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Public Health and Law

Last winter, I packed my bags and headed to Cape Town for a two‐month internship with Sonke Gender Justice. As a research assistant in the Policy, Research and Advocacy unit, I would be working under Emily Keehn, a UCLA Law School Graduate and recent Cape Town transplant on a project involving the South African Prison system. The opportunity involved writing a publication mapping the pertinent laws and policies relating to HIV and AIDS prevention and education and violence prevention within detention facilities.

The project was unique as it involved combining the fields of law and public health. As a public health professional, I had a slight understanding of the close relationship between the two fields. However, I had no idea how inextricably intertwined they were. Working with Sonke provided me with the opportunity to interact with law professionals and obtain first hand experience and insight into the close link public health shares with legal systems.

Finding the link between Public Health & Law

The prisons context provides the perfect example of this. There is, in fact, a critical link between public health and criminal rights. In South Africa, medical care is guaranteed under the bill of rights, and this right extends to inmates (within available resources) under the Correctional Services Act (CSA). Even though this is stated in law, in practice this is not always the case. Many prisoners living with HIV are denied access to antiretroviral medication and sexual education is sparse.

From a public health perspective, this is troubling. Prisoner health is linked to community health, and in South Africa, it is also closely connected to public health. With hundreds of thousands of inmates circulating in and out of the prison system each year, it is essential that law and public health professionals combine their efforts in the fight for inmate rights.

It is only in recent years that Anti-Retroviral Treatment has been made available to all prisoners in South Africa. This advancement did not come easy and required persistent protest from the prisoners themselves with both national and international advocates paving the way. In 2006, South African inmates launched a hunger strike, demanding that the government provide ARV treatment for infected prisoners. In response, Judge Thumba Pillay of the High Court ordered the Department of Correctional Services to adopt a comprehensive HIV and AIDS plan (Open Forum, 2009). This mandated that prisoners be provided access not only to ARVs, “but also to health facilities, regular counseling, and adequate nutrition… Unfortunately, this integrated ideal has yet to be translated into practical implementation.” (Health and Human Rights, 2009) Today, advocates, health workers, and inmates themselves continue to fight for full compliance with the decree.

The aforementioned example highlights the success that is possible when the disciplines of law and public health work together in advancing issues pertaining to both fields. During my time at Sonke, my passion for health care was solidified and law became an area of high interest. I was unaware of how much advocacy and litigation came to fruition from the amalgamation of law and public health prior to my internship experience. As a result, I have become increasingly interested in exploring this relationship further in terms of providing public health expertise in legal work. I will never forget my time with Sonke, for it provided me with insight into the exciting intersection between law and public health.

4 November 2011
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