Te r r a i n s
Hi v e r 2013 -
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Biopower and structural violence in the Russian health system
marginalised by poverty (Stern 2003: 179). Therefore the mistreatment of sick prisoners not only raises questions over what rights a prisoner maintains during incarceration, but how Russia’s prisons continue to manage and perpetuate health inequalities that appear to be structurally embedded in the justice system. By perpetuating the differential valuation of human life in Russia’s prisons, the justice system has produced a certain biomarker that not only separates prisoners from civilians, but sick prisoners with TB from healthy (or at least healthier) prisoners. Tuberculosis, especially the MDR-TB strain, is a physical marker that demarcates infected prisoners from those who are not, paving the way for new forms of solidarity. Medical doctor and anthropologist Vinh-Kim Nguyen describes this solidarity through the term “biosociality” which suggests “the possibility that a shared biological condition may foster new forms of belonging, however fragile” (Nguyen 2010: 178). Relating through a shared condition such as tuberculosis, which is highly contagious, can “confer on individuals specific rights (health, in this case) as well as responsibilities (such as not infecting others)” (2010: 186). Nguyen calls this ‘therapeutic citizenship’ (2010: 186). Prisoners suffering from TB are demarcated by their placement in TB prison colonies and, while they are technically guaranteed the right to treatment, it often involves incorrect prescriptions (Farmer 2003: 216). While the biosociality of Russian TB prisoner-patients is justified in some respects, their unique situation of incarceration relegates some of their rights as therapeutic citizens to the justice system. A prisoner’s ability to negotiate his treatment and disease transmission is restricted. Nevertheless, Nguyen’s terminology, originally employed to describe AIDS patients in Sub-Saharan Africa, is applicable to Russian TB convicts who face unique challenges as both prisoners and patients.
How treatment is managed and mismanaged in Russia’s penitentiaries depends on the power the justice system has over its prisoners. This power has the capacity “to foster life or disallow it to the point of death” through its access to the body (Taylor 2011: 43). Philosopher and social theorist Michel Foucault coined the term ‘biopower’ to describe the increasing phenomena of modern European states to “discipline, regulate, and monitor bodily conduct” at both the scale of the individual body and the larger, more complex, social body (Nguyen 2010: 112). Urban sanitation, public health initiatives, and the conducting of detailed censuses are all examples of how biopower is embedded in state administration (Nguyen 2010: 112). Prisons assert biopower over individual bodies as they deviate from norms (disciplinary power) but they also play an extensive role in regulating the norms the population abides by (biopolitical power) (Taylor 2011: 44-46). Thus, the current health situation in Russia’s prisons reflects how the differential valuation of human life and the subsequent disparity in available health care are intimately related to the assertion of biopower. Biopower in Russia’s prison system is best illustrated through the notion that the “body is both an instrument of power and the site of struggles over power” (McGuire 2003: 106). For prisoners suffering from TB, their illness is simultaneously a manifestation of the dehumanising conditions in which they live and a vehicle in which to express how the current political and economic situation has helped produce the poor treatment outcomes which characterise tuberculosis experiences in Russia’s penal system. “Biopower is power over bios or life” and for prisoners suffering from TB, how the government responds to the current TB epidemic reflects how their bodies are valued by that same government (Taylor 2011: 44). An example of this is the
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