Nurse Supports Improved Healthcare for Prisoners

Martha Paynter refutes the claim that healthcare within Burnside jail is better than healthcare outside of jail.

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On August 21, the prisoners at the Burnside provincial jail launched a peaceful protest, in solidarity with a large prisoner strike in the United States, to call for basic improvements in healthcare, rehabilitation, exercise, visits, clothing, food, air quality and library access.

Women’s Wellness Within, a registered non-profit organization of volunteers that support criminalized women and transgender people in pregnancy and parenting, has been going into Burnside for over five years for meetings with administrators and healthcare providers, to facilitate workshops for the women on health topics, and to provide one-on-one support during pregnancy, labour and delivery, and postpartum. Women’s Wellness Within has launched several advocacy campaigns to call for health equity for prisoners, and we support the prisoner strike action.

Our work is focused on women’s health. Women are a small minority of the Burnside prisoners, about 48 people. Two-thirds of Burnside prisoners are on remand, which is pretrial custody, and Nova Scotia has one of the highest rates of remand in the world. So most of the women are imprisoned before any conviction. Once imprisoned, their families are disrupted. The imprisonment of a parent is one of the core Adverse Childhood Events that was found to predict higher rates of disease and early death in the landmark “ACEs” study. Imprisonment separates women from their families and support systems.

Image description: black and white photo of prison bars. Prison cell is blurred in the background.

Most criminalized women are victims of crime. Most women inside have been subjected to sexual, physical, and emotional abuse as children. They are traumatized, and their mental health is affected. Rates of substance use disorder, mental illness, and suicide are extraordinarily high among imprisoned women. So are rates of infectious disease. Studies have found imprisoned women have low health literacy. Women inside need more healthcare, not less.

There have been claims that healthcare is better at Burnside than outside. This is simply not true.

Imprisonment removes someone’s autonomy for their own health maintenance and strips them of options for the self-care our society is so keen to promote.

Prisoners inside do not have access to the Internet. If a woman has symptoms, she cannot Google them to try to understand what is happening. The cost to call her mom for advice is prohibitive. She cannot walk to a drug store to discuss it with a pharmacist or purchase over-the-counter medication for common health concerns like a headache, a yeast infection, or constipation. She cannot line up at a walk-in clinic for a few hours.

She can write a request to see a physician, give it to a correctional officer, hope and wait for weeks. Burnside imprisons 370 people. There is a physician available two half-days per week. Burnside is a place of violence and injury. Common minor problems like yeast infections and constipation are not clinical emergencies, but living with them makes a challenging situation unbearable, and risks causing serious consequences.

Pregnant women at Burnside cannot use the Department of Health’s only prenatal program, the online Welcome to Parenting module, to prepare for their new baby. They are not informed of when they will be transported to clinical appointments offsite, such as for ultrasonography. They cannot have their partner or their mom with them for the joyful and the frightening parts of these appointments. They have no control over the food they get to eat while they manage morning sickness.

Depression is the most common complication of pregnancy, and yet women in Burnside cannot even go for a walk to clear their minds and stretch their legs. Unlike on Orange is the New Black, prisoners in Burnside do not have a grassy “yard” for fresh air and exercise. There is a small, concrete-floor, brick-wall enclosure, with chain-link fence over the top like a cage. Pregnant women are vulnerable to physical and mental punishment that includes solitary confinement (administrative segregation). The Deep published a story last year about the devastating impact of solitary confinement on a woman remanded late in her pregnancy.

Unlike at some federal prisons and a British Columbia jail, new babies cannot stay with their mothers inside Burnside. They cannot even touch their mothers at a visit. If how we treat pregnant women and new babies is a barometer of conditions, imagine what everyone else is experiencing.

We know most prisoners come from backgrounds of poverty, homelessness, unemployment, low educational attainment, and trauma. These are the determinants of poor health. Imprisonment is making the poor health of prisoners worse. Prisoners at Burnside are discriminated against and denied access to curative Hepatitis C treatment. Staff describe the jail as filthy. During this summer’s heat wave, prisoners called it stiflingly hot. The jail is criticized for overuse of solitary confinement. There is evidence that prisoners see their medications withheld. Burnside leadership say the jail is “operating as usual” despite the protest. That is the problem: normal at Burnside is not humane.

We need to support the prisoners in their basic requests, and we must work towards implementing alternatives to incarceration that will truly support health, rehabilitation, and a just and inclusive society.

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Martha Paynter is a Ph.D. student in the School of Nursing at Dalhousie University and a Registered Postpartum Nurse. @marthpaynter

A version of this commentary was originally published in the Halifax Examiner.