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Jail under court order to shape up
The fight to get better TB control procedures and other health care improvements for the 3,000 inmates at DeKalb County Jail in Atlanta has been anything but easy. To date, the struggle has been punctuated by the gangland-style slaying of a reform-minded sheriff, a drawn-out courtroom battle, investigations into charges of widespread corruption, and assorted threats to inmates.
In a blistering courtroom lecture, DeKalb County Superior Court Judge Hilton Fuller recently accused lawyers for DeKalb County of using underhanded tactics to oppose a lawsuit brought on behalf of inmates. A hemophiliac inmate at the jail scheduled to testify in the lawsuit landed in a hospital with razor cuts, the judge noted, after being assigned a razor-blade-packing roommate.
An editorial that ran in the city’s newspaper the next day noted that unless health care at the jail shapes up soon, conditions there may come to resemble those in Russia, where prisons are a breeding ground for multidrug-resistant TB.
Sheriff Thomas Brown, elected after his predecessor Derwin Brown was murdered (under circumstances still being investigated), says better health care for prisoners tops his agenda. Tamara Serwer, an attorney with the Atlanta-based Southern Center for Human Rights, which has led the fight for better health care for inmates of Atlanta’s jails, says changes aimed at improving TB control in the jail include the county-financed construction of six respiratory isolation rooms, the design of a TB control program to screen for TB and provide treatment, and outside monitoring.
Understaffed provider can’t keep up
Although construction of the isolation rooms is already under way, the new sheriff still has his hands full, adds Serwer. Care for inmates under Correctional Healthcare Services (CHS), the jail’s health care provider, "has been bad and has gotten progressively worse," says Serwer. "They’ve been under court order to [implement a TB control plan], but they’ve been so understaffed that they’re just barely functioning."
For better or worse, CHS is going out of business and will have finished selling off its assets once its contract with DeKalb expires this April, Serwer says. At that point, it’s expected that Sheriff Brown will appoint a new provider on an emergency basis for the next six months before putting out the health care contract to bidders. "We’ve agreed to give [the new provider] some back-up time, since they’re inheriting such a mess," adds Serwer.
In adjacent Fulton County, the jail system is also under court orders to shape up efforts for screening and treatment of infectious diseases, including TB and HIV. In Fulton, more progress has been made, says Serwer.