After decades of systemic and societal discrimination, an array of hope burst through the clouds of despair for transgender individuals. Recently, greater acceptance of transgender individuals in modern culture has opened doors to accessible and evidence-based transgender healthcare. Budding healthcare infrastructure has helped transgender individuals transition and care for their changing bodies providing relief for the marginalized community. Healthcare professionals and teams of scientists worked for decades through societal judgement and the subsequent roadblocks to ensure that the transgender community had an improved chance at a healthy life as non-transgender individuals. However, increasing vitriol exacerbated by politicians has tightened restrictions for gender affirming healthcare across the United States.
Cube beads spelling the word “transgender”; Source: Unsplash
Introduction
In February 2022, Texas Governor Greg Abbott and Attorney General Ken Paxton released a directive stating that gender transition therapies including hormone therapies, puberty blockers, or surgery given to minors can be investigated as child abuse and given criminal penalties. Officials, teachers, parents, nurses, and anyone involved in direct contact with children were required to report suspicions of such therapies, framing the act more as concern for children’s safety and innocence. Anyone found supporting or prescribing such treatment, including parents or healthcare providers, would be subject to child abuse investigations by the Texas Department of Family and Protective Services. The agency was instructed to prioritize cases in which parents who provide their transgender children with gender-affirming care above all other child abuse cases. Strangely, the caseworkers were told to investigate regardless of whether the standard of sufficient evidence was met and to not record their investigation in writing.
Days after the directive was announced, the Texas Department of Protective and Family Services launched an investigation into a federal employee, a mother of a transgender daughter, after she inquired when the directive would be made effective. A federal judge blocked the investigation only 2 days later. In the immediate weeks following the directive‘s release, at least nine families were already facing child abuse investigations for supporting their transgender children in obtaining gender-affirming care. This past spring, the clouds in an otherwise tranquil sky began to blot out blossoming hope as intimidated healthcare providers canceled hormone prescriptions and the few existing transgender youth treatment facilities closed. Families clamored to find alternative sources of hormones and puberty blockers for their children. Some became afraid to claim the transgender label, many moved out of the state, and hundreds more were at home, fighting for their right to exist as their gender identity and as themselves.
Image of protest with posters listing “Transgender Healthcare”
Medical Evidence
In a statement to the Texas Tribune, U.S. Surgeon General stated that this directive interferes with the physician-patient relationship which has no place for religion, beliefs, or politics. Abbott’s directive and Paxton’s following opinion sparked intense backlash from the medical community for blatantly ignoring decades worth of research supporting early transitional care.
When children first learn that they are transgender, they face a physical and mental health disorder known as gender dysphoria. Gender dysphoria is a condition where individuals experience severe dissonance between the gender they identify as and the physical manifestations of their biological gender. Depression, anxiety, and suicidal thoughts often follow this sense of “not self” that plagues many adolescents as they begin to come out to the world with their new name and pronouns. To significantly improve the outcomes of transgender individuals, all major medical organizations including the American Academy of Pediatrics, American College of Physicians, and American Psychiatric Association support gender transition as an effective therapy. Transitioning includes gender-affirming hormonal therapy and puberty blockers. Hormonal therapy begins and allows for a smoother transition into the opposite gender while puberty blockers suppress the body’s natural maturation process to increase the amount of time children and their bodies have to transition into a new gender. In the meantime, individuals receive mental health support and preparation for a successful transition and in unfortunate cases, wait for legislation to increase access to gender affirming treatments.
Overhead view of medications and hormone therapy. Source: Unsplash
The most prevalent medical reason for opposing gender transition is the possibility that a transgender individual will have regrets, because what is done cannot be undone easily. Although it is a valid concern, puberty blockers exist for children and individuals who are uncertain about their gender, because they provide ample time for the individual to choose not to change genders, if that is later realized. In addition, regrets are “extremely rare” and can be attributed to adverse social climates more than personal attitude. Proper mental health support and preparation are also important for a successful gender transition to recognize behavioral changes and tackle the paradoxical shared sentiment that transgender people are no longer welcome in conservative society.
Alabama and Florida Response
Governor Abbott’s attempt to restore conservative values in Texas is not a new phenomenon. Texas has seen several bills criminalizing medical care for transgender children which is reflective of a broader trend across the United States. In the past year alone, 21 states drafted bills to deny transgender medical care. Arkansas passed a bill making it illegal to prescribe puberty blockers and for insurance companies to cover transgender care. Other conservative states, such as Alabama, have taken Abbott’s directive as a green light and are preparing legislation to discourage transgender healthcare and marginalize the LGBTQ+ within their borders. Taking a slightly different approach, Governor DeSantis of Florida introduced what is commonly referred to as the “Don’t Say Gay” Bill (House Bill 1557). Also known as the Florida Parental Rights in Education Act, the bill was signed into law and passed by the Florida Senate in March 2022. This bill would effectively prevent gender identity and sexual orientation education in classroom discussion in Florida. Experts worry that the vague descriptions in the law indicate that it be used it to suppress all actions that remotely fall under the literal definition of sex and gender, leading to a dangerous slippery slope that may open a dark path of minority discrimination.
Black and white image of a protest with the phrase “No Body Is Illegal” centered.
On April 8th 2022, Alabama Governor Kay Ivey signed into law two bills preventing medical professionals from providing gender-affirming care and forcing individuals to use the restroom of their biological gender. In an unprecedented move, the Vulnerable Child Compassion and Protection Act makes arranging gender-affirming treatment including puberty blockers, cross-sex hormones, and surgery for children under 19 a felony with a possible sentence of up to 10 years in prison if convicted. The second bill is culturally similar to Florida’s “Don’t Say Gay” Bill. This bill prohibits teaching or using words related to “sex” and “gender.”
Current Status
A lawsuit filed by families of transgender children weeks after Abbot’s directive was announced resulted in an injunction from federal courts. Abbott vs Doe reached the Supreme Court in May 2022 during which the court ruled that Abbott had no authority to control child welfare officers and direct them to investigate providing transgender healthcare. The country released a sigh of relief, but the fight is not over. Stopping Abbot’s directive seems more akin to a pause on the right’s crusade against the transgender community than a stop.
Recent reports from The Washington Post also suggest that Attorney General Paxton attempted to collect gender marker changes and other transgender identifying information on driver’s licenses from the Texas Department of Public Safety in early 2022. Human Rights Campaign reports that Paxton’s office requested the names and license plates of these individuals later in the inquiry, as well. This news comes as a new shackle for transgender Texans. Some have changed back their gender identity on their licenses to the way it was prior. If not, police or other government officials would know of their transgender identity with the search of their name during traffic stops or unrelated incidents which could lead to dangerous discrimination.
To support the fight for transgender safety in Texas, support politicians and lawmakers who oppose legislation limiting transgender healthcare. Advocate for the reopening of the University of Texas’s youth transgender clinic, the only one of its kind in the southwestern United States, that closed last November. People in Texas and across borders can also donate Lambda Legal and the American Civil Liberties Union (ACLU) which are organizations working to keep the injunction in place on Governor Abbott’s directive after AG Paxton filed an appeal against the federal court decision. They, in conjunction with the Transgender Education Network of Texas and Equality Texas have also assembled the LGBTQIA+ Student Rights Toolkit which is a set of explanations and guidelines to understand Texas’s current plight as well as additional resources such as TX Trans Kids.
An image of a tightly packed women’s prison. Source: Soumya Misra (Nursing CLIO) via Yahoo Images Public Domain
This is a continuation of the conversation about the Alabama Prison Crisis as exposed by Mary Scott Hodgin in her podcast, “Deliberate Indifference.” If you have not read the previous blog post on this topic, “The Ongoing Alabama Prison Crisis: A History”, it is recommended that you do so. Also, if you would like more information and details regarding this topic, please listen to the podcast, “Deliberate Indifference,” by Mary Scott Hodgin. Now, without further ado, let us jump right in from where we left off.
In the previous blog, we focused on the history of prison systems in America, and particularly, some of the legislations and ideologies that laid out the foundation for the correctional institutions we know today. We explored in detail the convict leasing system that helped rebuild the infrastructure of the Antebellum South following their defeat in the Civil War, and the racialized laws and legislations that disproportionately landed Black and Brown people in prison over their White counterparts. The War on Drugs era followed by the Tough on Crime era landed hundreds of nonviolent offenders in prison, serving longer and harsher sentences and life without parole. While our focus in the last blog was more nationwide, it was necessary context to set the stage to better understand the realities that face the Alabama prison systems focused on in this blog.
The objective now is to look deeper into the conditions of the penal system in Alabama, the lawsuits they faced in 2017, and the most recent one in 2020, how the pandemic exacerbated these conditions, the prison strikes that took place within these prisons, and some ways to move forward to bring about actual change – change in the mindset of our fellow Alabama voters, and a shift in the way the prison population is viewed and treated as a whole. We will look at some groups that are trying to do just that, from organizations like Alabama Appleseed and the Offender Alumni Association to religious groups and other educational groups that sponsor programs within the prison system to provide opportunities for higher education to the imprisoned population.
Prison Conditions
An image depicting a dormitory-style housing unit. Many of Alabama’s prisons are structured this way. Source: Yahoo Images via ACLU
While exploring the most recent reports that resulted from the federal investigations of Alabama’s prisons, there were many similarities in the reports. While the problems of understaffing and overcrowding were expressed in detail, (which will be discussed below), there was also extensive observation of the living conditions inside the prisons. What the investigations revealed was shocking, and despite having been advised to address these issues even in the 1970s investigation of Alabama’s prisons, the conditions had not improved. Rather, it had deteriorated even more due to the consequences of staffing and crowding issues.
Both reports extensively provide detailed examples of violent outbreaks within the prisons, between prisoners, and even at the hands of prison staff targeting the prisoners. Many such incidents go unreported, and others have even ended in the death of the imprisoned person. One of the things that contribute to this violence is the structure of the prison itself. Many of Alabama’s prisons are fashioned in a dormitory-style of housing units instead of the individual cell units depicted in popular culture. These housing units are essentially enormous halls that are secured on the perimeters, with bunk beds piled into the room as close as they can fit. With little to no privacy, and jampacked in tight spaces, people can get easily agitated, and this can lead to violence. Due to the overcrowding issue, many people are even expected to sleep on the floors, which can be unsanitary and uncomfortable. Due to the continuous staffing issues these prisons face, these large units may go unguarded for long periods of time, sometimes even entire shifts.
This puts both the inmates within the units at risk for violence, and the prison staff who, to the incarcerated individuals, represent the authority from which these conditions are sanctioned. Even still, many officers, due to the understaffing issue, have overlooked contraband possession (such as drugs or cell phones), deciding to pick and choose their battles in an already tense environment. As a result of all these issues, corruption is rampant within the prison walls, and many prison staff, according to narratives from both reports, take advantage of this tense environment to assert dominance over prisoners with increased brutality. People who are incarcerated are not viewed by society as individuals with their own pasts and presents. They are only viewed as “criminals,” remain invisible to society and are dehumanized. Regardless of the crimes that a person commits, they are at the end of the day, still, people, who deserve dignity and basic human decency. As an institution of the state, prisons are legally responsible for providing a safe and secure environment for people who are incarcerated to serve out their sentences as punishment. The American Constitution does not support “cruel and unusual punishments”, and under the Universal Declaration of Human Rights (UDHR), the rights of imprisoned individuals are fully supported.
An infographic that lists the universal rights protected under the Universal Declaration of Human Rights (UDHR). Source: Irish Times via Yahoo Images Public Domain
2017 Federal Investigation
In the previous blog, we focused on how the prison system of Alabama has been under federal investigation nearly 50 years ago in the 1970s. Unfortunately, the conditions outlined in those reports were never fully addressed, and the issues that were highlighted have only been exacerbated over the years. In September 2017, the Department of Justice from the federal government toured one of Alabama’s prisons, Bibb County Correctional Facility, for their official investigation of prison conditions in the Alabama penal system. What they uncovered was outlined later in a report published in 2019, stating over 50 pages worth of evidence against Alabama, and the minimal expectations the federal government laid out for Alabama to achieve, both short-term and long-term.
The report is prefaced by the fact that these concerns were underlined within a week of their investigation. According to the report from the observations made in 2017, the Alabama correctional facilities faced a myriad of issues, including an overcrowded prison population, with dangerously low staffing, issues of contraband entering the prisons, and a host of observations pertaining to violence within the prisons, including physical, mental, and sexual violence. As discussed in the previous blog, these overcrowding issues come from the various legislations that were passed, increasing the lengths of sentences, criminalizing drug abuse and mental health issues (instead of treating them as medical issues requiring rehabilitation and treatment), and incorporating mandatory sentencing minimums and three-strikes laws. Along with identifying the concerns stated above, the report also deemed the penal system’s inadequate protection of its inmate population from harm, violence, and death, a failure. The report discussed at length how, along with unsanitary living conditions, there are dangerous weapons and drugs that are circulating within the prisons, making them unsafe for both the incarcerated people, as well as the officers who work there. This in turn is both caused by and exacerbated by the issues of overcrowding and understaffing within the prison walls. With fewer officers to supervise the dormitory-style prisons in Alabama, incarcerated people are packed together to fend for themselves.
While not all people locked up in prison are violent offenders, studies have shown that desperation, (which is rampant in these prisons), can lead to violence, distrust, and increased criminal behavior within the population. While the study referenced focused on populations outside of prisons, it is safe to assume that these results are only amplified within the prison system. The people within are both desperate and already undergoing punishment, which means that even the threat of punishment is not a deterrence from committing these violent acts. This also means that with fewer officers to supervise the dorms and halls of the prison, the overall violence within the prisons is increased, making it dangerous for the entire prison population.
As explained in both the report by the federal investigation, as well as the podcast by Mary Scott Hodgin, there were at least 11 men that died in 2019 alone due to the increase in violence within the Alabama prisons. To make matters worse, the federal investigation also found that the Alabama prison system’s record-keeping on these incidents and others was inaccurate, finding that there were many incidents that went unreported, and even many deaths misclassified as due to natural causes or medical reasons rather than due to the violence found within the prisons. If you count the total number of deaths within the inmate population in 2019 classified as natural causes or otherwise, the number is as high as 119 deaths.
An infographic providing statistics on mental health in the prison system. Source: Cabrini University via Yahoo Images Public Domain
In addition to the misclassifications and incidents not being reported, Hodgin also details in her podcast the inadequate mental health care offered to incarcerated individuals within Alabama’s prisons. This can lead to an escalation of violence, and abuse of drugs, and place incarcerated individuals dealing with mental health issues in dangerous situations. Without the proper medical attention required to treat these individuals with mental health illnesses, prisons can become a charged environment that can exacerbate their conditions, making them more vulnerable to both becoming victims of violence, as well as the perpetrators of the violent acts. Unfortunately, because people with mental health issues are four times more likely to be imprisoned instead of receiving treatment and care, many individuals in prison already enter the system without knowing how to follow social norms. This can put them in danger of being abused by officers and other imprisoned individuals alike, and without proper care, their conditions can become worse, and at times, can end in death, either at their own hands or at the hands of another.
Another major topic of concern addressed in the report is that sexual abuse and sexual violence. Sexual violence is rampant in Alabama’s prisons, and this issue is exacerbated by the understaffing issue present within these facilities. With fewer officers staffed to care for increasing numbers of imprisoned people, there is less monitoring and supervision taking place, creating a breeding ground for violence, both sexual and physical. Much of the sexual abuse either go unnoticed, or unreported by staff members, and while the victims can report these incidents too, many choose not to for fear of retaliation or feelings of shame. Their fear is not unsubstantiated, as many accounts have been provided in which sexual assaults took place in retaliation to the victim’s reporting of a previous sexual assault. In addition to the low staffing numbers, many of the facilities in Alabama are constructed in a dormitory style, meaning that imprisoned individuals are grouped into a big hall rather than individual cells. This can be challenging for clear visibility of each individual inside the prison and their whereabouts. At times, only one or two officers may be in charge of the entire unit, and sometimes, the incarcerated people go unsupervised.
Many incidents of sexual assault occur as a result of “drug debt”, where an incarcerated person owes another incarcerated person money for drugs or other contraband and does not pay. There have even been incidents where family members of people who are incarcerated have been extorted for money, with the threat of sexual violence against their imprisoned family member. Many victims of sexual abuse within the prisons also alleged that these instances occurred after the victims themselves were drugged or held at knifepoint. While much of this goes unnoticed by the prison staff, some reports that do manage to document these incidents have even labeled sexual assault as “homosexual acts” rather than nonconsensual sexual abuse. People who are incarcerated that belong to the LGBTQI+ community are even more vulnerable to sexual violence simply for their identity. Unfortunately, many of the officers in charge of ensuring that the prisons comply with the Prison Rape Elimination Act (PREA), are not even aware of who among their incarcerated population belongs to the LGBTQI+ community. The PREA flags the LGBTQI+ population as being most at risk for sexual crimes, and the PREA managers in the Alabama Department of Corrections are not fully complying with the standards set by the legislation.
After identifying and explaining the various issues the Department of Justice found within Alabama’s prison system, the report argued that these conditions violate the constitutional rights of the incarcerated people, and as such, provided some bare-minimum measures that Alabama should take immediately to avoid a federal takeover of the prisons. These remedies included addressing the issues of overcrowding and understaffing, the rampant violence (both physical and sexual), the access to contraband, and the living conditions within the facilities. In addition to these short-term measures, the report also suggested some long-term measures to implement, including – among a list of other things – better incentives to improve staffing issues, improved systems to track, record, and address issues of violence, and more regulation over prison conditions and treatment of the imprisoned population. Alabama closed down one prison after this report (Draper Correctional Center) and closed a particularly harmful “behavioral modification unit” or “hot bays”, (where incarcerated individuals are held as punishment for violence and drugs within the prison) at Bibb Correctional facility. While these closures were a good place to start, they should be in no way, the only solutions to the long list of problems outlined by the report following the federal investigation. Unfortunately, Alabama, as expressed in the report itself, has been “deliberately indifferent” to these situations, and as a result, experienced yet another investigation in 2020.
2020 Federal Investigation
An image of an overcrowded cell colored in red symbolizes prison violence. Source: ProPublica via Yahoo Images Public Domain
The 2020 report from the Department of Justice’s investigation into Alabama’s prisons found similar problems echoed in the 2017 investigation they conducted. As mentioned in the 2017 report, the 2020 report also addressed issues of overcrowding of prisoners, stating that all of Alabama’s 13 prisons held thousands of people over the capacity they were designed for, making Alabama’s prisons among the most overcrowded prisons in the nation. This report also referred to the dangers of not having adequate staff members to care for and run these overcrowded facilities, this time focusing on how these staffing and overcrowding issues have led to an increase in officers using excessive force against the incarcerated individuals, further aggravating the violence that exists within the prison walls. This issue of excessive force is further examined in the report, claiming it is a violation of the Eighth Amendment to the Constitution of the United States which outlaws cruel and unusual punishments against imprisoned people.
The 2020 report details the many reasons why officers use excessive force against people who are imprisoned. Unfortunately, many officers have been known to use violence and excessive force to “handle” a situation, even in times when there is no physical threat to the officer, and even when the incarcerated people are complying with the given orders. This has the tendency to escalate the situation, placing both the incarcerated individual and the officers in danger’s way. The report provides various examples of such incidents where the imprisoned people are reported to be complacent with the officers’ instructions, even handcuffed without ways to fight back, but have still been beaten, tortured, and abused inhumanely. These officers filed false incident reports claiming that they did not engage in such actions, and even after investigations of the incidents, the officers did not face any legal consequences or disciplinary actions for their behavior.
At times, excessive force is used by officers as a form of punishment or retribution for disrespecting the officers or reporting them. The 2020 report describes multiple incidents where excessive force was used against incarcerated people simply for not following the specific directions laid out by the officers. One incident includes an imprisoned person being physically abused and forced to eat all the leftover chicken for simply wanting some extra food. Other incidents outline the use of chemical sprays to punish incarcerated people or as a form of retribution for not following verbal orders. Chemicals sprays are used even in times when the imprisoned people do not pose any physical threats to the officers. Finally, many officers also use force to simply assert dominance and inflict pain on their charges, something that not only endangers the people involved (both officer and incarcerated individuals) but also causes the incarcerated individuals to distrust the officers in charge, escalating the tensions between the two groups.
All these incidents are violations of the eighth amendment, and while many of the investigations that these incidents resulted in agreed that there was no justification for the use of excessive force in any of these outlined incidents, the officers faced little to no disciplinary actions for their conduct. The Department of Justice also included this issue in their report, arguing that unsurprisingly, officers either fail to report or inaccurately report incidents where excessive force is used. Many times, excessive use of force is investigated internally and recommended for an I & I investigation (Investigations and Intelligence unit of the Alabama Department of Corrections in charge of investigating misconduct by prison staff). Unfortunately, the report declares that of all the incidents recommended to the I&I unit, only 40% of them are actually reviewed. To make matters worse, many of the cases that are investigated by the I&I unit, where excessive force has been confirmed, are seldom referred to be criminally prosecuted. This means that many of the officers abusing their authority and misbehaving with incarcerated individuals go unpunished for their conduct. Many more of the incidents where excessive force is used go unreported, with only the victim’s bruises to bear witness to the incident. For fear of retaliation, many imprisoned persons go without reporting the abuse they face at the hands of officers. If the victim does not cooperate in the investigation, the incident is deemed “unsubstantiated”, and the investigation is closed.
Following their investigation, the federal government proposed a list of measures that Alabama’s Department of Corrections needs to take in order to fully comply with federal regulations for correctional institutions. These immediate measures included the need for more I&I investigators, a better system for victims of abuse from officers using excessive force to report their incidents anonymously and independent of the prison’s authorities, clear procedures for accountability for officers, and better documentation and investigations of incidents where excessive force is used.
COVID-19 and Its Impact on the Prison Population
A cartoon depicting a prisoner digging with a shovel, with a caption underneath reading: “I’m not escaping. I’m just trying to get tested for Covid-19.” While this image was referencing the protocols followed by Mississippi prisons, this was essentially the same in Alabama’s prisons as well. Source: Mississippi Today via Yahoo Images Public Domain
In addition to these inhumane conditions the imprisoned population experience that violate the basic human rights of incarcerated people, the outbreak of Covid-19 greatly amplified this issue, and soon, the prisons became a contagious and deadly environment for both the prison staff and their charges. With little to no access to adequate healthcare and deteriorating mental health caused by the conditions of their environment, people who are incarcerated are especially vulnerable to disease outbreaks. On the national level, according to a study conducted in 2020 by the American Medical Association, people incarcerated were five times more likely than people living outside the prison system to be infected by the virus, and the death rates among prison populations were higher than the national average at the time. Making matters worse, due to conditions of overcrowding inside the prisons, the outbreak was especially dangerous, as incarcerated people were unable to adequately quarantine and unable to maintain safe social distance between each other. There was also the probability of prison staff bringing the virus into the prisons from the outside world, and also recirculating the contagion within the prisons back into the larger society. A UAB publication by the School of Public Health declared the prisons a “petri dish for COVID-19”.
To add to this problem, the prisons were notoriously unsanitary, meaning that preventative measures such as maintaining clean spaces and washing hands with anti-bacterial soaps, were impossible to maintain. Furthermore, understaffing issues complicated this situation, as those who were infected were either neglected until conditions were too bad to ignore, or they were provided with inadequate healthcare measures. In Alabama, a unique situation further complicated the negative consequences of the pandemic. A large portion of Alabama’s prison population belongs to the older age groups due to the strict and long sentencing laws of the state, and the fact that the pandemic was considered to be even more dangerous for elderly people further put people incarcerated within Alabama’s prisons in jeopardy. Access to healthcare within the prison system makes this issue life-threatening, and despite the urgency from the American Medical Association to include the prison population in the vulnerable communities list for vaccinations, the Equal Justice Initiative reported that Alabama’s prisons denied its incarcerated people vaccinations. While some prison staff received vaccines, they were not required by the state to be vaccinated to work in the prisons, continuing to place the lives of incarcerated individuals in peril. As a result of inadequate protective gear (such as masks), and negligent behavior on part of the state and the prison staff, the prisons in Alabama encountered a large number of Covid-19 deaths.
Alabama Prison Strikes
A group of people protesting prison conditions and calling for the protection of the rights of incarcerated people. Source: Occupy Oakland via Yahoo Images Public Domain
After living through the grave conditions of the pandemic, and witnessing the unchanging environment within the prisons, the incarcerated individuals decided it was time to take matters into their own hands. In September of 2022, incarcerated people from all of the 13 prisons in Alabama began striking against the prison conditions they endured. They argued that the prison system was violating their basic human rights, provided inadequate healthcare, and did not in any way prove to be a place of rehabilitation for the imprisoned population. Instead, they initiated a strike, refusing to work their prison jobs (such as in the laundry department and the maintenance department) that they did not receive compensation for, called for improvements in prison conditions, and demanded reforms to the harsh sentencing laws currently in effect in the state of Alabama.
While imprisoned persons are demanding to be treated fairly in prison, the governor of Alabama, Kay Ivey, insisted that the demands of the prison population were “just unreasonable,” maintaining that the new construction of the two mega prisons in Alabama would solve all these issues of understaffing and overcrowding. These mega prisons, built with the use of funds designated to the state for pandemic relief, (causing public debate on this controversial subject), are supposed to provide more space for the overcrowded prisons in Alabama, and reports have surfaced about the possibility of hiring more officers for the newer mega prisons. This project will receive a total of over $1.2 billion in funding, of which $400 million comes from the pandemic relief funds.
What is vital to include here is that while these two new prisons will provide more space to house incarcerated individuals, (up to 4,000 in each), these prisons are replacing existing prisons with newer technologies and facilities. While this may seem like an improvement in some prison conditions, (such as more security and cleaner, sanitary units), it does not solve issues of overcrowding or staffing issues. The massive budget awarded to this project, instead of going toward building two mega prisons, could have been used more wisely to address the core issues of society that increase crime and criminality within its community. In addition, certain legislation and reforms could have been passed to overturn the harsh sentencing laws that exist in Alabama today. This would have solved both the issues of overcrowding and understaffing, as with fewer people being incarcerated and more people qualifying for parole, the total amount of people within the system would decrease, which would also lead to a decrease in the number of incarcerated people the prison staff is responsible for. A decrease in the prison population would also lead to a decrease in violence and more space for each individual within the prison walls.
Existing Resources
An infographic depicting the difference between education and incarceration. Source: Yahoo Images via QEDfoundation.org
There are many organizations that have attempted to address both the various issues that incarcerated people face within the prison system and those face as they re-enter society after completing their sentences. These organizations include Alabama Appleseed, Offender Alumni Association, Shepherds Fold, One Roof, and Aid to Inmate Mothers. Alabama Appleseed, which belongs to the national Appleseed Network, is a Center for Law and Justice that focuses on equity and justice, and research around prison reforms in Alabama’s penal system. The Offender Alumni Association, recognizing the importance of human connection, focuses on providing support and engagement within the prison walls, and community and stronger familial relationships outside, all while aiming to end the stigma around imprisonment. This organization is a support system for incarcerated people run by people who have been formerly incarcerated and engage in community efforts such as their Heroes in the Hood program to help inspire meaningful goals within the younger generations of high-risk communities to channel their energy toward community restoration. Shepherds Fold, as a transition home, provides similar services from a faith-based approach, instilling Christian values within their participating members. One Roof, an organization whose mission is to end homelessness in Alabama, is yet another resource for people re-entering society after being incarcerated. Through their practice of Coordinated Entry, or an in-depth needs assessment, One Roof is able to secure housing for those in need and point them to additional resources they may require based on their assessment. This can be very helpful for many, especially those who have been incarcerated for decades long, and who may not be aware of what resources exist in the community, or how to go about securing them. Finally, Aid to Inmate Mothers (AIM) is an organization that provides assistance to mothers who are incarcerated, both during their incarceration, as well as their transition period into society after their sentences have been served. AIM provides transportation to children for visitations with their mothers in prison and provides incarcerated mothers opportunities to record bedtime stories for their children. Their reentry programs aim to reconnect mothers with their children, provide a few essentials for those leaving prison, provide classes on life skills, job preparedness, parenting, and other topics for those who are interested, and even provide transition housing for a year, though it comes with a few eligibility requirements, including rental fees charged weekly.
There are also educational opportunities that are provided for incarcerated people in Alabama’s prisons. The Alabama Prison Arts and Education Project led by Auburn University, and the Donaldson Lecture Series led by the University of Alabama at Birmingham (UAB) are only two such programs. The Alabama Prison Arts and Education Project provides incarcerated individuals a chance to earn college credits while serving time. These courses are offered in the field of arts and sciences, and for those who can keep up with the standards of Auburn’s academic programs, this is a great opportunity for incarcerated individuals to pursue higher education, and as a result, be better equipped to handle the professional world upon their release. Similarly, UAB also offers lecture series at Donaldson Prison. While not as extensive or academically progressive as Auburn’s program, the Donaldson Lecture Series focuses on educational talks given to incarcerated individuals within the prison every other Tuesday for academic enrichment purposes.
Shifting the Mindset Around Crime and Punishment
An image of solidarity in favor of Prisoner Rights; Source: Yahoo Images Public Domain via Racism.org
These resources are well-intentioned and have helped save so many lives to date. Yet, this is not enough; there is a much-needed shift in the societal mindset around crime and punishment. The issue of the prison system is rooted in the racist founding of this nation, and as such, has systemic implications on various areas of a person’s life. Reforms can only go so far, as they are still pieces of legislation that try to make changes to the existing laws, but they still operate under those same laws. There needs to be a shift in the way incarcerated people are viewed within the larger society, and there needs to be a reexamination of the laws on the books since most of the institutions in America are rooted in beliefs of supremacy. Some things that can help us rethink the way we approach topics that involve imprisoned people are suggested below.
As explained earlier, changing the language around how people in prison are talked about can humanize the population and foster compassion towards the group. Refer to them as imprisoned persons or people in prison rather than branding them the title of “prisoner” or “inmate”. This helps shift the narrative. “Prisoner” or “Inmate” seems to imply that these individuals are criminals at the core, and brands them as “others” in the eyes of society. Instead, referring to them as “imprisoned people” implies they are human, with natural rights, and only living in a condition of imprisonment rather than being defined by their conditions.
Finally, I leave you with a challenge: rethink how crime and punishment are framed in our society. Who is held accountable? Who isn’t? What acts are considered criminal and what aren’t? Who decides which acts to define as criminal and which ones do not? Who benefits from the current criminal “justice” system? Does committing a crime make you a bad person, a “criminal” for the rest of your life, or should you be given another chance to reform? Should people be branded innately “criminal” or are their actions influenced by the conditions of the society they live in and dependent on the context and motivations behind the crime committed? Is it fair to punish someone based on actions (mistakes yes, but still actions) committed as young people for the rest of their lives? Why is it that our society places the label “criminals” on people who commit crimes, but refuses to see them as anything else? People can be “criminals” and still be artists, musicians, poets, writers, activists, metal workers, etc. Why does our society insist on placing a singular label on this population? Could it be to easily forget their existence, to remove humanity from their essence? All these are necessary questions to ask ourselves to understand our own biases towards imprisoned people and began to rethink our own actions that can have long-lasting consequences on the lives of so many. After all, this prison crisis is happening in our own backyard, and if we do not speak out against these atrocities, we are just as guilty as those committing them.
Since the pandemic began, you might have seen multiple different snippets of Chinese citizens in their homes under complete lockdown. You might have even seen drones patrolling the streets and citizens shouting lamentations out of their window.
What you may not have known is that all of these scenarios mentioned above are a direct result of China’s COVID protocols. Currently, China is imposing a “zero-COVID” policy on all of its citizens. However, as President Xi Jinping was just re-elected for a third five-year term, we can assume that the policy will not be going anywhere anytime soon.
The “zero-COVID” Policy: Prevention
(source: yahoo images)
Let us now evaluate what this so-called “zero-COVID” policy is and what it entails. Supposedly, China “recognizes domestic outbreaks are inevitable, and its policies are not geared towards having zero cases at all times but instead, are about “dynamically” taking actions when cases surface.”
China’s policy can be split into two distinct features: prevention and containment. In the case of prevention, China ensures PCR tests (which are fast and highly accurate ways to diagnose COVID) are readily available for anyone at any given time. The normality and presence of tests has in turn caused certain businesses and buildings to require individuals to show proof of being COVID negative to enter these public spaces. However inconvenient this might be to those who are not tested, this notion has definitely kept cases low—after all, if functioning in life requires having a negative test, why would one risk getting sick? One surely would not want to risk getting sick since it would mean they would be practically unable to enter any public places. Hence, prevention of COVID prevails in China.
The “zero-COVID” Policy: Containment
(source: yahoo images)
Prevention of COVID seems to be rather successful in China. However, the other part of China’s zero-COVID policy seems to be the one that sparks controversy and frequently makes its way into mainstream media: containment.
Allegedly, China’s “[control tactics] aimed at swiftly cutting off transmission chains to forestall outbreaks, involve quarantining cases at government-supervised facilities and locking down buildings, communities or even entire cities.”
Picture this: you wake up, get dressed, and are having your typical morning routine. Perhaps you might be feasting on some waffles or eggs as you prepare for your day. In any case, you eat your breakfast, and then head out to work. You get to your office around 10 minutes early, anticipating it will be a good day.
About halfway through your work day, you receive word that you will not be heading home to your family that night. Someone in that building (a coworker of yours), tested positive for COVID, and the city decided to place your entire office building on lockdown.
Swiftly, within hours, government officials are shoving mattress and bed materials through the window. Additionally, food supplies are en route to the office. The basic necessities of human survival are all now being prepared to be delivered to your office, which, for the next couple of days, will be your home.
This scenario is one that many people living in China have experienced. Starting your day normally to simply head to work and be told that you would not be allowed to go back home for a couple of days is a harsh reality in China.
This ability for the government to impose this upon its citizens is all, as one would expect, due to China’s commitment to its zero-COVID policy.
However, in addition to putting entire office buildings under lockdown for days, China is also able to put entire cities on lockdown. The population of the cities which fall victim to China’s harsh quarantine policies matters not—Shanghai, China’s largest city, was even placed on lockdown. Other cities that have been placed on lockdown include Xian, Chengdu, Tianjin, Shenzhen, and regions such as Xinjiang, Tibet and Jilin.
When a city is placed on lockdown, its citizens typically get little notice. The lockdowns, unsurprisingly, are complete lockdowns—there are no exceptions. Everything closes. Everyone is required to stay inside, no matter what. China ensures complete and total lockdown.
The government guards and watches over the streets 24/7 and ensures that no one roams the streets without permission. On top of that, drones often fly about, blaring messages out loud to remind everyone of the lockdown procedures.
When China decides to place a city under lockdown, eeriness overflows the streets. The scene is reminiscent of ghost towns and movies of towns left abandoned due to some unforeseeable incident.
The Impacts and Implications
(source: yahoo images)
These efforts on China’s end, despite how draconian they might appear, have definitely accomplished China’s goals. Globally, China is practically one of the least impacted nations by COVID—despite the fact the virus allegedly originated from China in the first place.
According to OurWorldInData, China’s all-time COVID case count is about 1 million. The United States’s total is about 97 million. Additionally, in China, only about 5,000 have died from complications with COVID, while over a million people have died in the United States.
Naturally, this presents an ethical dilemma—how should a government go about protecting the lives of its citizens from an illness? Should the government take China’s route of practically removing one’s agency over their own life in order to keep cases and deaths down, or should a government take the route of the USA where COVID mandates are less harsh or non-existent?
The low incidence of COVID outbreaks might make it seem as if China is doing the correct thing—governments should step in and enforce lockdowns onto people. However, while this surely will indeed keep cases at a low count, it will also imply other things—most importantly, the implication that the government ultimately knows what is best for its people and has the final say in how people live their lives. If a government can step in randomly and deny its citizens the free will to leave an office building, what else can it do in other situations? This notion of a government exuding agency over its people in times when it deems best surely is not a notion that is only demonstrated in situations of COVID—it is a notion that is bound to resurface in other parts of one’s life.
What the correct and best thing for a government to do, as it relates to infection control, is not as clear cut as one might think. It is certainly problematic for a government to have total authority over its people (which thereby would give it the power to strictly enforce COVID policies). At the same time, this has been an effective strategy in keeping cases low. On the other hand, the United States has been uncertain as to how to implement COVID policies. The USA is not used to enforcing policies in situations that have never occurred before, such as the COVID pandemic. Hopefully, if there is one positive thing we could gain from the entire pandemic, it is that if a pandemic were to ever break out again, due to COVID, we are better equipped to deal with it.
Cameroon, once a bastion of peace and tranquility, is now a nation beset with a series of violent and armed conflicts. Since late 2016, an armed conflict between the state defense forces of Cameroon and the non-state armed groups (NSAGs) of Southern Cameroons’ has ravaged the country. In the last six years, there have been more than 6,000 deaths, 765,000 internally displaced persons (IDPs), and 70,000 registered refugees in neighboring Nigeria, with approximately 2.2 million people in need of humanitarian aid. The Norwegian Refugee Council has referred to the conflict as one of the most neglected in the world. The long-term human capital consequences of this conflict are enormous.
A more comprehensive background of the armed conflict and humanitarian crisis in Southern Cameroons can be found in a previous IHR blog post, “Cameroon, a Nation Divided”.
Source: via Yahoo Images
It is against this backdrop that the Cameroon Humanitarian Relief Initiative (CHRI) in partnership with the Institute of Human Rights (IHR) co-hosted an international webinar, “Updates on the Humanitarian Crisis from the Ongoing Armed Conflict in the Southern Cameroons”on the 18th of October, 2022. The aim of this event was to discuss the current humanitarian crisis from a multi-perspective panel. The speaker biographies can be found at the bottom of this blog post.
Excerpts from this webinar were edited and woven together for this blog post. The full recording of the webinar is available on request by contacting ihr@uab.edu.
Source: via Yahoo Images
Overview
What are the current humanitarian needs for Internally Displaced Persons (IDPs) in Southern Cameroons?
Atim Evenye: The current context and the magnitude of the ongoing crisis in the Northwest and Southwest regions remain tense. There is continuous violence in targeted areas. We have the destruction of properties. We have abductions and kidnappings of both community people and administrators. We have killings and local arrests. We have continuous attacks on schools and students. Humanitarians face threats and direct [armed] attacks. [These are carried out] by both parties, the non-state actors and the state defense forces.
The population [has] really [been] under duress and stress for over six years.
Food Security: Atim Evenye: When it comes to the current needs for IDPs, at the moment, I would say food security remains one of those outstanding needs. Especially in the rural areas, because these IDPs have fled their place of abort. They don’t have access to their farms. [As such,] they don’t have the economic capital [for even] daily subsistence. So, there is a lot of dependencies now on family members, [or] world food programs, and other humanitarian organizations bringing food assistance in the area.
Education Accessibility: Atim Evenye: There is a strict restriction around education. In [the rural areas] of the Northwest and Southwest regions, we have children who have not been able to go to school until date. In urban areas, there is a possibility of schools for those who can afford it. Currently, in our zone in the Northwest and Southwest regions, we have lost one month [of school this term], because we are only starting now. So, it becomes challenging on how to catch up. There’s a need for accelerated learning. [Additionally,] teachers have been abducted [and] schools have been burned. [To add to that,] there is a lot of psychological trauma, [as] many children have witnessed or experienced violence firsthand. Both the state and non-state actors [are] not conscious of the impact their actions are having on children. The government doesn’t want to hear about community schools as prescribed by the separatist. So, it’s really very challenging to access education.
Dr. Emmanuel Nfor: Education is one of the issues at the origin and at the core of the crisis, and formal education has been used by NSAGs, [the non-state armed groups], as a political instrument. NSAGs have advocated and enforced a “no school policy”, leading to public school closures for the past four years in many areas. More than fifty percent of threats against buildings in communities have been directed against schools, and many school buildings have been taken over by organized armed groups. Accessing education in emergency services, or going to school in such a volatile environment, is proven to be risky for children, as well as for teachers. Pupils who were in school in most rural areas have dropped out, some joining armed groups, others displaced, and some have outgrown their ages for the classes in which they were and cannot continue. Many parents have lost their means of livelihood and are unable to sponsor their children in school. Despite repeated calls from humanitarian and human rights organizations for education to be depoliticized, schools have been burnt, teachers and students intimidated, kidnapped, and even killed, and some have seen their hands chopped off by members of armed groups.
Gender-based violence (trigger warning): Atim Evenye: We see [a great deal] of gender-based violence. In certain assessments we have conducted, for example, [many of these] young girls in rural areas are not able to go to school. What are they left to do? There is a lot of harassment, rape, and [sexual assaults]. They’re looking for five hundred francs CFA, that’s like one dollar, to [be able to just buy] food to eat. So then, they depend on young men to give them that money. And at the end of the day, they [get pregnant and become] teenage mothers. The whole cycle is really detrimental, it’s a really difficult one.
Dr. Emmanuel Nfor: Sexual violence is rampant, as a direct consequence of the crisis but also due to decreasing livelihoods, negative coping mechanisms, and lack of protection structures. The boy child is an endangered species, at risk of accusation and arbitrary killing from GFs [state defense forces], and forced recruitment by the NSAGs. There are no specific programs by both UN agencies and Internal bodies that address the needs of the boys.
Housing: Dr. Emmanuel Nfor: If we look at where the IDPs in particular are, we have IDPs that are living in the rural areas, in the bushes. We have those living within host communities. We have some that have been able to rent. [But if] they are able to pay for accommodation, [there are] a lot of difficulties because they want them to pay upfront, and they cannot do it. In all three groups, they lack basic WaSH and health services, NFIs [non-food items], and protection from natural hazards. Those who fled to other regions face stigma and severe protection risks related to exploitation, and socio-economic vulnerabilities including extortion, sexual exploitation, and child labor.
Healthcare: Atim Evenye: The next principal need I would say is around healthcare. In recent times we have [had] heath centers burned, and the staff attacked. So, it’s really challenging. Statement needs to be completed, even before the crisis, access to health care has been a serious challenge, especially in rural areas. And then, currently, with the crisis, it’s even more exacerbated. It becomes difficult now [for] humanitarians on the ground who are trying to meet the needs of these people. Take, for example, Doctors Without Borders. They have [had] to put their activities on the hold because they had issues around access [and safety] of their staff.
Dr. Emmanuel Nfor: [There is a lot of] healthcare [needs] for the vulnerable. [Safe practices in regard to] water, sanitation, and hygiene are not being followed. People who live in rural areas don’t have a good source of water. But they could be educated on the fact that even though your source of water is doubtful, you could take it, you boil it, you purify it, or you do something to make it [potable]. That education, they don’t have, or the chemicals for water treatment. Additionally, there is a lack of emergency medical and psychological units, to provide emergency care to the wounded and psychosocial support to those traumatized by the violence. We can educate people on how to prevent simple infections. How can you prevent diarrhea infection? How can you prevent malaria? If this education is done, it could be [one] way to [improve basic healthcare].
Healthcare, which is supposed to be a protected area, unfortunately, has not been the case in this conflict. We have had health centers closed; more than fifty percent of the health centers in rural communities have been closed. Not only the health centers, [but] the health workers do not feel comfortable staying there. So, a lot of them have abandoned [the centers]. The [people] left in these communities cannot access healthcare. Women cannot access antenatal clinics. Vaccinations [are] not being done, and thousands of children are at risk of contracting common vaccine-preventable infections.
The population has been abandoned to themselves.
Health centers that are open in semi-urban and urban areas are overwhelmed by people who have [been forced by the conflict to flee]. And what’s worse is that most of those who have [fled] do not have the means to pay for the treatment. We have some health centers that have accumulated huge unpaid bills because those who access healthcare cannot afford to pay those bills. For the facilities that are open, IDPs cannot afford to pay for the treatment that is given to them.
We have [also] had cases of drugs and other medical equipment [being] seized along the way by organized armed groups. So, it’s difficult to render care because the drugs and medical supplies do not reach the vulnerable in the hard-to-reach areas. Free supply of drugs and medical equipment is disturbed by locked downs, roadblocks, and/ or are seized at gunpoint.
Then the last very worrying thing is that healthcare workers are being attacked or kidnapped for ransom. A lot of them have been attacked both by the non-state actors and by the state forces; [health workers are] kidnapped by the non-state actors and/or arrested by the [state forces]. So, it is not safe [from] either side. They see you as collaborating with the other, and [so the question is] whether you should treat wounded combatants or not. According to the healthcare regulation, we take any wounded persons as patients. But unfortunately, when these [combatants are] treated, we [the healthcare workers] are blamed. The non-state actors blame you for treating the state forces. The state forces blame you for treating the non-state actors. It’s really a dilemma in which we are in.
Future Directions:
Looking towards the future, are there any resolutions to the humanitarian crisis in Southern Cameroons that you can think of that can be implemented at this point?
Dr. Emmanuel Nfor: I think the first thing we need to consider for the humanitarian crisis is that we need to speak the truth.
We need to make a truthful appraisal of what is happening on the field. Address the needs. For example, we are told that the crisis in Cameroon is one of the least funded in the world. Why? Because the data and the reposting are for some reason concealed.
So, if we must be able to go forward with the humanitarian situation, we need to know how many people are living in the bushes, how many are living in host communities, in what conditions are they living, and be able to address it. [These] figures are often contested, they say the number is lower, or they want to sway the number for their gain. So, we must start with you right data. If we have the right data on needs, it will be possible to see where the solutions should come from.
Possible resolution options, specifically for the humanitarian crisis, could consider the following:
-A community-based approach to raise awareness of protection risks in the community and identify and support community-based solutions.
-Advocate for access to civil documentation, especially birth certificates, to avoid a stateless generation and mitigate protection risks associated with a lack of civil documentation.
-Support community mediation of localized conflicts to reinforce the dialogue between host communities and IDPs and avoid tensions within the communities.
-Advocate with parties to the conflict to respect the protection rights of communities, and respect International Humanitarian Laws.
-Finding durable solutions for IDPs intending to stay in their host communities, like those who have established businesses in the new areas.
-Shelter support in rural areas as a high percentage of households live in tents or informal collective shelters
Atim Evenye: When it comes to setting strategies that we can use to resolve this conflict, I would say it’s imperative, for the powers that be to consider the roles of different parties in the conflict. There is a need for parties in this conflict to come to the table and talk. There is a need for dialogue. There is a need for unity. We need to have a unity of purpose, to push our agenda in one voice.
True is the fact that they have been the major national dialogue, [there] have been consultation meetings and other forms of dialogue in smaller circles. But the question is, during this dialogue are the needs of the different parties considered?
For example, we have women who have suffered a lot as a result of this conflict. But at the same time, we have that arm of women who are also seeking solutions on how to resolve the conflict. Women are now spearheading and speaking for themselves. And I think, there is a need to give a listening ear to what the women are saying because I think time in memorial, women have always demonstrated that ability to resolve conflict. So, one way to consider the proposals that women are giving here in Cameroon.
Secondly, there is a need to give academia and research a place. There are a lot of people in the academic who are gathering data, but the fear around it is the dissemination of this information. The administrative system is such that once you do a publication that is not supportive of what is happening, you get targeted. And by both sides. Thus, we try to be balanced in all information dissemination. There is a need for that deliberation and freedom of speech, especially in the area of academia. People should not be afraid to publicize or to make public the research and the results of what they have found in the field. So that’s another way that can be an added value to the approaches to conflict resolution.
Also, there is a need to consider the root causes. The conflict did not just start like that, it degenerated along the line. So, there is a need to go back to the drawing board and understand what pushed the Southern Cameroonians to arrive at this point. What are the different trends that have been changing through the crisis?
When it comes to how to resolve the humanitarian crisis, I think the humanitarian needs are more than what the humanitarian organizations can do, funding is very limited. It’s obvious that humanitarians cannot meet all the needs. So where should we turn to? We should turn to other actors who can bring assistance. We have development actors who can bring resilient, [long-term, skills-building] projects so that the communities will not be too dependent. The people of the Northwest and Southwest have never been those who are dependent on handouts.
They are people who are hard-working. We hear the aches of people wanting to be self-sustaining. They want to just be, to go back and be what they had been doing [before the conflict].
Dr. Emmanuel Nfor: If we don’t put away falsehood, if we don’t speak the truth and have the right data and have the right information about what is going on, on the ground, we will continue for many more years doing much but with very little impact.
The people of Northwest and Southwest can lead by themselves. These are hard-working people. They just need to be empowered, to go back to where they have lived before. There are many people who are longing to go back home, but the problem is that they go to homes that have been burnt. They go to farms that have been abandoned. They go to be reminded of the horror. So, we need psychological treatment and support. We need some form of equipping them to be able to cope with what they have lost. We should be able to end the hostilities and give people the opportunity to go back home.
So, we should rather empower them, than continue to give them aid. Let peace reign, [so that] we can empower them to reveal what they have lost and then see how they can bring up that life again. [Then] we can go forward. But hostilities should cease, and we should speak the truth; to face each other face-to-face and speak the truth.
Speaker Biographies
Atim Evenye Niger-Thomas, received a Ph.D. in Student Conflict Management and Peacebuilding at the International University of Applied sciences for Development (IUASD) Sao Tome in partnership with IPD Yaoundé. Since 2016, Atim Evenye has worked and grown in different roles at the Authentique Memorial Empowerment Foundation (AMEF). Currently, she holds the position of Assistant Director and trainer for Humanitarian Negotiation. Under this supervision, AMEF has grown to be one of the leading humanitarian organizations in the Southwest Region. AMEF runs four core programs namely,Education and Child Protection (ECP), Economic Development and Livelihood (EDL), Gender, Protection and Peace (GPP), Health/Nutrition/ WASH (HNW).
Dr. Nfor Emmanuel Nfor, holds a PhD in Medical Parasitology from the University of Yaounde I, Cameroon. In February 2017, he joined the Cameroon Baptist Convention Health Services (CBCHS), as the Malaria Focal Point. While working with the CBCHS, he attended a Peer Review Workshop on Humanitarian Negotiation organized by the Centre for Competence in Humanitarian Negotiation (CCHN) Geneva. After many other online courses, and several National and International Conferences, he was appointed Trainer and Advisor of Humanitarian Projects within the CBCHS. In this capacity, he coordinated projects executed by the CBCHS with funding from WHO, UNICEF, and UNFPA. He has been at the forefront of Humanitarian activities within the CBCHS during the ongoing sociopolitical crises in the North West and South West Regions of Cameroon, working closely with the Cameroon Humanitarian Response Plan.
This is the second in a series of blog posts that will look further into the conflict in Cameroon. Each month a humanitarian need and/or organization working in response to the humanitarian crisis will be featured on the UAB Institute for Human Rights’ blog.
Recently, I sat and had conversations with fellow peers in graduate programs and professional schools ranging from subjects such as Master of Art Education to Medical School and Graduate studies in Nonprofit Management. We talked about mental health resources and access within their schools and professors. Our conversations ranged tremendously, with some saying they are provided with resources and time off if stressed, to some feeling like they are not seen or cared for within their programs but are cared for by their professors. With the immense pressure of graduate and professional schools, students tend to go through many life changes that have had effects on their mental health. Graduate programs and professional schools contain an intense climate and harbor a strong need to succeed. With the stress, long hours studying, and a lost balance of life, many students do not feel that they are provided with the proper mental health resources. Mental health is typically overlooked or not given as much importance when considering human rights. The right to mental health is just as important as any other human right and has increased importance at the Human Rights Council. The balance between studies, life, work, and outside obligations, takes a toll on any individual. Ensuring that every person has access to free or affordable mental health services has been a goal for human rights advocates and organizations. The UNHCR notes that the right to health includes mental health.
Yahoo Images, Looking after Mental Health
Mental Health in Graduate School
A study done by Harvard found that students within graduate schools are three times more likely to experience mental health struggles than an average individual. The study conducted a survey of over 500 students in graduate programs and found that in every 10 students, one had suicidal thoughts over a two-week period. With the constant stress and studying, graduate students begin to develop depression and anxiety. The environment of graduate schools differs immensely when compared to the undergraduate level. Rather than having to attend class and prepare for exams, they spend their entire time—often 2-6 years—dedicated to a research project. Typically, 60 hours per week is spent preparing and studying research.
Many factors and challenges aid in stress for graduate students: poor mentorship, lack of access to counseling services, lack of training, and leave-of-absence policies. The list can go on and on about the challenges faced by graduate students. In addition, the biggest factor I found is the academic mindset. There is an embedded mindset within professional studies that a failure is never an option. Every student tries to be the best, the smartest, and the most achieved. This leads to many bad outcomes; a 2019 survey of Ph.D. students found that 76% of students work more than 40 hours a week on their research and projects and cannot attain a work-life balance. They have no room to take a breath or a break. As noted by a student, they said, “if you slack, you are out.”
Yahoo Images, Students studying
Mental Health in Professional Schools
Studying to become a doctor, lawyer, dentist, etc., carries immense stress. Students within professional schools dedicate their entire lives to a program in the hope of getting their dream careers. But the process of getting into professional school and finally being accepted to study all have factors that can deter one’s mental health. Within law school, it has been found that depression rates have increased from 10% to 40% among students. 96% of law students and 70% of medical students face significant stress. Factors that have been found ranging from loneliness, rejection, alcohol and substance abuse, academic performance, anxiety, depression, peer pressure, and the list can go on and on. There is constant stress and worry about entering the professional field. If one gets a good score on their exam, that determines the path of their career. While in professional school, the worry of not being the smartest, being able to handle the stress, or burn out. Although the studies and information are stressful, and the process of becoming a doctor or lawyer does contain high stakes, there still needs to be a fixation on acknowledging mental health. Many students are extremely gifted but get slowed down and begin facing challenges due to mental health neglect.
Yahoo Images, Mental health; students and schools
Where to Go from Here
It is very important for every institution and university to have the proper mental health resources; it is just as important to make sure these resources are constantly being worked on and evolved over time. The stigma and thought that students must be overworked and can’t take breaks must be removed. Within higher studies, a work-life balance must be implemented to ensure every student is learning and working at their highest potential. Over time, there have been drastic improvements in mental health awareness worldwide, but that is just a starting point. Mental health resources and accessibility must be a requirement within all universities and institutions. Below are resources for students and professionals to maintain and implement positive mental health practices.
Yahoo Images, Mental Health
For students at UAB:
UAB has a Student Counseling Service that provides mental health services, prevention, and outreach. The services include counseling and emergency support. Resources can be found here.
Source: Yahoo Images; People experiencing homelessness sleeping under a bridge
The homeless population in America tends to be neglected by the society they live in. They are among the most vulnerable, belonging to already marginalized communities that struggle to meet their day to day needs. As a result, the unhoused have little to no power or influence on social norms and affairs. As someone who has experienced homelessness both in India and in America, I have come to distinguish some of the common misconceptions society holds about the unhoused population. There are a lot of stereotypes and social stigma that surrounds the discussions around homelessness, which often blames the victims of systemic issues, instead of restructuring the conversation around how we as society can best help these marginalized groups realize their basic human rights to shelter. In order to do so, we must first understand what it really means to be homeless in America.
History of Homelessness in America
Homelessness is not an issue unique to the United States, as it can be found in countries all over the world. While homelessness in America can be found as early as the colonial times, modern homelessness rose as a response to the Great Depression, where people experienced high levels of unemployment and poverty. Especially interesting is the relationship between the growth of urban cities and the rise in homelessness. Coupled with low-wages and higher costs of living, people found it more expensive to find places to live in urban centers, such as New York and California. The aftermath of the Great Depression put a lot of people in desperate need of employment, and as the economy took to the service industry, more and more undereducated, impoverished people had no other choice but to turn to these low-income jobs. The country’s shift to a service economy meant that laborers were now being paid lower wages, leaving service industry employees unable to afford the rising costs of housing. Coupled with higher housing costs and lower wages, when people turned to social welfare programs, they found these programs to be lacking in funds as well.
Additionally, there was a campaign to “Deinstitutionalize” people held in mental asylums. While the campaign itself was well-intended, its applications were lacking in structure, and instead of providing patients with proper access to mental health resources, people with mental disabilities were released to fend for themselves. The neglect of these institutions led to the increasing numbers of mental health patients facing housing insecurity. To make matters worse, gentrification policies (made to bring in wealthy real-estate investors and high-income residents to underdeveloped parts of the city) led to the displacement of many low-income families, putting them out of their homes. These policies disproportionately affect people of color, something that has forced many marginalized communities to fall prey to an endless cycle of poverty and degradation.
Unfortunately, one of the most concerning additions to the homeless population is the disproportionate number of youths that identify as being part of the LGBTQ+ community. According to a recent study conducted by Chapin Hall at the University of Chicago, LGBTQ+ youth had a 120% higher risk of experiencing homelessness. These members who already belong to an ostracized community can become more vulnerable to harassment, violence and hate crimes.
Additionally, unable to find jobs after returning home from military service, many veterans end up homeless with nowhere else to go. Although places do exist to support veterans who experience homelessness, many are either unaware of the resources at hand, or too ashamed to use these resources. As a result of the social stigma surrounding the topic, people experiencing homelessness often become withdrawn from society.
Society’s Attitudes Toward the Homeless
Source: Yahoo Images; An example of hostile architecture that prevents the unhoused from sleeping on benches
Homelessness is received with wildly different attitudes among different cultures. America is a very diverse country, with people that share hundreds of different cultures and traditions, and these cultural attitudes can carry over in the way they respond to contemporary social issues. Different cultures share a varying definition of what a “home” means, and even more distinctions in their approach toward people experiencing homelessness. What the dominant White culture might consider to be a home, (an individual unit of space for nuclear families), might not be what someone who belongs to the Indigenous population believes. They might argue that a home is where you can interact with your community, a place to feel safe and share with friends and family. Even the attitudes toward helping people who are unhoused have strict cultural implications. As described in Islam, it is part of the every-day religious ritual of a Muslim to give alms and help the poor in their community. In Hinduism, while helping the poor with food and shelter is allowed, certain castes are not allowed to eat alongside with or sit beside people of lower castes. People experiencing homelessness have their own unique culture, where certain skills or strategies for survival on the streets are shared amongst each other.
Along with all these complexities, the unhoused also undergo various types of stigmas, including social stigma, and cultural stigma. Social stigma can be discrimination and harassment directed toward the homeless population by the institutions, systems and people that make up society. Cultural stigma can refer to the stigma expressed by friends and family members or other religious or cultural institutions that may shame and blame the victims for being homeless.
Unhoused people also have a hard time finding employment. This is partly due to the fact that the job application requires a home address for the application process to be completed. As a result, people who are dispossessed also experience difficulties when finding housing. The applications for apartments include a proof of income/employment section and applying for government housing takes months to be processed and reviewed. Many states have long and complicated application processes, and even then, it is not a guaranteed housing option. Nevertheless, applicants can be denied, and they would still need a place to stay while awaiting their application to be approved.
Adding to these difficulties, people in the homeless community are constantly harassed with wild stares or abuse, (both verbal and physical), from members of society. The law enforcement agency, an institution designed to serve and protect people of the community, may make matters worse by deteriorating the situation further. Without proper training, police approach the homeless defensively, ready to attack at the slightest “abnormal” reactions. What they haven’t been trained to realize is that many people experiencing homelessness are also at high-risk of developing mental health issues due to the stress and realities of being homeless. These altercations can turn deadly, and unfortunately, many people of the homeless community have either been locked up or even killed by officers of the law. Many of these instances were even caught on camera, yet these officers faced little to no accountability or legal punishment.
People experiencing homelessness are also easy targets to getting their possessions robbed, and many times, police will raid their camps and confiscate what few belongings they might acquire, including sleeping tents and toiletries. Society also treats the homeless population as a burden and blames them for being “lazy” or “druggies” or “criminals/suspicious,” without any provocation from the homeless community. It can be especially insulting for the people experiencing homelessness to be judged for their situation while society simultaneously fails to criticize the state’s inability to protect peoples’ fundamental human rights to food, shelter, and other basic needs.
The Legal Response to Homelessness in America
Source: Yahoo Images; An example of hostile architecture to deter the homeless from sleeping under bridges
The legal response to the homelessness crisis in America has not been a heartwarming one either. Urban cities all over the United States have put in place anti-homelessness measures, otherwise known as hostile architecture. These include slanted benches, benches divided by armrests, spiked and rocky pavements to prevent people from sleeping there, and even boulders under bridges. Not only are these measures inhumane, they also cost the tax-payers a lot of money. These atrocious tactics are put in place to discourage homelessness, attempting to connect rising numbers of homelessness to increased crime rates. As recently as July of this year, Los Angeles even went so far as to make homelessness downright illegal, restricting homeless encampments in majority of the city. The city has even prohibited the homeless from sitting, sleeping, or laying in public. Due to the fact that homelessness overwhelmingly affects people who belong to already marginalized communities, a rights-based approach is necessary, one that addresses the existing systemic issues which need to be fixed first.
Covid-19 and How it Continues to Impact the Homeless Population
Source: Yahoo Images; Homeless shelters can be crowded, without proper social distancing measures in place
The Covid-19 pandemic continues to impact many different communities in a variety of ways. The pandemic hit especially hard among the homeless population, where access to hygienic products are often slim, if not non-existent. People experiencing homelessness may not have the ability to continuously wash and sanitize their hands, with limited access to clean water and soap products. They also been experience complications with social distancing measures, forced to be in crowded spaces like homeless shelters, which has only increased their risks of getting infected. Furthermore, even when infected, or exposed to the disease, the homeless population has very limited ability to quarantine, further allowing the spread of the disease to others in close proximity. The unhoused population has limited access to healthcare and medicinal treatments, and many are already immunocompromised or have pre-existing conditions, which increases their vulnerability of catching the disease. Stereotypes geared toward the homeless population labeling them as “junkies” or “druggies” has influenced the care they receive, leading to many cases of misdiagnoses or mistreatment as a result of biases held by healthcare professionals and others in the health care industry. Due to the rise in unemployment numbers during the economic shutdown as a response to the pandemic, millions of people who did not qualify for unemployment benefits, and could not make ends meet, also became homeless as a result.
Some Successful Approaches to Ending Homelessness
source: yahoo images; An unhoused person advocating against hostile architecture
There have been some successful attempts at ending homelessness in America as well as in other nations. Utah attempted to decrease its rates of homelessness back in 2015, which successfully reduced its homelessness by 91%. They executed a policy known as “Housing First,” which gave their chronically homeless populations free housing, a decision that cost the state less money than alternative anti-homelessness measures. This program unfortunately has not been a complete success, as people experiencing homelessness in other states have been migrating to Utah, making it too expensive for Utah alone to pay for the country’s increasing homelessness crisis. A national policy, on the other hand, that could implement the Housing First approach taken by Utah, may be the easiest, and essentially cheapest option to ending the homelessness crisis in America. This is essentially what Finland did. In 2019, Finland approached the homelessness issue with the most obvious of answers, by providing housing for all those who are unhoused. Like Utah, they applied the “Housing First” policy, (which came with no strings attached), recognizing that housing is an essential human right that should be protected and promoted. They also understand that in the long run, providing the homeless population with housing is the cheaper option to society. Also, as examined earlier, if applied in America, this Housing First policy will inevitably save more lives, with fewer interactions between the homeless and the police.
While homelessness is not something people are normally born into, the unhoused face discrimination, stigmatization, and marginalization from society just as much as any other group. Although people’s socioeconomic status is a major factor in determining who is most vulnerable to experiencing homelessness, as we’ve seen in the case of the LGBTQ+ youth, and older veterans as well, homelessness can impact people of any and all races, at various age levels, and at any given time. The pandemic itself has expanded the homeless population as people are unable to pay their backed-up rent or mortgage payments. While alternative approaches can assist to eradicate levels of homelessness in our society as implemented in Finland and Utah, it is crucial that we also continue to destigmatize being homeless in American society and take a rights-based approach to finding long-term solutions to end their suffering.
Social Work Students’ Accreditation Visit 3.26.13. Source: Southern Arkansas University, Creative Commons
Social work is a field in which professionals are intended to do their best to help connect members of vulnerable populations with the resources necessary to allow them to live with their rights and general well-being safe. However, on October 12 of this year, during a meeting between the Texas Behavioral Health Executive Council and the Texas Board of Social Work Examiners, a section of the social workers’ code of conduct was altered. A section which previously stated, “A social worker shall not refuse to perform any act or service for which the person is licensed solely on the basis of a client’s age; gender; race; color; religion; national origin; disability; sexual orientation; gender identity and expression; or political affiliation.” During the meeting, the words “disability; sexual orientation; gender identity and expression” were taken out. They instead replaced that phrase with the word sex, making the social workers’ code match the Texas Occupations Code.
This is concerning for a few reasons, the most glaring one being that it leaves members of the LGBTQ+ community and people with disabilities in Texas, two populations that are already seriously vulnerable, even more vulnerable than before, as social workers can now turn away potential clients from those communities.
This led to an uproar among advocates for the LGBTQ+ community and people with disabilities, as at puts their ability to access important resources that are related to their basic human rights directly at risk. There is an increasingly serious concern that members of these populations will face even more obstacles in accessing the things they need than they already do.
The Human Rights Connection
It’s important to recognize that is an issue of human rights, even outside of the clear issue of discrimination against these groups that is involved. Consider some of the jobs of social workers. They include therapists, case workers, workers for Child Protective Services, and much more. In addition to working with people with disabilities and members of the LGBTQ+ community in general, many social workers specialize in work with children and older adults, two groups which overlap with the former. Then these vulnerable populations are unable to get the support they need in order to access the tools, programs, and resources that exist specifically to help them live life and access their basic needs, they are by extension often kept from being able to access their basic human rights.
Source: Yahoo Images
One clear example of this is when people with disabilities require financial aid to support themselves do to an inability to be a part of the general workforce. Social workers are an important part of the process of connect the people affected by this issue with the resources and government programs they need. Without the aid of social workers, they might have significant difficulty accessing their “right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control,” as recognized in Article 25 of the United Nations’ Universal Declaration of Human Rights.
The fact that this allows social workers to discriminate certain groups in accepting clients is human rights issue in itself, as according to Article 7 of the UDHR, all are entitled to equal protection under the law and,“All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.”
The Purpose of Social Work: Helping Vulnerable Populations
Another reason this change in the Texas social workers’ code of conduct is problematic is that the field of social work is inherently meant to involve professionals helping vulnerable populations (such as the LGBTQ+ community and people with disabilities). According to the National Association of Social Workers’ (NASW) Code of Ethics,“The primary mission of the social work profession is to enhance human well–being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.” A vulnerable population is a group or community “at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability.”
Social work is also built a set of core values: service, social justice, dignity and worth of the person, importance of human relationships, integrity, competence. It is the job of a social worker to do what they can to uphold those values by helping vulnerable populations access the resources they need. Therefore, social workers’ turning away members of the LGBTQ+ community and people with disabilities, particularly vulnerable groups, goes against the social work code of ethics.
The ethical principles of social work also bar social workers from participating in acts of discrimination on the “basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical ability.”
There is a meeting set for October 27, 2020 so that the Texas Behavioral Health Executive Council can discuss the issue of discrimination as it applies to the changes that were made to the Texas social workers’ code of conduct. It is vital that we do not underestimate the significance of this situation and the serious harm that it can cause.
This past summer, two pandemics plagued the world: COVID-19 and systemic racial discrimination and prejudice against Black communities. While the former was making modern history, the latter had been happening for centuries. As I thought of ways to address and educate myself and my family on these injustices, I found myself revisiting and reevaluating my own biases, particularly those I’ve experienced within the Indian community.
Growing up in South India, I would mimic my mother and grandma’s daily skin care routine when they used “Fair and Lovely,” a skin lightening and bleaching cream. I was constantly told to not play outside because I might get too dark, and my foundation for dance competitions and rehearsals was often shades lighter that what it needed to be. I was raised in a world where your worth was defined by the color of your skin, and if by chance your skin was too dark or too tan, then you were seen as un-beautiful, unworthy, and incompetent. Most women like my mom, my grandma, and I, as well as other individuals that suffer from the stigma that being dark is ugly, have often fallen prey to companies that profit off the ideology that whiter skin is equivalent to beauty, self-confidence, and self-worth.
Colorism in Indian Society
Colorism is an issue that is often ignored and rooted in societal pressure around fairness. It is a discriminatory practice in which institutions or individuals treat those with lighter skin tones more favorably, upholding instead White, Eurocentric standards of beauty. India is a mixture of diverse cultures, languages, and shades of brown. With different skin tones came colorism that continues to perpetuate stereotypes, prejudices, and discriminatory actions. For generations, Indian society has been brainwashed into the ideology that fairer skin is more desirable, leading to the nation developing a multibillion-dollar skin lightening industry. Everyday products like Olay’s Natural White Glowing Fairness Cream, Lotus Herbal’s White Glow Skin Whitening and Brightening Gel Crème, Pond’s White Beauty Daily Spot-Less Lightening Cream, etc. promote stereotypes against darker skin tones through their marketing strategies. For example, a current advertisement shows a young woman with a darker skin tone being rejected from a job later ends up using a fairness product to become more beautiful and thus confident. She then goes on to score an even better job at the end. Mainstream media also fails to provide accurate representations of India’s population, with many actors being light skinned and with frequent recruitment of foreign and predominantly White-presenting actors. Often the practice of “brown-face” is used among these actors and production companies to fit a certain role or aesthetic, thereby enforcing negative stereotypes when proper recruitment should’ve happened in the first place. Even more disturbing is that these stereotypes are so enforced in people’s homes and daily lives and can affect prospective marriages, job opportunities, and other relationships due to preferential treatment towards lighter skin.
The Origins of Colorism
Often, people mistakenly identify the origins of colorism with the caste system present in India. The caste system divides the Indian population according to labor and promotes the idea that each subgroup has its own functionally important role in society. Over time, this led to misrepresentation and manipulation of the caste system, because higher status on the ladder typically meant more prestigious work related to education, religion, trading, etc., whereas lower status meant more labor-intensive work that typically meant occupations in dirtier, outdoor environments. Naturally, those individuals lower on that ladder became darker due to their exposure to natural environmental conditions. Their natural and seasonal tanning along with their status as Dalits (“the untouchables”) within the caste system can be argued to have contributed to colorism. While the caste system does play a part in this ideology, it doesn’t fully explain why discrimination continues to happen, especially among individuals that identify with a higher status on the caste system but are also darker. Apart from that, multiple text depict Hindu deities as “dark-skinned,” and who hold a tremendous amount of respect, honor, and power. Neither the caste system nor religion can wholly explain the origins or colorism and why it still continues to perpetuate today.
Source: Source: The Ancient Wisdom Project
Colonization, the third factor of this equation, seems to be the missing part of the puzzle. Like many countries, India was not exempt from British rule and had only in the past century gained its independence. During the centuries of British rule and oppression, “colonization was embedded in the idea that fair skin people were the ruling class, and darker skinned people were the subjects.” Apart from this, there was also blatant favoritism by the newly erected British government towards light skinned Indians that directly affected social and class mobility as well as a family’s socioeconomic status. This was seen through discriminatory practices, such as offering lighter skinned individuals government pardons, jobs, and a voice, which were not offered to Indians of darker skin tones. This mindset, that the only way to be worthy, to be accomplished, and to be civilized and beautiful, slowly became an innate mantra amongst the Indian population, creating generations of individuals that strive for a beauty standard deeply rooted in anti-ethnic, anti-Indian, and anti-minority sentiments. The effects of colonization intermingled with the stereotypical notions of the caste system to give us unique and deeply rooted coloristic principles.
Difference between racism and colorism
Earlier, I mentioned that I wanted to address my own biases regarding systemic racism and educate myself on this issue. However, as an Indian-American immigrant, I found it difficult to navigate the differences between racism and colorism as the two are often intertwined and seen together in my community. But the more I researched on this issue, I found that people, often non South Asians, frequently mistook colorism for racism because it can perpetuates anti-Black sentiments within South Asian communities. Except, they are very distinct concepts. For example, in the U.S. (but not exclusive to the U.S.), skin color is the foundation of race, and continues to be a criterion in determining how they are evaluated and judged. The United States’ historic treatment and oppression of Black Americans is racially based, and within that exist preferences for certain skin tones. However, in a lot of Asian and colonized countries, race is not the primary indicator of how an individual will be treated. Instead, the color of a person’s skin on the wide range of the color spectrum will be the major determinant. While the two sound very similar, “the pervasiveness of a color hierarchy” is the crucial factor in social and class mobility, not necessarily race. Colorism and racism, while closely related problems need different solutions, and while these some of these solutions may overlap, each has a unique set of problems.
Source: Socially Urban
Right now, certain skin care and make-up companies, such as Unilever’s “Fair and Lovely,” that release skin whitening, bleaching, and lightening products have issued public apologies and are removing, re-advertising, and rebranding their products. While this alone is not enough, because the consumption of such products is based in generational trauma surrounding discrimination around darker skin and beautiful shades of brown, it is a step forward in addressing how such companies are profiting off anti-Black sentiments and how to halt such practices.
Continue to callout and critique companies that promote skin bleaching and whitening products because cosmetic changes such as rebranding products is not enough to halt harmful beauty standards.
Most importantly, it’s important to address and actively combat our own implicit biases that are rooted in generational trauma.
“I used to be chained around the waist and one ankle. My waist used to hurt because the chain was so heavy. My leg used to hurt, I would scratch it and cry. I felt relieved when the chain was removed.”
–Rose, Kenya
An estimated 792 million people globally – that is 1 in 10 people, including 1 in 5 children – have a mental health condition. Despite this irrefutable fact, governments spend less than two percent of their health budgets on mental health. The absence of proper mental health support and knowledge of how to cope with a mental health condition has lead to thousands of people being shackled in inhumane conditions.
“People in the neighborhood say that I’m mad [maluca or n’lhanyi]. I was taken to a traditional healing center where they cut my wrists to introduce medicine and another one where a witch doctor made me take baths with chicken blood.”
—Fiera, 42, woman with a psychosocial disability, Maputo, Mozambique, November 2019
This brutal practice is an open secret in many communities, according to Kriti Sharma, the senior disability rights researcher at the Human Rights Watch. Sharma and her team compiled a 56-page report titled “Living in Chains: Shackling People with Psychological Disabilities Worldwide,” shedding light on the conditions in which people with mental disabilities are bound by families in their own homes or in overcrowded and unsanitary institutions against their will. This is due to the widespread stigma and taboo of mental health issues within governments and health institutions in several countries. In state-run, private, traditional, and religious institutional “healing centers,” people with mental health conditions are often forced to fast, take medications or herbal concoctions, and face physical and sexual violence.
“A mentally ill patient is chained in a cell at Mia Ali Saeb Shrine in Samar Khel, Afghanistan on Nov 12, 2008. Patients, usually brought here by family members, are only given daily rations of bread, black pepper and water, and are kept in their cells for 40 days. With mental illness widely misunderstood, many Afghans believe God will cure the patients with such treatment.” Source: Yahoo Images.
The Human Rights Watch’s study of 110 countries unveiled evidence of shackling people with mental health conditions across age groups, ethnicities, religions, socioeconomic levels, and urban and rural areas in about 60 countries. Countries that indulge in these types of practices include Afghanistan, Burkina Faso, Cambodia, China, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Palestine, Yemen, and several more.
Though a number of countries have started to acknowledge mental health as a real problem, the inhumane act of shackling remains largely out of sight. There is no data or coordinated effort at either international or regional level to eradicate the binding of people who are mentally ill. The act of shackling impacts both the mental and physical health of someone who is already ill. Some effects include post-traumatic stress, malnutrition, infections, nerve damage, and cardiovascular problems, not to mention the loss of dignity. The #BreakTheChains Movement is an organization devoted to bringing awareness of shackling to nations and increasing access and awareness of mental health services in countries where shackling is a common problem. The movement has been successful in Indonesia where its country-wide interviews and advocacy led the government of Indonesia to deepen its commitment to #BreakTheChains. Over 48 million households in Indonesia now have access to community-based mental health services.
Laymen can also assist the movement by following two easy steps: sign the pledge, and share the movement on social media to promote awareness. It is time to acknowledge that mental health is a real issue that affects millions of people, and shackling and ignoring the issue will not resolve any issues, nor will it reduce the stigma associated with mental health. If we, as global citizens, have learned anything from this pandemic, it is how deathly and dangerous the invisibility of a disease is. Mental health is invisible like COVID-19, but there are always symptoms. Make an effort to educate yourself, and take the opportunity to check in on people by simply asking how someone has been. It really is that simple.
Amidst the global pandemic, we have all had to make some changes to our daily lives. It used to be normal to go to restaurants, movie theaters, and concerts, but now, for the most part, we stay away from those activities and social distance instead. While social distancing has slowed the spread of COVID-19, most of us are aware of the toll it takes on our mental health. Humans are a very social species, and social isolation can have a severe impact on overall wellness. Financial hardships and anxiety over illness contribute to a decline in mental health as well.
Social isolation has many benefits when it comes to slowing the pandemic. However, it drastically impacted the lives of many people in an unintended way. Loneliness has skyrocketed due to people only having contact with the people they live with—or no one. The effects can be even more confusing because social isolation affects everyone differently. Some people have pre-existing mental health conditions, and when the pandemic forced them into isolation, they recognized their symptoms worsening. While their original symptoms worsen, they also are more likely to develop PTSD than their counterparts without pre-existing conditions.
Even those without pre-existing mental health conditions are vulnerable to worsened mental health when facing social isolation, especially children and adolescents. Many people in this age group get most of their social interaction through school, and with many schools closed or on limited schedules, they’re not receiving the social interaction they need to grow. Because of the loneliness these children and teens are feeling, there is the increased risk that some of them will develop depression at an early age, with even higher rates than normal among those that have a family history of depression.
College students are facing very similar challenges that adolescents in middle and high school experience, except many have the added pressure of being away from their families while also no longer having a strong social network on campus to rely on. Many students are experiencing increased fear and anxiety in addition to depression, which can lead to physical health issues; anxiety and depression can worsen sleep and eating habits, which can have profound effects on a student’s energy, and in turn their performance in school and overall health.
Financial struggles have been shown to have severe impacts on a person’s overall wellbeing outside of this pandemic. Over a third of the United States’ population experienced negative financial impacts due to the pandemic. Hourly workers, who typically already struggle financially, were hard hit, which creates a lot of stress for them and their families. People who are worried about their finances may also be unable to seek mental health help from professionals, which could potentially improve mental health.
Many people with stable work before the pandemic hit, lost their jobs. They experience an added stress of worrying about evictions and foreclosures and where their next meal is going to come from. This can lead to higher levels of anxiety and depression, and in the past, economic downturn, which we have experience during the pandemic, is associated with an increased rate of suicide.
This pandemic has been a new experience for all of us. The COVID-19 pandemic wasn’t the first pandemic, and many are realizing it won’t be the last. This realization is increasing anxiety in many people, along with worrying about the health of immunocompromised loved ones or personal health. Additionally, many are worried about dying alone. This increase in stress can lead to an increase in anxiety and depression, along with other mental health issues, and worsen existing mental health conditions.
Being home all day has kept people in front of the TV, watching the news. It’s beneficial to be informed, but studies have shown that too much COVID-19 news can worsen mental health issues. This can exacerbate issues that already existed. One way to reduce being overwhelmed with the news, but to stay informed is to limit the time watching the news and instead get reliable information from the CDC, which updates information regularly.
Mental health is a human right, and should be a priority, especially during times or social isolation, financial hardship, and illness. An emphasis should be put on practicing self-care, but it’s also important that people who need help from a psychologist or psychiatrist get the chance to see them. During this pandemic, mental health has been put on the back burner. While many of the steps taken have saved countless lives, their impact on mental health should not be overlooked. In the future, when we take drastic measures, such as social isolation, we need to make sure the mental health aspects will be given the attention they need to be able to keep our population healthy in every way possible.
UAB is an Equal Opportunity/Affirmative Action Employer committed to fostering a diverse, equitable and family-friendly environment in which all faculty and staff can excel and achieve work/life balance irrespective of race, national origin, age, genetic or family medical history, gender, faith, gender identity and expression as well as sexual orientation. UAB also encourages applications from individuals with disabilities and veterans.
