Just One Breath: Tips for Covering Health Problems in Prisons

Published on
November 28, 2012

For most of the past 12 weekends, the Reporting on Health Collaborative has published an installment of the Just One Breath series about valley fever. Perhaps the most difficult task in that series fell to journalist Rebecca Plevin.

Her assignment? Write about how prisoners develop valley fever as a result of their incarceration in prisons surrounded by the fungus that causes the disease.

She actually assigned herself this task. She led the efforts to report on the financial toll of valley fever, and one of the biggest costs is the price taxpayers pay to treat inmates who are infected. The logical question from that story was: Are prisoners being punished twice?

Here are some tips from Plevin’s excellent reporting on this question.

1. Treat prisoners as people. We tend to write about prisoners as if they are all one thing: bad people who did something horrible and who deserve to be punished. It doesn’t matter if they gunned down people in a shopping mall or were spotted by their neighbor planting cannabis among their chrysanthemums.

But each prisoner is different and, even if they did something horrible, they deserve some basic human rights. This idea was so central to the founding of the country that it was included in the Bill of Rights, which prevents "cruel and unusual punishment." 

Even with that in mind, Plevin realized that readers would be less sympathetic to prisoners. So in reporting the story, she kept coming back to the idea that while, yes, these prisoners had done something wrong to get themselves incarcerated (setting aside the fact that at least a few of them likely were wrongly convicted), their punishment was prison, not lifelong illness from valley fever.

She started by describing how the disease has affected one federal prison inmate, Kevin Walker, and wrote:

The California prison system estimates about 200 inmates are hospitalized every year due to valley fever. Most of them are diagnosed with the disease while serving sentences in eight institutions in the San Joaquin Valley, where the airborne fungus that causes valley fever is rampant. That doesn’t include federal inmates at prisons like Taft, which was described in one lawsuit as a "petri dish for valley fever." …

When you add up all the time state inmates spend in the hospital for valley fever, it amounts to an average of 5,000 days, or about 25 days for every inmate. 

2. Map the problem. Prisons are their own little worlds. If you have ever visited one, you know that you are in foreign territory the moment the doors close behind you. I covered the trial of a prisoner accused of murdering another prisoner, and it was both disturbing and fascinating to hear descriptions by inmates of life behind the walls. One of the big differences in prison life is the rate of illness. Plevin explained why:

The rates of valley fever in the communities surrounding the prisons in Central California already are high. Someone in Bakersfield, Fresno, Stockton or Merced has a much higher chance of contracting the disease compared to someone in Los Angeles, according to the California Department of Public Health. 

But the rates inside the prisons are worse. An April 2012 study found that at Pleasant Valley State Prison, the rate of valley fever was 7,011 cases for every 100,000 people. In states that report cases, fewer than 20 people out of every 100,000 are diagnosed with the disease.

3. Don’t let legal secrecy stop your story. Plevin found out that current and former prisoners all over California were trying to bring cases against state and federal agencies after being diagnosed with valley fever. She visited a law office in Los Angeles that hat gathered stacks of letters from inmates, health care records and other documents. The lawyers, though, said she couldn’t review any information that identified the inmates because, by doing so, she might be breaking attorney-client privilege.

Plevin had two choices: ignore the files or attempt to make some use of them. She opted to review the portions of the files that were anonymous and to talk with the attorneys who were handling the cases in order to describe the larger trend. She wrote:

Experts and inmates alike question whether it’s fair to doubly punish people — once for a crime, and again with a horrible disease whose symptoms and related costs could linger long after the prison sentence.

That’s a concern lawyers Ian Wallach and Jason Feldman hear on an almost daily basis. Since they took the case of a former Taft inmate who contracted valley fever — and this summer helped him earn a $425,000 federal settlement — the Venice-based lawyers have received hundreds of letters, phone messages and emails from inmates with valley fever seeking help.

"They’re all scared about future medical expenses, and who is going to pay for this when they get out," (Wallach) said. "Whether they got it in Avenal, whether they got it in Pleasant Valley, wherever they got it — they want money for pain and suffering because they have been hurting."

4. Expect difficulties. I asked Plevin if she had any specific lessons, and she wrote back:

This story took a very long time to come together. There were times I doubted it would come together at all. For months, we knew what we wanted to say in the story, but it took a long time to find experts who would comment on the issue, inmates who would share their experiences, and the documents to back it all up.

The lesson, at least for me, is to keep casting out lines, and be patient until you get some "bites." We'd talked about running this story back in September, but I'm glad we didn't rush it.

Have thoughts on how to write about prisons or about the Just One Breath series? Drop me a note at askantidote@gmail.com or via Twitter @wheisel

Related Content:

Just One Breath: Valley Fever Turns Short Prison Terms Into Lifelong Penalties

Taxpayers Spend Millions on Valley Fever in Prisons

Valley Fever Costs Mount for Patients and Taxpayers

Q&A with KPCC's Julie Small: Investigating Prison Health Care

Photo Credit: Courtesy of Kevin Walker