"If we had waited one more week, you would have died from uremia," the surgeon at the prison hospital in Hachioji City had informed the prison inmate, who was suffering from an enlarged prostate.
At the time, the man, presently 64, was incarcerated at Tokyo's Fuchu Prison in 2007. He had been suffering from chronic prostate enlargement and high blood pressure. He had requested an outside hospital to continue filling his prescriptions, but his requests were denied and his conditioned progressively worsened. The man's wife also pleaded in vain with prison authorities. Only after the man began urinating blood was he finally sent to the prison hospital for surgery. The process, from initial application to the surgery, had taken 18 months.
"In prison, first you explain your condition to a nurse's aide," the man relates to journalist Kazue Fujita in Shukan Kinyobi (Sept 30). "But as likely as not, you'll be suspected of malingering, and it doesn't get reported to a doctor. Even when you finally get to see a doctor, it'll be a physician in a different specialty, and at any rate, the consultation is over in a matter of seconds."
In the background of this problem are a growing shortage of physicians and reduction in the budget allocated to their medical care. Although prisons nationwide have slots for 226 regular physicians, over 10% are currently unfilled. And because growing numbers of inmates are enfeebled elderly or people from economically disadvantaged classes, the amounts spent per each inmate have been burgeoning. Compared to about 3 billion yen in 2005, medical expenditures at prisons had bloated to 4.9 billion yen in 2009.
The Kangoku Jinken Center, an NPO set up to monitor human rights at prisons, reports a growing number of horror stories, such as guards who forced a man with a chronic circulatory ailment to remain in "seiza" (formal kneeling position) for an extended time, or, in another case, as no surgeon was available, an internist was forced to remove a tumor, and as the incision was improperly treated, it became infected.
At Chiba Prison in 2006, the administrators were said to have broadcast to inmates that "for budgetary reasons, prescribing drugs will be restricted." The Ministry of Justice denies the allegation, saying the Bureau of Corrections has "never been instructed to cut back on medications to inmates."
"In the case of minor injuries that occur during work details, if the inmate is judged to be at fault, he might be subject to punishments," says a former inmate identified only as Mr B. "Even if it was judged accidental, though, the injury will only be treated with ointment and band-aids; and sometimes the inmate's wages will be reduced.
"Because failure to avoid an accidents is a criteria that is factored into the guard's evaluation of the inmate, an inmate who gets injured is discouraged from reporting it. Or, he'll try to conceal an injury that's serious. There have been inmates whose condition became progressively worse because they didn't seek treatment."
In the course of researching her article, Fujita frequently received such remarks as "It's absurd to devote public funds to medical treatment for criminals."
"Prisons," she observes, "are a mirror that reflects the true feelings of the state and its citizens. Is providing inmates with a bare minimum of treatment intended to serve as a kind of punishment to be imposed, in addition to their incarceration?
"The current gap between the ideal as espoused by the law and the actual situation cannot be easily rectified," she concludes.© Japan Today