In Custody, in Pain

Harvill did not know that would be the last time Fleming would treat her. The next day, Harvill was moved down the road to the county jail. The government never explained the move, although she and her lawyers have asked repeatedly.

Last week, ICE officials told The Post: "Florence is not well equipped to provide long term medical care for female detainees. Female detainees are transferred from Florence to Pinal because of its better capability to provide long-term medical care to women. Ms. Harvill received appropriate medical care at Pinal with physician oversight."

Harvill lives in Cell 323 in Pod E300, part of a wing built for an eventual 600 detainees whom the federal government pays the county to house.

Her isolation at the county jail is almost complete. Her lawyers cannot call. Family members, if they came to visit, would not be allowed to see her in person, not even though plexiglass. The jail allows only "video visits," with visitor and detainee in separate parts of the building. Harvill, while longing for her family, has told them it is not worth the trip. She hasn't seen her husband in a year.

Most of her moments outside come when immigration officers take her in a white van on a three-minute ride to a little courtroom at the Florence federal compound for video hearings with her Miami immigration judge, and when they take her to the public hospital, an hour and 20 minutes away, where, as likely as not, little will get done.

Harvill gets shuttled back and forth to the hospital in Phoenix because the jail does not have a doctor on its staff. There is no hospital within 30 miles of Florence, despite its thousands of prisoners. The Central Arizona Medical Center, on the city's outskirts, has been closed since 1999, and the small hospital building is empty. On a white sign out front, the blue lettering that says "clinic" has almost faded away.

One morning last summer, Harvill was taken up the road to the Florence compound for a repeat session to take photographs and fingerprints that immigration officers told her had gotten lost. Before she went inside, she later put in her journal, she noticed Fleming, the doctor who had treated her when she first arrived, going by "in a little golf cart."

I was glad to see her I had so much to ask her. Nurse here says that she is still my doctor and that all that happens to me goes to her. . . . I asked to talk to her for a minute. She told me that she was very busy, that she would try to talk to me later. I knew she wouldn't talk to me because she has not seen me for the last 2 months I was so sad. . . . Actually I felt as though she was angry with me. I stood there with tears in my eyes, but I had to go with the officer to get my fingerprints done.

The fleeting encounter with Fleming disturbed Harvill. The closest thing to a doctor she has seen at the jail during her 11 months there -- apart from a psychiatrist who has prescribed lithium and other drugs, but has not really diagnosed her -- was a physician assistant.

Fleming resigned days later.

According to internal government documents, one-third of the 29 medical positions at the Pinal County Jail were vacant as of February. The jail, the Florence compound and the large compound in nearby Eloy each had no full-time doctor.

In such an environment, complaints sometimes surface about the shortages and their effects. Last summer, two Eloy nurses sent a memo to headquarters in Washington, laying out the working conditions that were leading them to resign.