Russell v. Johnson ( 2004 )


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  •                                                      United States Court of Appeals
    Fifth Circuit
    REVISED JULY 9, 2004
    F I L E D
    IN THE UNITED STATES COURT OF APPEALS          June 28, 2004
    FOR THE FIFTH CIRCUIT            Charles R. Fulbruge III
    ______________________                    Clerk
    No. 03-60529
    ______________________
    NAZARETH GATES, etc., ET AL
    Plaintiffs
    versus
    THOMAS D. COOK, etc., ET AL
    Defendants
    ________________________________________________________
    WILLIE RUSSELL, Etc., ET AL
    Plaintiffs
    WILLIE RUSSELL, on his own behalf and on behalf of those
    similarly situated; SHERWOOD BROWN, on his own behalf and on
    behalf of those similarly situated; KEVIN JORDAN, on his own
    behalf and on behalf of those similarly situated; JOHN NIXON, on
    his own behalf and on behalf of those similarly situated; PAUL
    WOODWARD, on his own behalf and on behalf of those similarly
    situated
    Plaintiffs-Appellees
    versus
    ROBERT L. JOHNSON, COMMISSIONER, MISSISSIPPI DEPARTMENT OF
    CORRECTIONS, in his official capacity; CHRISTOPHER EPPS, Deputy
    Commissioner, Mississippi Department of Corrections, in his
    official capacity; EMMITT L. SPARKMAN, Superintendent,
    Mississippi State Penitentiary, in his official capacity; JESSIE
    STREETER, Warden, Area IV, Mississippi State Penitentiary, in his
    official capacity; LARRY D. HARRIS, Captain, Unit Administrator,
    Unit 32, Mississippi State Penitentiary, in his official capacity
    Defendants-Appellants
    __________________________________________________
    Appeal from the United States District Court for
    the Northern District of Mississippi, Eastern Division
    ___________________________________________________
    1
    Before DEMOSS, DENNIS, and PRADO, Circuit Judges.
    DENNIS, Circuit Judge:
    Willie      Russell    (“Russell”)     brought   suit    in    the   Northern
    District     of    Mississippi     against   officials    of   the    Mississippi
    Department of Corrections (“MDOC”) on behalf of himself and other
    prisoners confined to Death Row, or Unit 32-C, in the Mississippi
    State Penitentiary in Parchman, Mississippi.              Russell alleges that
    certain conditions of confinement on Death Row violate the Eighth
    Amendment’s prohibition against cruel and unusual punishment.                    By
    consent of the parties, the case was tried to the magistrate judge,
    who   found       several    Eighth   Amendment     violations       and    entered
    injunctions       designed    to    alleviate     those   conditions.          MDOC
    appealed.1     We affirm in part and vacate in part.2
    1
    Russell filed a motion to dismiss the appeal, arguing
    that this court was without jurisdiction because the order from
    which MDOC appeals was inherently tentative. We disagree. In
    addition to having jurisdiction to review final decisions of
    district courts, 28 U.S.C. § 1291, this court has jurisdiction to
    review interlocutory decisions “granting, continuing, modifying,
    refusing or dissolving injunctions.” 28 U.S.C. § 1292(a)(1).
    The order from which MDOC appeals is the “Final Judgment” issued
    on May 21, 2003. That order imposes ten detailed injunctive
    requirements on MDOC. As Russell points out, the order also
    requires MDOC to report its “progress in meeting the remedial
    actions” on July 7. The requirement of a progress report does
    not change the fact that the May 21st order grants injunctions
    against Mississippi requiring immediate action. In fact, this
    court granted MDOC a stay of this injunctive order to relieve
    MDOC from the burden of compliance pending appeal. In short, the
    May 21st order qualifies as an order granting an injunction;
    thus, this court has jurisdiction pursuant to 28 U.S.C. §
    1292(a)(1), and Russell’s motion to dismiss for lack of
    2
    BACKGROUND
    Russell argues that the prisoners housed on Death Row are
    knowingly and deliberately subjected to profound isolation, lack of
    exercise,     stench   and    filth,       malfunctioning     plumbing,    high
    temperatures, uncontrolled mosquito and insect infestations, a lack
    of sufficient mental health care, and exposure to psychotic inmates
    in adjoining cells.       On May 21, 2003, the trial court issued a
    “Memorandum    Opinion”      containing      its   findings    of   fact   and
    conclusions of law in which the court found that a number of the
    conditions alleged by Russell violated the Eighth Amendment’s
    prohibition against cruel and unusual punishment.              That same day,
    the court also issued a “Final Judgment” in which it mandated that
    MDOC comply with injunctive relief designed to alleviate those
    conditions.    MDOC timely appealed.         The trial court denied MDOC’s
    motion for a stay pending appeal.            MDOC then filed a motion for
    stay pending appeal with this court; we granted MDOC’s motion.
    ANALYSIS
    Should this case be dismissed because it was not brought in
    accordance with the Gates v. Collier class action framework?
    jurisdiction is denied.
    2
    As mentioned in Footnote 1, this court previously granted
    MDOC’s motion for a stay of the injunctive relief pending appeal.
    On March 31, 2004, Russell filed a motion to lift that stay. Due
    to the filing of this opinion, the stay pending appeal is vacated
    and Russell’s motion to lift the stay is denied as moot.
    3
    MDOC first argues that this case should have been brought
    under   the    framework   for   enforcing         injunctive   relief   on    the
    Mississippi prison system provided by Gates v. Collier, 
    501 F.2d 1291
    (5th Cir 1974).       MDOC bases this argument on this court’s
    decision in Gillespie v. Crawford, 
    858 F.2d 1101
    (5th Cir 1998).
    The plaintiff in Gillespie attempted to bring suit in federal
    district court challenging prison conditions in Texas state prison.
    At that time, a separate district court still retained jurisdiction
    over Ruiz v. Estelle, 
    503 F. Supp. 1265
    (S.D. Tex. 1980), a class
    action that successfully challenged unconstitutional Texas prison
    conditions, to monitor the prison system until the injunctions
    issued in Ruiz had been met. See 
    Gillespie, 858 F.2d at 1102
    .                  The
    Gillespie court stated:
    Separate individual suits may not be maintained for
    equitable relief from allegedly unconstitutional
    Texas prison conditions. To allow individual suits
    would interfere with the orderly administration of
    the   class    action   and    risk    inconsistent
    adjudications. Individual members of the class and
    other prisoners may assert any equitable or
    declaratory claims they have, but they must do so
    by urging further action through the class
    representative and attorney, including contempt
    proceedings, or by intervention in the class
    action.
    
    Id. at 1103.
    Gates involved alleged constitutional deficiencies in the
    Mississippi prison system, and in 1998, after twenty-five years of
    oversight,     the   District    Court       for   the   Northern   District   of
    4
    Mississippi finally dismissed the action from its inactive docket
    as to state-owned, state-operated, and private-company-contracted
    facilities (not as to county facilities), complimenting the state
    on its compliance with prior orders.             No. GC-71-6.       The court
    stated:
    This dismissal shall be without prejudice for the
    plaintiffs, through counsel, to petition the Court
    to reopen the case or a portion thereof in order to
    enforce, amend, or seek additional injunctive
    relief. … This dismissal shall not apply to any
    order of the court with respect to the payment of
    attorneys fees and costs/expenses to plaintiffs’
    counsel, who shall, post-dismissal, continue to
    monitor compliance in state-owned, state-operated,
    and private-company-contracted facilities…. [T]he
    court finds and concludes that the rule of
    [Gillespie] will continue to apply in this case
    with respect to prisoners in state-owned, state-
    operated,     and     private-company-contracted
    facilities, and the court will continue to forward
    such prisoner petitions to plaintiffs’ class
    counsel.
    No. GC-71-6.   Thus, in writing this dismissal order for Gates, the
    court apparently assumed that Gates was the sole vehicle for future
    prisoner complaints.    Although Russell argues that the court only
    intended Gates as an option for seeking future equitable relief,
    the court’s invoking the rule of Gillespie indicates that it was
    meant to be the sole vehicle.
    But it does not appear that the reasoning of Gillespie is
    applicable   here.     The   Gillespie   court    justified   its    rule   as
    follows:
    5
    Permitting multiple courts to entertain equitable
    claims and issue decrees that might affect the
    Texas prison system would require other courts to
    become familiar with the Ruiz decree, the current
    problems of the Texas prison system, and the
    possible disruptive effect of the exercise of
    equitable powers over matters covered by the Ruiz
    decree. Moreover, if separate suits for equitable
    relief are filed in other districts than that in
    which Ruiz is pending, even with respect to
    problems not encompassed by the relief granted in
    Ruiz, the court's orders may hobble the effect of
    the Ruiz court's continuing decree over the Texas
    prison system and its power both to enforce and to
    modify that decree.
    
    Id. at 1103.
        As this passage illustrates, the Gillespie court was
    concerned with avoiding the inefficiency of a situation in which
    multiple courts would be forced to familiarize themselves with the
    problems of the Texas prison system.             Similarly, the court was
    concerned with the increased confusion and decreased effectiveness
    that    would   likely     arise   if   multiple    district   courts   were
    simultaneously exercising equitable powers over the state prison
    system.
    In the present case, the district court judge who was the
    author of the Gates dismissal order assigned this case to this
    magistrate judge in light of this magistrate’s previous experience
    with Gates.     Thus, we are not here faced with either the problem of
    a new district court being forced to get up to speed on the
    factually-intensive problems of the state prison system or with the
    problem of      multiple   district     courts   simultaneously   exercising
    6
    equitable     powers    over    the   prison       system.       Additionally,      the
    magistrate judge purported to consolidate this case with Gates
    after certifying the death row inmates as a subclass of Gates.
    MDOC argues that this is not sufficient, citing cases stating that
    “consolidation does not merge [multiple] suits into a single
    cause.”      See, e.g.,Johnson v. Manhattan R. Co., 
    289 U.S. 479
    (1933). Nevertheless, because of the consolidation and because the
    same judge has jurisdiction over the present action and Gates, the
    problems addressed by the Gillespie court are not present here.
    MDOC    points    out    that   the       Gates   class    counsel     and   class
    representative     are    not    being      utilized.           But   MDOC   does   not
    articulate what difference that makes, and we find it to be of no
    import.     In fact, this court has already recognized that it may be
    proper for different counsel to represent a Gates subclass.                         See
    Gates v. Cook, 
    234 F.3d 221
    , 227-30 (5th Cir 2000) (reversing the
    district court’s denial of a motion for substitution of counsel by
    a   Gates    subclass    comprised     of       HIV-positive      prisoners    in   the
    Mississippi prison system).           Because this case was dealt with by
    the same court and judge who dealt with Gates and was consolidated
    with Gates, the concerns behind Gillespie are not present here and
    there is thus not any reason to dismiss this case.
    Should this case have been dismissed because of the class members’
    alleged failure to exhaust administrative remedies?
    7
    MDOC argues that the judgment should be vacated and the case
    dismissed because the trial court did not require all of the
    inmates who are members of the present class to exhaust their
    administrative remedies.    The plaintiffs respond that the named
    plaintiff, Russell, did exhaust his administrative remedies, and
    that no more is required. MDOC disputes the plaintiffs’ contention
    that Russell exhausted his administrative remedies.
    The Prison Litigation Reform Act (“PLRA”) mandates that “[n]o
    action shall be brought with respect to prison conditions ... by a
    prisoner ... until such administrative remedies as are available
    are exhausted.”   42 U.S.C.A. § 1997e(a).    The Supreme Court has
    held that “the PLRA’s exhaustion requirement applies to all inmate
    suits about prison life, whether they involve general circumstances
    or particular episodes.”     Porter v. Nussle, 
    534 U.S. 516
    , 532
    (2002).   The Court made clear that exhaustion is now mandatory.
    
    Id. at 524.
      This court has held that the available administrative
    remedy must be pursued to its conclusion. Wright v. Hollingsworth,
    
    260 F.3d 357
    (5th Cir 2001).     Thus, if the plaintiffs did not
    exhaust administrative remedies, this suit should be dismissed.
    The trial court found that Russell was the only class member
    who had completed the MDOC Administrative Remedy Program (“ARP”).
    If true, this is enough to satisfy the requirement for the class.
    See, e.g., Oatis v. Crown Zellerbach Corp., 
    398 F.2d 496
    , 498-99
    (5th Cir. 1968) (exhaustion of remedies requirement satisfied for
    8
    class      action    if   named     plaintiff      representing        class    exhausted
    remedies); 7A CHARLES ALAN WRIGHT, ARTHUR R. MILLER & MARY KAY KANE, FEDERAL
    PRACTICE    AND   PROCEDURE: CIVIL     2d    §    1776    (2d    ed.    1986)    (“[W]hen
    prospective         relief    is    the     primary      remedy    being       sought,   a
    representative who has exhausted his administrative remedies may
    bring a class suit on behalf of those who have not done so.”).
    Thus, if Russell completed the ARP, exhausting administrative
    remedies, this case was ripe for adjudication.                         Again, the trial
    court found that Russell had completed the ARP and that the record
    adequately        reflected    Russell’s         and   his   counsel’s     steps    taken
    through the administrative remedy process.                      MDOC disagrees.
    MDOC maintains that the ARP is a three-step process: 1) the
    inmate writes a letter3 to the Superintendent/Deputy Commissioner
    in care of the Legal Claims Adjudicator that is referred to a
    respondent by the Legal Claims Adjudicator; 2) if dissatisfied, the
    inmate      may     request        relief    from      the      Superintendent/Deputy
    Commissioner; 3) if dissatisfied, the inmate may appeal to the
    Commissioner in care of the ARP Administrator.                         The Commissioner
    will notify the inmate of his final decision within forty days of
    receiving the appeal.               If a request is rejected for technical
    reasons or matters of form, the inmate is given five days from the
    date of rejection to file a corrected grievance.                          The ARP also
    3
    The ARP rules indicate that the letter should state that it
    is a request for an administrative remedy and should present as
    many facts as possible.
    9
    provides that “[n]o more than ninety (90) days from initiation to
    completion of the process shall elapse, unless an extension has
    been granted” and that “expiration of response time limits without
    receipt of a written response shall entitle the offender to move on
    to the next step in the process.”4
    The ARP rules also provide that an inmate may make a request
    for emergency review by sending an emergency request to the Legal
    Adjudicator “to determine to what level the grievance must be
    forwarded if substantive actions must occur.       The request shall be
    handled as expeditiously as possible, and shall be reviewed at the
    Commissioner’s level by the Commissioner or his designee.”            The
    emergency review procedures further provide that, if the grievance
    is ruled not to be an emergency, it “may be resubmitted as a
    regular grievance” and that “[a]buse of the emergency review
    process ... shall be treated as a frivolous or malicious request.”
    The emergency review procedure thus expedites the review process in
    certain   situations   so   that   the   request   can   be   dealt   with
    4
    Although no part of the ARP rules provide for a
    certificate of completion, MDOC asserts that the inmate receives
    a certificate of completion upon finishing the ARP. Under the
    prior version of section 1997e, before its amendment in 1996, the
    administrative remedy was required to be certified. 42 U.S.C. §
    1997e(a)(2)(1994)(amended 1996). The 1994 district court order
    certifying the ARP under the prior version of the statute
    required inmates to complete the procedure and to attach a
    certificate to that effect to their complaint.
    10
    expediently at the Commissioner’s level.5            The ARP does not provide
    a definitive end for the emergency review procedure, but, as the
    emergency    review   procedure      facilitates     quicker   review    at    the
    Commissioner’s level, it follows that the requirement that the
    Commissioner    provide   a   written       answer   within    forty    days    of
    receiving the complaint likewise applies to the emergency review
    procedure.
    Russell    maintains     that    he    exhausted    his   administrative
    remedies by utilizing the emergency review process. On January 31,
    2002, Russell’s counsel delivered to MDOC Commissioner Johnson a
    document titled “Emergency Request by Inmate Willie C. Russell for
    5
    MDOC argues that the emergency request procedure only
    provides a mechanism for temporary relief and does not excuse an
    inmate from pursuing relief through the three-step ARP process.
    Thus, MDOC maintains that Russell did not exhaust administrative
    remedies because, in addition to utilizing the emergency relief
    process, he did not complete the three-step process culminating
    in a certificate of completion.
    But MDOC’s contention is simply not supported by the
    language of the policy outlining the ARP process. The portion of
    that policy detailing the procedure for emergency relief requests
    does not indicate that the inmate must simultaneously proceed
    through the three-step process. In fact, it refers to the
    regular grievance process only as an alternative when an
    emergency request has been deemed to be a non-emergency. MDOC
    never rejected the emergency request nor advised Russell to
    resubmit it as a regular grievance. The policy does not indicate
    that the emergency request procedure is simply designed to
    provide stop-gap measures while the request proceeds through the
    normal administrative procedures. The most natural reading of
    the policy leads to the conclusion that the emergency request
    procedure simply expedites the administrative process by allowing
    the request to be reviewed at the Commissioner’s level without
    having to proceed through the entire three-step process in
    limited circumstances.
    11
    an Administrative Remedy Concerning Conditions on Death Row,”
    complaining of the conditions at issue here and requesting a
    meeting   to   discuss    these     problems       in     an   effort   to    avoid
    litigation.6      On   March   8,    before    a    March      12   meeting    with
    Commissioner Johnson, Russell’s counsel sent the Commissioner a
    memorandum, outlining the complained of conditions on Death Row in
    greater detail.
    On   April   1,   Russell’s     counsel       sent    a   third    letter   to
    Commissioner Johnson referencing the original emergency request for
    an administrative remedy.           This letter noted that Commissioner
    Johnson had agreed to remedy such conditions, if they existed, at
    the March 12 meeting.     It further asked MDOC to respond by May 1 so
    as to inform Russell whether it would be able to make the necessary
    repairs by June 1.     On April 15, Johnson sent a letter to Russell’s
    counsel asserting that Russell’s concerns regarding ventilation
    (heat) had been addressed by simply drilling some holes in the
    metal sheet on his cell door and that the concerns regarding
    6
    Although the form was submitted directly to Commissioner
    Johnson instead of being sent through the Legal Adjudicator, MDOC
    never rejected the request for technical reasons or for matters
    of form. To the contrary, as discussed below, MDOC addressed the
    substance of Russell’s request, albeit with some delay. As MDOC
    ignored this technical defect but instead addressed Russell’s
    request at the administrative level and denied it for matters of
    substance, it cannot now claim that Russell failed to exhaust
    based on this technical defect. Cf. Wendell v. Asher, 
    162 F.3d 887
    , 890 (5th Cir. 1998) (stating that the exhaustion requirement
    imposed by the PLRA is subject to the defenses of waiver and
    estoppel).
    12
    sanitation   and   pest   control   were   unwarranted.   On    June   14,
    Russell’s counsel sent Johnson a final letter reiterating Russell’s
    complaints and disputing Johnson’s April 15th denial of the accuracy
    of the inmates’ claims; Commissioner Johnson never responded.
    Throughout these negotiations, MDOC never rejected the emergency
    request on technical grounds or for matters of form nor advised
    Russell to resubmit it as a regular grievance.        On the contrary,
    MDOC addressed Russell’s core concerns by simply disagreeing with
    Russell’s characterization of the conditions on Death Row.
    We agree with the trial court that Russell concluded the ARP
    and thus exhausted administrative remedies. Initially, MDOC failed
    to comply with ARP procedures by failing to deal with Russell’s
    complaint within the time limits provided by the ARP.      Over ninety
    days expired between the time that Russell initiated the process
    and the time he finally filed suit, and Commissioner Johnson did
    not provide a written response to Russell’s complaint within the
    forty day period.   Available administrative remedies are exhausted
    in compliance with the PLRA when the time limits for the prison’s
    response set forth in the prison grievance procedures have expired.
    Underwood v. Wilson, 
    151 F.3d 292
    , 295 (5th Cir. 1998).        Similarly,
    per the terms of the ARP, Commissioner Johnson’s failure to provide
    a written response to Russell’s complaint within the forty day
    period entitled Russell to “move on to the next step in the
    process.”    As review at the Commissioner’s level constitutes the
    13
    final step in the process, Russell was then entitled to file suit.
    Finally,    even   if     MDOC   was     allowed    to   unduly   delay   the
    administrative process in violation of the terms of the ARP by
    failing to provide an answer from Commissioner Johnson within the
    forty day period, the April 15th letter denied that relief was
    warranted, effecting a rejection of the claim.             That letter thus
    terminated the administrative process, as evidenced by Commissioner
    Johnson’s   refusal      to   respond    to   any   further   communications
    regarding these complaints. We agree with trial court’s conclusion
    that Russell completed the ARP by utilizing the procedure for
    emergency review.       Thus, Russell, and by extension the plaintiffs,
    properly exhausted administrative remedies.
    Should the injunctions be vacated on the grounds that they are not
    justified by conditions constituting cruel and unusual punishment
    in violation of the Eighth Amendment?
    The Eighth Amendment Standard
    MDOC argues that none of the provisions of the injunctive
    decree were warranted by conditions constituting Eighth Amendment
    violations.   The Eighth Amendment dictates that cruel and unusual
    punishment shall not be inflicted, U.S. CONST. amend. VIII, and it
    is applicable to the States by reason of the Due Process Clause of
    the Fourteenth Amendment.        Robinson v. California, 
    370 U.S. 660
    ,
    675 (1962).   The treatment a prisoner receives in prison and the
    14
    conditions under which he is confined are subject to scrutiny under
    the Eighth Amendment. Helling v. McKinney, 
    509 U.S. 25
    , 31 (1993).
    The Constitution does not mandate comfortable prisons, but
    neither does it permit inhumane ones.              Farmer v. Brennan, 
    511 U.S. 825
    , 832 (1994).      Prison officials must provide humane conditions
    of confinement; they must ensure that inmates receive adequate
    food, clothing, shelter, and medical care, and must take reasonable
    measure to ensure the safety of the inmates.                
    Id. This circuit
    has
    worded the test as requiring extreme deprivation of any "minimal
    civilized measure of life's necessities.” Davis v. Scott, 
    157 F.3d 1003
    , 1006 (5th Cir 1998).           Further, mental health needs are no
    less serious than physical needs.              Partridge v. Two Unknown Police
    Officers of City of Houston, Texas, 
    791 F.2d 1182
    , 1187 (5th Cir.
    1986). The Supreme Court has made clear that the standards against
    which    a   court   measures   prison         conditions      are    "the   evolving
    standards of decency that mark the progress of a maturing society"
    and not the standards in effect during the time of the drafting of
    the Eighth Amendment.      Estelle v. Gamble, 
    429 U.S. 97
    , 102, 50 L.
    Ed. 2d 251, 
    97 S. Ct. 285
    (1976) (internal quotation omitted).
    A prison official has violated the Eighth Amendment when he 1)
    shows a subjective deliberate indifference to 2) conditions posing
    a substantial risk of serious harm to the inmate.                    
    Farmer, 511 U.S. at 833-34
    .     Whether a prison official had the requisite knowledge
    of   a   substantial    risk    is    a        question   of      fact   subject   to
    15
    demonstration     in   the    usual   ways,   including   inference   from
    circumstantial evidence, and a factfinder may conclude that a
    prison official knew of a substantial risk from the very fact that
    the risk was obvious.        
    Id. at 842.
    Conditions of confinement may establish an Eighth Amendment
    violation "in combination" when each would not do so alone, but
    only when they have a mutually enforcing effect that produces the
    deprivation of a single, identifiable human need such as food,
    warmth, or exercise -- for example, a low cell temperature at night
    combined with a failure to issue blankets.         Wilson v. Seiter, 
    501 U.S. 294
    , 304 (1991).     The Supreme Court has noted that "the length
    of confinement cannot be ignored.... A filthy, overcrowded cell ...
    might be tolerable for a few days and intolerably cruel for weeks
    or months.”     Hutto v. Finney, 
    437 U.S. 678
    , 686-87 (1978).         It is
    also important to note that the inmate need not show that death or
    serious illness has occurred.         
    Helling, 509 U.S. at 32
    (“It would
    be odd to deny an injunction to inmates who plainly proved an
    unsafe, life-threatening condition in their prison on the ground
    that nothing yet had happened to them.”).
    Standard of Review
    MDOC argues that many of the trial court’s findings of fact
    were clearly erroneous.        In reviewing the factual findings, this
    court   employs    a   “clearly    erroneous”   standard.     Alberti    v.
    Klevenhagen, 
    790 F.2d 1220
    , 1224 (5th Cir 1986).            A finding is
    16
    clearly erroneous when, although there is evidence to support it,
    the reviewing court on the entire evidence is left with the
    definite and firm conviction that a mistake has been committed.
    
    Id. Whether the
    official showed a deliberate indifference to the
    condition is a factual finding that is reviewed under a “clearly
    erroneous” standard. Brice v. Virginia Beach Correctional Ctr., 
    58 F.3d 101
    , 105 (4th Cir. 1995).      Once the facts are established, the
    issue of whether the facts constitute a constitutional violation is
    a question of law to be reviewed de novo.           
    Alberti, 790 F.2d at 1224
    . If a constitutional violation is found, we employ an abuse
    of discretion standard in reviewing the equitable remedy itself.
    Swann v. Charlotte - Mecklenburg Bd. of Educ., 
    402 U.S. 1
    , 15-16
    (1971).
    The Trial Court’s Factual Findings
    The trial court made the following findings of fact, inter
    alia, as to the conditions on Parchman’s Death Row.
    Sanitation
    Inmates have been subjected to cells that were extremely
    filthy with chipped, peeling paint, dried fecal matter and food
    encrusted on the walls, ceilings, and bars, as well as water from
    flooded toilets and rain leaks.       Inmates are routinely moved from
    cell to cell and are forced to clean their new cells that may have
    been   left   in    horrendous   sanitation   by   the   prior   occupants,
    17
    especially if the occupant were mentally ill.     Adequate cleaning
    supplies and equipment are not routinely made available for inmates
    to clean their cells.   These filthy conditions contribute to the
    infestation of pests and play a role in the mental well-being of
    inmates.   Russell v. Johnson, 
    2003 U.S. Dist. LEXIS 8576
    at *4-5
    (N.D. Miss.).
    Heating and Cooling
    The summer temperatures in the Mississippi Delta average in
    the nineties with high humidity, and Death Row is primarily not an
    air-conditioned facility.   There are industrial type fans in the
    hallways to help with air circulation, and most inmates have
    smaller fans.   Relief from the heat can be obtained by keeping the
    windows open in the cell using fans.   But keeping the windows open
    increases the mosquito population in the cells since there are
    holes in the cell window screens and the screen gauge is not
    sufficient to keep mosquitoes out.    The ambient temperature in the
    cells is within reasonable limits except during the summer months.
    The ventilation is inadequate to afford prisoners a minimal level
    of comfort during the summer months.      The probability of heat-
    related illness is extreme on Death Row, and is dramatically more
    so for mentally ill inmates who often do not take appropriate
    behavioral steps to deal with the heat.       Also, the medications
    often given to deal with various medical problems interfere with
    the body’s ability to maintain a normal temperature.    The inmates
    18
    are not afforded extra showers, ice water, or fans if they don’t
    have fans when the heat index is 90 or above.        The heat problem
    extends to all of Death Row and possibly throughout Parchman.         
    Id. at *5-7.
    Pest Control
    The heat problem also exacerbates the problem of pest control.
    Mosquitoes in Mississippi, and the Delta in particular, are a
    problem that cannot be eliminated.         But the problem must be
    addressed and the impact lessened, especially with the incidence of
    West Nile virus, a mosquito-born disease increasing in Mississippi.
    Inadequate screening on the cell windows causes the inmates to
    choose between suffering from the heat or increasing the mosquitoes
    in their cells.      The problems of heat and mosquitoes must be
    addressed to provide the inmates with conditions that would meet
    minimal constitutional standards. The problem of roaches and other
    vermin will be met by adhering to the ACA standards and by meeting
    the sanitation goals the court will set.     
    Id. at *7.
    “Ping-Pong” Toilets and Plumbing
    Fecal and other matter flushed by a toilet in one cell will
    bubble up in the adjoining cell unless the toilets are flushed
    simultaneously.     This has been a problem since the unit opened.
    Parchman   officials   have   identified   the   problem   as   one   of
    calibration, especially if the water is shut off.    The toilets must
    be recalibrated to work properly.      Recalibration has helped, but
    19
    not eliminated, the problem of ping-pong toilets.       No one in
    civilized society should be forced to live under conditions that
    force exposure to another person’s bodily wastes.     The showers,
    water temperature, and quality of water are adequate. 
    Id. at *7-8.
    Lighting
    The lighting in the cells is grossly inadequate.    While    20
    foot-candles7 is the appropriate level of lighting for the cells,
    the maximum foot-candles measured by Russell’s expert was seven or
    eight, with the typical cell being in the 2-4 foot-candle range.
    
    Id. at *9-10.
    Preventive Maintenance Program
    The preventive maintenance program instituted by MDOC appears
    to be adequate, although it should be in writing.   
    Id. at *10.
    Laundry
    The inmates’ laundry is returned foul-smelling, necessitating
    the inmates to wash their clothes in their cells.   The inmates are
    entitled to laundry that is clean and not foul-smelling.   
    Id. Mental Health
    Issues
    7
    A foot-candle is “[a] unit of measure of the intensity of
    light falling on a surface, equal to one lumens per square foot
    and originally defined with reference to a standardized candle
    burning at one foot from a given surface.” THE AMERICAN HERITAGE
    COLLEGE DICTIONARY 530 (3rd ed. 1993).
    20
    At least six severely psychotic prisoners are housed on Death
    Row, and many more are diagnosed with quantifiable mental health
    problems. The extremely psychotic prisoners scream at night, throw
    feces, and generally make life miserable for the other inmates and
    guards. As stated by Dr. Kupers, a psychiatry professor and expert
    for Russell, “it boils down to warehousing people with severe
    mental illness ... some are medicated, but there is essentially no
    other mental health services.” The mental health care afforded the
    inmates on Death Row is grossly inadequate. The isolation of Death
    Row, along with the inmates’ pending sentences of death and the
    conditions on Death Row are enough to weaken even the strongest
    individual.     What mental health services are provided generally
    take place at the inmate’s cell within hearing of other inmates and
    guards.   This results in the failure of inmates to tell the mental
    health specialists anything of substance.   Moreover, comprehensive
    mental health evaluations are consistently inadequate. Inmates are
    also prescribed psychotropic drugs with only sporadic monitoring.
    This can result in life-threatening situations due to the toxicity
    of these drugs. Appropriate treatment of mentally ill inmates will
    in turn help address the issues of excessive noise and sanitation
    problems caused by severely psychotic inmates.    
    Id. at *11-12.
    Exercise
    Proper exercise is advantageous for mental health and well-
    being.    The exercise facilities provided are adequate.   While, in
    21
    general, the use of “flip-flops” is understandable as a security
    measure, such shoes do not allow effective exercise.     The inmates
    should be given access to sneakers prior to entering the exercise
    pen and should be given access to water and shade while exercising.
    
    Id. at 12.
    The Trial Court’s Conclusions of Law
    The court concluded that the conditions identified in the
    court’s findings of fact constituted Eighth Amendment violations
    because they posed a substantial risk of harm to the inmates’
    health and, based on the obvious nature of these risks, the prison
    officials showed a deliberate indifference to such harm.
    Injunctive Relief Entered by the Trial Court
    The court directed the following remedial actions.
    1.   If defendants wish to continue the practice of
    moving inmates from cell to cell in Unit 32-C, they
    will insure that the cell to which an inmate is
    moved is clean prior to the move. While an inmate
    should be required to keep his own cell clean, he
    should not be required to clean the cell of another
    inmate in order to inhabit it.
    2.   Adequate cleaning supplies and equipment shall
    be provided inmates in order that they may clean
    their cells at least weekly.
    3.   A general preventive maintenance schedule and
    program shall be reduced to writing within 60 days
    of this order.
    22
    4.   Defendants    shall    take   the    necessary
    measurements in the unit in order to determine the
    heat index on the individual tiers.           These
    measurements shall be taken daily at 10:00 a.m.,
    1:00 p.m., 4:00 p.m., and 7:00 p.m. during the
    months of May through September and at 1:00 p.m. in
    all other months.    If the heat index reaches 90
    degrees or above, the defendants will insure that
    each cell is equipped with a fan, that ice water is
    available to each inmate, and that each inmate may
    take one shower during each day when the heat index
    is 90 degrees or above.     As an alternative, the
    defendants may provide fans, ice water, and daily
    showers during the months of May through September.
    This remedy shall apply to all of Unit 32.
    5. The defendants shall continue their efforts at
    mosquito eradication and pest control.         The
    defendants shall also insure that all cell windows
    are repaired and screened with 18 gauge window
    screen or better. This remedy shall apply to all
    of Unit 32.
    6. The defendants shall insure that the problem of
    “ping-pong” toilets in Unit 32 as a whole is
    addressed.   The defendants shall provide to the
    court within 60 days the details of a plan to
    eradicate this problem. The court is not convinced
    that recalibration is sufficient, but will await
    the defendants’ report on their plan.
    7. The defendants shall also upgrade the lighting
    in Unit 32 as a whole to provide lighting in each
    cell equal to 20 foot-candles.
    8.   The defendants shall insure that the proper
    chemical agents are used at the laundry so that
    inmates’ laundry is returned clean and without a
    foul smell.
    9. The defendants shall insure that the new vendor
    for medical services complies with the ACA and the
    National Commission on Correctional Healthcare
    medical and mental health standards. Each inmate
    on Death Row shall be given a comprehensive mental
    23
    health examination in private. These comprehensive
    examinations shall be conducted on a yearly basis.
    Those inmates diagnosed with psychosis and severe
    mental health illnesses shall be housed separately
    and apart from all other inmates. The medication
    levels of all inmates receiving psycotropic
    medications shall be monitored and assessed in
    accordance with appropriate medical standards. All
    inmates receiving mental health counseling or
    evaluation shall meet with the mental health
    professionals in a private setting.
    10.   The inmates on Unit 32-C shall continue to
    receive the opportunity to exercise as currently
    available. However, the inmates shall be given the
    opportunity to wear sneakers while exercising if
    they prefer rather than “flip-flops.”     A shaded
    area for exercise shall be provided with access to
    water.
    Russell v. Johnson, 
    2003 U.S. Dist. LEXIS 8573
    at *1-4 (N.D.
    Miss.).8
    8
    MDOC makes a cursory argument that the injunctions must be
    reversed because the trial court failed to make particularized
    findings required by the PLRA, 18 U.S.C. § 3626(a). There are
    multiple problems with this argument. The first is that MDOC
    never presented this argument to the trial court. This court
    does not generally review issues raised for the first time on
    appeal. See, e.g., Yohey v. Collins, 
    985 F.2d 222
    , 225 (5th Cir.
    1993). Additionally, MDOC cites Castillo v. Cameron County, 
    238 F.3d 339
    , 351 (5th Cir. 2001), for the proposition that a court
    must make particularized findings, on a provision-by-provision
    basis, that each injunction is narrowly drawn, goes no further
    than necessary to correct the violation, and is the least
    intrusive means of correcting the violation. But MDOC’s reliance
    on Castillo is misplaced. Castillo requires such findings to be
    made when the district court holds that prior injunctive relief
    should not be terminated, relying on section 3262(b)(3). 
    Id. at 351-54.
    Section 3262(b)(3) on its face requires such written
    findings. Conversely, section 3262(a)(1), which applies to
    prospective relief and is thus applicable here, does not.
    24
    Is the injunctive relief entered by the trial court justified by
    conditions in violation of the Eighth Amendment’s prohibition
    against cruel and unusual punishment?
    MDOC   asserts   that,   as   to   several   of   the    injunctions
    (Injunctions #2, #5, #6, #7, and #9), it is already meeting,
    intending to meet, or attempting to meet the standards enunciated
    by the trial court.    Thus, MDOC argues, the injunctions are not
    required.   But MDOC’s assertions that it intends to meet these
    standards do not suffice to moot the issue.        It is well settled
    that a defendant's voluntary cessation of a challenged practice
    does not deprive a federal court of its power to determine the
    legality of the practice.     Friends of the Earth, Inc. v. Laidlaw
    Envtl. Servs. (TOC), Inc., 
    528 U.S. 167
    , 190 (2000) (citations
    omitted).   If it did, the courts would be compelled to leave “the
    defendant . . . free to return to his old ways.” 
    Id. In accordance
    with this principle, the standard for determining whether a case
    has been mooted by the defendant's voluntary conduct is stringent:
    "A case might become moot if subsequent events made it absolutely
    clear that the allegedly wrongful behavior could not reasonably be
    expected to recur."    
    Id. The "heavy
    burden of persuading" the
    court that the challenged conduct cannot reasonably be expected to
    start up again lies with the party asserting mootness.           
    Id. The trial
    court’s citation to Friends of the Earth accompanied by its
    assertion that Russell’s claims were not moot indicates that the
    25
    trial court was not persuaded.               The fact that many of these
    conditions   have     persisted   for    years     despite   MDOC’s     purported
    efforts leads us to likewise conclude that MDOC has not met the
    heavy burden of showing that its voluntary conduct has mooted any
    of the issues presented here.
    Similarly,    MDOC   also      argues,    as   to    several       of   the
    injunctions,    that    Parchman’s       accreditation       by   the    American
    Correctional Association (“ACA”) is proof that the conditions in
    question don’t violate the Eighth Amendment.             But it is absurd to
    suggest that the federal courts should subvert their judgment as to
    alleged Eighth Amendment violations to the ACA whenever it has
    relevant standards.      Additionally, the ACA’s limited inspections
    are not be binding as factual findings on the magistrate or on this
    court.    While compliance with ACA standards may be a relevant
    consideration, it is not per se evidence of constitutionality. See
    Ruiz v. Johnson, 
    37 F. Supp. 2d 855
    924-25 (S.D. Tex. 1999)
    (recognizing   the     limitations   of      ACA   accreditation      and    noting
    situations where it has not equated to constitutionality), rev’d on
    other grounds, 
    178 F.3d 385
    .
    MDOC finally argues that none of the injunctions are based on
    Eighth Amendment violations and, thus, that all of the injunctions
    must be reversed. Using the relevant Eighth Amendment standard, we
    will examine each of the injunctions in turn.
    Injunctions #1 and #2
    26
    MDOC argues that the first injunction, which prohibits MDOC
    from requiring inmates to clean the cells into which they are
    transferred, cannot stand because there was no proof of any medical
    injury or illness resulting from this practice.            MDOC similarly
    maintains that the second injunction, which requires that adequate
    cleaning supplies be provided to the inmates at least weekly, is
    unsupported by any evidence of medical illness arising from this
    situation   or    a   showing   of   deliberate    indifference   by   MDOC
    officials. MDOC also contends that cleaning supplies are regularly
    issued to inmates and that the cells were clean as of the date of
    trial.
    This court has previously held that filthy cell conditions may
    constitute an Eighth Amendment violation.          See Harper v. Showers,
    
    174 F.3d 716
    , 720 (5th Cir 1999).         Other circuits have made similar
    holdings; the Eighth Circuit has held that a prisoner being placed
    in a cell covered with filth and human waste for a two-year period
    without proper cleaning supplies constitutes cruel and unusual
    punishment.      Howard v. Adkison, 
    887 F.2d 134
    , 137 (8th Cir. 1989)
    (recognizing that “inmates are entitled to reasonably adequate
    sanitation, personal hygiene, and laundry privileges, particularly
    over a lengthy course of time”); see also McBride v. Deer, 
    240 F.3d 1287
    , 1292 (10th Cir. 2001) (holding that three days in a feces-
    covered cell states a claim upon which relief could be granted).
    27
    Russell     points     to    testimony      adduced       at   the   trial   court
    indicating that the cells were “extremely filthy” with crusted
    fecal matter, urine, dried ejaculate, peeling and chipping paint,
    and old food particles on the walls.                     Living in such conditions
    would present a substantial risk of serious harm to the inmates,
    and we cannot say that trial court’s decision to credit this
    testimony was clearly erroneous.                  Also, in light of substantial
    testimony indicating that such conditions were not atypical and
    were   easily      observed,       we    cannot    say    that    the    trial   court’s
    conclusion that MDOC officials showed a deliberate indifference to
    this risk     is      clearly      erroneous.       Further,       the   testimony    was
    conflicting as to the frequency and quality of the provision of
    cleaning supplies,           and    we   cannot     say   that     the   trial   court’s
    conclusion      to    credit       testimony      supporting      the    inadequacy   of
    cleaning supplies was clearly erroneous.                   As living in such filthy
    conditions would present the inmates with a risk of serious harm to
    which MDOC officials have displayed a deliberate indifference,
    Injunctions      #1    and   #2     were   justified      by     an   Eighth   Amendment
    violation.       They are, therefore, affirmed.
    Injunction #3
    MDOC challenges the third injunction, which directs MDOC to
    reduce a general preventive maintenance schedule and program to
    writing.     MDOC argues that there is no evidence supporting the
    elements required for a finding of cruel and unusual punishment
    28
    that would support this injunction.        Russell responds that “[t]he
    risks of squalid conditions and the constantly recurring break-down
    of the water, plumbing, and other operating systems were obvious,”
    and Russell’s environmental health and safety expert testified that
    the same problems would continue to recur if MDOC did not put a
    written plan in place.
    While   federal   courts   can    certainly   enter   injunctions   to
    prevent Eighth Amendment violations, they are not to micromanage
    state prisons.   Bell v. Wolfish, 
    411 U.S. 520
    , 562 (1979).              The
    trial court entered injunctions to directly remedy each of the
    complained-of conditions that rise to the level of an Eighth
    Amendment violation.    Russell has cited no case that supports the
    proposition that the trial court can further affect the internal
    operations of MDOC by requiring it to produce a writing preventive
    maintenance program to which it will adhere.               The additional
    requirement of a written preventive maintenance program, while
    desirable, is not independently supported by additional conditions
    that constitute an Eighth Amendment violation, and it cannot stand.
    Thus, we vacate that injunction.
    Injunction #4
    The fourth injunction directs MDOC to provide fans, ice water,
    and daily showers when the heat index is 90 degrees or above, or
    alternatively to make such provisions during the months of May
    through September. The injunction also purports to apply to all of
    29
    Unit 32, as opposed to only Unit 32-C.   Initially, it is important
    to note that the class represented by Russell consists entirely of
    Parchman’s Death Row prisoners, who are housed in Unit 32-C. Thus,
    to the extent that the injunction purports to apply to parts of
    Unit 32 beyond Unit 32-C, it exceeds the scope of the litigation
    and is therefore invalid.   See Thomas v. County of Los Angeles, 
    978 F.2d 504
    , 509-10 (9th Cir. 1992) (reversing an injunction as
    overbroad when it purported to apply to the entire Los Angeles
    County Sheriff’s Department although the plaintiff’s complaint and
    evidence only applied to one specific station).
    MDOC contends that no Unit 32-C inmate has ever suffered any
    serious heat-related illness.    But, as noted above, Russell does
    not need to show that death or serious illness has yet occurred to
    obtain relief. He must show that the conditions pose a substantial
    risk of harm to which MDOC officials have shown a deliberate
    indifference.   Russell presented the court with expert testimony
    from Dr. Vassallo9 that it was “very likely” that, under current
    conditions on Death Row, an inmate will die of heat stroke or some
    other heat-related illness.     In fact, Dr. Vassallo’s testimony
    indicated that Death Row prisoners had made many complaints of
    9
    Dr. Vassallo is a faculty member of the Department of
    Surgery and Division of Emergency Medicine at New York University
    School of Medicine and is a medical toxicologist at the New York
    Regional Poison Control Center. She has lectured extensively on
    thermoregulation and hyperthermia (heat illness) and has authored
    the “Thermoregulatory Principles” chapter of Goldfrank’s
    Toxicologic Emergencies, a textbook on medical toxicology.
    30
    symptoms commonly recognized to be related to heat-related illness
    and that those conditions had simply gone undiagnosed.
    MDOC further cites language from Woods v. Edwards, 
    51 F.3d 577
    (5th Cir. 1995), in which Woods, a prisoner at the Louisiana State
    Penitentiary at Angola, claimed, inter alia, that the conditions in
    extended      lockdown    were    unconstitutional.              Extended     lockdown
    isolates inmates as punishment for disciplinary violations. One of
    Woods’ claims was that the cell used in his extended lockdown was
    inadequately cooled and that the high temperature aggravated his
    sinus condition.      
    Id. at 581.
         This court noted that Woods “failed
    to present medical evidence of any significance.”                     
    Id. This court
    went on to state: “[w]hile the temperature in extended lockdown may
    be uncomfortable, that alone cannot support a finding that the
    plaintiff     was   subjected     to   cruel      and    unusual        punishment   in
    violation of the Eighth Amendment.”                
    Id. The Woods
    court found
    that Woods had not presented medical evidence sufficient to state
    an   Eighth    Amendment    violation;         Woods   does     not   stand    for   the
    proposition that extreme heat can never constitute cruel and
    unusual punishment.         Finally, MDOC points out that the Seventh
    Circuit has held that one shower a week is sufficient.                        Davenport
    v.   DeRobertis,    
    844 F.2d 1310
    ,     1316-17      (7th    Cir.    1988).      But
    Davenport is inapt, as it dealt only with cleanliness while the
    testimony upon which this injunction rests indicated that cold
    showers would help alleviate the risk of heat-related illness.
    31
    Based on the evidence presented, we cannot say that the trial
    court’s finding that the probability of heat-related illness is
    extreme at Unit 32-C was clearly erroneous.   Thus, this condition
    presents a substantial risk of serious harm to the inmates.   Again,
    based on the open and obvious nature of these conditions and the
    evidence that inmates had complained of symptoms of heat-related
    illness, the trial court’s finding regarding MDOC’s deliberate
    indifference is not clearly erroneous.    Thus, Injunction #4 was
    justified by an Eighth Amendment violation, and it is affirmed
    insofar as it applies to Unit 32-C.10
    Injunction #5
    The fifth injunction requires MDOC to continue its efforts at
    pest control and, more specifically, to ensure that all cell
    windows are repaired and screened with 18 gauge window screen or
    better.    Injunction #5 purports to apply to all of Unit 32.
    Initially, like Injunction #4, to the extent that Injunction #5
    purports to apply to parts of Unit 32 beyond Unit 32-C, it is
    invalid.
    10
    In a footnote in its brief, MDOC asserts that the extra
    showers ordered by the trial court would cause a major prison
    security problem. Russell replies that no such evidence was
    presented at trial and, thus, that the trial court should be
    given the first opportunity to rule on this issue. In their
    reply brief, MDOC admits that such evidence was only presented to
    the court as part of MDOC’s July 2003 progress report. But only
    the May 21, 2003, final order of the trial court is currently
    under review, not any subsequent monitoring of the trial court’s
    injunctive relief. This issue is thus not before us.
    32
    MDOC first argues that there is no basis for a federal court
    to order MDOC to continue to do what it is already doing.   But, as
    discussed above, the pest infestation problems persist, and MDOC
    has not met the burden of convincing the trial court or this court
    that its efforts at pest control have mooted this issue.      MDOC
    also argues that the evidence shows that there were no holes in the
    screens at the time of trial.    But the trial court was presented
    with testimony that there were cells with holes in the screens,
    and, in any event, the insufficient gauge on the screens would
    allow the infestation problem to continue even in absence of holes
    in the screens.
    MDOC argues generally that Russell did not show either a
    substantial risk of harm to the inmates or deliberate indifference
    on the part of MDOC officials.   But the trial court was presented
    with testimony that insects swarm in the inmates’ food and beds and
    that the inmates often must choose between opening the window for
    relief from the heat or closing the window for protection from
    mosquitoes, as the gauge on the screens is too large to keep out
    the mosquitoes.   It is important to recognize that this injunction
    is supported by the trial court’s findings on heat, as the court
    noted that the mosquito infestation accompanied by the insufficient
    screen gauge exacerbated the heat problems by deterring the inmates
    from opening their windows to increase circulation. In addition to
    the risk of heat-related illness, the pest infestation problems
    33
    were linked to chronic sleep deprivation, which exacerbates the
    symptoms of mental illness.        As Injunction #5, like Injunction #4,
    is supported by the constitutional violation stemming from the
    excessive heat, it is affirmed as to Unit 32-C.
    Injunction #6
    The sixth injunction requires MDOC to remedy the problem of
    “ping-pong” toilets.     Like Injunctions #4 and #5, this injunction
    is invalid to the extent it purports to apply to parts of Unit 32
    outside of Unit 32-C.
    MDOC argues that there is no evidence of any serious medical
    problem stemming from the ping-pong toilets and, further, that in
    absence of objective evidence of such a problem there can be no
    finding of deliberate indifference on the part of MDOC officials.
    MDOC cites Tokar v. Armontrout, 
    97 F.3d 1078
    (8th Cir. 1996), for
    the proposition that exposure to raw sewage is not cruel and
    unusual punishment where there has been no demonstration of an
    adverse medical reaction.     But MDOC seriously misconstrues Tokar.
    Tokar complained generally that the prison toilets were “filthy”
    without specifying how long the toilets remained filthy and while
    acknowledging that he had not asked for cleaning supplies because
    cleaning the toilets was the job of other inmates.           
    Id. at 1081.
    The facts of Tokar are quite different from the facts presented
    here, in which inmates have regularly been exposed to each others’
    feces   for   over   a   decade.      In   fact,   the   Eighth   Circuit’s
    34
    recognitions that exposure to waste may constitute cruel and
    unusual punishment and that the length of time a prisoner must
    endure   unsanitary     conditions       is    undoubtedly      a    factor    in   the
    constitutional calculus, 
    id. at 1082
    n.4, both weigh in Russell’s
    favor.    While evidence of a past medical injury would clearly
    strengthen Russell’s case, Russell does not have to prove a past
    medical injury.    He must prove a substantial risk of serious harm
    and MDOC officials’ deliberate indifference to that harm.
    Russell points to expert testimony stating that the situation
    presented   when   the    feces     of    one    inmate    bubbles      up    in    the
    neighboring cell, exacerbated when the toilets overflow, does
    constitute a serious health hazard. Russell also presented evidence
    to the trial court that the Mississippi State Department of Health
    warned   MDOC   every    year   for      the    past   eleven       years    that   the
    malfunctioning toilets in Unit 32-C are a critical public health
    problem requiring       immediate     attention.          Additionally,       Russell
    points to several circuit court cases indicating that “courts have
    been especially    cautious       about       condoning    conditions       involving
    exposure to human waste.” Fruit v. Norris, 
    905 F.2d 1147
    , 1151 (8th
    Cir. 1990); see also, e.g., Despain v. Uphoff, 
    264 F.3d 965
    , 974
    (10th Cir. 2001)(exposure to human waste “evokes both the health
    concerns emphasized in Farmer and the more general standards of
    dignity embodied in the Eighth Amendment”).
    35
    MDOC    also     asserts   that    there          was    substantial     testimony
    regarding its attempts to correct the toilet problem, presumably
    arguing      that    this    further    rebuts          a     finding    of   deliberate
    indifference.         As evidence of deliberate indifference, Russell
    points to the fact that the problems persist despite MDOC officials
    having been warned that the problem was urgent for more than a
    decade.      Frequent exposure to the waste of other persons can
    certainly present health hazards that constitute a serious risk of
    substantial harm. Given the evidence presented to the trial court,
    we cannot say that the court’s factual findings regarding the ping-
    pong toilets or the MDOC officials’ deliberate indifference were
    clearly erroneous. Thus, this injunction, as applied to Unit 32-C,
    is affirmed.
    Injunction #7
    This injunction requires MDOC to upgrade the lighting in each
    cell to the level of twenty foot-candles.                        This injunction also
    purports to apply to Unit 32 as a whole and is invalid insofar as
    it purports to apply beyond Unit 32-C.                          MDOC argues that the
    injunction is wholly invalid because MDOC officials were in the
    process of upgrading cell lighting. As with the sanitation issues,
    the   pest    control       issues,    and        the   ping-pong       toilets,   MDOC’s
    assertions that it is working on the problem are inadequate to moot
    the issue.          MDOC also argues that there was no evidence of a
    substantial risk of serious harm stemming from the admittedly
    36
    inadequate lighting or of MDOC officials’ deliberate indifference
    to such harm. But the trial court judge apparently credited expert
    testimony asserting that the lighting in the cells was grossly
    inadequate for the purposes of sanitation, personal hygiene, and
    reading, that this condition also contributes to further mental
    health   deterioration,     and   that   twenty   foot-candles     was   the
    appropriate minimum level at which these activities could take
    place.      Thus, this injunction is supported by the conditions
    supporting Injunctions #1, #2, and #9, discussed below, and it is
    affirmed.
    Injunction #8
    The eighth injunction requires MDOC to return the inmates’
    laundry clean and without a foul smell.            MDOC argues that the
    prison laundry condition is not sufficiently serious to implicate
    the Eighth Amendment, citing Green v. Ferrell, 
    801 F.2d 765
    , 771
    (5th Cir. 1986), and similarly that there was no proof of any
    serious medical harm to any inmate stemming from this condition.
    The Green court reiterated that “jails must provide ‘reasonably
    adequate’     sanitation”   but    overturned     the   district    court’s
    injunction requiring the jail to provide laundry services because
    the prisoners were provided with laundry detergent that they could
    use to wash their own clothes in the sink located in their cells.
    
    Id. 37 Russell
       points   to   testimonial    evidence     that,    unlike   the
    situation in Green, the Death Row inmates are not provided with
    detergent and in fact can be disciplined for doing their own
    laundry.     First, the trial court found that the inmates do in fact
    wash their own clothes, as conceded by one of MDOC’s witnesses, who
    testified that the inmates wash their own clothes because it is
    part    of   “prison    culture.”      This    finding    was     supported    by
    substantial evidence and is incongruous with the proposition that
    inmates are disciplined for washing their own clothes.                Given that
    the inmates do wash their own clothes, the only distinction between
    this case and Green is that the prisoners in Green were provided
    with laundry detergent while the Death Row inmates in this case
    wash their clothes with the bar soap.              The difference between
    laundry detergent and bar soap is not sufficient to distinguish
    this case from Green and thus does not implicate the Eighth
    Amendment.       Injunction #8 is therefore vacated.
    Injunction #9
    The   ninth   injunction     outlines   a   number    of     requirements
    designed to alleviate some of the problems stemming from the
    allegedly inadequate mental health care afforded the inmates on
    Death Row.       This injunction requires MDOC to comply with ACA and
    National Commission on Correctional Healthcare (“NCCH”) standards
    regarding mental health, to give each inmate private, comprehensive
    mental health examinations on a yearly basis, to monitor and assess
    38
    the   medication       levels      of     inmates       receiving      psychotropic
    medications, and to house the inmates with psychosis and severe
    mental illnesses separately from the other inmates.
    MDOC   argues    that   it    was    already      in   compliance     with    ACA
    standards and, somewhat contradictorily, that MDOC has already
    begun the process of selecting a new medical vendor that would
    comply with ACA and NCCH standards.               Once again, MDOC’s assertion
    that it was already on the path towards compliance is insufficient
    to moot the issue.       Further, the injunction does not require only
    ACA compliance.       In any event, MDOC’s assertion that it is already
    in compliance with ACA and NCCH standards is incongruous with the
    trial court’s findings, including the statement that “the mental
    health   care   afforded      the       inmates    on    Death   Row   is    grossly
    inadequate.”    These findings were based on substantial testimony
    adduced at trial and apparently credited by the trial court.                        For
    example, Russell produced evidence that the isolation and idleness
    of Death Row combined with the squalor, poor hygiene, temperature,
    and noise of extremely psychotic prisoners create an environment
    “toxic” to the prisoners’ mental health.                There was also evidence
    that the severely psychotic prisoners smear garbage and excrement
    in their cells, scream all night, and flood the tiers.                             This
    contributes to the problems of uncleanliness and sleep deprivation,
    and by extension mental health problems, for the other inmates.
    There was also testimony that prisoners seldom see medical staff
    39
    and that monitoring of medication was sporadic, with prisoners
    potentially being prescribed the wrong medication or no medication
    for   long   periods   of   time,   potentially       leading   to   extremely
    dangerous physical side effects or psychotic breakdowns.
    MDOC also points out that two inmates have refused psychiatric
    medication so as to remain incompetent for execution.                 But this
    does not refute the trial court’s findings that the mental health
    care afforded to inmates on Death Row is grossly inadequate. MDOC
    is only obligated to make adequate mental health care available for
    all Death Row inmates.      The fact that some inmates may refuse to
    take advantage of such treatment so as to avoid execution is
    irrelevant to whether MDOC is meeting its obligation of complying
    with constitutional standards.
    MDOC   further   argues   that    there   was    no   demonstration   of
    deliberate indifference to any serious mental or medical problem
    stemming from insufficient mental health care.              In analyzing this
    argument, it is important to remember that mental health needs are
    no less serious than physical needs.            Partridge v. Two Unknown
    Police Officers of City of Houston, Texas, 
    791 F.2d 1182
    , 1187 (5th
    Cir. 1986).    This court has previously held that an inmate stated
    a nonfrivolous claim in complaining that he was placed in cells
    next to psychiatric patients who scream, beat on metal toilets,
    short out the power, flood the cells, throw feces, and light fires,
    resulting in his loss of sleep for days at a time.                   Harper v.
    40
    Showers, 
    174 F.3d 716
    , 720 (5th Cir. 1999).                 The trial court’s
    findings indicate that the inmates are subjected to substantial
    risk of serious harm based on the mental health conditions on Death
    Row, and, based on the evidence presented to the trial court, we
    cannot conclude that the court’s credibility determinations and
    factual   findings   are    clearly      erroneous.     We    agree    that   the
    conditions of inadequate mental health care, as found by the trial
    court, do present a risk of serious harm to the inmates mental and
    physical health.     Again, the obvious and pervasive nature of these
    conditions     supports    the   trial     court’s    conclusion      that    MDOC
    officials displayed a deliberate indifference to these conditions.
    Thus,   this   injunction    was   justified     by    an    Eighth   Amendment
    violation and is affirmed.
    Injunction #10
    The tenth injunction requires MDOC to allow the inmates to
    wear sneakers instead of flip-flops while exercising and to provide
    the inmates with a shaded area for exercise and access to water.
    MDOC argues that this is impermissible micromanagement of state
    prison operations and that no evidence was presented establishing
    a constitutional violation.        The evidence shows that inmates are
    allowed an hour of exercise four or five days a week.              The evidence
    also shows that shoes and boots were replaced with flip flops
    because the inmates used the boots and shoes to kick other inmates
    and to throw at MDOC staff, and because the flip flops make escape
    41
    more difficult. In fact, the trial court stated that it understood
    “the    use    of    ‘flip-flops’   as   general      footwear    as    a   security
    measure.”
    Russell argues that the flip-flops make it difficult or
    impossible to exercise vigorously. But there is no support for the
    proposition that exercising in flip-flops constitutes cruel and
    unusual punishment.         Nor is there any support for the proposition
    that an hour of outdoor exercise without water or shade constitutes
    cruel    and    unusual    punishment.        While    exercise    is       certainly
    beneficial      to    physical   and   mental    health,    we    find      that   the
    provisions for exercise made by MDOC are appropriate and that the
    tenth injunction is not justified by conditions in violation of the
    Eighth Amendment.         Thus, the tenth injunction is vacated.
    CONCLUSION
    Injunctions #3, 8, and 10 are vacated in their entirety.
    Injunctions #4, 5, 6, and 7 are vacated to the extent they purport
    to apply to portions of Unit 32 beyond Unit 32-C.                The remainder of
    the injunctive relief is AFFIRMED.
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