This article appears in the The Earth Died Screaming Issue of VICE Magazine.
When Manie Foskey told his mother, Geraldine Waters, that he had lost more than a hundred pounds in three months, she knew something was wrong. At 45 years old, he had always been slightly overweight but still able-bodied and fit. In 2004, Foskey had been sent to State Correctional Institution Fayette, in La Belle, Pennsylvania, to serve a life sentence, and he had grown accustomed to spending his afternoons competing with other prisoners over who could lift the most weights. But the person who came out to see his mother in the prison's visiting room last March was a thin, weak-looking man in a wheelchair. A pus-like fluid was coming out of his fingers where the skin had busted open, and parts of his dark-brown complexion had turned white where the skin had tightened. Waters and her daughter, Tracey, almost didn't recognize him.
When Waters demanded her son go to the infirmary, he argued it would be a waste of his time. "No one wants to go to the infirmary," Foskey told her. The medical staff was indifferent and cruel to the patients at SCI Fayette. Foskey told his mother that a fellow inmate had once shown up at the infirmary vomiting and spitting up blood. The medical staff on duty insinuated that he was faking the symptoms in order to get time out of his cell. Foskey himself had been accused of faking symptoms on multiple occasions.
Unsatisfied, Waters began calling officials at the prison to push for proper medical attention for her son. "I already lost one child. I'm not losing another," she told a prison official. At first, the medical staff resisted sending Foskey to an outside doctor, but eventually he received a skin biopsy and was admitted to Allegheny General Hospital, in Pittsburgh, for six weeks. He was diagnosed with diffuse scleroderma, a disease of the skin and internal organs that is commonly found in coal miners because of their proximity to the silica in coal ash. Foskey was then transferred from SCI Fayette to SCI Laurel Highlands, which had a more advanced medical facility where he could receive dialysis for his emerging kidney problems, caused by the scleroderma.
Waters was confused as to what scleroderma was and how her son could have possibly gotten such a rare disease after being healthy for so long. While researching Foskey's illness, she found a 2010 article in the Pittsburgh Post-Gazette about health concerns in La Belle. Residents had been developing cancer, kidney disease, and bizarre skin issues at an alarming rate. On one street with only 18 houses, there were nine documented cases of cancer. In Luzerne Township, where La Belle is located, the death rate from heart disease was 26 percent higher than the national average and mortality levels from diseases linked to air pollution were "elevated." Another article Waters found mentioned a report and advocacy work done by the Abolitionist Law Center (ALC) and Pennsylvania's Human Rights Coalition, and she reached out to tell them what had happened to her son. Meanwhile, just because Foskey had been transferred didn't mean she was going to stop making noise at SCI Fayette: "I know people are dying," she told a Fayette official over the phone. "I'm gonna be the first one to let the world know what you are doing and how you're treating the inmates." She was referring to the fact that SCI Fayette sits on top of a coal-ash dump.
In 2000, the Pennsylvania government broke ground on a new maximum-security men's prison on 237 acres of land in La Belle that it received from Matt Canestrale Contracting, Inc. The plot of land where the new prison would be was shared with MCC's main business, a coal-refuse site with a coal-ash dump and two coal-slurry ponds that served a nearby mine. La Belle residents had been complaining about the coal ash, the fine-particle residue produced by the coal-mining process, drifting down from the site at the top of the hill since it opened in 1997. In their multiple complaints to the Pennsylvania Department of Environmental Protection, they remarked on how the ash collecting like dust around their homes was making it difficult to breathe. Still, the state decided it was a good location for a new prison, and in 2003 SCI Fayette opened its doors to a few dozen inmates who would be tasked with manufacturing the state's license plates. It took about a year to fill the prison to its capacity of 1,826 inmates. When Foskey arrived, in 2004, after he pleaded guilty to shooting two people, he was placed in the F Block, the final cellblock to receive inmates. (He has since appealed his conviction, saying he was mentally ill and had ineffective legal counsel.) The prison, more than half of whose population is black, is now 11 percent over capacity, with 2,031 inmates.
Soon after arriving at SCI Fayette, Foskey began to notice that "trucks were dumping this black stuff on top of the mountain." At the time he didn't know what it was, but he wasn't the only one who noticed. Eric Garland, a guard at the prison, was familiar with the dangers of coal ash; his father has worked at a coal-fired power plant for 30 years. In 2010, he contacted the Center for Coalfield Justice (CCJ) with worries about the dump after he was diagnosed with hyperthyroidism. Concerns about the environmental and health effects of coal ash have been widespread in Pennsylvania for years. The state produces more than 15.4 million tons of the stuff a year, the most in the nation. Coal ash typically contains arsenic, lead, mercury, cadmium, chromium, and selenium—toxins that if ingested can cause cancer, heart damage, lung disease, respiratory problems, and a host of other ailments. Drinking water from a well near an unlined coal-slurry pond, like the one the coal-ash dump in La Belle was built on top of, increases your chance of getting cancer to one in 50.
After the CCJ heard from Garland, they forwarded his complaint to the ALC, a public-interest law firm in Pittsburgh that works on cases involving human rights abuses in prisons. In August 2013, the ALC began interviewing prisoners about their health issues and environmental concerns. In all, 75 inmates agreed to participate, but only 14 would be quoted by name, fearing retaliation from the prison. In "No Escape," a report released on September 2, 2014, the ALC outlined the health issues people were experiencing in the prison, including skin conditions, throat and respiratory illnesses, thyroid issues, and tumors. Out of the 75 people surveyed, 61 reported experiencing breathing and sinus conditions, 51 had experienced gastrointestinal issues, 39 had experienced skin issues, and nine had been diagnosed with a thyroid disease or had a previously diagnosed thyroid issue that worsened after incarceration at SCI Fayette. The report also noted an alarming rate of cancer—11 of the 17 prisoners who died at SCI Fayette between 2010 and 2013 passed away from the disease.
Perhaps most concerning in the report were the inmate accounts of lack of medical attention and, in some cases, accusations of medical neglect. Darin Hauman, an inmate at SCI Fayette since 2010 who works in the prison infirmary, outlined how medical staff deprived a sick man (who later died of brain cancer) of drinking water. He told the ALC, "In his last few weeks of life certain nursing staff deliberately induced dehydration by simply refusing to assist him in drinking water. No hydration by way of intravenously either. With healthy humans it takes a short time being dehydrated for organs to begin shutting down. Regarding Greg, I would have to sneak into his ward area, I would have to dip my finger into water to moisten his lips as they were 'glued' shut, then would have to drip a few drops of water onto his tongue just so he could use a straw to get a few sips of water. Of all things I was yelled at numerous times for doing this. This pisses me off each time I think of this. To deny a man a drink of water speaks volumes as to the ideology of this particular nursing staff."
One prisoner told the ALC that "almost with every inmate who is admitted into the infirmary, [the nursing staff] accuses those inmates of 'faking [symptoms].'" Another said that he hadn't seen a doctor in two and a half years despite having breathing problems and chronic headaches because "they charge too much for sick call and don't do nothing for symptoms." (Many inmates, who make at most 42 cents an hour, cannot afford the $5 charge per medical visit.) In some cases of cancer, "prisoners were denied evaluation until the cancer was life-threatening… evidence of the dangerous level of neglect exhibited by medical staff," the report said.
For Derek Downey, a 28-year-old who has been incarcerated for three years, the medical neglect he has been shown has had grave consequences. Downey's account didn't appear under his name in the ALC report, but he told me about his trials after it was released. On June 30, 2013, after a month of having bloody and liquid bowel movements, Downey was sent to the emergency room at Allegheny General Hospital. He was diagnosed with ulcerative colitis and given a set of medications with instructions for the medical staff at SCI Fayette. But the prison staff failed repeatedly to follow the instructions, and they attempted to abruptly take him off the prescribed medication more than once. When this negligence caused Downey's health to deteriorate and his symptoms to flare back up, a doctor at SCI Fayette prescribed Downey medicine that caused him to develop a hernia. This past December, the doctor again prescribed Downey medication that he was instructed by outside specialists not to give him. (A spokesperson from the Pennsylvania Department of Corrections would not comment on any of the allegations of poor medical treatment.)
Before coming to SCI Fayette, Downey said he had always been healthy. Now, the environmental effects coupled with the poor medical care at the prison seemed to have seriously affected his well-being. "It is draining everything out of me," he told me. "I just want to get healthy again."
In the end, the ALC investigators argued that if inmates were being exposed to contaminants that were adversely affecting their health, it would violate the Eighth Amendment's ban on cruel and unusual punishment. They acknowledged that their findings were limited because they had spoken only to a small fraction of the prisoners, but they hoped their efforts would lead to transferring the inmates to another facility and closing SCI Fayette.
A week after the report was released, Anthony Willingham went to the prison infirmary because he had thrown out a muscle in his back from coughing so vigorously. Willingham, a 55-year-old African American standing at five feet seven, started experiencing shortness of breath, a chronic cough, and constant mucus discharge about six months after arriving at SCI Fayette, in December 2011. At the time, he was prescribed an inhaler and told he had a sore throat. He wasn't allowed to go to the hospital for tests for another year and a half, and when he finally did, doctors found that it was more than just a sore throat. He had chronic obstructive pulmonary disease and had to have a potentially cancerous growth removed from his throat. When he heard about the ALC investigation, Willingham agreed to participate, and he was one of the few still incarcerated at SCI Fayette who elected to have his name published.
At the infirmary last September, the medical staff examined his back but gave him only ibuprofen. They let him "lie out and scream for seven days," he said. His pain was so severe that he could not use his legs or get out of bed. Knowing this, the staff put his food tray on the chair, ten feet away. He was refused a bedpan and ended up peeing on himself several times. For a week, he was not even given a change of clothes or sheets. "It was brutal," he told me of the medical staff's reaction to his participation in the ALC report. "Everyone's demeanor changed… The physician's assistant who normally sees me has gotten arrogant and is pushing me to say something out of line."
The medical staff at the infirmary also took away the breathing treatments that Willingham is prescribed to take twice a day. They only restored the treatment when, according to Willingham, his doctor from Allegheny General Hospital, Billie Barker, called the prison and demanded it. But Willingham's fragile health has continued to deteriorate this year. He has lost 36 pounds in the past ten weeks, his ankles are swollen, and he has swollen lymph nodes.
In the fall, Willingham had been seeking a job at the prison so he could make more than the $14 a month given to unemployed people incarcerated at SCI Fayette. But after the report came out, no one at the prison would hire him. Willingham writes jazz scores, and he was hoping to get a job fixing musical instruments. He had been volunteering his help for several months, but at the end of September, his supervisor told him he wouldn't hire him for pay. Now, flat out broke, Willingham barely has enough to put in sick calls, let alone make calls to family or buy necessities at the commissary.
Surprisingly, Willingham doesn't regret being identified in the report. "I want the world to know what I've gone through," he said. "I may die tomorrow, but I refuse to die before I get the message out that brothers in this particular jail are being mistreated. This is a form of mistreatment." Willingham is worried about the younger guys also incarcerated at SCI Fayette. "I'm doing life, but a lot of these guys aren't. You already got sentenced once; you didn't come here to get sentenced to death."
Last New Year's Eve, the Pennsylvania DOC announced that it had completed an investigation into the health effects of the coal-ash dump, and a two-page press release was published. The press release stated that SCI Fayette's water supply had been tested in August and that it had met all relevant drinking standards. The DOC also compared the cancer death rates at Fayette with the cancer rates of other state prisons in Pennsylvania from 2010 to 2013. While the SCI Fayette cancer death rate (1.34 per 1,000 inmates) was higher than the statewide average (1.09 per 1,000 inmates), it still ranked only seventh out of the 26 state prisons. (Two days before the DOC findings were released, the state Department of Health announced that based on its own review of inmate cancer diagnoses at SCI Fayette, "there isn't an indication the environment contributed to the risk.") The DOC also looked at the number of medications ordered by the prison for pulmonary, gastrointestinal, and respiratory illnesses and compared it with those prescribed in other institutions; SCI Fayette fell in the middle or slightly below average, the DOC reported. In short, they said, there is no reason to be concerned.
However, after the report came out, many environmental experts questioned the DOC's findings and methodology. Lisa Evans, an environmental lawyer based in Massachusetts, told me that testing the prison's drinking water once was not sufficient to get an accurate sense of the contaminant levels. "Water monitoring is not reliable if you're just taking a snapshot once of what you're drawing from a well," she said. "When there's mandated groundwater monitoring it's not an annual requirement. It's usually semiannual, often quarterly." (The DOC told me that the results of a more recent water test, which they were not sharing with the press, were "good.")
The Tri-County Joint Municipal Authority, the water source for both the prison and the residents of La Belle, has been under fire from Pennsylvania's Department of Environmental Protection for years. The water company's level of total trihalomethanes, the often carcinogenic byproducts of water disinfection, has been running above the maximum contaminant level (MCL) of .08 mg / L since at least 2008. In the last quarter of 2014, the level reached as high as .11 mg / L. The authority is required to send out a notice each time the level is above the drinking-water standard. The company's notice warns that "some people who drink water containing trihalomethanes in excess of the MCL over many years may experience problems with their liver, kidneys or central nervous system, and may have an increased risk of getting cancer." These notices have been sent to La Belle residents quarterly since at least 2008; the most recent one was dated March 2, 2015. But inmates at SCI Fayette do not see these letters, despite being the only population exposed to the water source that is not allowed to drink any water from another supply. (At SCI Fayette, bottled water is considered contraband.)
The ALC criticized the DOC for measuring the rate of gastrointestinal, respiratory, and pulmonary diseases by reviewing the amount of medication prescribed at the prison. Several inmates have pointed out the medical staff's failure to give proper treatments, stating they overprescribed ibuprofen and allergy medicine for problems that clearly necessitated stronger medication and refused to do further tests, even when remedies did not alleviate symptoms. One inmate, who had a large growth on his vocal cords that needed to be removed, was only prescribed Claritin. Another, who had been having muscle spasms for six months, was only prescribed Motrin, despite the fact that he is allergic to the drug. He told me that he is so frustrated that he has since "given up on putting in sick calls."
The DOC's investigation did not acknowledge the air quality of the prison or inmates' accounts of dark matter collecting in vents and on the windowsills—seemingly from the dry-coal-ash dump. High levels of fine particulate matter are one of the biggest concerns regarding dry coal ash. If lodged in your lungs over a period of time, it could cause significant respiratory diseases and contribute to premature death.
In July 2010, Analytical Laboratory Services, Inc. (ALSI) conducted a two-day air-quality test inside and outside SCI Fayette. It's possibly the only one conducted at the prison. ALSI found that the levels of particulate matter were as high as 390 mcg/m3 outside and 213 mcg/m3 inside the prison. In all, 25 out of 31 sections of the prison—including ten out of 11 cellblocks—were over the recommended guideline of 50 mcg/m3. The average measurement of particulate-matter levels in the cellblocks was two-and-a-half times what's considered healthy. The report also acknowledged that the most likely source of high particulate-matter levels was the "outdoor levels" of particulate, and "supply and/or return vents appeared dusty or dirty in some locations," corroborating the inmates' accounts of matter collecting on vents. When asked about the air quality at the prison, the DOC said the 2010 test showed the particular levels were healthy, in direct contradiction to the ALSI report obtained by VICE. A DOC spokesperson declined to comment on the discrepancy.
The ALC, unsatisfied with the DOC's findings, announced that it would expand its survey to all 2,031 people incarcerated at SCI Fayette and began sending out questionnaires by mail in February. The study asks inmates to describe symptoms and diagnoses for any gastrointestinal, pulmonary, or respiratory diseases or cancers. Dustin McDaniel at the ALC predicts that they'll receive about 500 or 600 responses total; they've already received more than 300 completed surveys. The health survey is coupled with one being conducted by La Belle residents, which will document the health diagnoses and symptoms of the 300 residents in the town.
"What we do know about the DOC's review is that it was a very narrow study designed to deny and dismiss the existence of a problem at SCI Fayette," McDaniel said in a press release. "Many people living next to this dump both in prison and in the community are sick. What we don't know is how many people and the extent to which they are suffering from the same problems. With this survey, prisoner advocates and community leaders are working together to find out."
After getting in touch with the ALC, Geraldine Waters, whose son was transferred after his scleroderma diagnosis, attended two meetings in Pittsburgh with family members of those incarcerated at SCI Fayette and two meetings at the firehouse in La Belle, where residents meet once a month. The community's goals are simple: to get the coal-ash dump closed down, to receive compensation for their health problems, and to get financial and logistical help relocating. For those advocating on behalf of the prisoners, the main goal is to close the facility. Family members of the incarcerated, calling themselves the Fayette Justice Project, have released a petition demanding Pennsylvania governor Tom Wolf perform a special audit of both the Department of Environmental Protection and the DOC to determine "if and how [the departments] have put the health of prisoners, prison staff, and community members at risk due to pollution from both the dump and the water supply. This audit should also determine if and how both departments have been negligent of or have attempted to hide from the public evidence of pollution and health problems."
A month after the ALC's initial report was filed, Shirley McIntyre,* a Philadelphia woman whose grandson is incarcerated at SCI Fayette, heard a rumor that two guards had plans to sue the prison over the environmental health hazards. The four guards with documented thyroid issues denied they were preparing a lawsuit, but one current guard told me that officials wouldn't come forward because they feared retribution from management and backlash from their union. (He asked to remain anonymous for the same reasons.) "I don't want to say it was a cover-up, but I think [the DOC's] investigation was insufficient," he told me. "They're doing a poor job of protecting the people who work there." He was highly critical of the medical staff as well. "Whatever you heard from the inmates is probably spot on," he said. When McIntyre heard about the sick guards, she worried the prison would do something to protect them but ignore the concerns of the inmates. She decided to join up with the Fayette Justice Project.
McIntyre has been riding low-cost buses for family members organized by the Pennsylvania Prison Society since her 32-year-old grandson was sent to SCI Fayette, in 2009. After she discovered the health issues, she started to board the bus equipped with flyers detailing the findings of the ALC report and facts about the coal-ash dump. McIntyre had already started to contact her representatives, and she also felt it was her duty to tell the family members who take the bus to SCI Fayette. "The water is cloudy," she told me. "If something is going on up there at the prison, I feel as though we, the loved ones, should know, because we enter that property too. We also use their facilities."
On a recent trip back to Philadelphia from La Belle, McIntyre passed out information about the report, which included a list of symptoms to look out for in those incarcerated at Fayette. "Aren't you afraid they're going to start messing with your grandson?" the other mothers asked her. "The reason I didn't put my name on it is because I didn't want my grandson harassed [by prison officials]," she told me. She made sure to pass out the flyers on the way back so prison officials wouldn't see them or hear anyone talking about them during their visit.
In March, I met the families at the pickup spot in Philadelphia for a 2 AM bus to the prison. The seven-hour ride was very quiet as the passengers mostly slept, but arriving at SCI Fayette in the morning was a momentous affair. People visiting different inmates caught up with one another; many had become close after riding the bus together. One thing was certain: There was nothing solemn or sad about visiting day. It was exciting—the time when people get to see their partners, siblings, parents, or friends for the first time in months. There was no shame here. In its place was an understanding among visitors of the complex layers of America's criminal justice system. There was an impatience to pass through security and get to the visiting room as quickly as possible—the more time spent with loved ones, the better.
McIntyre nudged me as we got off the bus. "Don't forget to check out the water," she said. When I got inside, I went to the water fountain to fill up my bottle. It was cloudy, and I could see small particles floating, so I decided not to drink it. McIntyre then introduced me to her grandson, a young man just under six feet with a light brown complexion and a striking resemblance to his grandmother. With his baby face, he could pass for 20. He is serving a life sentence, without the possibility of parole, on a murder conviction. McIntyre has been helping him appeal the case, which has already cost them $10,000. She said he was in prison for a murder he didn't do. "It was a homicide, and he wasn't even around, didn't know nothing about it," she told me. "I'm his grandma. I know what he does, and I'm not [one to] cover up for nobody."
I was at the prison to meet and interview Willingham after a few months of exchanging letters and phone calls. We sat down on one side of the huge visiting hall, away from the guards peering over their elevated desk at the front. Willingham's voice was raspy, and he spoke softly. In the middle of the interview, he began to cough, and we had to stop. He went over to the guard to get his inhaler, pausing for about 20 minutes as he held his chest. People are "scared to death," he told me. Prisoners have been "trying their best to get transfers either one way or the other—by being nice and requesting it or being nasty and doing stuff to get out of here.
"It's gotta shake you up to watch everyone deteriorate and die," he said, motioning to the younger inmates around him. "They always worry about me." But Willingham is worried too. Just a few months ago, John Perry, one of his friends at SCI Fayette, died, after being diagnosed in September with stage IV lung cancer. He shared many symptoms with Willingham. "They say he was going to have ten months to live, [and] he didn't last four months," Willingham told me in disbelief.
Rural towns where prisons are being built are often home to toxic sites damaging the environment and the population's health—sometimes, the prisons are built right on top of the toxic land.
Before he died, Perry was among a loose group of inmates organizing from the inside. Led by an inmate who got sick last year after losing motor function in his arms and legs, the inmates all sign up for the same activity at the same time so they can meet without arousing the suspicion of prison officials. They've been coordinating their efforts along the same lines as the Fayette Justice Project. All the while, Foskey has been agitating from his cell 75 miles away in SCI Laurel Highlands, just as his mother has been doing on the outside. "They should close [the prison] down," he told me. He's also advocating for prisoners to receive compensation for their health issues. "When you're placing them in an environment that you know is unjust, you put them in harm's way. That's cruel and unusual punishment."
Environmental justice and prisoner rights have long been seen as two separate issues in this country, but they are often deeply intertwined. Rural towns where prisons are being built are often home to toxic sites damaging the environment and the population's health—sometimes, the prisons are built right on top of the toxic land. In New York, three quarters of Rikers Island jail is built on a landfill composed of substances not disclosed to the public. In recent lawsuits, corrections officers have accused the landfill of causing cancer. San Joaquin Valley, in California, is home to both a third of the state's adult prisons and a number of corporate polluters, toxic-waste dumps, and incinerators. In 2011, Pennsylvania allowed the land of 24 state prisons to be leased for fracking and drilling infrastructure.
Little Blue Run, the largest coal-ash impoundment in the United States, is about 75 miles from La Belle, on Pennsylvania's border with Ohio. Residents in the area have dealt with dozens of leaks and spills that have contaminated drinking water and killed wildlife. For years, they have been protesting and advocating for its closure—an act that will finally happen thanks to an agreement reached in 2012 between the site's operator and the Department of Environmental Protection. The government has ordered the company to stop dumping at Little Blue Run by the end of 2016, but the power plant producing the nearly 3.4 million tons of ash annually deposited there will still be operational. The plan? Ship it on barges up the Ohio and Monongahela rivers to the Matt Canestrale Contracting site in La Belle and dump it on the steps of SCI Fayette.
* Name has been changed.
Editor's Note: Some identifying details about current inmates have been removed from this article.