BATTLE BEHIND BARS
Calls to improve jail health care
Chris Parchomchuk is persistent.
For one, he survived a shotgun blast to the back of his head and the ensuing infection.
He also spent a lot of time and money, particularly for an inmate, on 20-minute-max phone calls while serving a 30-month sentence in provincial correctional centres.
Those two facts are connected. See, Parchomchuk is determined to tell people about what he calls the “inhumane” treatment he received in one of the province’s correctional facilities. For the better part of a year, Parchomchuk frequently called the Leader-Post, desperate to find a listening ear.
“It’s not just for me,” he says. “It’s to make sure this doesn’t happen to anybody else in the future. What happened here is wrong.”
Parchomchuk, 32, spent five days in hospital for his gunshot wound before being remanded at the Regina Provincial Correctional Centre.
The October 2016 attack, which he chalks up to being in the wrong place at the wrong time, followed his unrelated assault on a landlord.
If he had been on the outside, Parchomchuk likely would have had the followup care he needed.
But he was on the inside, on the remand unit in Regina’s jail, where his wound festered and became infected, leaking yellow, green and white fluid. According to documents filed in a failed appeal of his sentence, it took multiple requests and several brief visits to the hospital in order to be readmitted to properly treat the infection. By this time, he was in a wheelchair and throwing up. As a result, Parchomchuk’s permanent injuries include hearing loss, loss of taste and smell, severe migraines, blurred vision, insomnia, anxiety, PTSD, neck stiffness and some loss of mobility, according to documents.
Those same documents, filed by Parchomchuk’s Legal Aid lawyer at the time, Carson Demmans, state that the loss of hearing was because of the infection.
“This could have been avoided if he had not been in custody and received proper medical care. Although the medical profession acknowledges his chronic pain, he was denied the most effective treatment for it while in jail.”
Parchomchuk, who has since been transferred to the Prince Albert Correctional Centre until his August release, has filed a civil suit against the province containing these allegations. He also has extensive concerns about muchdelayed access to either a psychologist, psychiatrist, plastic surgeon or physiotherapist.
The former long-haul truck driver, who previously served a 15-month term, knows the jail isn’t responsible for the nine shotgun pellets that were removed from his skull, but Parchomchuk blames the system for not taking his infection seriously — what he believes equates to severe neglect. He also believes that, while his is an extreme case, the experience reflects a broken system failing its population.
Two more former inmates have similar allegations and concerns about the quality of health care in the province’s correctional institutions, specifically regarding access to needed medications, long wait times and a process overly reliant on complaints. One says he tried to kill himself seven times in the Prince Albert jail over the intense pain caused by nerve, kidney and liver damage that was not properly treated inside. Another, a longtime drug addict with HIV and hepatitis C, says he waited six weeks to get important blood work and was only taken seriously after filing a complaint at the Regina jail.
The concerns are being taken seriously by lawyers and politicians in Saskatchewan who are pushing the provincial government to be more transparent with its inmate health care processes.
And it’s not just the inmates who are talking about this issue. In March last year, Justice Jeff Kalmakoff, while sentencing a Regina woman, called on the Ombudsman’s Office to investigate when she nearly died of a severe bone infection, sepsis and a brain abscess due to a lack of treatment while remanded in custody.
The Children’s Advocate also raised the alarm in a 2016 report about a teenage boy with hearing loss who died after a failure to recognize he was critically ill.
Questions were raised about incustody care even more recently at inquests into the deaths of Breanna Kannick and Gerald Burnouf. Burnouf ’s cause of death was ruled undetermined while Kannick’s was ruled accidental, but a total of 14 recommendations were made out of the two inquests.
No one, including the inmates, takes an issue with doing the time for their crime. But while they serve it, they’re in the care of the state, and that includes attending to the health care needs of someone like Parchomchuk before a festering infection makes matters worse — costing the inmate, the public purse and, ultimately, taxpayers more.
Drew Wilby, spokesman for the provincial Ministry of Justice, says health care for inmates is a priority.
“Ideally, an individual that’s either in the community or in a facility is treated no differently. They’re both patients,” he says.
“We try to deliver that service as best we can and in as timely a fashion as we’re able to.”
He acknowledges room for improvement and, while it won’t be a “silver bullet,” Wilby is optimistic a new mental health and corrections facility in North Battleford that can house 96 inmates will help to address some of the strain on the medical process.
He says a health review looking at how to be more open and transparent was ongoing before the provincial auditor’s recent report, which provided six recommendations to the ministry about providing primary medical care in adult secure-custody correctional centres. The recommendations include regularly updating provincial medical care policies, developing and regularly reporting on measures to evaluate the provision of medical care to inmates, requiring staff to transfer inmate medical files between centres and responding to inmate complaints about medical care within required timeframes.
Wilby says the ministry’s primary focus in correctional centres is the safety and security of staff, inmates and the facility itself. He says inmates’ health plays an important role.
“We do rely on our health partners for a lot of that. If someone has a gunshot wound, obviously we would hope that they would be treated in an emergency room and that they would come to a correctional centre in a position where they are healthy enough to be there and that they don’t need that level of continuing, ongoing primary care,” Wilby says, adding that if special care was required after, the ministry hopes information would be shared with corrections staff.
He says communication, staffing and funding are consistent challenges.
According to the auditor’s report, “the majority of inmates are vulnerable and come from backgrounds that increase the likelihood of declining health, and the primary care received in a correctional centre can play a role in reducing this health inequality.”
With this vulnerable population comes an increased demand for mental health and addictions resources. Correctional centres use external health partners or contract directly to provide additional medical services like lab services, substance abuse programs, infectious disease clinics, dental, optometry and sexual health clinics.
Each centre has a doctor on site between six and 11 1/2 hours a week.
The auditor’s report found adequate medical personnel was available to inmates in Pine Grove, Prince Albert, Regina and Saskatoon correctional centres. However, it notes each centre had an average wait time of about a month to see a general practitioner. Later, the provincial auditor says the office did not find evidence the ministry was tracking key medical care activities or measures like wait times for medical care or the number of inmates per medical staff. In 2016, as part of a ministry health-services review of the correctional centres, it tracked some data for a three-month period.
Of the 799 corrections complaints received by the provincial Ombudsman in 2017, about 25 per cent, or about 200 of those were about health care. While down from 2016, complaints last year are still 18-per-cent higher than the average of the previous five years.
Several of those complaints were filed by Cory Cardinal, who, after more than 100 convictions, has learned how to get results inside.
“If you don’t know how to write a complaint, then you’re just going to f---ing cope,” he says.
In his experience, inmates who don’t know how to take initiative by filing complaints or appeals end up waiting between three and six weeks to see a doctor. Despite what should be an accessible process, Cardinal, 35, says his knowledge came from other inmates. It’s a skill that has produced results.
“My quality of life became better because I started sticking up for myself and filling out these complaint forms and appealing them,” he says.
Even still, Cardinal says he waited almost two months for blood work to monitor his HIV after screening at the Regina jail.
“All I know is that the healthcare system in the correctional is supposed to match the health-care system on the street,” Cardinal says. “And I know that I don’t wait six to eight weeks to see a doctor on the street when I have problems with an illness that could potentially end my life.”
Cardinal calls himself a “specialist” at getting released from jail. Hours after he got out of the Regina Correctional at the end of May, he reflected on how he may be successful avoiding a criminal lifestyle this time around, as a selfdescribed “transient” person.
“You have to have a network of support,” Cardinal says.
As an addict with HIV and hepatitis C, he has to plan ahead of his release to make sure he’s getting the life-saving medications he needs to make it from Thursday to Monday, when he can see a doctor on the outside.
“I’ve been saving some meds, because they don’t give you a supply that’s going to tide you over until you see the doctor,” Cardinal says.
Cardinal estimates he has spent about 10 years in jail over the past 17 years, many of those stints caused by probation breaches because of his lifestyle on Saskatoon streets. While he has similar concerns to Parchomchuk about delayed access to doctors, a problematic complaint process, restrictions on medications and a general dismissive attitude from correctional workers, Cardinal says it is easier to manage his illnesses inside.
“Considering my street life, I’d say in the correctional I’m more stable,” he says. “When I’m out, I’m transient. I’m homeless. I lose my meds. I’m living in a backpack, so it makes it harder.”
The delays described by inmates like Cardinal caught the attention of NDP MLA Nicole Sarauer, who first asked about wait times in summer 2016 when she became the party’s corrections critic and started touring correctional centres.
“At that point in time, I couldn’t get a lot of information in terms of how long the wait times were because they were telling me they weren’t keeping track of the data, which I thought was bizarre,” Sarauer says.
A year-and-a-half later, Sarauer asked again in an Intergovernmental Affairs and Justice Committee meeting. Deputy Minister of Corrections and Policing Dale McFee went on to list the varying averages inmates wait for medical care at each of the four facilities: Between one and three weeks for a general practitioner; between one week and four months for a psychiatrist; between no wait and seven months for an optometrist, and between no wait and one month for harm reduction. Every methadone program other than the Regina jail has zero wait times.
“I’m not sure if that’s entirely consistent with what I’ve been hearing,” Sarauer says. “It depends on what that means.”
Basically, she’s not entirely sure about those numbers. “I think it’s important to know what the stories are behind the data and what the issues are and what sort of medical needs are being addressed or not addressed.”
The last time Devon Schubert was incarcerated, the 29-year-old Regina man tried to kill himself seven times over extreme pain caused by nerve, kidney and liver damage sustained on the outside, he says. Schubert also claims to have been admitted into P.A. Correctional with a double hernia and waited four months for emergency surgery.
“They didn’t listen to me; they didn’t believe a word I had to say,” Schubert says. Like Parchomchuk, he believes permanent damage may have been mitigated by speedier access to a doctor.
Since he was locked up for the first time as a teenager, Schubert estimates he has spent about 10 years in jail over more than 250 convictions. The treatment he has received over those many stints has convinced him the system doesn’t care about the well-being of inmates. He believes access to doctors and medication is based on preferential decisions made by guards and nurses.
“If you’re a repeat offender, you’re going to have to write a lot of complaints because you’re a career criminal and that’s why they don’t like you,” Schubert says.
“When you’re in that much pain and they don’t believe you and you have to sit with that, it’s like the end of the world.”
When he got out of P.A. Correctional after another year-long term over charges that included a couple arsons and dangerous driving, Schubert turned to heroin to deal with the pain.
Between managing addiction, chronic pain and a debilitating leg injury now that he’s a free man, Schubert struggles to get to medical appointments, much less search for work. He would like to see more rehabilitation programs in correctional facilities that could set inmates up for success when they’re released.
Without opportunities for him in jail, “I’m stuck on the streets doing crime again or selling drugs to get my money,” Schubert says. “It’s a rough life.”
It might be easier for all parties outside the ministry to accurately judge the health care practices in Saskatchewan’s jails if they could see the policies. But, for security and safety reasons, the provincial government will not release them.
Carly Romanow, executive director and staff lawyer at Pro Bono Law Saskatchewan, has seen an increase in calls about access to proper medications, access to doctors and the long waits. But, she notes repeatedly, you can’t know if the practice is in line with policies you haven’t seen.
“The federal institutions, they have all of their policies online available to the public,” Romanow says.
Pro Bono tries to fill the gap between Legal Aid and hiring a private lawyer, meaning they’ll take on an inmate who gets charged with a discipline offence or loses telephone privileges.
Some of Parchomchuk’s many phone calls have been to Romanow. While she’s not his counsel, Romanow helped Parchomchuk organize his suit and access the civil court system.
“There is a question of whether or not he received adequate medical care while at Regina Correctional,” she says.
“I can’t comment on whether or not they were following policy. However, I think there would be different care if he was outside of an institution.”
For Parchomchuk, none of the reviews, recommendations or even his civil suit can change what he endured the first days on remand. He has come to terms with the wound that left a gap at the base of his skull where the soft tissue is supposed to be. But he will never forgive those inside.
“I thought I was going to die in the jail,” Parchomchuk says.
If all goes as planned, he will be released in about a month’s time. In addition to the physical scar, he says he will also carry the trauma with him as he walks out the doors. But even after he’s gone, he still wants the jail health-care system to improve. “There has to be something that can be done because this is too much,” Parchomchuk says. “I’m not the only one and this has to change for guys in here.”
(In 2016), I couldn’t get a lot of information in terms of how long the wait times were because they were telling me they weren’t keeping track of the data, which I thought was bizarre. NICOLE SARAUER, NDP MLA
When you’re in that much pain and they don’t believe you and you have to sit with that, it’s like the end of the world. DEVON SCHUBERT, 29, who says the system doesn’t care about the well-being of inmates, and alleges preferential treatment regarding access to medical care.