As I diligently stock up this week on Tylenol, hand sanitizer and granola bars in anticipation of a possible COVID-19 shutdown, I am thinking: “What about people in prison?” They have no autonomy over their access to medication and food. They are not allowed hand sanitizers. And they are already managing multiple comorbidities including respiratory illness, blood-borne infection, head injury and depression. Who is thinking of them and preparing for their care?
As a nurse who works to advance the health of prisoners in this province, I am worried.
Prisons are petri dishes. Hundreds of people are under one roof with poor ventilation, barriers to health services, substandard nutrition, limited participation in exercise and time outdoors and inadequate information provision. The No. 1 demand of the Burnside prison strikers last year was improved health care, but air quality, physical activity, food and library access all made the 10-point list.
In Nova Scotia, the vast majority of prisoners are on remand, pretrial detention before any conviction or sentence. Unsurprisingly, this “holding cell” system involves constant turnover. According to the Department of Justice, last year the median length of stay in Nova Scotia provincial corrections was between four and eight days, depending on the race and gender of the prisoner. By using our prisons in this way, they become a revolving door for introduction of infectious disease from the community, its incubation and transmission inside, and its spread back out through the community when prisoners are released.
Tight restrictions on what is allowed in the prisons result in serious threats to sanitation. People who are incarcerated have reported to me a lack of access to dish soap and other basic cleaning products. Why is this? Because of fear of diversion — that the products will be consumed “inappropriately.”
Most incarcerated people have extraordinary histories of abuse and, unsurprisingly, experience substance use disorder stemming from their efforts to cope with untreated trauma. Lack of understanding of the value of safe supplies of alcohol and drugs for this population, and a consequent lack of pharmacological support for management of substance use disorder, leaves people inside at risk of dangerous withdrawal symptoms. Things like hand sanitizer, alcohol wipes, mouthwash and other hygiene products are considered contraband because they could possibly be used to self-manage withdrawal.
At the federal level, last month the Office of the Correctional Investigator released its most recent report on prisons in Canada. Since 2011, when the Harper government passed legislation allowing consecutive life sentences, more prisoners than ever are aging and dying behind bars. A quarter of prisoners are over the age of 50. Prison is aging — people over 50 face a host of threats to their well-being. These are the people most vulnerable to fatal infection with COVID-19.
During times of crisis, communities come together, share resources, support each other. After hurricane Juan, a neighbour of mine made our whole street coffee on his Coleman stove for five days straight. Who is supporting people inside the prisons? Who is even allowed in? How are the messages and actions of community solidarity able to reach inside those walls?
Many were distraught, imagining themselves like those quarantined on the cruise ship off Japan earlier this winter, without sunlight, with anxieties about dwindling medication, and without much ability to communicate with family and friends at home. This is the reality of prison on a normal day. What kind of lockdown, isolation and restrictions might prisoners face with COVID-19?
As we prepare together for COVID-19, we must consider the needs of the most marginalized. Those living in poverty do not have extra funds this week for stockpiling supplies. Those experiencing homelessness do not have safe and clean homes to hide away in. But those in the prisons are at great risk of both infection and of the anxious anguish of not being able to do anything to protect themselves.
Martha Paynter is a registered nurse and a PhD candidate at the Dalhousie University School of Nursing, where she studies reproductive and prisoner health. She is founder and chair of Women’s Wellness Within, a non-profit organization for reproductive justice in Nova Scotia.