The heartbroken family of a woman who died in custody of a suspected aneurism have raised concerns about the quality of medical care in WA prisons, following claims she was refused pain relief and her symptoms were not taken seriously.
WARNING: Aboriginal and Torres Strait Islander readers are advised that this article contains an image of a person who has died, used with the permission of their family.
Martu woman Dannielle Lowe died in hospital on December 24 after suffering a "medical event" three days earlier at Wandoo Rehabilitation Prison in Perth's southern suburbs, according to the Department of Justice.
Prison officers and medical staff at Wandoo "provided the woman first aid before an ambulance arrived", the department said in a statement.
It said Ms Lowe was put on life support in hospital, and died after her family — including her eight children — were able to spend time with her.
Her partner, with whom she has a three-year-old girl, said Ms Lowe repeatedly told him during phone calls in the lead up to her death she was having health issues.
Carrum Mourambine said Ms Lowe told him she was struggling to speak, coughing up blood, experiencing breathing issues and was in a lot of pain.
"She was always crying, ... just crying to me and saying Carrum, 'I can't speak'.
"I couldn't hear her over the phone.
"Then she got the migraines."
Mr Mourambine said his partner repeatedly claimed she was not being listened to by staff.
"She was told it was all in her head," Mr Mourambine said.
He last spoke to Ms Lowe on December 21.
"She rang me that Wednesday morning and told me that she had migraines," he said.
"I was so happy that I told her I loved her before I hung up. I didn't know that was going to be my last call."
Ms Lowe had been due for parole in March.
She had just graduated from a rehabilitation program at Wandoo, a comprehensive drug and alcohol course that prisoners must self-refer themselves to.
"She changed her life, she graduated from prison, ... I was so proud of her," Mr Mourambine said.
"She was so loving, caring, ... I was waiting for her to come home.
"It absolutely breaks my heart because now my little girl is three years old ... she's still waiting on her mum's phone calls.
"The difficulty to tell a little baby that, you know, mummy's an angel now, is heartbreaking."
Plea to treat sick inmates with empathy
Fellow Wandoo detainee Karlee Betts said in the months prior to her collapse Ms Lowe was suffering bleeding from her nose and mouth, and struggled at times to speak and breathe.
Ms Betts said while she never saw this happen, Ms Lowe told other inmates when she asked for headache tablets from staff at Wandoo they refused and told her the symptoms were "all in her head".
Ms Betts was so concerned about Ms Lowe's experience that following her death, she penned a letter to staff titled "Dannielle's life matters".
"We are someone's daughter, we are somebody's mother, we are somebody's sister, aunty, niece, cousin, friend, cell-mate," she said.
"We need you to treat us with respect and provide us with our basic rights.
"We ask that you listen to us (and) trust in us."
Ms Betts said a history of drug abuse should not stop staff from being alert to inmates' medical issues.
"If you’re going to work in a therapeutic community you have to be sympathetic to the people that are there,” Ms Betts said.
“Yes, we are drug addicts, but we’re recovering drug addicts.
“We don’t say we want Panadol because we’re drug addicts, we say it because we’re in pain.”
The ABC has put the claims regarding refusal of pain medication and suggestions Ms Lowe's health concerns were dismissed to the Justice Department.
However the Department said it could not comment on Ms Lowe's case.
"As this matter is now subject to a coronial investigation and inquest within the jurisdiction of the State Coroner it is not appropriate for the Department of Justice to comment on untested allegations," it said in a statement.
However, it said prisoners received primary health care "at a standard comparable to what is available in the community."
"The Department provides specialist medical care if clinically necessary and referred secondary and tertiary care if required," it said in a statement.
Calls for answers
Ms Lowe's cousin Craig Somerville, who is a former head of the Aboriginal Legal Service and former deputy chair of the WA Prisoners Review Board, questioned whether she should have been taken to hospital sooner in light of the claims which have since emerged.
He said Ms Lowe had complained to family members of "having long term what she described as flu symptoms, also migraines, headaches, and receiving no response and being very distressed".
"My cousin was in the middle of the metro area. Why not take her to hospital?" he asked.
"If you or I feel unwell, we go to a hospital."
Mr Somerville feared as people in prisons had no control over whether they were taken to hospital or not, there was a risk their care could be delayed.
Mr Somerville said Ms Lowe's family had been told she had probably suffered a brain aneurysm.
He remembered his cousin as a caring and loving mother and grandmother.
"Dannielle was beautiful, loving [and] she loved her family," he said.
"She had eight children. She desperately loved them all."
He said it was a tragedy that she had become involved with drugs, but she had been getting her life back on track through Wandoo's rehabilitation program.
WA bucks trend on prison healthcare
In WA, prison healthcare is provided by the Department of Justice, not the Health Department.
In 2006 and 2008, reviews were conducted into the provision of health care in WA prisons, following a World Health Organisation recommendation that prison health care be provided by independent health organisations, and a decision was made to transfer responsibility for inmates' health to the Health Department, for an estimated annual cost of $20 million.
However, the transfer of responsibilities never eventuated, and the Department of Justice continues to administer health care in WA prisons.
Mr Somerville said he had been advocating for improvements to the prison health system for years.
"We have been pushing to connect prisoners who often are on short term stays to be connected with their Aboriginal health service on the outside, before during and after custody," he said.
"But they just don't seem to be interested and treat health issues as security or management issues rather than treating people's needs."
Mr Somerville also criticised WA's track record on deaths in custody of Indigenous prisoners, including 22-year-old Yamatji woman Ms Dhu in a South Hedland lock-up in 2014.
Ms Dhu ultimately died of sepsis complications from a broken rib, despite being twice taken to hospital in the days before her death, where staff dismissed her health concerns after being told by police officers she was "faking it" and had "behavioural issues".
A subsequent coronial report was scathing of the attitude of officers at the lock-up, where she had been detained for non-payment of fines, describing her treatment as "inhumane".
Mr Somerville said Ms Dhu's case revealed Western Australia's sad history of not taking detainees health complaints seriously.
"She [Ms Dhu] is very sick, three trips to the hospital, and officers are giving misinformation I think to to the staff," he said.
"Straight across the road [from the lock-up] is one of our largest and most sophisticated Aboriginal health services ... and they never took her there."
Mandela rules apply to prison health care
Curtin University Professor of Health Equity Stuart Kinner said people in prison should be afforded the same healthcare as they would receive in the community under the UN's Mandela rules on the rights of prisoners.
The rules are named in honour of South African president Nelson Mandela, who was imprisoned for years during his fight to dismantle his country's racist apartheid state.
"Most people in prisons in Australia spend a relatively short period of time there before they go back to the community," professor Kinner said.
"We know that a lot of people have terrible health outcomes after they leave prison.
"Having people already engaged with relevant community health care providers, improves continuity of care, improves health outcomes, and thereby reduces crime."
He said the government could provide continuity of care and avoid "role conflict" by using community health providers instead of the Department of Justice.
"I think most people working in prison health, no matter who employs them, are doing their best to do a good job ... I'm not questioning the integrity of healthcare providers," professor Kinner said.
"But it is an inherent role conflict, to provide health care on behalf of the system that's charged with punishing people."
