Ailing American Woman Sarah Krivanek Receives First Visit at Russian Prison in 9 Months: 'Crisis Situation'

Sarah Krivanek's wellbeing remains a concern for activists and loved ones, heightened after an official saw the American woman's condition in person for the first time since she was imprisoned in Russia.

Natalia Filimonova, a prisoner's rights activist working for nonprofit organization Russia Behind Bars, organized a visit from the state-run Prisoner Monitoring Service recently. She tells PEOPLE that foreign inmates do not have access to money and supplies from family and friends abroad "so they find themselves in a critical situation if their health deteriorates."

"They don't have a Russian medical card and so they can't use the prison clinic," she says. "When any inmate finds themselves in a state of crisis, that's the moment we go in to see them. If we didn't do this many people would perish in prison."

Krivanek is serving a one-year, three-month sentence in connection with domestic assault charges that stemmed from a November 2021 dispute involving a Russian man named Mikhail Karavaev. She nicked him on the nose with a knife, which she claimed was after she was physically abused.

After indicating in court that she was defending herself in the incident, Krivanek was released on bail. But while trying to flee Russia with the help of the U.S. Embassy on Dec. 15, 2021, Krivanek was arrested at a Moscow airport before she was able to board her U.S.-bound plane.

A family member who Krivanek calls "Nanny" — and who asked to be named only as Caroline — tells PEOPLE, "I worry about her day and night." Caroline has been like a mother to Sarah, who she says was hospitalized for near renal failure in the U.S.

"If she's not getting treatment, I'm afraid she's not going to make it," Caroline says.

Anita Martinez, a close friend of Sarah's, has repeatedly written to the State Department through the White House website, urging them to visit her. A U.S. official told her in early August the State Department is "very concerned" and "doing everything they can to ensure her well-being." But she's heard nothing more and Krivanek has yet to receive a visit from the embassy in Moscow, a four-hour drive from the colony.

Viktor Boborykin, the Prisoner Monitoring Service official who visited Krivanek around Sept. 14, confirmed (via his colleague) to Russia Behind Bars that Sarah was in ill health, but gave no further details. The group works hand in hand with the Federal Penitentiary Service and is wary of any public criticism regarding conditions in prison.

Russia Behind Bars also arranged a drop-off of fresh fruit and vegetables, vitamins, milk products, warm clothes and basic toiletries such as shampoo and soap through two local volunteers on Sept. 14. Krivanek had begged for the items in a prison-censored letter to a Russian contact.

The volunteers who traveled from nearby Ryazan to deliver the goods in person were not permitted in to see her. "They told us we needed proof of Covid vaccinations. But that wasn't posted as a requirement on the prison site," explains one of them, Ekaterina Vulikh.

"The last three kilometers [to get to the penal colony] was just a dirt track," Vulikh says. "It's in the middle of nowhere. It's strange when you approach because you come upon this old, dilapidated set of Soviet-era buildings ringed by barbed wire. There's complete silence."

An online review site of Prison Colony No. 4 in the Ryzansk region describes the appalling conditions. "The food has maggots and cockroaches in it and if you open your mouth to complain you're sent to the Shizo [isolation cell]," writes Viktoria Naklonova. "In Winter the cold is unbearable…In a word, it's hell there."

Yekaterina, a relative of an inmate, writes: "There is absolutely no medical help here, my relative had open ulcers on her legs and she wasn't even given a bandage."

Another relative, Alexei Ivanov, said: "The only way to survive here is if you have money."

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Svetlana Gorbacheva, a lawyer for Krivanek who has received two distressed phone calls from her client since December, has personally sent her money. She knows that friends and family are unable to transfer funds into Russia following the war in Ukraine. "I feel so sorry for her," she says. "She desperately needs help. She's sitting waiting for someone from the Embassy to come."

The Russian judicial service "asked constantly" for a representative of the U.S. Embassy to be present at her trial but "they didn't respond at all," she adds.

A U.S. State Department official told PEOPLE in early August, "We take our role in assisting U.S. citizens abroad seriously and are monitoring the situation." Responding to the latest news about Krivanek's health concerns, an official tells PEOPLE that the State Department's requests for access to detainees are "consistently delayed or denied" by Russian authorities.

Filimonova from Russia Behind Bars was surprised that Boborykin's visit was attended by a prison guard and a priest — those meetings are supposed to be private. "We stressed that it had to be a one-to-one confidential meeting so that we could get information on how she really feels, what her conditions are and what medicines she needs."

She believes the guard was present because she's an American citizen. She adds that Krivanek had been in the prison system long enough to "understand the dangers of saying anything that could get her into trouble."

Krivanek is due to be released on Nov. 11 and then deported, but her lawyer insists that the deportation process "is to be avoided at all costs." Unlike the U.S., the Russian government does not pay deportation costs and foreigners convicted of crimes are kept in a holding cell until they can organize their own trip home.

"Normally what should happen is that the Embassy makes contact with the prison administration and arranges for conditions of her release," adds her lawyer.

Filimonova says she knows of foreigners who've been in a detention cell for up to a year while they try and raise funds for a flight home. Krivanek will be penniless upon her release and likely still unable to contact friends and family from her cell.

"We will try and get one of our volunteer lawyers to take on this case and see if we can avoid deportation," she says. "If that isn't successful, we can help arrange her flight home."

Meanwhile, Martinez says she's happy that people are finally paying attention to her dear friend. "I'm eternally grateful for the help shown by these brave Russian volunteers who've arranged for potentially life-saving supplies to be sent to Sarah," she says. "And to PEOPLE for establishing contact with them."

Filimonova agrees that you have to be "a courageous person" to come to the aid of an American prisoner in Vladimir Putin's Russia.

On Sept. 12, Martinez sent another letter to President Joe Biden, which she shared with PEOPLE. She begs him to show Krivanek the same attention he has given to WNBA player Brittney Griner, who is also imprisoned in Russia and is now awaiting news on the appeal of her nine-year sentence for drug possession.

Biden recently met with Griner's family members at the White House to assure them that her case is still a top priority for the administration. Martinez has yet to hear back from the president regarding Krivanek.

"Please do not let her die in a Russian prison!" she writes. "She said that she feels abandoned by the U.S. Government. Please do something to let her know that this is not the case and that she has not been forgotten. Do right by her and bring her home before it's too late."