Drs. Margaret Hayden and Sanjay Kishore see their work as primary care physicians at the Equal Justice Initiative clinic in Montgomery as reinforcement for the reasons they went to medical school.

The EJI clinic provides free health care for people released from Alabama jails and prisons. The patients carry higher risks of certain physical and mental illnesses than the general public and, for many without health insurance, fewer options to get care.

“I wanted to become a doctor to help people who needed it,” Hayden said. “Attending to the suffering of others and being there to cure when you can and just to walk with people through suffering when you can is why I came into medicine. I’m really grateful to be a part of this space, where people who haven’t had access to healthcare for decades are able to come and create a welcoming, dignified, respectful space.”

The EJI clinic began treating patients early this year. On a first visit, patients have their blood drawn for screenings for diabetes, cholesterol, liver and kidney problems, HIV, and other conditions. Registered nurse Ryan Pratt does the lab work on site and patients learn their results during that first visit. The clinic can provide certain prescription drugs on site, including medications for common conditions such as diabetes, high blood pressure, high cholesterol, and depression.

Hayden said patients get time to talk to the doctors, ask questions, and learn options for follow-up care.

“I don’t get pressure to see them in 15 minutes and see as many patients as I can,” Hayden said. “We have a setting where we have time to really address their needs and listen and give them the dignity and respect that we all deserve, we all would want. It’s really a privilege to be here.”

This week, the EJI is launching a mobile clinic that will provide the same health screenings. The mobile clinic’s first stop will be Wednesday at the Alabama Bureau of Pardons and Paroles day reporting center in Opelika. EJI plans to use the mobile clinic throughout the state.

An important safeguard for people who have been incarcerated is a screening procedure for hepatitis C, which is more prevalent among incarcerated people than the general public.

Dr. Kishore said the clinic has five patients in active treatment for hepatitis C and one who has just completed treatment. Hepatitis C is a viral infection that causes inflammation of the liver and can go undetected for years and cause serious liver damage. The disease is spread through infected blood. Injection drug use and tattoos are two of the ways it spreads in prison. Medication to treat the virus is expensive but the clinic has been able to obtain it at no cost to patients through special programs offered by pharmaceutical companies.

“We know this saves lives,” Kishore said. “There’s no reason why people that need these medicines should not be getting them.”

Kishore said the hepatitis C detection is an example of how the clinic can make a difference even for the patients it will not see on a long-term basis. The medication can cure the disease in about two months. Kishore expects to see many more patients who need the treatment.

“This is something that even if we just have a relationship for few months with them, we can offer a big service,” Kishore said. “And so we really want to be aggressive about it.”

Hayden and Kishore are both graduates of Harvard Medical School and are part of a seasoned staff at the clinic. Pratt, an Air Force veteran, has nearly 15 years experience as a registered nurse. Social workers Laquarria Nevins and Maria Morrison, EJI senior attorney Charlotte Morrison, and clinic managers Mary Ellen Luck and Meghan Hunter coordinate the health care and follow up services intended to help patients reestablish their lives after incarceration.

EJI is a private, non-profit social justice organization known for its advocacy and legal representation of Alabama state inmates and for research that has drawn attention to problems in the prison system, among other work. The health clinic is part of an anti-poverty initiative EJI launched last year that includes support for food banks and helping families obtain healthy foods. EJI founder Bryan Stevenson said access to health care is an essential component for people seeking to establish stability after incarceration.

“So many of the people we represent have chronic diseases and illnesses and health challenges that undermine their ability to do well when they come out,” Stevenson said. “We can address food insecurity by helping people get access to food and groceries. We can provide supports to people who are needing housing and other reentry services. But if we ignore the health problems of people who are suffering from high blood pressure or diabetes, if we don’t address these kind of issues, Hepatitis C, and a range of other challenges, then we’re not going to really meaningfully impact the quality of life for these folks.”

Stevenson, an attorney and author of the bestselling book “Just Mercy,” which was turned into a 2019 movie, said because Alabama has not expanded Medicaid to cover low-income adults, which 40 states have done over the last decade, means less access to medical care for former inmates. Making that care available can help them cope with their problems without resorting to destructive habits that can put them back behind bars.

“For a lot of chronic health problems, people who can’t get access to health care, who can’t get the treatment that they need, what they end up doing is self-medicating,” Stevenson said. “And it leads to a lot of abuse of drugs and alcohol. They’re really trying to respond to discomfort, illness, pain, suffering that isn’t being addressed medically. And of course, it doesn’t help, it aggravates all of those things. But we know that that’s a very common problem, particularly for people who are uninsured and particularly for people who are dealing with the issues that many of the folks released from prison deal with.”

The clinic is the latest in a series of projects the EJI has developed in Montgomery over the last five years. In 2018, the EJI opened the National Memorial to Peace and Justice, an outdoor monument to lynching victims, and The Legacy Museum: From Enslavement to Mass Incarceration. In 2021, the EJI reopened an expanded Legacy Museum in a new location.

Kishore said he is glad to use his medical training to be part of EJI’s latest initiative.

“The mission of this clinic, and the Equal Justice Initiative at large, to help people who are suffering and to understand the structural reasons for why that suffering exists and to try to move the needle, that’s why we became doctors,” Kishore said. “And it’s part of the oath we take as physicians is to be there for people who need you irrespective of insurance status or class or anything like that.

“The other thing I would say is EJI is unique nationwide for its ability to couple directly caring for people with an understanding for history and for kind of telling the story about how we got to a place where things were difficult and how we move forward. We felt like we could learn a lot from the lawyers, all the staff of the organization. We were very humbled to be a part of this.”

Hayden said working in the clinic reminds her of the early stages of her medical training when she had more time to listen and understand patients.

“When you’re a medical student, you’re given hours to sit with a patient and get their story,” Hayden said. “And then as you progress along your medical training you kind of internalize the virtues of efficiency and we want to see as many people as quickly as we can and that’s what it means to be a good doctor. And this is kind of going back to that more innocent time where it feels really profound to sit with someone, to create a space where they feel trust. They feel like they can tell you things they haven’t told anyone. And to not have that stopwatch in your head of ‘Oh, there’s 18 other people I need to see.’”