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Kirstie Allen
SOC 365
Essay One
April 21, 201
Tuberculosis and the Effects in Prisons
Mycobacterium Tuberculosis is a preventable disease that is killing millions of people
worldwide. Due to the lack of health care, shortage of medicine, numerous people living in
poverty and over crowed communities, are all considered reasons for the cause of this infectious
disease to spread easily and quickly. With many victims with the disease or even some who are
unaware that they have this disease, tuberculosis is spreading rapidly and some cases are going
untreated. A facility that has undergone many untreated victims or have the lack of essential care
to cure Tuberculosis, are inmates in many prisons. In the book Pathologies of Power, health,
human rights, and the new war on the poor, which is written by Paul Farmer, he explains
inequalities of those who are in prison and their unnoticed social and economic rights they still
have; especially the prisoners who are already infected or who are at high risk of the infection,
tuberculosis.
Equality is the central challenge for the future of medicine and public health in prisons.
One thing that might benefit is the acknowledgement of social and economic rights for all. We
need to judge, observe, and act on ways to prevent tuberculosis not only within the communities
that suffer from poverty, but in over populated prisons as well.
Paul Farmer explains the conditions in a Russian prison and the over crowed population
by which many of these inmates have either gone into prison with or eventually developed
tuberculosis. It is estimated that every one out of ten inmates have active tuberculosis (Farmer
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119). The victims in prisons who have been diagnosed with this disease all have been processed
with treatments and medical attention to try to cure this preventable infection. Treatments where
going on the right direction until there was a shortage of medical needs for inmates. This caused
the prisoners to not only continue on with active tuberculosis, but eventually led some to
multidrug resistance tuberculosis. Paul Farmer argues that people in prison should still have the
same social and economic rights as those who are not. An argument that has been ongoing is
that, should inmates be treated the same as everyone else. Tuberculosis is not only a sickness, but
it is also a social inequality.
Paul Farmer visited this prison in Russia where it is extremely over populated. Farmer
interviewed a man named Sergio, who was an inmate in this Russian prison in which he was
diagnosed with tuberculosis shortly after. During his time in this prison, Sergio suffered from
tuberculosis and was going through treatments until there was a shortage of medicine. Sergio, as
well as many other inmates, had to leave their disease untreated again which eventually led them
to develop Multidrug Resistance Tuberculosis (Famer 118-119).
Drug resistance arises due to improper use of antibiotics in therapy of drug susceptible
tuberculosis. The improper use is a result of a number of reasons including the administration of
improper treatment regimens and the failure to ensure that patients complete the whole course of
treatment. Overall, drug resistance arises in areas with weak tuberculosis control. This is all due
to the lack of supervision of inmates and their treatments they need to take to cure their
infectious disease. A patient who develops active disease with a drug-resistant tuberculosis strain
can transmit this form of tuberculosis to other individuals (WHO).
The first step to help individuals realize that the inmates in prisons are not receiving
equal treatments they deserve as part of their social and economic human rights is to observe.
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Observing, according to Farmer, is one of the main parts of the formula key to solve social and
economic rights for prisoners with tuberculosis. It involves careful review of a large body of
literature that seeks to explain the distribution of the disease within populations, to explore its
clinical characteristics, and to evaluate tuberculosis treatment regains (Farmer 146). We as a
whole society need to observe and find the reasons why these outbreaks are occurring. It is clear
that the incidence of this disease is not random. Over crowed prisons are a leading cause of
tuberculosis and we clearly observed this as a society, but by judging and taking actions is the
most important part of a way to find cures for these outbreaks.
The next step that needs to be done is to judge. Judgment is the next factor after
observing to examine how these inmates in certain prisons are being treated and a better chance
to understand those who suffer from this preventable disease. Tuberculosis is one of the worlds
leading causes of preventable adult deaths. With the possible exception of emerging strains, it is
more than ninety-five percent curable with inexpensive therapies that have been developed
decades ago (Farmer 147). Poverty can put many people at risk of tuberculosis and then once
their submitted into prison, this bars them from access to effective treatment. We need to
moderator and make decisions for how these inmates are being cured. Dying from starvation
and torture is surely not the same thing as dying from drug-resistant tuberculosis. Isnt it
important that critics, both local and imported, understand the complex series of events and
processes that have conspired to make tuberculosis once again the leading cause of deaths in
Russias prison (Farmer 126). This quote was stated by Farmer after observing and judging the
Russia prison and the inmates who have developed this disease. Understanding the danger for
those who are at high risk of developing tuberculosis is one of them. We need to find certain
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solutions to prevent this infectious disease from spreading in prisons and judge if these
treatments are accurate and completed.
After we observe and judge, the next step that needs to be done is to act. Acting on ways
to prevent tuberculosis is simple, heal the sick. But is it really that simple? Promoting diagnosis
and curing tuberculosis are by means, ways to prevent new infections to others, but the
treatments need to be completed in order for the proper cure. A vast majority of patients do not
complete treatments once they begin. A way to prevent this from happening is to start taking
control of these inmates actions on how they are taking their medicine and treatments. Wardens
should start taking better control on making sure the prisoners with tuberculosis are finishing
their treatments in order to prevent the mast spreading to others, especially in those facilities that
are over populated. Actions within the prisons are not proper. Prisons need to treat victims with
tuberculosis just as equal with their treatments compare to those outside of prisons. Prisons lack
the fact that inmates have the same social and economic rights as any other human being. There
should be no reason for them to suffer or even eventually die from a preventable disease.
Also, another reason why tuberculosis is not being properly treated is due to a lack of
medical supplies. Medical equipments should not have a shortage within the prison facilities.
Prisons should be treated just the same as any other community that involves people with an
infectious disease. It is very uncommon for a hospital or medical center to have a shortage or
even the lack of treatments for patients with tuberculosis. Prisons should have the same human
rights as those who are not in prison. Medical treatments should be provided for inmates to cure
them and prevent it from spreading to others. Inmates deserve the same equality for health care.
Tuberculosis should not be a social inequality. Having such a lack to medical supplies for those
who suffer from this preventable disease has the higher chance of developing multidrug resistant
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tuberculosis. Ineffective treatment regimens have produced drug-resistant disease, and since
only the susceptible strains are being treated effectively, the proportion of drug resistant cases to
grow (Farmer 119). This then can spread easily to others making these over crowed prisons
worst and more cases of tuberculosis.
Everyone should have the right to effective therapy, even in prisons. Paul Farmer
explains that this can be considered structural violence and even extreme human suffering.
Structural violence includes a host of offensives against human dignity such as extreme and
relative poverty and social inequalities (Farmer 8). In this case, inmates are treated with
inequalities due to their proper lack of medical care. Many of these prisoners will enter the
Russian prison already diagnosed with tuberculosis from living in extreme poverty. Many may
not have the money or the medical attention needed to be treated. The infected people will then
enter the overly populated prison and without the medical attention they need when admitted into
the prison can have the higher chance of developing multidrug resistant tuberculosis and spread
it to other inmates. This is or can be an ongoing cycle that needs to end in order to prevent more
people from getting infected. We need to start observing the certain causes and how infected
inmates are being treated, judge if they are being treated properly, and then take action on how
the proper care should be done.
Extreme human suffering, explained by Paul Farmer is more insidious assaults on
dignity, such as institutionalized racism and gender inequality, are also acknowledged by most to
cause great and unjust injury (Farmer 29). Suffering alone is just bearing endless pain, misery,
or distress. In this case with the prison inmates, they are in extreme suffering by not being treated
with proper care or medical equipment. This is not giving the inmates their proper human rights
to medical treatments. It is violating these human social and economic rights that they have.
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These Russian prisoners or any other over crowed prisons may develop tuberculosis due
to their bad ventilation systems, improper cleaning and treatments of medical tools and extreme
over populated facilities. This all can be prevented easily by installing appropriate ventilation
systems, providing useful, new tools for medical care, and by building a new prison. Money is an
issue sometimes, especially in poverty communities and it is very expensive to build a new
building or even provide medical care to all. So an alternative may possibly be dividing the
prison in ways that the sick are located in one portion and the people without active tuberculosis
are on the other portion of the prison. By keeping inmates separated can decrease the likelihood
of others developing tuberculosis. This is a very easy preventable disease that can be cured to all.
Everyone who has tuberculosis should be treated equally, either in prison or not.
Dying from starvation and torture is surely not the same thing as dying from drug-
resistant tuberculosis. Tuberculosis is a very preventable disease that is affecting many nation-
wide. It can be easily cured in prisons with proper treatments. Inmates have the same social and
economic rights as anyone else and they are getting treated unfairly or unnoticed. Everyone
should be treated with the same respect. We need to start observing the cause and effect of how
tuberculosis is spread in these over populated facilities. Then judge how the treatments and
medicine are being used. Then take action to fix the problems. Health care is a universal human
right for all, regardless their situation.






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Work Cited
Farmer, P. (2003). Pathologies of power: health, human rights, and the new war on the poor.
Berkeley: University of California Press.
Multidrug-resistant tuberculosis (MDR-TB). (n.d.). WHO.
http://www.who.int/tb/challenges/mdr/en/