Joe, a Michigan prisoner housed at the Macomb Correctional Facility where I am also incarcerated, considered contacting prison nurses a month ago. He had a cough that lasted more than a week, a fever and shortness of breath. Joe (whom I’m describing using a pseudonym here) thought he might have contracted “that virus talked about nonstop on the TV.”
However, Joe had plenty of previous encounters with prison health care, and few — if any – had ended with adequate medical attention, thanks to the lack of resources devoted to the health needs of incarcerated people. At a time like this, the lack of real care boded ill not only for Joe, but for everyone at the prison. In here, social distancing is purely aspirational. Every activity that we’d be able to do on our own on the outside, such as eating, showers, telephoning, taking medication, even going to the toilet, is organized around a close mutual contact model. The current situation is a tragic indictment of the state’s appropriation of human beings’ individuality and personal agency.
Based on past experiences, Joe felt it made no sense to pay the $5 co-pay for a medical appointment, since the prison only allows him $11 a month to purchase necessities. He knew that other prisoners with similar symptoms were simply being told to drink lots of water. He decided instead to ride things out, hoping to feel better in a few days. Joe has now tested positive, and, at the time of this writing, has been housed in the prison gymnasium for several weeks with at least 46 other confirmed cases of COVID-19.
I have not personally been to the gymnasium. But those who have say the squalor and stench is recognition that dignity and full-fledged human rights, which are so prized in theory in the United States, are in practice myths, especially for incarcerated citizens. In one of the world’s wealthiest societies, a global leader in many areas, and a land of unsurpassed technological innovation, humans are being warehoused instead of cared for.
To their credit, health care staff are working hard to prevent further spread of the highly infectious and deadly virus. But like Joe, health care staff lack authority to make decisions based on their training and expertise. Health care decisions, like who gets medicine, or a decision not to send prisoners to the hospital — even when more critical care is warranted — are made by a private insurance company in Oklahoma City, Oklahoma, hundreds of miles away.
Quality-of-care decisions are being made by a lot of people who have nothing to do with what is happening here. People who are disconnected from directly impacted people: patients, nurses, some guards who are pitching in and helping, prisoners who are doing the same. They are making decisions about what to do based upon costs. These decisions include leaving us without basic sanitation and hygiene supplies.
Prison officials’ initial response centered on bleach and disinfectant, but within a week of the outbreak they were severely scaled back and watered down. It’s an impossible situation. Disinfecting supplies are now dispensed at the leisure of guards who first use what is available for the areas they occupy for themselves. If any is left over, they spray down toilets and mirrors. It is a scary situation in here, all around.
I’ve ceased sending clothing to central laundry and wash everything by hand, including bedding. Also, I no longer eat food prepared by the prison. I only eat what I can afford to purchase from the prison commissary.
While there is no magic recipe for eliminating COVID-19, and each level of government must make its own good-faith decisions, human rights considerations should invert these cost-saving measures – the measures that deny prisoners adequate sanitation supplies and medical care. Making decisions based on human rights would mean acting on the belief that quality of care depends on the involvement of those who have the most on the line, not on what is going to save a buck. Trying to save a buck is failing Joe and dozens of other incarcerated people. Moreover, the current situation is making it ever more clear that prisons and jails themselves are not in the interest of public health, and that prison abolition should be in our sights.
We can no longer pretend we do not know what to do. Throughout the country, formally and informally, people are tackling the unprecedented challenge of COVID-19 in ways that reflect core values honoring family, community and mutual destiny. In prison, higher-up authorities are attempting to tackle it in a way that keeps the status quo. If there was ever a time to release large numbers of people from prisons and jails (as grassroots efforts inside and outside of prisons are currently demanding), this is it. And it is a time to listen to incarcerated people who are saying what we need.
Incarcerated people here at the Macomb Correctional Facility are rooting for the rest of the country and people around the world to pull through this crisis. We need support from outside these walls to pull through ourselves.
There is no single answer, nor a perfect one, but when we admit to the failure of cost-based determinations as to who does and does not receive care, or the quality thereof, we become responsible for trying something different. Health care, not to be confused with health insurance — in here or out there — is, in fact, a social good. It should not come with a price tag for patients, and its quality should not be based on a desire to cut costs.
The solution to the COVID-19 crisis, here inside, is not hope, as that is all incarcerated people at Macomb Correctional Facility are currently working with. We are trying to gain control and establish a sense of agency relative to a life-or-death virus. We are beginning to assemble a coherent narrative regarding what is taking place behind bars, so we can share it with the world. We are developing a stronger sense of responsibility and empathy for everyone within these walls. We want to help plant the seeds of recovery. But we need your support from outside to help us do that, in advocating for the release of as many people as possible, and for better health care for those who remain inside.
Joe did not have good options to begin with, to secure his basic safety and health in a way that was responsive and meaningful to him. Therefore, he is at greater risk for an unfavorable outcome. Because he is incarcerated, this outcome will inevitably be hidden behind the veneer of public safety, when really, it’s a matter of a cold cost-benefit analysis: whose life is determined to matter, and whose is not.