11/29/2008 05:12 am ET Updated Nov 17, 2011

Carswell Prison Blues

Darlene Fortwendel was sent to the hospital with a diagnosis of early stage liver cancer and a recommendation that doctors start treatment immediately. Instead, new tests were ordered and then delayed for months. Even when tests finally confirmed the original diagnosis, treatment was never begun. Six months later Fortwendel was dead. She was 45.

A couple of years earlier, at the same hospital, Janice Pugh, with a history of lung cancer that had been in remission, was admitted for observation and soon began coughing up blood. A recommendation from the hospital's contract oncologist that an immediate biopsy be done was ignored. Instead, Pugh was released with an assurance from a medical officer there that she was cancer free. Two months later she was dead at 52 from lung cancer that had spread throughout her body.

These cases didn't occur in some primitive Third World medical clinic. The two women were prisoners serving their sentences at the Federal Medical Center Carswell, the only hospital in the country for women who have been convicted of a federal crime--and their stories are the norm, not the exception. Located behind a razor-wire fence on a former Air Force base just outside Fort Worth Texas, it houses 600 to 700 offenders who have critical medical or psychiatric needs. They are as old as 86 and as young as 18 and hail from every ethnic, social and economic class, most of them having been convicted of white-collar or drug-related crimes.

The oldest inmate to die at FMC Carswell was Alva Mae "Granny" Groves, who succumbed to various age-related illnesses in 2007 after her family's pleas for early release were consistently denied. She was in the thirteenth year of a 24-year sentence, convicted of trading crack cocaine for food stamps. Her real crime, her family said, was refusing to testify against her adult children, who were the actual targets of the FBI investigation that sent her to prison as a "co-conspirator."

The youngest to die there was Nicole Vasquez, 27, who was serving 18 months for a drug crime. She was sent to Carswell three years ago to recover from heart surgery performed at an outside hospital. Yet she was assigned to clean toilets on her floor, and had been denied treatment for weeks after reporting severe flu-like symptoms. Her death was initially attributed to septic shock, then to complications from the surgery.

Besides medical neglect, rape is another threat routinely faced by the women of Carswell. Since 1997, seven men--including two chaplains, a counselor and two doctors--have been convicted of rape or other sexual offenses against women there (one was fired for sexual misconduct but never brought to trial). ACLU Prison Project staffer Jackie Walker said that so many convictions of high-level staff raise questions about "just what kind of culture there allows this to happen."

The Carswell stories, which I've been documenting for almost a decade for my home paper, Fort Worth Weekly and most recently for the summer 2008 issue of Ms. magazine, are hardly unique in a nation with more than 2 million citizens behind bars. From the local jails to the state and federal systems, egregious medical neglect and rape is rampant, say prison reform advocates such as Brenda Smith, a professor at American University Washington College of Law in D.C. and a specialist in women-prisoner issues. And she warns that what happens in our nations prisons doesn't stay in the prisons: Most of these men and women will be released at some point, bringing back to their home communities untreated and contagious diseases such as AIDS, tuberculosis and hepatitis-B, as well as a host of psychological problems (especially among the rape victims). These women will ultimately be the responsibility of that community's taxpayers and its overwhelmed medical system.

And then there are those who won't come home because they have died from neglect or indifference, leaving orphaned children and broken families whose despair and anger will eventually have a huge social impact.

Yet the medical neglect in our prisons is too-often accepted by the public as just another price paid by those who commit crimes. But as the angry sister of Fortwendel said about her death, "My sister's sentence was for a white-collar crime--it wasn't a death sentence, but that's what she got when she was sent to Carswell."

To keep women behind bars better informed of their rights and what is happening on their behalf, readers can donate a year of Ms. magazine to a woman in prison at