Skip to main content

Inhumane Prison Conditions Threaten Life, Health of Alabama Inmates Living with HIV/AIDS

Letter to Governor Bob Riley Regarding Preventable Deaths of Prisoners

Dear Governor Riley:

In September 2003, we wrote expressing our serious concerns about the appalling conditions endured by inmates living with HIV/AIDS at Limestone Correctional Facility documented in an August 2003 report by Dr. Stephen Tabet. In February 2003, Alabama had released its own report on the dismal health conditions for Limestone inmates living with HIV, identifying many of the same serious problems as Dr. Tabet. Given the extensive documentation of the problems at Limestone, we were deeply disturbed to learn from Dr. Tabet's March 2004 update that little has changed. There is no justification for the state’s failure to protect adequately the health and lives of those it has incarcerated. We urge you to take immediate action to end the atrocious abuses of the rights to life and health that continue to plague Limestone's HIV-positive inmates.

In his August 2003 report on health conditions at Limestone, Dr. Tabet raised his concern about the number of preventable deaths among HIV-positive inmates at the facility. His recent report documents five inmate deaths since October 2003 and indicates that HIV-positive inmates continue to die because of incompetence or negligence on the part of those charged with providing medical services. Inadequate staff training and lack of internal medical review allows this situation to persist, at the cost of inmates' lives.

Dr. Tabet's August 2003 report warned that "without adequate infection control practices, the possibility of an outbreak of drug-resistant tuberculosis" was acute. Yet despite this warning, late in September 2003, a patient with active tuberculosis was placed in general population, potentially exposing other HIV-positive inmates (as well as staff) to tuberculosis. Limestone's failure to heed this warning and ensure adequate protection from tuberculosis--a contagious disease that can be deadly for people with compromised immune systems--suggests serious indifference to the health and lives of inmates.

We were stunned to learn that HIV-positive Limestone inmates continue to experience problems in obtaining lifesaving medications used to treat HIV/AIDS or prevent illnesses that could prove life-threatening to them. It is also shocking that Limestone still fails to meet basic dietary needs for HIV-positive inmates, apparently failing to provide medically necessary food or supplements for HIV-positive persons with diabetes or those suffering from wasting.

Human Rights Watch researchers have visited incarcerated persons living with HIV/AIDS in a number of countries, including in the former Soviet Union and Africa. As we noted in our September 2003 letter, the conditions described by Dr. Tabet are worse than Human Rights Watch has observed in countries much less prosperous than the United States, and certainly constitute a serious human rights crisis for Limestone inmates living with HIV/AIDS.

International human rights instruments establish the right of prisoners to humane conditions of confinement, which include access to decent water and sanitation facilities and to adequately nutritious food. Prisoners also have the right to medical care by qualified staff, including emergency or specialized care as needed and adequate protection from contagious diseases. International law and the Americans with Disabilities Act also provide protections against discrimination for inmates with disabilities. In this regard, the state’s failure to ensure access to bathing facilities for inmates with disabilities is unacceptable.

More than a year has passed since Alabama released its report on the dismal health conditions for Limestone inmates living with HIV. Replacing the medical services contractor for the Department of Corrections with the current contractor as of November 2003 appears to have improved conditions at Limestone only slightly. We urge you once again to address with all urgency the atrocious abuses of the rights to life and to health documented by Dr. Tabet and to make a public report of the actions undertaken by the state to address these conditions. We further recommend that the Department of Corrections establish a system of independent monitoring by public health experts of the health conditions at Limestone to ensure that care and treatment of inmates living with HIV comply with appropriate standards. We also recommend that there be independent monitoring of other correctional facilities in Alabama to ensure that conditions at Limestone are not being replicated elsewhere in the state.

Incarceration should not be a de facto death sentence for people living with HIV. It should also not, short of death, contribute to serious illness or be an excuse for allowing illness to go untreated or be treated in substandard ways. We again call on you to take immediate steps to honor the state's obligation under U.S. constitutional and international human rights law to ensure safe and humane prison conditions and adequate medical services to protect the lives and health of people in state custody.

We look forward to following the state’s response to this urgent matter.

Very truly yours,

Joanne Csete, Ph.D., MPH
Director, HIV/AIDS Program

Jamie Fellner, Esq.
Director, U.S. Program

cc: Hon. Troy King, Attorney General, State of Alabama
Mr. Donal Campbell, Commissioner, Department of Corrections
Dr. Ron Cavanaugh, Director, Treatment Services, Department of Corrections

Your tax deductible gift can help stop human rights violations and save lives around the world.

Region / Country
Topic