By Carla Crowder and Carl Green

Carl Green learned how to provide emergency medical care to his fellow prisoners after they were beaten, stabbed, and cut inside Donaldson prison. Sentenced to life imprisonment without parole for a series of fast food restaurant robberies, Carl served 36 years in prison. No one counted exactly how many lives he saved.

Carl never expected to be released from prison. Appleseed took on his case several years ago after learning about him from Ronald McKeithen, our Director of Second Chances, who has known Carl since they were teenagers in Birmingham. Both of them came from difficult, impoverished backgrounds and they met in the City Jail. Carl was from New York, where he dropped out of school and went to work to help support his family at age 13, first as a delivery boy for a deli, then as a restaurant bus boy. There were five children in his family and no father figure, so he was committed to helping his mother. 

Eventually the family made its way to Alabama. Carl fell into struggles with drugs and alcohol as a young man. By age 30, his felony convictions – none of which involved physical harm of another person – resulted in a mandatory sentence of life without parole. He spent all of it in Donaldson Correctional Facilities, one of the most violent prisons in Alabama. 

Beginning in 1993, he began providing medical care to injured incarcerated people, learning from another incarcerated man. Carl estimates that he stitched up between 20 and 25 people with varying degrees of injuries over the years. “Most of the jobs I did was butterfly stitches,” he explained. 

Carl walked out of Donaldson prison for the last time in December, thanks to a decision by Jefferson County District Attorney Danny Carr not to oppose resentencing. Presiding Circuit Judge Michael Streety entered an order resentencing Carl Green to time served and finding: “This Court is confident that had petitioner been sentenced according to today’s sentencing standards the imposed sentence could have been dramatically shorter in time.” 

Since his release, Carl is frequently in our office, working with Appleseed’s reentry team to develop plans for moving forward with his life at age 65. “I see myself as an old man now and opportunities aren’t as available as when I was young,” he said recently. “I regret the crimes I committed. I wish I could tell my victims how I feel.” 

We prod him into sharing stories of his medical work in prison, in part because these make-shift heroics seem nearly unbelievable in a cell block setting: bleach for disinfectant, paper clips for needles, guards who knew what he was up to and thanked him. Yet, they became commonplace. So we asked him to write about his efforts so others could know both how horrific the violence is inside our prisons and how generous and determined to help some of the people our state has thrown away have proven to be.  Here are a few of his stories in his own words:

Around 1996, the violence had begun to pick up. A drug deal had gone bad within the gang, a package was not delivered on time. So the middle man was beaten and stabbed several times. I was asked to fix him. He was my first patient. He had a busted eye, a busted lip, two stab wounds to the shoulder. Being that he was the first inmate I ever worked on, I only used alcohol pads and just patched up the holes in his shoulder. And gave him some ice for the swelling on his mouth and eye. The big part was negotiating to keep him from being killed. 

As the years passed, the gangs became more violent and injuries were more severe. I once had to work on an inmate who had beat another inmate out of $25.  He had underestimated the situation and found himself in a world of trouble. This inmate was being held in a cell by two inmates that were killers. He had been sliced in on the neck with a box blade, (similar to a utility knife) all of this for a little of nothing, I thought to myself.

When I entered the cell to examine him I found this man holding a towel to his neck scared to death, eyes full of tears with a towel wrapped around his neck soaked in blood. There was an inmate at the door and another standing behind him. I got a spray bottle of bleach and sprayed the wound which sent him through the roof, oh the pain. When he calmed down I looked at the laceration. Two inches, long, third-degree injury. Barely missed his jugular vein. It was horrible.

I told the inmate with the box blade I can’t fix it. He almost lost his mind. He said if I can’t fix it, he’s a dead man. So I said “Wait, wait let me take another look.” The guy was begging for his life. I said I can fix it. Salt to stop the bleeding, bleach for infection, surgical tape strips for the suture.

A few hours of work, and a madman wanted to bring me another victim while [I was] working [on] the first victim. I said if you do I’m out and you got lockup. He came to his senses. And I finished my job. The two never had another problem. I saw my work a few weeks later, and it seemed I never stopped stitching inmates.

The next inmate got robbed while selling alcohol. He was beaten, stabbed, cut, and skin popped. I had to get another prison doctor to help me. Further he was more experienced and had all the medical supplies I needed. A good friend of mine. We had to check and make sure his lungs weren’t punctured and make sure he was not bleeding internally.

Puncture wound to his back, chest, laceration to face, chest and back, pumpkin head, face swollen, eyes, lips. I cut surgical strips, you suture, I pinch suture, I patch, go. No bubbles in holes and he’s bleeding out. Good, we’ve got 20 minutes before count time. Need a clean up man.

We fixed this guy in 20 minutes. We used Pine Sol, bleach, salt, real needles, and surgical tape strips, pressured his chest by hand, discovered no air in or bubbles in his blood, in the chest or back, and all the puncture wounds were bleeding out which meant we could work on him and didn’t have to send him to the infirmary. That’s prison doctor talk.

The worst, worst wound: an ice pick or a knife pointy as an ice pick. Or a Bone Crusher, or a short dog.

A friend of mine got hit with a short dog in the neck. He had beat a guy out of some drugs earlier in the month. Well, the inmate he beat out of the drugs happened to be a friend of mine as well. I talked to the both of them prior to the stabbing. It was quashed, until the one who stole the drugs started feeling untouchable. Face fights, reckless eyeballing, and a sneaky grin, set the battle in motion. Three on one; the drugs weren’t worth the violent torture. Three maniacs exacting revenge for their stolen drugs. It took every bit of energy to peel them off of him, and just for good measure a couple of shots to the back and shoulder blade on the way out, with the short dog. Three-inch blade, three-inch handle. Usually made from short steel scissors.

The shot in the shoulder blade caused a blood clot, which caused blood to flow to his neck. There was a knot on his neck the size of a baseball. I told him he wouldn’t make it to the infirmary if he didn’t let me get the clot out of his neck. At first he refused, when asked to look at his neck in the mirror and he saw his neck he took a seat and let me work on him. He held his breath while I pressured his chest, after several attempts the blood flowed out the hole in his shoulder blade. A blood clot popped out as big as a quarter. He was soaked in blood and so was the cell.

I negotiated his safe return to his cell and that he be left alone. And to stop the bleeding I used salt which made him hit the ceiling. I fed him for two days. Also, the fact that he had fainted from the strain and the loss of so much blood. He moved to another unit before being fully healed.

These are some of the things that can be made into weapons in prison:

1. Metal boxes- knives, hatchets, axes
2. Kitchen oven grills- ice picks 
3. Plexiglass windows- knives, can’t be detected by metal detectors
4. Bed rails- Make knives that are considered bone crushers
5. Toenail clippers- make box blade, similar to a utility knife, after being filed down
6. Locks- put on the end of belt buckles or in socks, used as slings
7. Batteries- multiple batteries and a sock used as a sling 
8. Steel short scissors- broke apart used as a short dog, [for] close-in fights.

These are some of the things that can be made into materials for medical work:

1. Paper clips large or small, used as suture needles
2. Good for curving: metal wire from brooms or mops. Metal from the arms of eyeglasses, guitar string. 

And all of the above you only have to flatten one end and make a hole in it. Now you have a sewing needle. I cannot forget to mention smuggled needles from the laundry.

These are some of the things that can be used as infection preventions: 

1.  Salt- stops bleeding and starts healing process, burns the wound, painful as hell
2. Pine Sol
3. Bleach
4. Sea breeze

Mix any of these, healed overnight.

This is not nearly close to the medical help given. The most important part is being able to negotiate to bring about a peaceful solution to a violent situation. That’s the real reward. In all the years of my work I’ve never charged one inmate. But have accepted a gift or two for my diligence. 

By Carla Crowder, Executive Director

Dear friends and supporters, Five years ago, Appleseed waded into the despair within Alabama’s prison system with a determination to confront unnecessary incarceration one life at a time. Today, we celebrate freedom for 30 people once condemned to life sentences. Not 30 cases. Not 30 wins. These are 30 people, fellow Alabamians who now walk alongside us in our fight for justice.

Many grace the cover of our 2025 Annual Report. People like Larry Garrett, who served 36 years in prison for burglaries, then took up truck driving two years ago. He now drives tractor-trailers across the United States at age 72. People like John Meadows, 54, who devoted his incarceration to education and now works as a plumber. And people like our team member Ronald McKeithen, who spent 37 years behind bars and now inspires others by sharing his story across the country. This year, Ron was appointed to the Statewide Reentry Commission and he got married!

Alabama’s broken and brutal prison system was exposed in new ways across the United States this year with the release of the HBO documentary, “The Alabama Solution.” The suffering displayed in this challenging but important film reminds us why Appleseed remains focused on pragmatic, bipartisan solutions to the state’s overreliance on prisons and punishment.

The only way to solve this crisis is to care about our fellow human beings who are incarcerated, to believe in redemption, and to support formerly incarcerated Alabamians as they navigate the worries and the wonders of life on the outside after decades in the darkness of an Alabama prison. We could not be more grateful for the judges, district attorneys, family members, and reentry partners who have made our legal work possible for the last five years. We are indebted to dozens of funders who have invested in this monumental effort. But there is so much more to do. That’s why Appleseed has taken on a new project, supporting criminalized survivors, women whose convictions were driven by domestic violence. We’re also stepping up our parole advocacy, representing people with life sentences as they become eligible for parole. This year we took eight parole cases and won release for each person we represented.

And we helped two clients earn pardons. While 30 is a nice, round number worth celebrating, there’s another number that tells us so much more about how needless these extreme prison sentences are: zero. That’s how many Appleseed clients have returned to prison. Thank you all for playing a role in their success.

Here’s to more freedom in 2026!

Read the full Annual Report here.

By Eddie Burkhalter, Appleseed Researcher

More people died in Alabama prisons per capita than in any state in the nation in 2024, and at a rate that was nearly double those of the next highest state. In 2023 Alabama’s prison death total was even higher. 

Alabama prison’s mortality rate in 2024 was 101.81 per 100,000 incarcerated people, when 277 people died inside our prisons. The next highest state was Georgia, where the prison death toll reached 65.29 deaths per 100,000, according to UCLA School of Law’s Behind the Bars Data Project, which collects such data nationwide. 

Alabama’s prison deaths reached a record high in 2023, when 327 people died, which came to 122.7 deaths per 100,000. That was far higher than even the second highest state, Vermont, which saw 75.08 deaths per 100,000 that year. 

Alabama Appleseed’s own project to track and publish state prison deaths began in 2024 and the initial batch of data we have collected has been included in UCLA Law’s data. (Individual-level data on Alabama prison deaths in 2024 can be found by visiting UCLA Law’s Github site and navigating to the raw data for Alabama. The project will soon add Appleseed’s 2022 data to the site.)

Prior to UCLA Law’s project, journalists, researchers and the public were left with incomplete data, sporadically released by the federal government under the federal Deaths in Custody Reporting Act. Federal policy changes since 2019 have made that data less accurate, so Appleseed’s own research is helping shed light into the details of how so many people are dying inside Alabama prisons, which we hope will help lead to the systemic changes needed to save lives.

Database of Alabama prison deaths

Filmmakers with the documentary “The Alabama Solution”, which highlights the plights of incarcerated men in Alabama fighting against their unconstitutional mistreatment, also built a database of Alabama prison deaths, which include deaths that occurred during the years 2019-2024. The film is garnering worldwide attention and is helping spread awareness about Alabama’s broken prison system.  

Those filmmakers also note issues in gathering detailed data on Alabama prison deaths, which include a large reduction in the number of autopsies for those who die inside Alabama prisons since May 2024. The Alabama Department of Corrections since then only seeks autopsies for “deaths resulting from unlawful, suspicious or unnatural causes” which leaves suspected overdose deaths and those who died from suspected natural causes and other unknown causes, without receiving full autopsies. Appleseed first reported this change in autopsy procedures in May 2024. 

It’s critically important to the families of those who died in custody, and to the public, to understand why these deaths are occurring, and when they were preventable.

Aaron Littman, assistant professor of law at UCLA School of Law, deputy director of the UCLA Law Behind Bars Data Project and faculty director of the law school’s Prisoners’ Rights Clinic explained it this way: “There is a national crisis of failure to report and understand deaths in custody, and the importance of that really can’t be overstated,” Mr. Littman said. “These deaths are happening out of public view, and in institutions that have total control over people’s access to information, access to medical care, institutions that are often plagued by violence, and often access to illegal substances.”

Lack of transparency by ADOC

An additional barrier to the data remains a lack of transparency from ADOC around prison death reporting.  A 2021 state law requires the department to publish a quarterly  report containing statistical data on the number, manner, and cause of inmate deaths occurring in prisons “including the results of any autopsy provided to the department by a third party.” ADOC began including a section labeled “Final autopsy results” in those reports. However, without stating a reason, the department removed that section from the reports beginning with the last quarterly report in 2022, despite the reports still containing the phrase that “the final autopsy results reflect the opinion of the medical examiner conducting the autopsy of the final cause of death.” 

The lack of transparency surrounding these deaths is all the more alarming given ADOC and the state’s legal battle over the unconstitutional treatment of incarcerated men. The U.S. Department of Justice’s Civil Rights Division in 2019 released its first report detailing the out-of-control prisons for men in Alabama, The federal government in December 2020 sued the state and ADOC alleging widespread use of force, corruption, rampant drugs and contraband, and the inability of ADOC to keep men safe from sexual and physical violence and death.  

During President Donald Trump’s second term there has been a mass exodus of staffers from the DOJ’s Civil Rights Division, which is investigating and prosecuting Alabama’s case, leaving concern that the DOJ’s case could be jeopardized. All parties in the lawsuit are currently in mediation, according to court records. An October 3, 2025, filing from the judge in the case states that “Despite the Government shutdown, the parties are ORDERED to continue their ongoing mediation efforts, including attending the mediation scheduled next week before Judge Ott. Signed by Judge R David Proctor on 10/03/2025.” 

UCLA Law’s prison death data is a valuable resource but the data has limitations, however. Not all states report prison deaths publicly or to the federal government, and there were discrepancies between some state’s own records and what the states sent to the federal government. That’s a problem Appleseed’s own research into these deaths discovered, so we compared data from several state and federal agencies, as well as news accounts and deaths collected by advocates, to get a fuller picture of who is dying and why. 

An “awfully low” number of people in drug treatment

Appleseed thus far has finalized its death records for the years 2023 and 2022, and is working to collect data that will eventually cover the decade between 2014 and 2024. The picture already emerging is one of uncontrolled overdose deaths, unchecked violence and large numbers of deaths caused by illnesses in younger people, pointing to the possibility of substandard medical care. 

Drugs are prevalent inside Alabama’s prisons, and are the major driving factor in violence and death throughout the state’s 14 major prisons. Alabama prison’s overdose mortality rate in 2023 was 20 times higher than the national average across all state prisons in 2019, the last year for which the federal government has made that data available. Illicit drugs are most often brought in and sold by Alabama Department of Corrections (ADOC)  staff themselves, as publicized arrests and interviews with incarcerated people show, and while ADOC has made increasing efforts in recent months to catch and charge these employees, drugs and the overdose deaths persist. 

Despite the prevalence of drugs inside Alabama’s prisons, very few incarcerated people are receiving medically-assisted drug treatment while incarcerated. Members of Alabama Legislature’s Oversight Commission on Alabama Opioid Settlement Funds met in October and applauded the state’s more than 30 percent drop in drug overdoses. 

During that October meeting lawmakers on the commission heard from ADOC’s Deborah Crook, Deputy Commissioner of Health Services, who spoke on the department’s use of opioid settlement funds to launch the department’s Medication-Assisted Treatment (MAT) program in 2024, to provide evidence-based addiction treatment inside the state’s prisons. 

“Financially, we haven’t used all of the money allocated,” Crook told the commission. ADOC has served 500 incarcerated people in the MAT program and at the time had 256 people in treatment. 

Crook was asked by a Commission member Sen. Larry Stutts. R-Tuscumbia, what percentage of Alabama’s incarcerated population has a substance abuse disorder, and while she didn’t have Alabama-specific data, she said that nationally the figure is approximately 60 percent of incarcerated people in state prisons.

Sen. Stutts noted the low percentage of incarcerated people receiving treatment, saying that if even half of the state’s then-just more than 21,000 incarcerated people were battling addiction “and only 250 are in a treatment program…that just seems like an awfully low number.” 

ADOC Commissioner John Hamm told the commission member that MAT treatment is “voluntary” and that the department is working to drive more into treatment. Crook said that while the number of participants in MAT was low, thousands more were in other non-medication assisted treatment programs. While this may be true, the waiting list for those other drug treatment programs can be months long, and the programs themselves are lacking, according to Appleseed’s discussions with incarcerated people and their families. 

The prevalence of drugs inside Alabama’s prisons is also driving large numbers of assaults and homicides. 

In 2023 there were 14 homicides in Alabama prisons, which translates to 67 per 100,000 incarcerated people. The UCLA data doesn’t show causes of death for the second highest death rate state that year, but does for Tennessee, the third highest, a state that saw 6 homicides in 2023, translating to 24 per 100,000. 

ADOC hasn’t yet completed death investigations for all who died in 2024, but so far the data shows there were at least 12 homicides that year, double that of homicides in Tennessee prisons last year. 

Families left behind to grieve

These failures are not confined behind prison walls. They impact the families left behind, like the Roneys from Birmingham. Deandre Roney’s family begged ADOC to keep him safe. Just five months before his scheduled release date of Nov. 6, 2024, Mr. Roney was stabbed in his back and in his head at Donaldson Prison by a makeshift knife and died June 9 at UAB Hospital. Chante Roney, Deandre’s sister, told Appleseed last year that the day before he was attacked he asked officers to move him to another dorm because a man had been chasing him with a knife. 

“He was reaching out, uneasy. He didn’t feel safe. He felt like something was going to happen before he made it home by November, and they failed him. They really failed him,” Ms. Roney said. 

Mr. Roney was one of four men killed in Alabama prisons during the month of June last year. 

“We were saving money up for him to come home, to buy him clothes, because he’s been gone all these years,” Ms. Roney said. “He was coming home the first week of November, His birthday was at the end of November, and he didn’t even make it.” Instead of using that money to help her brother make a  life outside of prison, the family used it to bury him.