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Emerging from the Nightmare

Hongkham Souvannarath. File photo.

After spending time in a Fresno jail, an API mother is awarded $1.2 million

By Neela Banerjee

On April 22, 52-year-old Hongkham Souvannarath followed a golden robed Buddhist monk through the rooms of the Fresno County jail where she was held illegally for over 10 months for failing to take her Tuberculosis medication.

The “soul-calling” ceremony was one part of a three-part settlement that Souvannarath won in a civil rights case against the county because her constitutional rights were violated when she was illegally incarcerated — without trial or access to lawyers. Along with the ceremony, Souvannarath also received an official written apology from the county’s Board of Supervisors and $1.2 million in damages.

“The ceremony in the jail was one of the most beautiful experiences I have ever had,” Souvannarath’s attorney Catherine Campbell said. “Especially because for Hongkham, it was so richly meaningful. It signified to me how far the county had come in righting the wrongs they had done.”

The Souvannarath family nightmare began in late 1997 when Souvannarath first fell ill. Souvannarath and her six children had fled Laos in 1984, by rowing across the Mekong River to Thailand in the middle of the night. After spending two years in refugee camps, the family found a United States sponsor and moved to Ohio. They later moved to Kentucky and eventually relocated to Fresno, for warmer weather and the booming Southeast Asian population.

In 1997, Souvannarath began falling ill. She found herself short of breath at times, and suffered from general discomfort. After several trips to doctors, who could not diagnose her, TB was finally found in one of her lungs.

Mycobacterium Tuberculosis, an air-borne bacterial disease, infects 10 to 15 million people in the United States. Though not as contagious as the flu, TB can easily spread between people in close quarters. Treatment can last anywhere from six months to two years, depending on the strain of TB involved. If patients fail to complete their medication regimens, the bacteria can become resistant and harder to treat.

Public health workers are instructed to confine non-compliant TB patients civilly in treatment facilities under court order, as long as they resist treatment. The detainee is entitled to counsel and an opportunity to appear in court.

For Souvannarath, what followed her initial diagnosis was a series of mistakes in treatment and more glaringly, in interpretation, which led to her incarceration.

In March 1998, Souvannarath was put on medication for Multiple-Drug Resistant TB, from which she suffered intense side effects such as rashes, sweats and dizziness. After many months on the medication, Souvannarath stopped the drugs and planned a move to Ohio to live with her son. When Souvannarath failed to make the move, the county suspected she was hiding from them, and county officials came after her. Errors in communication made the situation worse.

According to her 21-year-old daughter Sonexay, the translator who accompanied the health worker said the medications would kill and that Hongkham should not take them. Campbell pointed out throughout her case summary that the county did not have adequate translation services, often taking Hmong translators to speak to the Souvannarath family who only speaks Lao. The wrong translation confused and enraged Souvannarath. She stopped showing up for her clinic appointments. And at one time, she threatened the county health worker with a screwdriver .

On July 30, 1998, the county worker and two police officers went to Souvannarath’s house and took her to jail, after intimidating her with their weapons. At first, because of another translation error, Souvannarath was placed in a suicide cell in the basement of the jail, which she described as “dark and filthy with human waste.”

For the next six months, she was kept in the jail infirmary, and then she was placed on the sixth floor among the general prison population.

The doctor responsible for diagnosing Souvannarath and placing her in jail was Dr. Michael Reynolds. Through her investigation, Campbell discovered that Reynolds had no pulmonary training, could not read x-rays, had a history of alcoholism and cocaine addiction, and had been sued numerous times for malpractice.

Campbell also pointed out that Reynolds’ diagnosis of Souvannarath and prescription of highly toxic I.V. drugs could have been a misdiagnosis, and that he did not even try out less toxic drug alternatives.

After the months Souvannarath spent behind bars, the county found out she was there without official proceedings and tried to take her to court for further detention. This is when Campbell stepped in and took the case, freeing Souvannarath from jail in a civil action case against the county.

Campbell went on to win another case asking the superior court of Fresno County to order that the county no longer incarcerate civilly detained TB patients in jail.

“Patients are much more protected now than they were before,” Campbell said.

The federal case that won Souvannarath and her family $1.2 million also called for changes in the translation system at the county level, including the required use of native language translators and training in cultural sensitivity. Action on these issues has been postponed because they are to be worked out in a larger context that will affect public services across the whole county, not just health services. Fresno County officials said the changes will happen over the next year.

“I am waiting to see exactly what they are going to do on a cultural level,” Campbell said. “The start is not real promising because they have hired a doctor who does not have any background in TB to run the TB clinic again.”

Campbell said that people do not understand how complicated a balancing act that public health issues really are, “between the rights of the patient and the need for the public to be protected from diseases.”

Since the settlement, Reynolds and the other county health workers responsible for Souvannarath’s incarceration have all been fired from the clinic.

Meanwhile, Souvannarath and her daughters moved into a new home and are taking a trip to Thailand to see family. The “soul-calling” ceremony was an emotional time for all, but also a strong closure to the incidents of the past few years.