By Selin Ocal

When I talk about my interests in social justice and the health of incarcerated population, my classmates are often surprised: “How did you get into that?” “You mean you’re interested in criminals?” “But I thought you were pre-med.”

Following my freshman year, I had the privilege of shadowing hospital physicians, routinely visiting patient rooms and witnessing teams of health professionals at work. One morning, while participating in rounds around the hospital, I was told I was not allowed to accompany the physicians to see their next patient. When I turned to look at the neighboring examination room, I saw two police officers on either side of the door.

Though I was not allowed to meet this particular patient—who had been brought in from the Durham County Jail—his presence had dramatically changed the way I viewed medicine and public health.  

There are more than two million individuals behind bars in the United States, and I had never thought much before about how this population was receiving healthcare. I couldn’t even recall if it had ever come up in conversation or on the news, let alone in my classes at Duke. Mass incarceration has become a popular political term, but very few realize the magnitude of the health-related ramifications of this uniquely American phenomenon.

This curiosity pushed me further into the largely overlooked area of correctional health and prisoner rights. Last year, I worked with prisoners on death row through a Durham-based non-profit, and learned about the pitfalls of our justice system from my work in the office and from the inmates themselves. When thinking about the justice system, most people can see the implications of mental health on crime and corrections. But few know the inextricability of mass incarceration, the opioid epidemic, and infectious diseases.

Behind bars, where there is injection drug use, tattooing, and poor sanitary conditions, infections can spread rapidly. Specifically, the high incidence of Hepatitis C serves as both a challenge and an opportunity in the prison system, and this is part of the focus of my research this summer. I am investigating the prevalence of disease in NC prisons and jails under the guidance of my physician faculty mentor here in Durham. I am exploring the different types of testing and treatment models currently being used around the state, and making recommendations in order to devise equitable and cost-effective solutions to curtail the spread of disease. Using findings from large-scale public health studies performed in the correctional systems of other states or even of other nations around the world, I argue that targeting the incarcerated population for treatment is crucial to eliminating the Hepatitis C epidemic in the general population.

 As I carry on with my summer, learning from the trailblazers of the field and digging for information in the sparse literature of this area, I am inspired every day to continue pushing this human rights issue out from the margins of society and into the spotlights of justice and health policy. It has been extremely rewarding to learn more about this subject where North Carolina’s health system and legal system collide, and to better understand my role in this public health issue as a student and future physician.