The Free Man in Prison: Visiting Davon Acklin.

Wanted to let folks know that I was finally allowed to see Davon at ASPC-Tucson this weekend, and we had a really nice visit. Considering my recent protests and letters, I was kind of surprised that they didn't greet me with all sorts of bomb- and drug-sniffing dogs, hostile guards, petty rules, and unpleasantness falling just short of a strip search to get in. The whole affair was pretty low-key, though: the men and women in brown were civil - even friendly - as they checked me in and told me to keep my feet on the ground (they were killing me and I kept stretching them out on the bench).

Davon looked gaunt and pale, but his smile was warm, his hugs were strong, and our conversation flowed as if we had been friends for years. He's mature, insightful, bright, and kind. I correspond with a lot of prisoners, some of whom have committed pretty heinous crimes, but many of whom are either innocent or have been abusively sentenced. Davon is one of the few who takes responsibility for the decisions and conduct which led to his arrest and ultimate incarceration, even though his prosecution was inappropriate and the sentence was excessive - in my book, anyway.

Rather than ruminating on how unfair life has been to him, Davon's spent a lot of time learning what he can from being where he's at, and thinking about what things he needs to do differently once he's free again. It's not just that he wants to avoid returning to prison - he spoke both humbly and eloquently of his remorse for what he's put his family through, for stealing from others who worked hard to acquire their possessions, for letting addiction run his life and wreak havoc in the lives of others. We talked about our respective sources of spiritual strength and understanding, and struggles managing our moods and minds. I was AA-raised and he was prison-raised, but somehow we both ended up with similar conceptions about our responsibilities to our families, our communities, and ourselves.

Davon isn't in a 12-step program, nor is he enrolled in any kind of formal treatment in prison. But he's spent a bit of time studying religion, reflecting on his own values, exploring the world through the Discovery Channel, and growing despite his confinement. He is as engaged in the process of recovery as I was at his age, going to meetings every day and celebrating sobriety anniversaries (my 3 and 6-month ones over and over again the first few years) only he may well be more mature than I was at the time. His wisdom has come at greater price than most have to pay, though - and he'll likely be paying for it for awhile.


Davon worries more about his mom and little sister (whom he adores) than he does about his health. He wasn't nonchalant about it - he really hasn't been feeling well and as much as he wants a job to occupy his time and pick up a few more bucks a week (which is all it amounts to, literally), he admits he doesn't have the energy to be a predictable employee right now. The day we visited he said he was having a good day - that was evident by the life in his eyes and all the cupcakes he consumed. But once you get a job there, if you fail to show up for it you start accumulating tickets - there doesn't seem to be any real accommodation for someone who is struggling with fatigue, weight loss, and other symptoms like he is.

It was clear from our conversation that Davon's been studying up on Hep C and taking responsibility for not exposing others to his virus. A few months ago I sent him a calendar for prisoners about Hep C, which he read through and has been using. He talked about the different recommendations they made for preventing transmission in prison - like not sharing tattoo equipment, razors, or other items that could have blood on them. He observed that they were good recommendations for preventing HIV infection, too, so he's trying to protect both himself and others from further harm.

It was also clear to me that he doesn't have his hopes up about a pardon - I'm not sure he's convinced he "deserves" one. Davon sees men suffering around him every day who have heavier burdens that he thinks he does, and less help to carry them. He takes responsibility for his crimes and has accepted his sentence; he's not expecting to get out until his scheduled release date, though he appreciates everything that Julie and others are doing to try to spring him. He does hope to be better educated about his medical status, to get a full workup, and to have some kind of choice about treatment to rid his body of this virus - he realizes that the sooner that happens, the better his chances are of successfully recovering. He doesn't like being sickly and wasting away, and he's concerned about the implications of the labs that have come back thus far, as is Julie. He doesn't want to be an infectious threat to the health of others, nor does he want to die at an early age of liver or kidney failure. He wants to work in construction with his step dad and have a family someday; he wants to have a life after prison, and put what he's learned into better use for others than he has thus far. That doesn't seem to be too much for a young man to yearn for.

Davon is still good-natured about being a poster boy for Hep C in prison - he figures that with all the work his mom has done to get him decent health care, at least his misfortune can help educate and serve others. He seems to have the respect of his peers, and has managed to avoid being sucked into the gang scene. He stands on his own two feet, but I can tell there are plenty of fellows there watching his back, too. According to him, that's as much due to the help his mom has given the other guys and their families as it is to his own reputation and character. He chuckles knowing that he's probably experienced some retaliation by guards as a result of Julie's activism as well, but sees a certain amount of that as unavoidable.

Not that he's happy about that, but he seems to think that it's still better to be mistreated because of something good he or a loved one does than to be ignored for being indifferent to injustice or suffering. He's not stupid and running to everyone's rescue, but his value system tells him that doing nothing when something is clearly called for can be worse than getting in trouble for doing the wrong thing. That's the kind of person he is.

I have no idea how long we ended up visiting Sunday, and there's a whole bunch of stuff we talked about that I can't even begin to get into, but that pretty much sums up the heart of it all. Davon apologized for not writing back to everyone who's written to him - those letters really do mean a lot, and he loves the pictures he gets of other places in the world. Postage is hard to negotiate sometimes - especially for letters overseas. And he just doesn't have as much energy or focus as he used to - even I don't get as much mail from him now. He asked me to extend his appreciation, though, to everyone who's written to him, signed his mom's petitions, joined his cause, and pulled for him in one way or another. He's especially relieved to know that Julie isn't in this alone, for her sake. He loves her and worries about her a lot. He doesn't want her to worry so much about him. Because of that, I suspect that he's feeling worse than he lets on most days.

Davon's rap sheet would tell you that he's an out of control drug-addicted, mentally ill violent criminal - a repeat offender, even - who some would say shouldn't ever see the light of day. But a closer look at him reveals a compassionate, responsible, maturing young man who has become a better human being despite, not because of, the dehumanization of life in an Arizona state prison. Perhaps his good character shouldn't have any bearing on whether or not he gets medical treatment for his Hep C infection, but we all know that value judgments figure into equations like that anyway. Why else would the state eliminate AHCCCS funding only for those liver transplants needed by people with Hep C, if it wasn't because the population is made up largely of those who have been criminalized for their addictions? It's the same reason we took so long to do anything meaningful about treating AIDS: the twisted logic goes that these are society's undesirables, anyway, who did it to themselves, and therefore deserve what they get. Some sick pups would even call such a fate divine justice. They've clearly never lost anyone they love before.

Davon is a more free man in prison in many ways than a lot of us - he chooses who to be and how to conduct himself without making excuses like so many do. He deserves better than what he's getting now, I can assure you, whatever standard you measure that by. They all deserve better, but he's the one in my sights right now.

As for Divinity's role in this young man's future - God is Love, as I understand it, and works miracles through the actions of ordinary people. Davon seems to be doing his part. So, please join the cause, visit the new page Julie's friend set up for her urging that he gets treatment now, and sign the petition to the Clemency Board if you haven't already - then spread the links to your friends. If you've done all that and want to take it a step further, write Governor Brewer a personal letter urging better treatment for all those with Hep C, and send a copy to Julie, the AZ Department of Corrections and your local paper. Remind them that prisoner health is public health, too. We need to be educating everyone else about this, before it's too late.

Prison Health is Public Health: UN

Got this from the UNSHACKLE list-serve - join it if you haven't already and are serious about these issues. This argument also applies to Hepatitis C - only it's even more infectious and prevalent than HIV/AIDS...

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UN warning on AIDS in prisons

By VERONIKA OLEKSYN

Associated Press Writer

VIENNA (AP) -- The U.N.'s top investigator on torture and punishment warned Friday that overcrowded prisons are breeding grounds for AIDS.

Often, inmates are held in inhumane conditions in which the HIV virus is spread through the use of non-sterile drug injection equipment, sexual contacts, tattooing and sharing of razors, Manfred Nowak said.

"There is a global prison crisis," he told an international AIDS conference.

Nowak, who has visited detention facilities around the world, urged authorities to inform prisoners of the risk of HIV transmission and to offer them free condoms, HIV testing and counseling. He also pressed prisons to offer needle and syringe programs, opiate substitution therapies and methadone treatments.

"Science tells us exactly what we have to do, it's just a question of political will to implement it," Nowak said.

In addition, prison guards should live up to their obligation to prevent rape and other forms of coercion that thrive in packed environments.

"One of the most important measures to prevent HIV transmission would be the reduction of overcrowding," since it leads to violence and conditions that are conducive to the spread of the virus, he added.

Nowak said that, although reliable figures are hard to come by, the prevalence of HIV in prisons is generally much higher than in a country's wider population.

In Ukraine, for example, the prevalence of HIV in prison is at least 10 times that of the overall population, he said.

Dmytro Shermebey of the All-Ukrainian Network of People Living with HIV/AIDS - who was diagnosed with HIV, tuberculosis and hepatitis after spending nine years in a Ukrainian jail - stressed that inmates have a right to both treatment and protection from the disease.

"They have the right because they are human," Shermebey said.

While about 10 million people are incarcerated every year, some 30 million enter and leave prisons annually - making it a public health problem for society, according to Nowak.

"Prison health is public health," he said.

Prisoner Health is Public Health

Prison's deadliest inmate, hepatitis C, escaping

Public-health workers warn of looming epidemic of ‘silent killer’

The Associated Press / MSNBC.com

March. 14, 2007

VACAVILLE, Calif. - The most dangerous thing coming out of prison these days may be something most convicts don’t even know they have: hepatitis C.

Nobody knows how many inmates have the disease; by some estimates, around 40 percent of the 2.2 million in jail and prison are infected, compared with just 2 percent of the general population.

Eventually, when they are released, medical experts predict they will be a crushing burden on the health care system, perhaps killing as many people as AIDS in years to come. At the same time, they will be carriers, spreading the disease.

Hepatitis C can be treated, but many prisons do not test for it. Among the reasons: Budgets are tight, and treatment is expensive. So prison officials close their eyes to the gathering emergency and pass it along to the outside world.

“Right now there’s a golden opportunity to bring solutions to this problem before it hits,” said Dr. John Ward, director of viral hepatitis at the National Center for HIV/AIDS at the Centers for Disease Control and Prevention in Atlanta.

Hepatitis C is already the most common disease of its sort in the United States — a chronic, life-threatening, blood-borne infection. It is most commonly linked to infected needles used for drugs, though prison tattoos and body piercing with non-sterile equipment are also risky.

'Silent killer'
What makes this virus particularly insidious is that as many as half of the people who have hepatitis C don’t even know they have it. The “silent killer,” already considered epidemic by the World Health Organization, often remains dormant for decades.

Some of the infected are lucky: One in five people who get hepatitis C will clear it out of their system naturally. But without treatment, one in four will suffer liver failure or develop liver cancer. Last year liver cancer was the only one of the top 10 fatal cancers in this country to increase, in large part because of hepatitis C.

More than $1 billion is already spent each year on this country on hepatitis C, and those costs are expected to soar unless prevention and treatment are expanded.

Without those changes, researchers project that liver-related deaths will triple from around 13,000 in 2000 to 39,000 by 2030. It’s also estimated that 375,000 Americans with hepatitis C will develop cirrhosis by the year 2015.

Anita Taylor, 48, is already there, in end-stage liver disease. Taylor speaks very slowly and moves with care. She often finds that she can’t say the words she wants to — they just won’t come out. Her body hurts most of the time. Her nose bleeds a lot.

'Doctor gave me a death sentence'
A mother of two and former heroin addict, Taylor said she learned she had hepatitis C when she was jailed in Nevada in 1991 for being under the influence of drugs.

“They tested me and told me I had hepatitis C. They didn’t tell me there was a treatment and a cure,” she said. “And I didn’t know to ask.”

Taylor’s experience is not unusual.

“The doctor gave me a death sentence, recalls Leslie Czirr, a 36-year-old parolee. “He told me, ’There’s no cure for this and you will die from it unless you are hit by a truck first,”’

Czirr learned she had hepatitis C during a prenatal examination in 1996, at a time when she wasn’t in prison. Czirr has been arrested 10 times for drug possession and served almost eight years in prison on various drug possession and dealing charges.

She has started to suffer exhaustion, brain fog and aches. She recently enrolled in a county program to be treated — treatment, she said, she was denied at California’s Norco State Prison.

“I asked and asked, but they barely want to give you a Motrin,” she said. “I really want to get well, not just for myself, but so I’m not putting anyone else at risk.”

Limited studies indicate that fewer than 10 percent of prisoners who have contracted hepatitis C are treated. The reason vary. Medical staff have other priorities, and not all are well-informed about the disease. Prisoners with short sentences are often excluded because they won’t be able to complete treatment, and drug addicts who are inclined to return to risky behavior are often turned away because it is assumed they will simply reinfect themselves.

No funding for treatment
Usually, though, it comes down to money. Prison officials say that even if they wanted to provide the treatment, it is extremely expensive — about $9,500 per patient per year — and no federal funds have been earmarked to pay for it.

“It’s a hard sell to convince taxpayers why additional resources should be spent on the health care of the incarcerated when there are a lot of people who aren’t incarcerated who don’t have adequate health care,” said Dr. Joseph Bick, chief medical officer at the California Medical Facility at Vacaville.

Many of the inmates in Vacaville’s hospice unit — reserved for those given six months or less to live — are dying from hepatitis C-related ailments. Bick said half of the prison’s 3,200 inmates have a history of having been infected with hepatitis C, and at any given time about 40 of those men are receiving the intensive drug treatment to cure it.

“I’m pretty sure this is how I got it,” said Anthony Harris, an inmate at Vacaville. He rubbed his forearm hard, as if trying to remove the prison tattoo bearing his children’s names.

Harris, 51, is a former barber serving a life sentence for second-degree murder. In 2003, a doctor at another prison told him he had Hepatitis C; he researched the disease in the prison library and has sought treatment ever since.

“They gave me shots for Hep A and B, got rid of them. I’d like to get rid of the C too,” he said. “I’m entitled to that. But some docs will give you the treatment and others won’t. I keep making appointments. I keep asking.”

The course of treatment can take a year, and involves taking pills twice a day and weekly injections. Side effects are like those associated with chemotherapy — nausea, exhaustion, depression, debilitating aches and pains — and the cure only works about half the time.

But Bick said the high cost of treating prisoners for hepatitis C is a bargain compared to the bill that would come due if these cases are left untreated. “It’s a tremendous opportunity for us to have an impact on the larger health of the community,” he said.

Dr. Lynn Taylor, an assistant professor of medicine at Brown University’s medical school, agrees that prison is “perhaps one of the best setting for treatment of high-risk individuals.”

'Window of opportunity' for public-health efforts
“Prison can be a window of opportunity to reduce the reservoir of infection,” she said.

But there are no federal rules about testing and treating hepatitis C. Federal guidelines, issued by the CDC in 2003, said correctional facilities should “become part of prevention and control efforts in the broader community.” But they don’t recommend screening for all inmates.

Instead, the CDC urged medical staff to ask new inmates about their risk factors, and only those prisoners who seem likely to be exposed should undergo screening, which costs $5 to $10.

The CDC guidelines fell short, said Dr. Josiah Rich, a professor at Brown who directs the university’s Center for Prisoner and Human Rights. Rich’s studies confirm that convicted criminals are almost always willing to be tested for hepatitis C, but will often lie to prison authorities about their past drug use.

“We already know that more than one in three people coming through corrections has Hep C, so by definition everyone coming in is high risk. It’s absurd that they’re not testing everyone,” he said.

Rich concedes that testing every inmate will “jack up costs” for prisons.

“An individual is going to say, ’Hey, you tested me, you said I was positive, and now I want to be treated, and I’m going to sue you if I don’t get treated,”’ he said.

Lawsuits on the rise
Lawsuits are, indeed, on the rise.

The first significant case came in 1999, when officials at the Luther Luckett Correctional Complex in La Grange, Ky., refused to allow inmate Michael Paulley access to free hepatitis C treatment. Paulley, who was serving a 25-year sentence for rape and burglary, sued and won.

But the treatment came late and he died in 2004, the year he would have been eligible for parole. The litigation prompted broader testing and treatment in Kentucky, but Paulley’s physician, Dr. Bennet Cecil, a Louisville, Ky.-based hepatitis C specialist, said prisoners still die “all the time” for untreated hepatitis C.

“I think it’s immoral if a country, a state a society is going to incarcerate somebody and then deny them necessary medical care. I think that’s an outrage,” he said.

Prisons in at least a dozen states — Alabama, California, Delaware, Florida, Georgia, Idaho, Michigan, Mississippi, Nebraska, New York, Oklahoma and Virginia — are being sued over failure to treat hepatitis C.

But it’s tough going, said Oregon civil rights attorney Michelle Burroughs. Although she’s won a settlement that mandated testing for at risk inmates and treatment for those who are eligible, five of the 10 inmates she’s representing in a class-action lawsuit have died while the litigation proceeds.

5-year wait
“It’s appalling, horrendous, horrifying. Prisoners wait five years just to be evaluated,” she said.

Rep. Barbara Lee, D-Calif., recently reintroduced legislation that would mandate prison testing and treatment of hepatitis C. Earlier similar proposals in recent years have failed.

“The plain fact is that prisoners do not stay in prison. With more than 90 percent of incarcerated persons returning to their communities, it is clear that when a prisoner is infected, we are all affected,” Lee said.

In North Dakota, it didn’t take legislation, court orders or new regulations to prompt medical services director Kathleen Bachmeier to begin screening every inmate for hepatitis C after a methamphetamine epidemic tripled her state’s prison population in about a decade. As the intravenous drug addicts arrived, so did the hepatitis C.

“It became obvious to me that these people are going to cost the state a lot of money if we don’t do something about it,” she said.

North Dakota now treats anyone who meets certain medical criteria, whose sentence is long enough to complete the course of treatment and who is willing to try to quit using drugs.

“We look at this as a huge public health initiative,” she said.

© 2009 The Associated Press.