Ask anyone who corresponds with Virginia’s prisoners, and invariably they will relate a story about inadequate or indifferent health care in one or more our correctional facilities. The ACLU of Virginia, as an example, receives hundreds of letters each year from inmates complaining about medical treatment. Their stories are often horrific.

A near lethal confluence of factors makes the practice of medicine in prison a risky proposition. First, it is only one part of a massive government bureaucracy that must oversee practically every minute of the lives of 30,000 individuals. Second, inmates do not elicit a great deal of sympathy from those appointed to care for them. Third, because prisons are virtual islands, where security is paramount, they function with little public oversight. Fourth, who believes the stories prisoners tell anyway?

We began this study with the idea of analyzing government documents to shed light on a health care institution that we only knew through anecdotes. What we discovered was that bad attitudes, bad laws and bad policies make getting to the bottom of health care in Virginia’s prisons an arduous, if not impossible, task.

Although far better informed than when we started, we end our study where we began: Health care in Virginia’s prison system, based largely on anecdotes, is woefully inadequate and leads to much unnecessary suffering and, in some instances, death. Along the way we discovered that Virginia’s correctional facilities are breeding grounds for Hepatitis C both inside and outside prisons, and that Virginia promotes cruelty and indifference by walling off the truth about prison health care from the public.

As a society, how civilized we are is reflected in the way we treat those whom we punish for not being civilized. It is our sincere hope that legislators and others will read this report and use it to begin addressing this problem of health care in Virginia’s prisons.

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