Health, Healing Justice & Liberation Statement

Statement from Medical Practitioners, Public Health Practitioners, Healers, and Birthworkers condemning forced sterilizations at Irwin County Detention Center and calling for full transformation of health systems to repair the harm.

 

This statement is written in partnership with Project South: Institute for the Elimination of Poverty & Genocide, based in Atlanta, Georgia and anchor organization of campaign to #ShutDownIrwin.

 

Co-Writers (in Alphabetical Order by Last Name):

Courtni Andrews, MPH, CHES, Campaign Against Racism, Data for Black Lives Atlanta Hub

Tanvi Avasthi, MSN, MA, RN, Campaign Against Racism

benita sokari brown, MSN, RN; RYT-200, Kindred Southern Healing Justice Collective 

Tamika Middleton, Kindred Southern Healing Justice Collective

Cara Page, Kindred Southern Healing Justice Collective & Changing Frequencies & OSF Soros Equality Fellowship (2019-2020) & MIC Timeline Project 

Rita Valenti, RN (retired), co-founder Project South, member National Nurses United and Board Healthcare-Now & Kindred Southern Healing Justice Collective 

 

Advisers to the Statement:

Harriet A. Washington, MA, lecturer in Bioethics and Columbia University and Writing Fellow in BIoethics at Harvard Medical School (Author of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present and Deadly Monopolies: The Shocking Corporate Takeover of Life Itself)

Dana-Ain Davis, MPH, Ph.D., Graduate Center, City University of New York  (Author of Reproductive Injustice: Racism, Pregnancy, and Premature Birth) 

 

Editors: (in Alphabetical Order by Last Name)

Michelle Morse, MD, MPH, Co-Founder, EqualHealth , Assistant Professor, Harvard Medical School, and Robert Wood Johnson Foundation Health Policy Fellow 

Eesha Pandit, co-founder of The Center for Advancing Innovative Policy (CAIP)

Lynn Roberts, PhD, Emeritus Board Member, SisterSong Women of Color Reproductive Justice Collective

 

 

 

 

INTRODUCTION 

We as global birth workers, healthcare workers, those who provide care and healing and public health practitioners, in partnership with Project South, are compelled to write this statement and join in the campaign to shut down the Irwin County Georgia ICE Detention Center. 

 

Weeks ago, nurse Dawn Wooten courageously blew the whistle on forced gynecological procedures, medical abuses, and a cascade of harms inflicted on immigrants detained at Irwin. This statement reflects our power and positionality under the backdrop of a dual pandemic of racism and COVID-19 to name and transform the medical industrial complex (MIC). The MIC is an industry that profits off of the production of care and that de-centers dignity and equity for all. We must name the MIC as an extension of state control, slavery, xenophobia, and racial capitalism that is perpetuated in prisons and detention centers through such acts as forced sterilizations, medical violence, and gender-based violence. While we do not condone these actions, we must also acknowledge that we are all part of this system that results in ‘medical apartheid’, (a phrase coined by Harriet Washington) which is normalized and perpetuated by our silence.

 

With this letter, that silence ends now. 

 

As health and healing providers, birth workers and public health practitioners, we are complicit in the systems that prevent us from providing equitable and just care. Through racism, xenophobia, and the policing of bodies, this systemic injustice has affected the people we care for and serve just as much as it has affected us. As a result, we cause harm and generational trauma rather than providing care. We adhere to a code of silence as an extension of the police’s and prison industrial complex (PIC)’s “blue wall of silence,” destroying the integrity and the ethics of our work.

 

Being complicit to silence debases us all. 

 

We stand in the belief that we need to transform the public health system and center the strategies of Healing Justice (also known globally as collective care and protection strategies) to shift power and dismantle racial capitalism. Healing Justice (HJ) is a US Southern-based political strategy aligned with the care and safety strategies of human rights defenders around the world that bolsters the dismantling of the Medical Industrial Complex (MIC) and colonization. Co-created in 2005 by the Kindred Southern Healing Justice Collective in the lineage of Black Southern radical traditions, HJ is a strategy seeking to intervene on generational, collective, and individual trauma from systemic violence and oppression, policing, and the Prison/MIC Industrial Complex. Through recovering our ancestral medicines and practices, we will remember and/or create new traditions that center our psychic/emotional/physical/mental/spiritual and environmental well-being for our collective liberation.

 

Rooted in the lineage of reproductive justice, disability justice, environmental, and transformative justice, HJ calls on healers and health practitioners to interrupt reproductive violence like the medical abuses experienced in Irwin County ICE Detention Center as an extension of state control, racial capitalism and the MIC. 

 

Join us by signing on to this statement. By adding your name, you declare your support to Shut Down the Irwin Detention Center and these demands:

 

• Immediate shut-down of Irwin County ICE Detention Center;
• Irwin County officials, US Marshals Service, and Immigration and Customs Enforcement (ICE) immediately terminate their intergovernmental agreement, including the contract with LaSalle Corrections; 
• No re-detention for those released; and 
• Transformative justice and reparations for survivors of trauma and forced sterilization.
• Immediate shut-down of Irwin County ICE Detention Center and release of all those detained;

 

 

This is our chance to intervene in a system in which we have been complicit. White supremacy has shielded us from truly seeing our patients and clients as visible in their own struggles. Instead, they come to us as ‘victims’ of the downstream effects of public health policies – and we blame them. These “social determinants of health” are so interlinked to the structures and systems that have supported the violence of our medical ‘care’ and have systematically disadvantaged many and advantaged few with good health. These systems have overlaid our respective fields for so long, it has become hard to see where the systems of racial capitalism, white supremacy, and policing bodies end and our fields begin. There have probably been times in your care practice that you have felt frustrated and overwhelmed by the “norms” that harm us: silence when a patient is begging you to stop the pain, witnessing our coworkers making “harmless” jokes, and the seemingly benign everyday acts of dehumanizations in our respective fields. We can imagine futures that exist without policing, destruction, and harm that center safety and healing for the people we care for.

 

So, it is time. 

 

 

The frameworks of Abolition and Healing Justice allow us to re-imagine our system. We can end our complicity. We must step up and stand in solidarity alongside Dawn Wooten, the women survivors of the Irwin County ICE Detention Center, and all the immigrants detained there and in ICE prisons across the country.

HISTORICAL & POLITICAL CONTEXT 

The abuse experienced in the Irwin County ICE Detention Center did not happen under the hands of one person, but under the complicity of us all. It is time to denounce the structures that poison the foundations of the work we do to improve the lives of others on a daily basis, including our own lives. We, as birth workers, healthcare workers, healers, and public health practitioners, must acknowledge this abuse and hold ourselves and our work accountable to these survivors.

 

Neoliberalism and imperialism ensure divestment and disinvestment from the global South, violently forcing migration. When members of our global family land in the US seeking relief and support, they are locked-up under the PIC and forced to suffer under the guise of “care” in the MIC. We must reverse the effects of imperialism and neoliberalism in order to rebuild the deep spiritual and physical connections to create a new future rooted in global solidarity. The birthing people from the global South who were treated inhumanely and violently, while detained in the US at the Irwin County ICE Detention Center, must be centered in building our practices of global solidarity. Global solidarity is not the white saviors of the global North inserting their narratives into the global South. This white savior industrial complex has undergirded public health policy for too long. The legacy of patriarchal reproductive injustice has come to a tipping point with the forced sterilizations of people from our global community in ICE detention centers in the United States.

 

The MIC did not develop overnight. Its roots lie in slavery and colonization, expressed today in every aspect of healthcare in America. From the minimal care given to some enslaved people to protect the plantation owners’ investment, to the mega academic and private corporate institutions of medicine that dominate the landscape today; distribution of healthcare has been and remains dictated by the needs of capital, not the health and wellbeing of our people. Within hospitals, clinics, research centers and even governmental institutions, thousands of healthcare workers yearn to provide the comfort, healing, treatment, and care that we were trained to provide, not to perpetuate trauma, stress, violence and control that so often undergirds our working experiences. Making this transformation requires knowledge of the history that brought us to this nodal point. 

 

THE LEGACY OF REPRODUCTIVE VIOLENCE & EUGENICS

 

History has repeatedly shown and proven the violent practices conducted on enslaved Black and Indigenous bodies, the untold suffering of those experimented on, and the inhumane treatment at the hands of those dubbed as pioneers within modern medicine. Indeed, the foundations of modern gynecology are based on the bodies and the pain of enslaved Black women. Consider the first consistently successful operation for vesicovaginal fistula repair. This procedure was developed by James Marion Sims, MD – a surgeon working in Alabama who conducted countless experimental operations on vulnerable, enslaved Black women and their infants between 1845 and 1849. One young woman, Anarcha, underwent 30 operations before reaching the intended outcome of the procedure. These procedures were conducted without the use of analgesia or pain relieving interventions, as Sims operated under the racist notion that Black people did not feel pain. Countless Black women died at the hands of Sims, yet he continues to be named the “father of modern gynecology.” 

 

In 1961, Fannie Lou Hamer, African American voting and women’s rights activist, received a hysterectomy by a white physician without her consent while undergoing surgery to remove a uterine tumor. Many physicians in support of eugenic sterilization used the event of childbirth as an opportunity to perform non-consensual  tubal ligations or salpingectomies, (a procedure to remove the fallopian tube). It happened so commonly in some parts of the South that these surgeries were nicknamed “Mississippi Appendectomies.” During the 1970s, sterilization became the most rapidly growing form of birth control for Black, indigenous & Women of Color in the United States, rising from 200,000 cases in 1970 to over 700,000 in 1980. 

 

A 1965 survey of Puerto Rican residents revealed that approximately one-third of the female population of Puerto Rico was sterilized, making it the highest rate of sterilization in the world. More than one-third of the women did not know that sterilization through bilateral (both-sided) tubal ligation was a permanent form of contraception. These mass sterilizations done in the name of public health were targeted practices intended to manage overpopulation, decrease poverty, crime, and unemployment. This was a direct response to the rise of the Puerto Rican Independence movement as forced sterilizations were used as a weapon of war by the state to target and erase the next generation of the Puerto Rican communities; echoing  colonization and slavery. The pseudoscience of trying to control the population through eugenics – despite being unethical, immoral, and criminal – is often presented as fact. The process of vetting something scientifically has been short changed, which increases lack of trust in the healthcare system. Politics has trumped science and we see pseudoscience used to support and defend politics. 

 

There is a long history of subjecting marginalized women to forced, coerced, and otherwise involuntary sterilization. In 1907, Governor Frank Hanly of Indiana approved the first eugenics law, making sterilization mandatory for “criminals, idiots, rapists, and imbeciles” in state custody. Over time, specific marginalized groups have been targeted, including but not limited; to people who are incarcerated and institutionalized, people living with HIV, poor people, transgender women and men, intersex communities, and people with developmental, emotional, mental and physical disabilities. These acts, among others, are clear violations of human rights within the healthcare system. 

 

Informed consent is a criterion for any medical service or procedure and ethical precepts which have governed research since the Nuremberg Trials in 1947. Non-consensual sterilization violates criteria for research and respect for persons. Surgery without consent is assault and battery – the fact that physicians are involved does not negate the legality. The American medical system has been built on the backs of marginalized people and communities. This systematic racism within American medicine goes far beyond any individual physician, politician, or legislator. 

 

These acts, and countless others, fit within the United Nations’ definition of genocide, curtailing communities within certain ethnic groups. In 1948 The United Nations General Assembly adopted the text of the “Convention for the Prevention and Punishment of the Crime of Genocide” affirming that genocide is an international crime with the aim of destroying national, ethnic, racial, or religious groups. Article II (d) directly names “imposing measures intended to prevent births within the group”. 

 

The COVID-19 pandemic has blatantly exposed the ugly intertwining of capitalism, eugenics and white supremacy. We have an opening, not witnessed since Reconstruction, to demolish the generational harm perpetrated by the MIC. This is a catalyst moment uplifted by the Black Lives Matter Movement, the Not One More Deportation Campaign, and the national call to defund the police within the US in solidarity with global movements to end fascism and white supremacy. We believe we can be led by such movements as Reproductive Justice, Environmental Justice, Disability Justice, and Transformative Justice to build equitable power without harm.

 

The global field of public health has emerged as an expression of the system of racial capitalism. On the one hand, the pseudoscience of race as a biological category justified crimes of grotesque medical experimentation, including sterilization, on Black, Indigenous & People of Color (BIPOC), people with disabilities, immigrants, Intersex, LGBQTGNCI and Two Spirit people, and those who were imprisoned in the name of scientific research. On the other hand, early 20th century immigration of impoverished Europeans provided needed fuel for the industrial revolution, which brought both innovation and destruction. 

 

Today, policing and surveillance are a large part of our lives – with so much human labor being replaced by robotics and other technologies, immigrants, especially People of Color, face deportation and detention. This rapid acceleration of technologies, of data, of biometrics also referred to as “Big Data” are included in the systems we are all too familiar with today “to control, surveil, and enact violence to maintain power structures and ensure profit.”

 

Often the faces and the people designing, developing, and purchasing these technologies are not among the oppressed, and thereby have no incentive to put people before profit. For example, one study showed data, from a major U.S. hospital, resulted in less referrals for Black patients with equivalent health needs compared to white patients to complex care management programs because of assigned risk scores through an algorithm. By prioritizing health needs by automated risk scores that focused on profitability, the programmed bias of the algorithm created a health equity disparity that could have been avoided. 

 

The scientific oppression, aggressive public policy and harmful algorithmic design needs to be stopped as they perpetuate the systems of oppression that have lasted so long that we are working to unravel.

 

Our bodies, our people, deserve better than to become numbers and figures. Working toward health and healing, we must think about the qualitative data we collect – the narratives, the stories, the perspectives, the history, the legacy – that inform us of the types of quantified “data” we are using in real time because”discrimination, fascism and neoliberalism [are] a high-tech enterprise[s].” These pseudoscientific quantitative metrics reinforce the “high tech enterprises” of oppression and dispossess the stories we as healers hear directly from the marginalized, rather than mitigating their potential for harm in the future. 

 

THE TANGLED WEB OF THE PRISON INDUSTRIAL COMPLEX

 

We are clear that the violence visited upon the survivors of sterilization at the Irwin County ICE Detention Center, is made possible through the insidious web created by the prison and medical industrial complexes. The PIC is a conglomeration of all these institutions – from policing, to media, to corporations, and surveillance – that work together to drive dramatic increases of people in jails, prisons, or under other forms of state supervision. Often, people exclude detention centers when we envision the system of incarceration. However, mass detentions and deportations feed the beast of mass incarceration. 

 

We must acknowledge that hospitals, medical centers, and other sites of healthcare provision are a part of that web, and that the prison industrial complex and healthcare system influence each other. Systems of healthcare and public health founded on white supremacy, ableist supremacy, capitalism, and cisgendered heteropatriarchy have shaped the way that wellness,value, and worthiness are defined. Within hospitals and medical centers, practitioners utilize surveillance and law enforcement through reporting policies and practices, the wielding of courts in labor and delivery units, and policing in emergency departments in order to enforce patients into compliance. 

 

This is only compounded when healthcare is brought directly into collision with the carceral system. Policies and practices that are commonplace in prisons become part and parcel of care provision. These are repeated signals of the harm that is being done. It should not be lost on us that a corrections officer in Clayton County, GA was fired and rehired repeatedly for bad behavior until finally calling an incarcerated person the “n word” this month. The physician responsible for the sterilization abuse in Irwin County, GA has a history of questionable practices on vulnerable patients going back more than 20 years. The questions of who gets quality care, who gets disposed of, and what, if any, penalties exist for maltreatment of the most marginalized communities continue to tie the prison industrial complex and the system of healthcare together. The ways in which health care and punishment (or retribution) are entangled to disastrous effects are made apparent by the harm impacting these women. The American Public Health Association’s recent statement on incarceration and health adds to the chorus of calls for recognizing and addressing the harms caused by mass imprisonment in this country. The realities of an immigration system rooted in racial capitalism and xenophobia only exacerbates that harm. 

 

This phenomenon is not new; it is consistent. 

 

Today, much has changed and much remains the same with all the roots of eugenics and white supremacy on full display in this pandemic. These incarceration institutions are fertile grounds for the spread of COVID-19 both within their walls and in the communities that surround them. Four of the ten early worst outbreaks have occurred in rural Southern counties that housed prisons. Doing anything less than ultimately abolishing the prison industrial complex means continuing to draw resources away from solutions to harm for the most vulnerable and pouring them into systems that perpetuate that harm. The rural South has been especially hard hit by these staggering inequities. Over 60% of rural hospital closures are in Southern states, and with one exception, all refused Medicaid expansion. What these states have not refused in their under-resourced communities are private prisons and detention centers.

 

We are not powerless and will not be silent. 

 

Transformative justice – a framework that centers survivor and community-led responses outside of the state –  progresses beyond the binaries of harm and care, forcing us to inspect our deep moral and ethical code on a daily basis. We believe the systemic harm and collective trauma that the legacies of injustice in reproductive care have produced can be transformed with our action. This time calls for a moment of transformative action that asks us as practitioners, birth workers, healers, public health officials and administrators to stand separately from the criminalization of immigrant and refugee women subject to this violence under the false guise of national security. 

 

There is no going back to a “normal” that got us into this massive system of healthcare inequity and carceral dominance. We commit to going forward to build the health and healing justice infrastructure necessary to meet our unmet needs, and to heal the sick, the traumatized, and ourselves in the process. 

 

If we care, we must change how our care looks.

HEALING JUSTICE 

What happened at Irwin County ICE Detention Center is rooted in the archaic beliefs of population control which is still perpetuated in law, government, infrastructure, policy and national security belief that women of color’s fertility is the root cause of environmental degradation. 

 

Population control has been used to justify wars and state sanctioned violence for centuries. Similarly eugenics has purported the ideology of who is healthy and who is unfit, based on who should survive and thrive on this planet and who is purely used for the reproduction of labor. As we have named throughout this statement, these incidences of harm and abuse are not isolated, but instead, are part of a long history of state sanctioned violence, as an extension of settler colonialism and slavery. 

 

Healing Justice (HJ) invites us to embrace radical and collective care and safety strategies to respond to white supremacy and reproductive violence under the false guise of national security. Whether you call it Healing Justice, radical care or collective care, the goal is to embed healing in politics and deploy it as a response to a white supremacist framework that orchestrates medical supremacy.  

 

We are asking global birth workers, healthcare workers, those who provide care and healing, and public health practitioners to embrace these political strategies to challenge systems of care that are immoral and unethical. We reject the idea that the medical industrial complex knows best and the belief that they are better than the people they are serving and therefore cannot be held accountable. 

 

Healing Justice seeks to transform the systems that have allowed this to happen as a root cause of racial capitalism, white supremacy and xenophobia. Healing justice strategies uplift the political and cultural projects that intervene and interrupt generational trauma for our collective survival and emotional, psychic, physical, environmental, and spiritual well being. This includes survivor-led strategies held by the grassroots campaign to shut down the Irwin County ICE Detention Center; to support the healing of the survivors; and to uplift the stories of their truths so we will always remember. 

 

As practitioners, we must stand up against the carceral state, to imagine what is possible, and to center our collective power. 

CALL TO ACTION  

 

We are united toward liberation.

We trust Dawn Wooten. 

We trust survivors.

 

Join us by signing on to this statement. By adding your name you declare your support of the petition to Shut Down the Irwin County ICE Detention Center and these demands:

 

• Immediate shut-down of Irwin County ICE Detention Center;
• Irwin County officials, US Marshals Service, and Immigration and Customs Enforcement (ICE) immediately terminate their intergovernmental agreement, including the contract with LaSalle Corrections; 
• No re-detention for those released; and 
• Transformative justice and reparations for survivors of trauma and forced sterilization.
• Immediate shut-down of Irwin County ICE Detention Center and release of all those detained;

 

 

 

 

 

 

For more info on the #ShutIrwinDown Campaign contact Project South