…..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…..