Jane Wilson is 36 year old drug addict. She was referred to me for an alcohol and drug assessment after being charged with possession of methamphetamine for supply. She started using meth about ten years ago and began selling to friends and acquaintances to fund her habit. She had also been smoking cannabis since she was 14 – usually on a daily basis. I interviewed her in July 2012 in Arohata prison – by which time she had been on remand for three months as her case slowly winds its way through the courts.
This is not an uncommon story – except that Ms Wilson has diabetes, diagnosed at the age of 11. So for 25 years she has been injecting herself with insulin on a daily basis and usually requires five injections a day.
Diabetes requires careful management. Diabetics are supposed to test their blood sugar levels four or five times a day in order to know how much insulin to inject. A normal reading is between 4.00 and 7.00 mmol. Readings below 4.00mmol are potentially dangerous as the brain is being starved of oxygen – a condition known as hypoglycaemia. The patient becomes weak, anxious and confused and if the blood sugar level continues to drop, they may become comatose and die.
Diabetics generally carry barley sugars or something sweet to give their sugar level a rapid boost if it drops too low. Soon after arriving in Arohata, Ms Wilson was given a supply of glucose tablets and the prison nurse gave instructions that she was to have these with her ‘at all times’. The nurse then went on leave for eight weeks. Apparently believing that inmates cannot be trusted, even with glucose, prison officers took the tablets off her and kept them in the office. So whenever her blood sugar tested low, Ms Wilson had to press the emergency button in her cell and ask for help.
These requests were met with a variety of unhelpful or insulting responses such as: “I hope you’re not cunting us around Wilson.” On another occasion when her blood sugar was down to 2.4mmol, an officer said: “We can’t be doing this every night Wilson.” On yet another occasion, about half an hour before dinner was due to be served, her blood sugar dropped to 3.4mmol. She pressed the buzzer twice and was ignored twice. She had to ask the officer who brought the dinner to give her some sugar as well. Next day Ms Wilson told a nurse what had happened and was assured the officers would be spoken to. Later that day, a male guard said: “We don’t appreciate being complained about so don’t be expecting any favours.” Another officer told her: “It’s not all about you Wilson.”
In the report which I provided to the judge, I pointed out that this situation was making Ms Wilson very anxious. She was so upset she cried virtually every day, and became so depressed she needed antidepressants. She was afraid she might die from a hypoglycaemic attack because the prison officers just didn’t care. In my report I wrote:
1) Ms Wilson’s situation is complicated by diabetes. Her concerns about the quality of care she currently receives significantly exacerbate her underlying anxiety. Ms Wilson worries that she might die in prison because prison staff either don’t care or don’t know how to assist her regulate her blood sugar levels – especially at night when medical staff are not available.
2) Corrections Department rules make it difficult for Ms Wilson to gain effective control of her blood sugar levels. I spoke to the specialist diabetic nurse (at Kenepuru Hospital) who expressed particular concern about the last meal of the day in prison being served at 4:30 p.m. She said that to maintain control of their blood sugar levels, diabetics need to eat six meals a day and need supper before going to bed in order to avoid developing low blood sugar during the night. She said that ‘low blood sugar is an extremely dangerous condition’ for Ms Wilson.
3) In a recent report on the health of prisoners, the Ombudsman reported that: “Prisoners continue to complain that the national menus implemented by the Department do not consider the specific health needs of prisoners, especially diabetics.” Ms Wilson’s GP and the specialist diabetes nurse both expressed concern about the fatty prison food which is not good for diabetics. They both felt that the prison regime with limited physical activity makes it even more difficult for a diabetic to manage blood sugar levels which require an appropriate balance between food intake and physical activity.
After nearly four months on remand, numerous hypoglycaemic attacks and one emergency visit to hospital, Ms Wilson eventually appeared in Court. The judge showed compassion and released her on electronic bail while her case proceeds. But if she receives a sentence of more than two years, she will have to go back to prison where she will be exposed to the same kind of treatment all over again.