THE ARCHAMBAULT REPORT 2.0 was first referenced here on November 19 in a posting focused on anti-black racism in the prison industry.  To refresh, the Archambault Report 2.0 is a series of essays written by inmates incarcerated in the Archambault Institution on the north side of Montreal, assembled by the Inmate Committee there and widely distributed on October 24 by the Progressive Inmate Assembly.

There are at least three forms of language discrimination at play within our federal prison industry.  The first is how Anglophone and Allophone inmates are treated differently than Francophone inmates in Quebec institutions.  The second, again endemic in Quebec, is inmates who are refused verbal communications in English from staff where English is the inmate’s only or preferred language, and inmates who are refused written or printed documentation in English, leading to time-consuming third-party interventions.

The third form of language discrimination is prison system wide.  Misinformation and disinformation often contaminate inmate files.  The former may be unintentional due to miscommunication, but the latter is always deliberate and calculated, meant to discredit an inmate to meet a Correctional Service of Canada (CSC) generated narrative.

Rectifying errors and fabrications first involve using the tools available through CSC, the grievance/complaints process, along with applications for file changes.  It will easily take a year or more to exhaust these avenues, and almost universally will not succeed.  The next move is to seek remedy in federal court, not necessarily an easy route to a win.  And, if the court does decide in an inmate’s favour, there is still the matter of CSC’s compliance.  Redress if changes are not met or don’t fully satisfy the court’s decision means going after the government again.

For now, this will centre on the first two forms of language discrimination.  Excepts from just two inmate contributions to the Archambault Report 2.0 will example Quebec’s effort to eliminate the use of English in federal institutions.

Again as we did on November 19, we’ll reference the comprehensive contribution to the report made by Andrew Belcourt, and what he wrote under his heading, Systemic Discrimination Based on Language:-
I’ll give you an example here that is short, simple, direct, & telling.  When they announce the work movement here at Archie’s (Archambault), the announcement is different, based on language.  In French they say, “Début de movement de travail,” basically, “Beginning the work movement.”  In English they announce, “Inmates report to the shops NOW!!!”  One is an announcement; one is a command.  One prisoner told me it reminded him of South Africa during apartheid.  How even language was weaponed with hate.
Solution:  Uproot all racists, stem and all.  Send a clear message.  These ‘tolerance courses’ or ‘race relations training’ staff get, just teaches them how not to get caught being a racist, by learning key defensive words against accusers.  And they also like to fall back on their training they took as proof of their tolerance.  Like, “No I don’t hate those people, I sat through a 2-hour training course that taught me to ignore my deepest darkest opinions of them.”

Gary Young is also an inmate contributor to the Archambault Report 2.0.  He was president of the long-term offenders group (LTO) and was involuntarily transferred to a maximum security prison, in part because of his essay.  This is the chapter he headed Systemic Language Discrimination:-
I am an Anglophone Canadian, and I am very concerned about my language rights being taken away completely.  The government claims that no mater what French changes happen in Quebec, that healthcare will never be affected by the language dispute.  This is simply not true.  I have been here for years, and I almost never have proper medical service in English.
This is abhorrent.  How can anyone claim that in the future my Charter Rights will be protected when they are not being protected now?  I have health issues, so I tend to see healthcare a lot more frequently than most.  I can see and feel what is going on.  When I talk to the doctor, I have a distinct feeling that I’m not getting the help that I need.  When I interact with the nurses, most of them will speak only French to me, and I know some of them speak English (I have heard them talk to others in the past.)  These interactions make me feel that I am doing something wrong, but it’s not me, it’s them!  There are French Canadians serving time outside Quebec, in other provinces.  I am arguing for the same protection for both languages suffering discrimination anywhere in Canada.  But we all know the truth.  Language discrimination may exist everywhere in Canada, but only in Quebec is the discrimination legal.  They are passing new laws, outlawing my official language.  That’s not happening anywhere else in Canada.  Also look at the numbers, there are 25-30% Anglophones serving federal time in every Quebec prison.  Outside Quebec, the average Francophone prison population is less than 1%.  Despite the need for language protection across the country, the need in Quebec is real and vivid.  Today, we are being discriminated against because the Quebecois feel they have ‘perceived’ social permission from Quebec to hate us.  Soon, they will have ‘perceived’ legal permission to hate us.  And things will get ugly.

These are only a sampling from just one report that echoes the common experience of English-speaking inmates in Quebec’s federal prisons.  Correctional Service of Canada’s national headquarters in Ottawa, and our federal civil servants who are charged with CSC oversight are fully aware of this travesty of policy.

What are they doing?  Obfuscating the facts.  Standard operating practice.

RETURNING TO DO BATTLE ON JANUARY 7
“If you’re not angry, you’re not paying attention.”

Who needs OPCAT?
WE DO!  WE DO!  WE DO!
NOW!

On November 1^st, Ivan Zinger, Canada’s Correctional Investigator, and Charlotte-Anne Malischewski, Interim Chief Commissioner for the Canadian Human Rights Commission, jointly emailed a three-page letter to six federal cabinet members and four deputy ministers.

The subject?  Open letter calling for Canada’s ratification of the Optional Protocol to the Convention against Torture and Other Forms of Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT)

It was sent to ministers Mélanie Joly/Foreign Affairs, Pascale St-Onge/Canadian Heritage, Arif Virani/Justice, and Dominic LeBlanc/Public Safety, expressing their concern for the lack of progress to Canada’s ratification of OPCAT, and the implications that had for “individuals deprived of their liberty in this country.”  Copies went to ministers Marc Miller/Immigration, Kamal Kher/Diversity and deputy ministers David Morrison/Foreign Affairs, Isabelle Mondou/Canadian Heritage, Shalene Curtis-Micallef/Justice, and Shaw Tupper/Public Safety.

According to the letter, OPCAT has been available for ratification for over 20 years, and there were currently 92 State parties and an additional 13 signatories.  Canada had indicated an intention in May of 2016 to ratify OPCAT, but despite many calls to follow though, “the public record on Canada’s ratification of OPCAT remains unclear.”  That was far too polite, given the evidence of rights’ abuses.  At one point, 27 countries recommended that Canada ratify the protocol.  (Editor’s note:  The United States has also declined to accept OPCAT.)

It went on to clarify the needs for ratification, the country’s inadequate current oversight of human rights for vulnerable people, and the readily available process to achieve the government’s 2016 intention.  The bottom line?  “Accordingly, we call on Canada to sign the OPCAT without delay and ratify it in a timely manner in order to strengthen human rights protections for people deprived of their liberty across Canada.”

We sent a supporting letter to the same 10 politicians and public servants on November 13; it was a much shorter and blunt endorsement of the Zinger/Malischewski appeal.  We asked for an apology to our vulnerable populations for obstructing their rights.  We inferred that CSC Commissioner “Anne Kelly, her senior CSC staffers across the country, and the Union of Canadian Correctional Officers management teams would have conniption fits at the prospect of compliance with OPCAT.”

Correctional Service of Canada fears OPCAT! was published here on August 27, 2023.  It underscored how ratification has been stymied by opposing forces in the public service.
An excerpt:-
“’I want to reassure you that we take any allegations of misconduct involving our staff very seriously.  All allegations, regardless of source, are duly investigated and, when required, we always take appropriate measure toward our staff members.’
This is from a prison warden’s letter this past July in answering one of ours.  Over the years, we have collected many letters from Correctional Service of Canada personnel at the national, regional, and institutional levels, citing this paragraph verbatim…or close to it.  Where inmate interests are involved though, the correct reaction is…no, they don’t…no, they don’t…no, they don’t.”

Commissioner Kelly sends out frequent “messages for correctional employees,” and “messages for offenders and their families.”  Less often she issues “messages for correctional stakeholders,” and “messages for volunteers.”

Her November 14^th message to offenders and their families included a shout-out for Nurse Practitioner’s Week (November 12-18) which prompted a comment from us on behalf of an inmate in an Ontario federal prison.  The relevant portion of our letter reads:-
“Referring specifically to paragraph three where you congratulate nurse practitioners as valuable members of the Health Services team who play a crucial role in providing high-quality care in institutions, you ask that nurse practitioners be thanked for their ‘expertise, compassion, and commitment to improving health.’

You have your head in the sand was the inmate’s reaction.

His implication is that what CSC publishes for public consumption does not match the inmate experience in federal institutions.  Or it might be that you truthfully believe what you commit to paper, in which case you are not familiar with life in the trenches.

The quality of care provided by nurse practitioners may be a minor issue in CSC operations overall, but it does example the need for OPCAT’s ratification as argued by Correctional Investigator Ivan Zinger and Interim Chief Commissioner Charlotte-Anne Malischewski of the Canadian human rights commission in their November 1^st letter to six cabinet members and four deputy ministers.

Canada talks the talk on human rights but does not walk the walk.  One wonders why.”

OPCAT promises to sort CSC facts from CSC narrative, and separate misinformation from disinformation.

Why wouldn’t we want that?

…..A PRIMER
“CSC is committed to building an anti-racist organization that is diverse, inclusive and equitable.”  Correctional Service of Canada – Anti-Racism, Diversity and Inclusion:  Progress Report 2021-2023, October 2023.

The Office of the Correctional Investigator 2021-2022 Annual Report’s chapter, Update on the Experience of Black Persons in Canadian Federal Penitentiaries, quoted from the Senate of Canada’s Standing Committee on Human Rights Interim Report – Study on the Human Rights of Federally-Sentenced Persons, released in February 2019, as follows:-

“The committee wishes to draw attention to the fact that it has heard personal stories of racism and discrimination from almost every Black individual with whom it has had contact during its fact-finding visits.  This includes persons servicing sentences and those administrating them…..  …..one witness stated, ‘one aspect of anti-Black racism in the prison system is that it is not only applied to prisoners but also to Black communities, families and advocates.’….the Correctional Investigator indicated to the committee that the CSC has not addressed the systemic issues related to racism and discrimination against federally-sentenced Black persons that the OCI documented in a 2013 report.”

The Correctional Investigator added this observation from the Standing Senate Committee on Human Rights final report released in June 2021: –

“The committee heard many stories from federally-sentenced Black persons about instances of blatant anti-Black racism against federally-sentenced Black persons and Black correctional officers.  Some of these instances include being called derogatory names, not having work opportunities available to them, being assumed to be gang affiliated for wearing a do-rag or being seen in a group of other federally-sentenced Black persons.”

The Correctional Investigator’s report went on with, “These condemnatory findings prompted the Prime Minister of Canada to issue a mandate letter to the Minister of Public Safety to address systemic racism in the criminal justice system, including federal corrections.  The PM directed the Minister to:
Continue to combat systemic racism and discrimination in the criminal justice system, including across all federal departments and agencies responsible for national security and the safety of Canadians.  This also includes supporting the Minister of Justice and Attorney General of Canada in their work to address systemic racism and the over-representation of Black and racialized Canadians and Indigenous Peoples in the justice system.”

Nonetheless, racism is so deeply embedded within the Correctional Service of Canada psyche that not even a mandate from the prime minister made an impact.

On October 24 of this year, the Progressive Inmate Assembly distributed The Archambault Report 2.0 which it secured from the Inmate Committee Archambault Institution.  This is a 39-page series of essays by inmates in this medium/minimum multi-level prison just to the north of Montreal and it includes several references to systemic racism within CSC.

To cite only one, in The Audacity of Hope in the CSC by Andrew Belcourt, the author includes his take on the subject in his multi-page contribution.  “There is no debate about the existence of systemic racism in both Justice and the CSC.  The only way to solve this problem is 1) everyone needs to admit this is real, and prisoners suffer the most from this type of systemic hate.  2) Have a financial penalty levied on any federal employee who abuses the system for ideological reasons.  3) Resolve the issue created by the incident (be it transfers, releases, inmate pays, diets, etc.)  4) Create a double-blind classification system that leaves no room for personal opinions (if math doesn’t work, the system is wrong).  The rule of thumb should be – there can be no place for personal opinion, anywhere in classification.  If you allow personal opinion, you allow the option of hate & discrimination.”  The report notes at the conclusion of this piece that, “Andrew Belcourt is 13 years into his life sentence.  He is a member of the Inmate Committee and donates his time to help others in prison.  He was involuntarily transferred out of Quebec, in part because of this report.”
CSC takes the easy route to justify its actions by inserting disinformation into an inmate’s file, in this case to facilitate an involuntarily transfer.

Brennan Guigue (Black/Indigenous) was not a part of the Archambault Report but was subject to many racist-related experiences during his five-months in Donnacona Institution near Quebec City.  Sabine Michaud, the Independent External Decision Maker (IEDM) who consulted with him, made several recommendations to prison management about his conditions of confinement, including his need for a job.  The prison basically ignored Ms. Michaud’s advice.

Brennan made several requests for a job which were routinely ignored.  There was an incident where a Francophone inmate working as the range cleaner was fired for moving contraband from one cell to another.  Brennan was denied an opportunity to replace him.  That fired inmate was working in the institution’s kitchen a week later.  And Brennan still had no work.

In September of this year, shortly before his transfer to Saskatchewan, Brennan knew the current range cleaner was leaving.  He asked that inmate to recommend him to the guards as a replacement.  The inmate came back with a message from the guards.

“Le nègre ne trouvera jamais de travail dan cette institution.”

Merci, la belle province!

…..FOR NOW.
There are countless narratives from prison inmates whose health care needs are not being met, often exacerbating conditions that can lead to poorer outcomes.  There are inmates who see their repeated requests for help ignored, putting them at risk for chronic illness or emergencies.  There are no alternatives and no options for second opinions.

There are no health services at night or weekends, leaving potentially dire medical events in the hands of staff who usually have only rudimentary intervention training.  The criteria to call for outside help may encounter bureaucratic delays.  Ambulances will likely come from a distance, and EMS personnel will wait for guard-escorts to the patient-inmate.  It can be scary for someone in crisis.  To its credit though, CSC doesn’t generally lose an inmate in urgent situations although end results may not be ideal.  Pity the man or woman who guards judge is able to wait for the nurse’s rounds in the morning.

Notices of deaths in custody are included in the Correctional Service of Canada web site news releases.  Privacy concerns limit details:  usually only the name of the deceased and the institution where the death occurred.  Interestingly though, CSC will always include the deceased’s convictions, the length of the sentence, and the date on which the sentence began.  Almost without exception, death is due to “natural causes” or “apparent natural causes.”  Simply put, death is due to internal factors like a cancer or heart disease, and not from an external trauma.  Given what is known about prison health care, one can wonder just how “natural” a death from “natural causes” is.

Noted earlier, Correctional Service of Canada does spend millions on inmate health care every year, but the system is nonetheless badly underfunded for our prisons’ high-needs population.

To this point, the Standing Senate Committee on Human Rights released its “Human Rights of Federally-Sentenced Persons” in June of 2021 which reported on page 109:  “During meetings with health care professionals as well as with federally-sentenced persons during site visits, the committee was informed that the CSC is struggling to deliver appropriate health services in a timely manner…..medical needs are going unmet or are inappropriately dealt with….the committee heard stories from witnesses and federally-sentenced persons of CSC staff withholding health care for punitive reasons.” 

In a public hearing, the Senate committee also exampled a story shared by Toni Sinclair, Executive Director, Elizabeth Fry Society of Edmonton, when she visited a woman in a federal prison.  “….when I saw her a few weeks ago, she said, ‘Toni, look,’ and she actually popped her bone out of her arm.  Like, it is completely broken.  And then when we bring it up to the warden, he says, ‘Oh you mean the woman who tried to escape and fell and broke her arm?’  As if to say because they didn’t like her behaviour that that somehow equated with not giving her adequate health care.”

Health care in our federal prisons spawns a constant stream of jolting accounts that thrashes the good work the clinics do every day.  This posting and the last three simply leave ajar the door to the CSC health care closet of nightmares.  What amazes, and what should embarrass our government and all of us in this country is how little impact the numerous organizations who call for changes has had on the system over the years.

This series will end with two tales from Brennan Guigue, who has a wealth of experience with prison health care.
Brennan is included in the Opioid Agonist Treatment (OAT) program for his opioid use disorder (OUD).  He is given suboxone daily but is not offered psychosocial support as is mandated by CSC’s own guidelines.  I doubt any inmate is.
Back on Wednesday, March 15 of this year at Port Cartier Institution in Quebec, he met with Dr. Geneviève Côté via video conference.  She administers the OAT program in the prison. A nurse was in the room with him.
“…..she agreed after too long (almost three months) to put my dose up .2mg to 12mg.
Gee, thanks.
Anyway….she says to me, ‘Yeah, I will put you up, but we should begin tapering down.’
‘Oh, so you’re saying that without any psychosocial counselling, or substance abuse programs, all I need to stop needing is to be on suboxone for a time and that’s it?’
‘No, no,, I’m not saying that.’
‘Okay, so how do we get at the root cause of my addiction if there are no programs?  How can you even suggest tapering down when you know the situation?’
‘Well, what about psychiatric team?’
‘Psychiatric team?’  I just began laughing, and so did the attending nurse.  ‘That’s a good one Dr. Côté.  Psychiatric team?’”

Not long after, in a letter Brennan wrote from Donnacona Institution on April 6, 2023:-
“No matter what I say to the nurses who come ‘round in the morning for a ‘wellness check,’ no matter how many times they tell me I will be seen by MH (mental health) nurse, nobody EVER shows up.
I got into a bit of an argument last Saturday because the nurse began questioning me out in the open for all to hear – guards, inmates could hear all – because I didn’t feel my privacy was being respected.
‘Why?  Why do you want to see someone from MH?  Is it urgent?’
‘I want to see MH for my mental wellness.  I’m not going to have this conversation in front of these guards and with my door wide open for all the hear!  You ask me if I’m alright and I say no, I need to see someone.  That is all that is required of me!’
Finally, I just told her to close my door and just leave me alone.”
And that’s what she did.

And so it goes, yesterday, today, and tomorrow…..

“…some imprisoned people tell us that guards have refused to provide them with their prescribed medication, including for pain.  Although seemingly passive, withholding pain medication constitutes torture under the Criminal Code because it is the intentional infliction of “pain and suffering” through “omission.”  Catherine Latimer, Executive Director, John Howard Society of Canada, quoted from her “Canadian prisons need international oversight to prevent human rights violations,” published in the Globe and Mail, August 7, 2023, and Class Action News, Issue 31, Fall 2023.

This is but one example of a violation of the Mandela Rules, and how dual loyalties interfere with health care delivery in federal prisons.  As referenced on September 24 in “Prison health care – It’s not okay,” clinical decisions may only be taken by the responsible health care professionals and may not be over-ruled or ignored by non-medical staff.

Just so, when guards escort inmates to health care unit appointments, those escort guards might not allow inmate privacy with a health care provider.  If an inmate is on cuff status (put in handcuffs when out of their cell), guards might not remove those restraints for treatment or consultation.  Guards can become privy to an inmate’s health care information which is passed on to other guards for use as convenient.  Confidentiality of medical information is required, unless maintaining such confidentiality would result in a real and imminent threat to the patient or to others.  What is or is not a threat is a subjective assessment but is not within the authority of a prison guard in any case.

Health care personnel shall not have any role in the imposition of disciplinary sanctions or other restrictive measures.  Not to impugn the professionalism of prison nurses and doctors, there is all the same a mirky, grey indeterminate space between the medical and non-medical groups.  An inmate’s conditions on a range and in a clinic can be shaped, and are shaped, by consultations between the two parties.

)()(

Kim Morin had no reference to damage to Brennan Guigue’s left knee in his prison health file at Port Cartier Institution in eastern Quebec when we spoke with her by phone on August 2, 2022.  She oversaw health care services in the prison at the time and the conversation was Correctional Service of Canada’s response to criticism of health care in that prison which began a few months earlier.

Brennan’s concerns had been ignored or brushed aside by the nurses and doctors since he arrived at Port Cartier at the beginning of the previous November.  We added our voice to his in a May 9, 2022, letter to Nadia Pelletier, who was then heading health care there before going on leave.  We copied the CSC’s assistant commissioner for health services in Ottawa, CSC’s regional health services director in Laval, and the correctional investigator and public safety minister, both in Ottawa.

On May 24, Manjeet Sethi, Acting Assistant Commissioner, Health Services, at CSC headquarters in Ottawa, answered our May 9 letter on behalf of Nadia Pelletier.  He ended with a typically baseless CSC position, “…I can assure you that Health Services are always available to Mr. Guigue, and that he is receiving care in accordance to his actual diagnoses and needs.”  “Factually incorrect,” we wrote back on June 24.   “Blatantly untrue” we noted when we copied the Sethi letter to Nadia Pelletier on July 2.  CSC NHQ in Ottawa then messaged Port Cartier via the Quebec regional office to snip this thorn.  Ergo the conversation with Kim Morin.

Kim Morin met with Brennan on July 15 for about an hour to discuss his concerns which at that time centred on his Opioid Use Disorder (OUD) Suboxone dosage and his relationship with Dr. Geneviève Coté who oversaw the program, and with his many requests for his mental health needs.  Our phone conversation followed on August 2, referencing those same two issues, but adding the status of a response to Brennan’s atrial fibrillation (AFib) and the treatment plan for his knee.

This was a refreshingly frank discussion, with Ms. Morin acknowledging she had no notation about AFib in Brennan’s file, even though he had been diagnosed at the same prison years before.  She had nothing about his knee on file although Brennan had been diagnosed with either a torn meniscus or damaged tendon two years before at Warkworth Institution, an MRI order was never executed, another doctor at Millhaven seconded the MRI order, again not executed.  I told Ms. Morin that Brennan had a video visit with the Port Cartier’s doctor two months earlier, brought up the problem with his knee, and the doctor’s response was, “Well, we’ll have to look into that.”

Ms. Morin conceded that inmates can be in for long waits.  For instance, the institution has 1 psychiatrist, who Brennan claims is in the prison once in every one or two months,1½ mental health nurses, 2 psychologist and 2 social workers to serve the rated 237 inmate population of Port Cartier.  An inmate who is not considered critical may never get on the list.  Health care resources overall are limited, but ‘understaffing’ is not in the CSC vocabulary.

So, what came of all this?  His Suboxone dosage was adjusted.

As a footnote, the correctional investigator’s office took an interest in that May 9 letter to Nadia Pelletier.  Derek Janhevich, the OCI director of operations for Ontario and Quebec wrote on May 20 that their senior investigator assigned to Port Cartier would be in the institution presently and would meet with Brennan.  They did meet in the second week of June, and Brennan reported, “I sat there talking to him for ten minutes. ‘I can’t help you,’ was his answer.  Useless.”  Why?  The correctional investigator’s team does have concerns about the care inmates receive but it can’t act.

It’s important to keep in mind that this cites health care issues of only one inmate, but that one inmate is representative of system-wide deficiencies for all prison populations.

Brennan Guigue’s left knee?  Well, he’s still waiting for help.

….WHEN YOU HAVE A TOOTHACHE IN PRISON?

“The lack of accountability CSC provides its physicians also allows for the negative stigma associated with criminal behaviour to infect those treating prisoners,” is from one of the media releases by Executive Director Catherine Latimer of the John Howard Society of Canada.

Prison inmates are no angels, and interactions with health care professionals can be difficult in some cases, but there is no place in the law or in our collective conscience for negative branding.  As omnipresent as it is throughout the penal system, the health care professionals treating incarcerated patients do well to recall our Supreme Court reminder that it is who we are, and not who they are, that governs our actions.  The few dissenters tarnish the reputation of their vocation, but any prison health care worker is under some pressure to compromise.

)()(

You have a toothache, or otherwise need the attention of a dentist.  Only fear or uninsured expenses stand in the way of asking for help.  You can be in a dentist’s chair within hours if necessary.  That’s not so in our federal prisons.

“Miss, I have a toothache.”  Most inmates will see or pass by a nurse daily.  “Put in a requisition,” will be the response.  That’s the routine; use the institution’s internal mail system to ask for a dental appointment, and then wait.  Wait to be called to health care when your turn comes up.

How long is the wait?  That depends.  That depends on how a need is triaged, at times without the input of a dentist, and sometimes it depends on the health care unit’s subjective assessment of the needs of individual inmates.  Then too, because inmates don’t have advance notices of appointments, the call to a range to send an inmate to health care may not get to the patient, in which case the record will show that the inmate ‘refused’ to attend.  But, when an inmate doesn’t show up for an appointment, why doesn’t health care double-check with the guards on the range?  Why not?  There should be a concern for why the appointment was missed.

There is much anecdotal evidence of the impact of delayed dental care on inmates.  From two inmates in a Kingston institution a few years ago who were put in hospital on intravenous antibiotics to combat infections while waiting months for care, to a more recent case of an inmate in Quebec with a badly swollen jaw and cheek who could squeeze puss out of his tear duct be applying pressure under his eye.  These men must have been suffering through heavy pain with no recourse but to wait for help, not knowing when that help would arrive, and hopefully with the resources to pay for expensive prison black-market illicit drugs for relief.

Dentists are authorized to provide basic and essential care and from all accounts they are diligent in their service within the contractual limits and imposed time constraints.  Government bureaucracy and the proverbial red tape can prolong contract renewals for medical services, and the maximum number of dental clinic hours allowed in those contracts are often insufficient to meet patient needs.  In the case of the former, there are no dental appointments in institutions waiting new contacts, and with the latter, too few treatment hours leave some inmates on long waiting lists.

Looking at terms in some recent agreements, Collins Bay Institution in Kingson can accommodate up to 750 inmates, but a dentist is on site there a maximum of 12 hours a week.  Warkworth about two hours away allows 1 day a week, about 6 hours, for a population of up to 537.  Millhaven in Bath has contracted for a maximum of 364 hours a year, averaging 7 hours a week over a 52-week year.  In some prisons, dentists may book clinics (about 6 hours) according to need but only up to the contracted maximum number of hours.

While contracts prescribe a maximum number of hours, no dentist has spare openings for prison patients.  What’s more, internal institutional issues affecting inmate movement and incidents that lead to lockdowns will delay or cancel health care appointments.  Security trumps toothaches.

)()(

Brennan Guigue’s inmate activism makes him a primary source of information, and this segment on prison access to dentists will end with one of his past oral health care experiences.

He was in Millhaven Institution at the beginning of 2019.  He’d been suffering with toothaches for a few months and was making futile requests for help.  He didn’t know then that CSC was still negotiating a new contract for dental services, and in the meantime, patients would have to wait.  Anxiety and discomfort exacerbated his distress as he watched what other inmates were going through.

We stepped in, expecting an intervention would be in vain.  Letters went to the institution, to the Assistant Commissioner for Health Services at CSC national headquarter in Ottawa, and to the Ontario regional headquarters in Kingston.  Eventually, a call from Ian Irving at the regional headquarters assured us that Brennan would be taken to a dentist.

By the first half of March, he had been transferred to Collins Bay temporarily due to operational issues.  He was taken from there to a Canadian Forces Base Kingson dentist on Monday, March 25, where x-rays were taken, as CSC had requested.  The dentist was concerned by the images, checked Brennan’s mouth, and felt he couldn’t let Brennan leave his office without help if he wanted it.

(“I can’t believe they left you in this condition.”)

Four teeth were extracted, including the 1-8 (upper right molar) which had a cavity and the beginning of an abscess, plus three others that were broken, pitted, blackened and rotting. The dentist gave him care instructions, a minimum supply of pain killers, and told him four other cavities needed attention but were not emergencies.

Brennan saw a dentist at Millhaven on Wednesday, May 8.

More prison health care, next…….

CSC CAN’T SEE THE MOUNTAIN

When concerns about the health care that offenders receive in our federal prisons is raised with Correctional Service of Canada staffers who can speak to it, there is this incessant insistence that inmates receive the appropriate health care services they need.

That’s not true, and those CSC spokespersons must know that.  There are simply too many complaints.  Are they misled by subordinates, or not following up on what passes in front of them?  Are they misinformed or disinformed?  There’s the rub.  The obfuscation is blinding.  Comparing the dates on health care requests filed by inmates and the dates they received service would prove a point.  The bottom line though is that if someone with a voice at Correctional Service of Canda admitted to health care struggles in the system, then CSC would be expected to do something ‘corrective.’

CSC spends millions every year on health care for inmates in its institutions and the offenders under its supervision in the community.  Because CSC is self-insured, those millions are a part its budget, and incentives are in place to hold the line on expenses.  The issues we have with health care in the community are usually centred on underfunding and staff shortages.  Prison health care is under the same stressors, and perhaps to a greater degree, given its high-needs population.  And since all care is triaged, lag times can be excessive, even for inmates with serious conditions.  It becomes problematic if an inmate is transferred from one institution to another while waiting for help.

There’s an additional irritant impacting the efficacy of prison health care.  Correctional Officers, guards, have a waste-of-skin type prejudice towards the offenders under their care/control.  “We’re treated like dogs; less than dogs,” one inmate lamented.  No question that while there are many guards who comply with their job profile, often in the face of co-worker hostility, inmate degradation prevails all the same.  And it can be infectious.

CSC employs some health care professionals, such as nurses and psychologists, and then contracts for doctors, dentists, psychiatrists, and other relevant specialists.  All are registered or licensed, meet professional standards, and almost universally work to deliver sound medical services.  Nevertheless, anti-inmate bias is frequently evident in the clinics.  One minor example is the response of a nurse to an inmate’s question as he was about to meet with a doctor after waiting weeks for an appointment.  He asked what happens if an inmate’s request for care is marked ‘urgent’.  He quoted her as saying, “Oh, we don’t pay attention to that.”

Then too there is “the challenge of dual loyalties.”  All CSC health care professionals are required to meet The United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules) which sets out the terms of dual loyalties for health care as:-
Health care personnel shall not have any role in the imposition of disciplinary sanctions or other restrictive measures.
Confidentiality of medical information is required, unless maintaining such confidentiality would result in a real and imminent threat to the patient or to others.
Clinical decisions may only be taken by the responsible health care professionals and may not be  over-ruled or ignored by non-medical staff. 

To be generous to CSC, the subjectivity here in these three directives is not umpired by empowered third party referees, leaving ample latitude for interpretation.  Plenty of evidence calls for intervention, but management prefers to defer to the muscle in the trenches, falling back on the comfort of the established policies it claims are enforced.  CSC is in a tough spot.  It’s unmanageable; it denies, deflects, and delays, leaving the fallout for Attorney General lawyers to arbitrate.  Our prison industry needs OPCAT (see August 27, 2023).

What happens when an inmate has a toothache?
Stay tuned.

A MOUNTAIN TOO HIGH?

A look at the Correctional Service of Canada’s (CSC) website is a place to start: “…one of our priorities is ensuring that individuals incarcerated in Canada’s federal institutions have access to quality, safe, patient-centred care.”

This is mandated under sections 85, 86, and 87 of the Corrections and Conditional Release Act.  Basically, it says that the Service will give every inmate essential health care, and reasonable access to non-essential health care.  This includes medical, dental, and mental health care delivered by registered professionals or persons acting under their direction.

While there’s no specifics with medical and dental care other than it “shall conform to professionally accepted standards,” it does define mental health care as, “the care of a disorder of thought, mood, perception, orientation or memory that significantly impairs judgement, behaviour, the capacity to recognize reality or the ability to meet the ordinary demands of life.”

And the Act further stipulates that the Service “shall take into consideration an offender’s state of health and health care needs” in all decisions affecting the offender’s placement, transfer, SIU confinement, disciplinary matters, and preparation for release.

This is CSC’s health care protocol on paper.  It doesn’t always jump off the page into practice.  It often doesn’t jump off the page into practice.  “Health non-care” is a common chorus heard among inmates for what CSC labels as health care.

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Health care in our federal prisons invites constant scrutiny and deserves an exclusive forum which is why, in the absence of dedicated surveillance, this space circles back to the subject frequently.  For this first of the next few postings, a reference from the Office of the Correctional Investigator’s 2018-2019 Annual Report underscores one of CSC’s health care failings.

Correctional Service of Canada facilities across the country include five regional treatment centres for offenders with serious mental health conditions.  Correctional Investigator Dr. Ivan Zinger’s report for that fiscal year focused in one chapter on the difference between protocol and practice for the use of force in the system in general but found “most troubling” the use of force in these RTC’s or psychiatric hospitals.  He exampled an incident at Millhaven RTC in the Bath Institution on the same grounds illustrating a reality in mental health care units.

We reprint it here:

Range video evidence shows an inmate, diagnosed with a serious mental health disorder with significant impairments, engaged in a therapeutic interview with a Behavioural Technologist (BT) in the recreation room.  During the interview, he asks an officer standing nearby at the control post if he could go to the yard for recreation after the interview.  The officer declines, explaining that due to ongoing maintenance work the inmate would have to wait until later.

The inmate becomes agitated, directing a verbal protest towards an officer standing just outside the barrier of the recreation room.  The officer’s response further escalates the situation.  While the BT attempts to de-escalate through verbal coaching, without warning or consultation, officers decide to discontinue the interview due to alleged “staff safety concerns.”  The BT’s report would later state that at no point did s/he feel the inmate had put anyone’s safety at risk, and that the inmate was “appropriate and polite” in all interactions.

An officer opens the barrier and orders the BT “get out of here.”  The BT attempted to leave the area; however, a group of four other officers had already gathered at the exit.  The inmate lunges toward the officers attempting to strike one of them.  The officers charge, tackling him to the floor.  The inmate is held down by the weight of the four officers while lying prone.  A nearby health practitioner reports later that an officer was kneeling across the inmate’s neck and that his face was purple.  The inmate is seen gasping.  One of the officers is reported to have said, “want me to jizz on you face?”  The others are seen laughing on video.

The inmate is handcuffed while on the ground and then lifted and slammed against a steel door, his head pressed against it while being held from the back of his neck.  He is searched while restrained in this position.  He is then escorted, without incident, to an observation cell.

Still handcuffed, he is forced onto the cell bed in a prone position with his face planted firmly onto the metal surface until his handcuffs are removed.  The last officer to exit the cell is seen pinning the inmate’s head to the bed and applying a “pain compliance” technique (forceful twisting and stretching of the arm and wrist) to maintain control as he exits the cell.

This is how CSC mental health care treatment can look in a prison hospital setting, and it’s closer to standard operating practice than it is an isolated incident.

There’s more coming……

“How Canada’s prisons can take on torture,” published in the August 7^th Toronto Globe and Mail, is an op-ed piece by Catherine Latimer, the executive director of the John Howard Society of Canada, an organization with multiple branches across the country committed to protecting the human rights of imprisoned people.

This is Canada.  We are told by our governments, no matter the party in power, that this is a land that upholds the human rights of every person, foreign and domestic.  We spend millions in international aid each year to promote those rights.  Canada ratified the UN’s Convention Against Torture (CAT).  Canada adopted the UN’s Standard Minimum Rules for the Treatment of Prisoners (the Mandela Rules).  Our country’s leaders speak up for the oppressed in other countries, and we have paid a political and economic price for doing that. So why is Catherine Latimer and the John Howard Society needed?  Why too the countless institutions and individuals with the same aim?

Many of us are vulnerable to exploitation and depravation, from our Indigenous peoples to refugees to the disadvantaged to the elderly in long-term care to children and youths in foster homes and juvenile carceral settings to the racialized and stigmatized to the 2SLGBTQIA+ community.  So too the inmates in our jails and prisons.

There can be no pecking order to grade the greatest needs for protection, but the nature of imprisonment compels the many calls for international third-party oversight.  As has been reprinted here several times, the Senate of Canada’s Human Rights Committee wrote of Correctional Service of Canada that, “The security features inherent to federal correctional facilities are designed to keep people in as much as they are to keep people out.  As a result, the management of the federally-sentenced population is largely conducted away from public scrutiny.  Invisible to the general population, federally-sentenced person are often forgotten.”

Ms. Latimer noted in her op-ed that the Canadian Human Rights Commission (CHRC) made a submission to the UN’s Universal Periodic Review (UPR) which focused on men and women in Canada who are “deprived of their liberty.”  As a member of the United Nations, we are now receiving a UPR assessment.  Our various stakeholders like our human rights organizations are invited to appraise the state of human rights in Canada.  In its statement to the UPR, the CHRC wants Canada to ratify the UN’s Optional Protocol to the Convention Against Torture (OPCAT), writing that this would allow “ongoing and enhanced independent oversight, monitoring and reporting in all places of detention.”

The John Howard Society endorses the CHRC recommendation, and this space has done the same, most recently in a June 18^th posting.  OPCAT was adopted by the UN in 2006.  The singular most important question for Canada’s government here is why it hasn’t ratified this protocol.  Why not?  Why has our government not provided an explanation?  Why will Canada not “put its money where its mouth is?”

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When Correctional Service of Canada talks about transparency and accountability, it’s referring to operations other than its relationship with and treatment of the inmates under its control.  CSC makes a sound argument supporting its pro-active disclosures in compliance with the government’s “measures to strengthen public sector management.”  As for the care of inmates, not so much.

Brennan Guigue is an activist inmate; he files numerous articulate and detailed grievances when justified.  Almost all are futile exercises, but they are kept in records.  Even occasional small wins only serve to accent CSC’s scant attempts at transparency and accountability when dealing with inmates.
This is one example:
More than two years ago, he was moving unescorted from one area of an institution to another.  He passed through a metal detector at a checkpoint, overseen by a guard with a reputation for taking opportunities to put his hands on inmates, and creating scenarios to use his fists.
The alarm went off.  Brennan’s watch was in his pocket.  He put it on a table, but the guard wanted to search him.  He said he wanted another to do the search.  With that, this guard pushed him against a wall and punched him in the stomach.  Other guards out of earshot, thinking this was an incident, rushed Brennan and threw him to the floor.
There were no institutional charges against him, there was no incident report, it just didn’t happen.  He filed a grievance.  There was video but no audio.  It took about a year for a response.  His grievance was upheld.  It ruled he should not have been treated as he was.  What was the outcome?  The guards involved would be asked to review proper procedures so this wouldn’t happen again.  That is CSC accountability.

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“I want to reassure you that we take any allegations of misconduct involving our staff very seriously.  All allegations, regardless of source, are duly investigated and, when required, we always take appropriate measures toward our staff members.”

This is from a prison warden’s letter this past July in answering one of ours.  Over the years, we have collected many letters from Correctional Service of Canada personnel at the national, regional. and institutional levels, citing this paragraph verbatim…or close to it.  Where inmate interests are involved though, the correct reaction is…no, they don’t…no, they don’t.…no, they don’t.

Canada needs OPCAT!