Medical Neglect, Abuse Lie in Wait for State’s Women Prisoners

Ellen Barry is founding director of Legal Services for Prisoners with Children and a 1998 recipient of the MacArthur award for her advocacy for women in prison

The spotlight now on widespread sexual abuse of women by guards and staff in California’s women’s prisons is long overdue. The Department of Corrections has managed to contain exposure of sexual exploitation for years, despite repeated attempts to bring it to light.

Still hidden from the headlines, however, is the life-threatening and widespread medical neglect and abuse in those same prisons. More than 11,000 women prisoners are subjected to seriously deficient medical care every day. A few examples illustrate the depth of the problem.

In the spring of 1997, Mia Doiron entered the Central California Women’s Facility (CCWF) in Chowchilla to serve a one-year sentence for drug possession. By Feb. 20, 1999, she was dead. What happened to her is a tragically common story of medical neglect and gross malfeasance in California’s women’s facilities that compound the already glaring deficiencies of our state’s correctional system.


Doiron first requested medical attention in September 1997 for severe pain in her leg. She did not obtain the correct diagnosis of bone cancer for another five months. Had she been diagnosed and treated properly in the early stages of her illness, her survival rate was estimated by a medical report to be about 90%. By the time she left prison, however, and was able to seek treatment on her own, her cancer was so aggressive that her chances for survival were just 10%. Doctors amputated Doiron’s leg to try to save her life, but it was too late. Her short prison term for drug possession had turned into a death sentence.

Tina Balagno was sentenced to four years in prison on drug charges in June 1998. While in custody at CCWF, she discovered breast lumps and was diagnosed with breast cancer. As with Doiron’s case, a series of delays in medical care resulted in receiving no treatment for five months, when Balagno finally had a mastectomy.

But it was too late for her as well. The cancer had metastasized to her bones, leaving her in excruciating pain. While in the prison system’s Skilled Nursing Facility, Tina was never given sufficient pain medication to keep her comfortable. She received no assistance with eating or bathing, even though she was too ill to move. In February 1999, she was granted “compassionate release.” She died one week later.

These cases are not isolated incidents but indications of a penal system in severe crisis. As an advocate for women prisoners for almost 25 years, I have interviewed thousands of incarcerated women, and their stories paint a consistent picture of systematic medical neglect that would horrify the average citizen if he or she knew that it were happening in the “free world.”

Medical neglect, as much as physical and sexual abuse, endangers, dehumanizes and in some cases kills prisoners who are thoroughly dependent upon that system for medical care. Yet California’s Department of Corrections has shown itself unwilling or unable to effect the kinds of changes that would bring the system up to the most basic standards of health care for prisoners established by both the U.S. Constitution and international human rights law.

But it’s not just a question of neglect. As the cases of Balagno and Doiron show, there is active harm done to women denied medically necessary treatment--a harm that is often totally preventable.


Gloria Johnson, a 45-year-old grandmother, recently was released from CCWF. She has multiple sclerosis, and while under the care of prison doctors, lost the use of both arms and legs. Housed in the Skilled Nursing Facility, a facility condemned by our own California Department of Health Services for its failure “to treat each patient as an individual with dignity and respect,” Johnson was denied assistance with her food and personal hygiene. She described needing to “eat my food like a dog when it was put in front of me.” Staff left her to lie in menstrual blood for up to eight hours at a time.

So much for the Hippocratic Oath, which reads in part, “to help the sick, and abstain from . . . abusing the bodies of man or woman, bond or free.”

Within the last two years, health care in California’s women’s prisons has been condemned by the United Nations and two international human rights agencies, Amnesty International and Human Rights Watch. It is abundantly clear that the Department of Corrections needs even more pressure from the outside to put its house in order. I welcome the call by State Sen. Richard Polanco (D-Los Angeles) for legislative hearings into conditions inside California’s women’s facilities.

Only by bringing the truth to light can we as a society be moved to encourage basic standards of medical treatment for women prisoners, and close this shameful chapter of California’s history.