The Pandemic Beyond Hospitals and Behind Bars: Remembering Incarcerated People are Essential Healthcare Workers, Too
By Susila Gurusami
My spouse, Saagar, is a physician. This makes him one of the “essential workers” who continues to go to work amid the increasing number of cases of COVID-19 throughout the United States. He reports to the hospital during the week, some weekends, and as needed in the middle of the night, even as most residents of Illinois — and all over the world — have settled into life under “stay-at-home” and self-isolation orders. It’s been terrifying for me to see him headed to work every day as cases of the novel coronavirus surge in Chicago, especially alongside news of PPE shortages in hospitals and desperate calls for DIY supplies. The families and loved ones of grocery store employees, sanitation staff, healthcare providers, gig workers, and other “essential workers” — who are paid and publicly recognized far less than physicians, but provide services critical to surviving the crisis — will be familiar with my particular, mounting anxieties during this pandemic.
However, as a sociologist and professor of Criminology, Law, and Justice, I am also compelled to look beyond healthcare workers like Saagar and towards a population largely excluded from the public conversation: incarcerated people. Those of us who have never been locked up may not know that both physicians and incarcerated people are expected to provide medical care to those in need. Patricia*, a woman who I have come to know in my work with formerly incarcerated Black women, explained to me that correctional staff habitually expected incarcerated people to provide substantial medical care for themselves and each other. They are denied PPE while doing this labor, and often go without so much as Tylenol to help people cope with pain or gauze to staunch bleeding after major surgeries.
A couple of years after she was released from prison, Patricia and I were sitting together on her couch when she described to me her initial reactions to providing care: “First of all, we not all nurses. I used to think that was really unfair for them to do that. So what are we supposed to do for them?” Patricia shared how she and others provided palliative care while locked up — with love, empathy, and no wage — to incarcerated people with terminal diagnoses. She also led organizing efforts in the prison to raise the wage for incarcerated suicide watch workers to be paid $1 per hour instead of the previously-established $.40 per hour.
Given the medical care and mutual support that Patricia and other incarcerated people arduously fought to give one another behind bars, I’d like to invite you to think about incarcerated people as essential healthcare workers. However, unlike the healthcare professionals working in hospitals and other medical facilities, incarcerated healthcare workers are laboring under conditions of extreme coercion, risk, and absent even marginal pay or public recognition. In other words, even though Patricia and other incarcerated people often act as medical providers, they do so without adequate access to medical professionals and advice, basic medical supplies, and medication themselves. What’s more, incarcerated people are doing the work we would ordinarily expect the state and paid employees to accomplish — especially given the gargantuan budgets granted to local, state, and federal corrections. Incarcerated people are treated both as essential and disposable healthcare workers.
And while Patricia’s experience may seem extreme, it is hardly extraordinary. Charisse Shumate, a founding member of the California Coalition for Women Prisoners, drew national attention in the late 1990’s for leading a class action lawsuit against the governor of California alleging that incarcerated women were medically abused and neglected to the point of cruel and unusual punishment. Though state officials promised sweeping changes to prison healthcare procedures in the wake of the lawsuit, incarcerated people in California (and all over the world) continue to report widespread medical abuse in prison.
Truly caring for people’s health — their physical, mental, and social well-being — directly conflicts with incarceration, despite some claims that prisons and jails are some of the largest healthcare providers in the country. The conditions of imprisonment — overcrowding, staggering rates of severe chronic illnesses, an aging population, poor sanitation conditions, restricted access to healthcare, coupled with physical, sexual, and emotional abuse by correctional staff — amount to medical cruelty in the best of times. And this moment is a catastrophe.
Giving Patricia What We All Deserve
People have rightly pointed out that prisons, jails, and detention centers are incubators for COVID-19 and are urging public officials to rapidly decarcerate to prevent mass deaths. While these calls are important and necessary to save lives, many focus on releasing only those who are charged and convicted of minor drug offenses or so-called “non-violent crimes.” But some groups — like the organizations behind #FreeThemAll Week of Action — are pressing us to think beyond who can “safely” be released. Leaving anyone in prison, jail, or detention facilities — including so-called “violent criminals” and even correctional staff — amounts to mass application of the death penalty. Given the racialized and ableist burden of both carceral punishment and COVID-19 deaths, this also means we are disproportionally dispensing death sentences to people of color — especially those who are African-descended, queer, immigrant, low-income, experiencing mental health challenges and trauma, elderly, and have preexisting health conditions.
An urgent and sweeping decarceration effort is an essential part of humanely and effectively responding to the pandemic. These efforts must, as Dr. Ruth Wilson Gilmore remarked, work toward “abolishing the conditions under which prisons became the solution to problems, not abolishing the buildings we call prisons.” Like the broader public health goal of reducing COVID cases as much as possible — to zero — we should have the same goal with incarceration. This pandemic is an opportunity for us to reimagine the organization of social life and our relationships to each other. It is a chance to advance a world that takes our individual and collective humanity seriously. This is a task that prisons simply cannot accomplish — pandemic or otherwise.
Abolitionist Work From Home
So what does this new organization of our social life look like? Those of us who are privileged enough to be at home right now can channel the suffering that comes with social isolation, boredom, and grief at the dissolution of our routines towards service and solidarity. As many of us gather and make supplies for essential healthcare workers like Saagar, let us not forget those who have been hidden from our gaze by bars, fences, and walls like Patricia. Join the decarceration and abolition policy efforts of organizations like National Bail Out and INCITE!. Call your local, state, and federal representatives and demand to #FREETHEMALL from prisons, jails, and detention centers. Write to incarcerated survivors by snail mail or email, or host a virtual letter writing event. Donate to emergency funds collecting masks, soap, and other essentials for people behind bars. Contribute to mutual aid funds and housing efforts that support formerly incarcerated people and their families.
The challenges Saagar and I face because of this pandemic read as those of respectable model minorities; we are a married, heterosexual, cisgender, class-privileged, South Asian couple. It is easy to sympathize with our family and claim to be in solidarity. But in this moment of heightened anti-Blackness, truly being in solidarity with our healthcare workers and their families in this pandemic means that we are called to speak out alongside currently and formerly incarcerated people in the same breath. Those who have been historically relegated to have the least should remain our concern in this current moment. We must amplify their calls for freedom, safety, and well-being as part of our own
*Pseudonym
Thank you to Ms. Cheryl Ward, Dr. Melissa Guzmán, Dr. Liat Ben-Moshé, Dr. William Lopez, Dr. Marisa Omori, Dr. Ranita Ray, Dr. Beth E. Richie, Dr. Saagar K. Sanghvi, Dr. David Stovall, and Dr. Julian Thompson for their comments and suggestions.
Susila Gurusami is an assistant professor of Criminology, Law, and Justice at the University of Illinois at Chicago. She is a sociologist of race, gender, punishment, and labor, with particular interests in carceral governance. She received her PhD in sociology from UCLA in 2017 and is a former University of California Chancellor’s Postdoctoral Fellow. Her work has been published in Gender & Society, Social Problems, and Punishment and Society. Recognitions for this scholarship include funding and awards from the American Sociological Association, Sociologists for Women in Society, Society for the Study of Social Problems, the Racial Democracy, Crime, and Justice Network, and the UIC Institute for the Humanities.
