Jailcare: Finding the Safety Net for Women Behind Bars by Carolyn Sufrin (review)

Carolyn Sufrin concludes Jailcare: Finding the Safety Net for Women Behind Bars with a poem from one of the key figures in her ethnography—Kima, a young woman continuously cycling between San Francisco jail, the city's Tenderloin district, and drug treatment programs in the Bay area. Kima's "Poetry Blues" speaks of the promise of redemption imbricated in incarceration: "Exploitation of guilt without a last name./A rectifiable beat that ticks to no end" (243). Sufrin grapples with the sense of guilt and ambivalence that pervades the San Francisco jail clinic for pregnant women, noting that theoretical terms like structural violence or the prison-industrial complex often fail to provide closure for those most affected. Indebted to works like Righteous Dopefiend (Bourgois and Schonberg 2009) and Addicted.pregnant.poor (Knight 2015), and careful to contend with the ethnographic scholarship that has already been conducted on structural disenfranchisement in the United States, Sufrin stipulates that her "observant participation" as a physician and anthropologist within the San Francisco jail aims to "destabiliz[e] monolithic representations of prisons (and the limited depictions of jails) as sites where only discipline and punishment occur" (33). Instead, Jailcare seeks to complicate characterizations of the carceral system that leave no room for ambiguity, or the possibilities of intimacy and care behind bars. Sufrin's notion of care operates on three dimensions—"as concern, as relationship, and as practice" (21), a conceptual approach that allows the author to situate the San Francisco jail clinic within the wider social services security net of the US federal government and illustrate the frayed edges and considerable gaps in such a system. The porous boundaries between the San Francisco community and the carceral clinic present difficult questions about the government's responsibility to care for pregnant women, who we consider to be fit for motherhood, how acts of caring about and caring for inmates play out within the custody of the state, and the opportunities for safety, motherhood, and medical treatment a jail cell provides. As the title would suggest, Sufrin is interested in how the carceral clinic articulates with the social safety net and the ways in which punitive institutions perform care for those otherwise abandoned by the system. This constitution of care within the correctional facility centralized in Jailcare further highlights the intersubjective negotiations of care between patients and clinicians, as well as configurations of kinship and motherhood in the jail.

Part I of Jailcare teases out the conflicting and often contradictory mandates of care afforded by the state to its citizens, even the criminals among them. The 1976 Estelle v. Gamble Supreme Court case proved a pivotal moment in dictating prisoners' entitlement to care. The state's obligation to care for prisoners under Estelle has had broadly sweeping consequences as the welfare system began to erode at the end of the 20th century. San Francisco's extensive safety net would suggest that women living on the streets should have access to the resources they need to survive. But, as Sufrin points out, availability of programming is not necessarily synonymous with quality or ease of access. The bureaucratic obstacles to care are such that many of the women who figure into Jailcare's narrative find the San Francisco clinic a far more palatable option than services that don't involve getting taken into custody. Sufrin draws upon Sharon Dolovich's (2012) idea of the "carceral burden" in Chapter 1 to illustrate that a prisoner's right to care, however, is also predicated on moral discourses of deservingness and the expectation of medical conversion. While recidivism is often cited among prison populations as evidence of the moral failings of "reformed" inmates, Sufrin points out that women's failure to "make it" out on the streets often results in a choice between chronic disease, addiction, and homelessness, and San Francisco's Jail Medical Care (JMC). The choice, for many women like Kima, is hardly a choice at all, but rather a "survival...