by Krystal Paco

Guam - The state of healthcare available to prisoners is up for debate. Parties describe a completely different environment behind prison walls.

Only 31% of the prison population had access to healthcare back in 2013. According to DepCor medical director Dr. Raja Saad, this figure is on the decline.

As he testified today at the District Court of Guam, he says "things are getting worse" adding "I'm the one really fighting the challenges."

As we reported last week, Dr. Saad admitted he was apprehensive to speak up about his concerns relative to access to healthcare at DepCor in fear of being "marked" by his superiors.

On the stand again today, he detailed that for six to nine months last year he went without getting paid and when he advised his employers he would suspend his services, he was threatened by Assistant Attorney General Donna Lawrence who he reports stated "I'll go to the medical board and revoke your license."

Dr. Saad was so intimidated by the event, he hired Attorney Pat Civille to represent him the next day.

In addition, Dr. Saad described other times Lawrence or DepCor director Jose San Agustin ordered he not disclose information to court monitor Attorney Bradley Klemm and not attend conference calls with the Department of Justice.

Although Lawrence denied ever making such a threat and blames miscommunication, the parties disagreed all day on what's really happening when it comes to access to care at DepCor.

As San Agustin took to the stand, he says he remains instrumental in bringing DepCor into compliance with the stipulated agreement from 1991, stating he hired Dr. Saad and two nurses and just days ago, hired two more nurses to round out the medical team saying "I'm for supporting Dr. Saad."

But it's not enough to hire, as Dr. Saad reported this afternoon, there's other limitations keeping DepCor from meeting minimum healthcare standards, including willingness to do so, planning, and budget. He added that despite the frustrating and intimidating work environment setting, he continues to remain passionate for caring for the DepCor population saying, "These people lost their freedom...my job is to take care of thee people and keep their health at minimum."

While status hearings continued today at the District Court of Guam, a memorandum from former DepCor clinical administrator Dr. Andrea Leitheiser addressed to DepCor director Jose San Agustin has also surfaced.

The memo, dated August 2013, requests that the director assist with intervention for warden Frank Crisostomo to include that the warden be counseled or ordered to anger management treatment because of unaccepting and alarming behavior.

Dr. Leitheiser describes an incident in which Crisostomo yelled at her accusing her of disrespecting the “power of the warden.”

When she countered his verbal attacks, he continued to yell. As a result, Dr. Leitheiser removed herself from the room. In a telephone conversation later that day, Dr. Leitheiser says Crisostomo continued to threaten her stating “I don’t care who you talk to or what you do… I have a mission to do and I am the warden.”

Other nurses have also expressed frustration with the warden for occasions where he would call on medical staff because he “wanted Vicks for himself…and for that I had to completely stop sick call.”