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As the government shutdown rolls onward, inmates at federal prisons have been unable to see their families, attorneys and, in some instances, have been unable to receive medication. In response, prisoners at a high-security federal jail in New York City have gone on a hunger strike in protest.

A group of inmates at Metropolitan Correctional Center (MCC) in Manhattan began a hunger strike—prompted, sources tell the New York Times, by the jail canceling family visits for the second straight week.

Sarah Baumgartel, a federal public defender, told the New York Times that her client, who’s participating in the protest, has already refused a breakfast and lunch, along with the rest of the unit participating in the hunger strike.

According to the times, the MCC has held high profile criminals like accused terrorists and white-collar criminals in the past, but the vast majority of its 800 detainees are “anonymous defendants awaiting trial in obscure cases.”

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The shutdown has cut into operations at a jail that was already severely short-staffed, and in the last couple weeks, inmates awaiting trial have not only been unable to see their families, but their recreation time has also been cut or canceled altogether. Most troubling, however, is a lack of medical care.

According to Serene Gregg, who heads the local chapter of the American Federation of Government Employees, a union representing about 200 of the correctional workers and staffers at MCC, inmates requesting care are taken out of their cells only to find there is no physician available to see them.

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As Gregg told the Times, “We are providing inadequate medical care at this point. We don’t have the medical providers to see them.”

As a result, tensions at the jail are high, Gregg says, with the hunger strike seeming to only heighten the stakes.

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Recent stories run on the Washington Post and USA Today painted federal prisoners living lavishly as correctional staff labored without paychecks—stories the ACLU says are deeply misleading. During previous shutdowns, commissaries in federal prisons went unstocked, essentials (like toilet paper) were carefully rationed, and classes, transfers and library access—as well as family visits—were canceled.

As Daniel McGowan wrote for the ACLU, visits are a “critical part” of prison life.

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“They help prisoners connect to the outside world, build and repair relationships with their families, and aid reentry, all of which contribute to reducing recidivism,” he wrote.

These visits have also impacted other parts of the criminal justice system: affecting detainee’s ability to see their counsels. According to the Times, lawyers were unable to visit their clients at Brooklyn’s Metropolitan Detention Center, which houses about 1,600 inmates, due to “staff shortages” brought on by the shutdown.