of something we already knew: sexual violence is epidemic within our country’s prisons and jails. According to the report, 64,500 of the inmates who were in a state or federal prison on the day the latest BJS survey was administered had been sexually abused at their current facility within the previous year, as had 24,000 of those who were in a county jail that day—a total of 88,500 people.

In fact, as we’ve explained before, the true national total is much higher. The BJS numbers don’t include thousands who we know are sexually abused in juvenile detention and other kinds of corrections facilities every year, nor do they account for the constant turnover among jailed detainees. Stays in jail are typically short, and several times as many people pass through jail in a year as are held there on any given day. Overall, we can confidently say that well over 100,000 people are sexually abused in American detention facilities every year.

As appalling as this figure is, mere numbers can obscure what is at issue here. So consider the case of Scott Howard. Scott was a gay, non-violent, first-time inmate in a Colorado prison when he was targeted by members of the “2-11 crew,” a white supremacist gang with over 1,000 members in prisons throughout the state. For two years he was forced into prostitution by the gang’s leaders, repeatedly raped and made to perform oral sex. Even after he told prison staff that he was being raped and needed protection from the gang, Scott was told that nothing could be done unless he named his abusers—even though they had threatened to kill him if he did. Because Scott is openly gay, some officials blamed him for the attacks, saying that as a homosexual he should expect to be targeted by one gang or another. And by his account, even those officers who were not hostile didn’t know how to respond to his reports, because appropriate procedures were not in place. They failed to take even the most basic measures to protect him.

Ultimately, despite his fear, Scott did identify some of the gang members who had raped him. Not only did the prison authorities again fail to respond, they later put Scott in a holding cell with one of his previous assailants on the day he was to be released from state custody. Again, he was beaten and forced to perform oral sex. Scott had a civil lawsuit settled in his favor recently, winning financial damages and seventeen policy changes that will now become mandatory in the Colorado prison system. Otherwise, however, nothing about his story is unusual.

In 2003 Congress passed the Prison Rape Elimination Act (PREA), legislation that, among other things, called into being the bipartisan National Prison Rape Elimination Commission (NPREC), a panel of experts charged with devising national standards for the detection, prevention, reduction, and punishment of sexual abuse in detention. But the implementation of these standards is now being held up, because, as Attorney General Eric Holder has explained, according to PREA the new rules should not “impose substantial additional costs compared to the costs presently expended by Federal, State, and local prison authorities.”

Last September, the Justice Department commissioned Booz Allen Hamilton to study what it would cost to implement the NPREC standards. Unfortunately, the results of that study are too flawed to be of much use. Even more concerning is that Mr. Holder has commissioned no study of the benefits of reducing prisoner rape; nor, apparently, does he plan to. Yet as a brief submitted to the Department of Justice by New York University Law School’s Institute for Policy Integrity makes clear, “substantial additional costs” can only be understood in relation to the standards’ projected benefits. Moreover, Mr. Holder is legally obligated to analyze the costs and the benefits of the new standards together: he cannot give greater emphasis to one half of the calculation than the other. By failing to perform proper analysis, the Attorney General is delaying the reform mandated by a unanimous Congress in passing PREA—and he has already missed his statutory deadline for issuing a final rule on the standards by more than two months.

Prisoner rape is far more a legal and moral issue than a financial one. Since cost considerations are impeding reform, however, it is worth taking a closer look at the true financial implications of sexual abuse behind bars. There are at least two ways in which the Department might try to estimate the value of reducing sexual abuse in detention. One—called “contingent valuation,” and used frequently by environmental economists—seeks to assign dollar-values to goods not traded in the marketplace. Using its techniques, a recent study concluded that the public values the prevention of a single incident of rape or sexual assault at $237,000, a greater worth than it places on preventing any other kind of crime except homicide.

Alternately, the Justice Department can try to quantify particular, identifiable savings and benefits of preventing prisoner rape, and weigh them against particular, quantifiable costs. The costs (no matter how benefits are measured) are the investments needed by corrections systems to comply with the recommended standards, divided by the Department’s estimation of the percentage by which the standards will actually reduce sexual abuse in detention. As for the benefits, a partial list of those to be considered might begin with the medical cost of treating rape victims, which must be shouldered by corrections systems. This is much more expensive in the prison setting than in the general community, because inmates must be transported to often-distant hospitals and escorted the whole time by security staff. And it is a cost that must be paid, not for every victim of prisoner rape, but for every instance. We can deduce from the new BJS study that victims of sexual abuse in detention suffer an average of three to five incidents apiece.

The Washington Department of Corrections estimates that the cost of providing mental health treatment for victims of prisoner rape or sexual assault—which is different from immediate medical care—is approximately $9,700 per victim. Neither category of care includes treatment for HIV, Hepatitis C, and other sexually transmitted infections, which are of course spread by prisoner rape and also impose great costs on prison health services. Making our prisons and jails safer should have a positive effect generally on the mental health problems that are endemic there. And reducing prisoner rape would also lower the number of suicides and unwanted pregnancies in our prison systems.

Quite apart from the horror it inflicts on the victim, failing to protect an inmate from sexual abuse contributes to the substantial legal costs our prison systems face. While it is extraordinarily difficult for an incarcerated victim to bring a civil lawsuit—the 1996 Prison Litigation Reform Act (PLRA) was enacted with the explicit purpose of limiting prisoners’ ability to be heard in court—prisons have still had to pay hundreds of millions of dollars in damages and fees to inmates who can establish that officials were “deliberately indifferent” in failing to protect them.

When inmates do report sexual abuse in prison, they are often put in “administrative segregation,” isolated housing that can entail being locked alone in a tiny cell for up to twenty-three hours a day. While this is purportedly done to protect them from more assaults, such housing is also used for punishment: inmates in solitary confinement are denied many programs and services, and the extensive isolation often causes or exacerbates mental and emotional problems. It is also enormously expensive. In California, for example, it costs an additional $14,600 per year to house a prisoner in administrative segregation.

Prisons and jails in which sexual abuse is widespread have been shown to be more dangerous than others generally. At such facilities, violence of every kind, importation of contraband, and other problems tend to flourish. Facilities with less sexual abuse thereby have lower overall security costs and fewer security breaches. When prisons are safer for inmates, they are also safer for corrections staff. The various measures called for by NPREC’s standards—among them better surveillance technology and external oversight—will provide a wide range of benefits for the facilities in which they are implemented, going far beyond the reduction of sexual violence.

Preventing prisoner rape will also help inmates successfully re-enter their communities when they’re released from prison (as almost all will be, eventually). Not only will recidivism be decreased and the enormous costs of re-incarceration lowered, this will lower the costs of disability payments, public housing, and other government-subsidy programs. As we know from our extensive work with survivors of prisoner rape, former inmates who have not been sexually abused are far more likely to become members of the legitimate workforce and pay taxes. Severe financial, emotional, and social burdens are removed from the families who support former inmates if their loved ones are released from prison without the lasting trauma of sexual abuse. And the children who depend on those former inmates will also do better. Today, more than a million children in this country have at least one incarcerated parent.

Testifying before a House subcommittee, Attorney General Holder said, “We want to effect substantive, real change, so that the horrors that too often are visited upon people in our prisons [are] eliminated…. It is something that I think needs to be done, not tomorrow, but yesterday.” That was on March 16. In mid-August a Department spokesman said that the Attorney General would send a proposed rule on the standards to the White House Office of Management and Budgets “in the fall.” Even then, however, it will take months for another layer of review. If well over 100,000 inmates are sexually abused every year, that is something like 300 every day, or even more. Since Attorney General Holder said that change needed to come “yesterday”—five months ago now—more than 40,000 people have been sexually abused in detention. Good corrections officers are doing what they can, but they are desperate for the support that binding national standards would give them. It is time for Mr. Holder to act.

August 26, 2010 2:15 p.m.