Uhuru Sasa can't speak for long. As an inmate in South Carolina's Broad River Correctional Institution, the mobile phone he is using is considered contraband.

"I'm sitting in a small little area right now, where I have two guys who are known as lookouts, or security. So they are looking out right now," he says, his smile audible through the phone.

Uhuru Sasa is not the name under which he was imprisoned - that he declines to provide - but a Swahili phrase that means "Freedom now". He is also known as 'D' in the prison and to the prisoner rights advocacy organisations with which he works.

He says he is in prison for murder.

Sasa is one of thousands of inmates across the country who went on strike to protest against what they describe as poor conditions and slavery in prisons throughout the United States.

If offered, prisoners may hold jobs or take classes in prisons. For those working within the prisons - making vehicle licence plates or cooking and serving food, for example - often make little to no money for their work. In federal prisons, they can make up to minimum wage - a matter left for each state to decide, but in private prisons, they don't have to be paid at all.

In South Carolina, where Sasa is imprisoned, prisoners are not paid for their work.

The 13th Amendment to the United States Constitution states: "Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States." But many prisoners say their unpaid labour means they are being enslaved.

Although no official statements have been released about the nationwide strikes, the Incarcerated Workers Organizing Committee (IWOC), one of the prisoner advocacy organisations that helped organise the strike, announced on April 1 that it would be taking place.

The strike began on September 9, affecting more than 40 prisons, and was organised around the 45th anniversary of the Attica prison riot - a 1971 uprising that took place in New York's Attica Correctional Facility in which prisoners demanded improved living conditions and basic political rights, such as an end to prison guard brutality, which falls under the Constitution's protection against "cruel and unusual punishment".

Some prisoners participated in hunger strikes, while others carried out work strikes, refusing to report to their jobs.

Although some prisons have ceased striking, as of September 25, Sasa and about 200 other inmates at Broad River were still carrying out their work strike in protest against what they say is bug-infested food, shoddy medical treatment, and cramped and mouldy living conditions.

READ MORE: Death by privatisation in US prisons

"We are seeing bugs and maggots. In the morning, when you get up, they put the grits in this big old barrel, like a trash barrel, but it's not where they put trash," Sasa says. "When you open them up in the morning, you see these bugs - some people call them bollweevils - crawling all through the grits. And they actually cook this stuff up and serve it to us. We have a rat infestation problem in the cafeteria where they are serving us from."

A staff member at Broad River, who declined to give her name, says that food is purchased from outside the prison, although she wasn't sure from where, and then prepared by staff.

Officials from both Broad River and the South Carolina Department of Corrections did not respond to repeated  requests for comment regarding the source and quality of the food.

Sasa also says that prisoners at Broad River are cramped inside cells "like sardines", and that there is mould growing in the showers.

He says that he hasn't worked his shifts at the prison licence plate shop since September 9 - which are typically shifts from Monday to Friday, starting at 6am and sometimes finishing between 12am and 1am the next morning.

Azzurra Crispino, the media co-chairwoman of IWOC, confirms that such long shifts are not unusual, and that although the jobs are presented as giving workers "training ... for jobs on the outside", she says this is not actually the case.

"In South Carolina, Ohio, and Alabama, the only licence plates that are made are in prisons," Crispino says. "It's not like he can say, 'Oh, I learned how to make licence plates, now I am going to go apply for a job in the free world making licence plates.'"

Medical care

Finally, Sasa says, the striking prisoners are protesting against the medical services available to prisoners across the state. He says that potentially life-saving drugs are being withheld from prisoners and that "lives are being lost" as a result.

Neither officials from Broad River nor the South Carolina Department of Corrections returned requests for comment regarding the medical treatment prisoners receive.

However, in 2014, the The Pew Charitable Trusts and the John D and Catherine T MacArthur Foundation released a five-year analysis of the state's spending on prisoner healthcare [PDF] .

The study lasted from 2007 to 2011, and found that South Carolina spent $2,933 per prisoner per year, the second lowest amount spent by a state on prisoner healthcare. South Carolina was followed closely by Oklahoma, which ranked lowest, spending $2,558 per prisoner. The state that spent the most on prisoner healthcare was California at $14,495 per prisoner each year.

READ MORE: Cruel and usual - US solitary confinement

Crispino says it is a good day when prisoners only go 24 hours without necessary prescription drugs.

"If you are arrested, and you have medications on you, they don't send those medications with you. They have to call the pharmacy, verify your prescription, then they dispense the payment, and probably won't give the same type of medicine to you because the rationale is that they don't have any way of knowing that what you have in your pill bottle is really what you say it is," Crispino says. "If everything is going well, it may take a day before you get your medication."

Moreover, she says that once prisoners do get access to their medication, they often aren't given the same drugs they were on before.

"They are almost always treated with generics," Crispino explains. "It's not too unusual when you are on medication for the state to decide it is too expensive and switch you to a different prescription."

Alan Mills, the executive director of the Uptown People's Law Centre (UPLC) in Chicago, Illinois, a nonprofit legal organisation that works on prisoner healthcare cases, concurs with Crispino when it comes to the states' cost-saving measures. However, Mills says that the issues in prison healthcare systems occur because the doctors simply don't care enough to do thorough tests.

"In theory, prisoners are able to get anything people on the outside can get, but the reality is that it is extraordinarily difficult," Mills says. "I don't think it's the lack of medication available. It's the doctors won't do enough investigation to figure out what's wrong. The diagnostic side is the problem, and then the lengthy delays in getting treatment."

Mills remembers a case in which a 50-year-old prisoner was experiencing joint pain and was only sent out for arthritis testing.

"It wasn't until two years later that a doctor came in and said, 'Yeah, you have cancer, and it's metastasised at this point'. And he died a couple [of] months later."

Mills recalls how the prisoner "was literally crawling around in his cell".

"It's really not that these medicines aren't available," he says, "It's that they don't have somebody with motivation to find out what's wrong with you, and then treat it."

Mills believes that the best way to judge how a medical system is performing is to look at mortality rates within that system.

The US Department of Justice Bureau of Justice Statistics released a report in 2015 that tracked the issues in prison healthcare systems occur because the doctors simply don't care enough to do thorough tests. The report found that there was a  four percent increase in the number of prison deaths in the final three years of the range surveyed. This increase included deaths from illness: for every 100,000 prisoners, the report found that 243 died of illness, compared with 234 in 2012  [PDF]. 

The same report also found that mortality rates increased for the leading causes of illness, namely heart disease, cancer, and liver disease.

"From some objective standpoint, prisoners should be the healthiest population in the world," Mills says.

"First of all, [prisoners] tend to be young, plus the 24-hour-per-day medical care - at least, in theory - the prisons control the diet, how much exercise they get … So, if they got adequate exercise, heat, ventilation, if they got fresh air and food, then … they would be among the healthiest people in the country. But, of course, they are not."

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A hunger strike on death row

Sasa says that while he has been striking, the guards have not tried to physically force him to perform his tasks, but they also haven't acted as though everything is business as usual. He says there has been "a huge restriction on visitations," and he believes the state learned of the impending strike beforehand, and instructed guards to take measures to discourage it.

"They locked down the entire facility, and they didn't give us a reason. So we didn't get an option to go to work; we were already locked down," Sasa says. "Over the last few days they've been really heavy, doing a lot of strip searches, and tearing your cell up … You may only have 10 pictures outside your photo album. They may take that extra picture that you have. This is when they are very upset at some action that you are taking."

Contradicting what Sasa says, another Broad River staff member, who also declined to give her name, says there are currently no strikes at the facility.

In Ohio, the protests took the form of a hunger strike. Siddique Abdullah Hasan, a death row inmate imprisoned under the name Carlos Sanders, was one of the 50 prisoners at Ohio State Penitentiary in Youngstown, Ohio, to go on the week-long hunger strike.

He says that he and others were protesting against the unequal treatment of death row inmates, as well as inadequate food portions for prisoners.

Bennu Hannibal Ra-Sun says he isn't allowed to supplement these meals with anything from the commissary [Photo courtesy of Bennu Hannibal Ra-Sun]

In 2011, Hasan and three other death row inmates went on a hunger strike to get contact visitation rights, and the right to receive food and clothing packages. They are on death row for their leadership roles and murders committed during a 1993 prison uprising known as The Lucasville Prison Riot at the Southern Ohio Correctional Facility.

During the riot - the worst ever in an Ohio prison - prisoners took over the facility for 11 days, killing one correctional officer and nine prisoners.

That hunger strike ultimately won the four men visitation rights, as well as food and clothing packages.

However, other inmates on death row at Ohio State Penitentiary are not afforded the same privileges. Hasan says that they are not even allowed "semi-contact" visits, in which prisoners and their families are separated by Plexiglas, but may touch and hold hands through holes in it.

They "have to scream at the top of their lungs to talk to family," Hasan says.

Laura Gardner, the warden's assistant and public information officer at Ohio State Penitentiary, confirmed via email that "visits are in a non-contact setting. They occur in private booths separated by Plexiglas. The booths are designed so that the inmate and visitor can communicate directly through the Plexiglas."

But, Hasan says, "They are just asking for semi-contact visits, and you can easily do that by just cutting a hole through the plexiglass".

He is speaking on a prison telephone, and every five minutes, a recorded voice breaks into the conversation, reminding him that the call is coming from a prison - and is recorded.

Hasan says that although the prison recently began serving full-size portions of food, before September 23, the portions barely filled half the 59ml portion cup.

Hasan counts himself lucky: He has family members who send him enough money to buy extra food, such as canned fish, at the prison canteen. As a result, he doesn't have to rely on what he describes as the meagre portions the prison has been providing since food company Aramark moved into the Ohio prison system in 2013.

Many believe food sanitisation is an issue in US prisons [Photo courtesy of Bennu Hannibal Ra-Sun]

Others have not been so fortunate. Hasan's neighbour, Ronald Shaffer, is much thinner than when he entered the prison in March 2014. Hasan bangs on the plexiglass separating the two men, to ask how much Shaffer weighed when he entered the prison and how much he weighs now. After a brief pause, Hasan says Shaffer entered the prison at 79kg, but is currently 59kg.

Although the prison has started providing Shaffer with six extra snacks per day, in addition to regular meals, Hasan says it took Shaffer going on a solo hunger strike a week before the September 9 protests began to secure that extra food.

"He shouldn't have had to go on a hunger strike to get that extra food," Hasan says. "He lost all that weight because they gave him the runaround."

Gardner said in an email that she could not confirm Shaffer's weight loss, or his food portioning, as "any information related to an inmate's medical history is not public record."

When asked how many inmates refused food on September 9, Gardner did not answer that question but explained that according to prison policy, the inmates are considered to be on a hunger strike in the case of missing nine consecutive meals.

Hasan says that food sanitation is also an issue.

"The food is supposed to be at a certain temperature ... and it is almost all the time cold." Because there are only two or three officers serving food to multiple inmates, and they may only open one food slot in a cell at a time, "food is just sitting there, getting cold," he says.

The sanitation practices of Aramark, which provides food for the facility, came under fire in 2013, after a report by investigative journalist Chris Hedges revealed that the company was serving spoiled food to prisoners in Michigan, making prisoners ill as a result. As recently as 2015, other investigations found maggots in the food, and an Aramark employee was fired for serving inmates food from the rubbish.

Food portioning has also been a problem for Aramark. In 2014, the company was cited 116 times in Ohio alone for failing to provide inmates with enough food.

Aramark did not respond to repeated requests for comment regarding the amount of food being served to inmates prior to September 23, or the overall quality of the food it serves. It also did not respond to requests to provide calorie counts for standard inmate meals at Ohio State Penitentiary, although Aramark spokeswoman, Karen Cutler, says portion sizes are dictated by the prisons, rather than the company.

When asked about standard calorie counts in prison meals, Gardner said in an email that the state of Ohio "establishes the nutritional parameters of the menu and its calorie count. Aramark's Registered Dietitians then design menus to meet the nutritional requirements specified by the facility, as well as the guidelines set by the American Correctional Association. ACA guidelines are based upon the most current Recommended Dietary Allowances and Dietary Reference Intakes".

READ MORE: Forgotten Youth - Inside America's Prisons

Stuck in solitary

Bennu Hannibal Ra-Sun, imprisoned under the name Melvin Ray, calls in from segregation at the William E Donaldson Correctional Facility in Bessemer, Alabama. The prison has the largest segregation unit in the US, capable of holding up to 300 inmates.

Also using a smuggled mobile phone, Ra-Sun can't talk for long as he says he is under close watch in the maximum security area. He is imprisoned for life for a murder he maintains that he did not commit.

"They sent us here because we are on total lockdown and are totally isolated. We didn't have an opportunity to organise. We had been in solitary confinement all that time," Ra-Sun says of his last few weeks. His voice is indistinct and echoes, as though he is holding the phone close to his mouth.

Ra-Sun cofounded the Free Alabama Movement, an organisation dedicated to supporting prison labour reform movements, as well as providing educational materials for the public about their efforts.

He and others in solitary confinement were unable to organise their own strike, but have been assisting striking prisoners in other prisons around the country, putting them in contact with prisoner advocacy organisations and the media, and getting the word out that these strikes are happening, using social media and smuggled mobile phones.

"We have a blog, a Facebook, we have our Twitter account, and we have the people we work with. They have phenomenal connections and people, so we go through them, and use everything that's available to us," Ra-Sun says.

As of October 1, Ra-Sun was still in solitary. He says he has been there since August 19, but has not been told why. This is unusual, he says, because inmates are usually given a reason for being sent to solitary.

Ra-Sun sleeps on an old mattress on a concrete slab [ Ra-Sun's photography]

"They know if they serve me paperwork on something like that, that I will be able to challenge them, so they are not going to serve me the paperwork. They are just going to violate my rights, violate the regulations and procedure of the prison and just hold me back here," Ra-Sun says.

Ra-Sun says the conditions in Donaldson are no different from other prisons. He sleeps on an old mattress on a concrete slab that juts out of the wall. He says he doesn't have blankets, and only has one sheet.

Because he is in solitary confinement, Ra-Sun says is not allowed to walk around with the other prisoners. Because the Donaldson facility, like the rest of the Alabama prison system, is under-staffed and overcrowded, Ra-Sun says he has not been able to exercise much in almost two months because there are no guards to escort him.

Moreover, Ra-Sun alleges that there are prisoners who roam around the Holman Correctional Facility in Atmore, Alabama, because there are no guards watching them.

"There are guys just going over to guys on death row, roaming around solitary, because there are no officers there," Ra-Sun says.

This is not unusual, either: The under-staffing situation in the Alabama prison system recently came to a head at Holman, when the guards went on strike to protest against the increasingly dangerous and violent conditions at the prison due to under-staffing.

Although the 28 facilities in Alabama are supposed to hold only 13,000 inmates, the Alabama Department of Corrections' website gives a total of 28,537 inmates currently housed in the state's correctional institutions.

Neither officials from the William E Donaldson facility nor the Alabama Department of Corrections responded to repeated requests for comment regarding the prisoners in solitary confinement, overcrowding in the Alabama prison system, or the conditions inside Donaldson.

Source: Al Jazeera News