Profiting Off of Trauma

Immigrant detention centers lack basic health care

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Jennye Pagoada López was about two months pregnant when she approached Customs and Border Protections (CPB) agents at the San Ysidro border, seeking asylum from a gang-afflicted life in El Salvador. CPB placed her in detention for five days, during which time she slept on the floor among other detainees, despite growing stomach pains. She eventually received medical attention. Three days later, medical staff informed her she miscarried.

López should never have been placed in detention, according to a 2016 memo stating pregnant women should only be detained in “extraordinary circumstances.” Her story is a tragic example of an immigration system failing to provide immigrants with basic health care.

Reports collected by Immigration and Customs Enforcement (ICE) revealed information regarding 18 deaths that occurred in detention from May 2012 to June 2015, out of 21 total deaths that occurred over the period. From the information released, however, it wasn’t clear which deaths were due to neglect or intentional mistreatment. Human Rights Watch (HRW) opened an investigation in 2017, finding that seven of the 18 reported deaths were due to substandard care.

Individual accounts from detention centers show how ICE Health Service Corps (IHSC) fundamentally fails to uphold its supposed commitment to health care.

The HRW investigation unearthed stories of detainees like Raul Ernesto Morales-Ramo, a 44-year-old citizen of El Salvador, who died of organ failure on April 6, 2015 after suffering from cancer that went untreated for two years. During this period, he was moved from Theo Lacy Facility, which is operated by the Orange County Sheriff’s Department, to Adelanto Detention Facility, which is privately operated by a for-profit prison contractor. In both centers, he received next to no medical attention despite his worsening condition.

He submitted a grievance in February 2015 that stated, “To who receives this. I am letting you know that I am very sick and they don’t want to care for me. The nurse only gave me Ibuprofen and that only alleviates me for a few hours. Let me know if you can help me.”

In addition to its own facilities, ICE relies on city- and county-run jails and private correctional facilities run by for-profit corporations such as GEO Group Inc. and CoreCivic to detain the growing number of immigrants facing deportation. By outsourcing detention facilities, ICE financially incentivizes the detention of immigrants — turning trauma into profit.

Because detainees are scattered across this assortment of facilities, oversight on behalf of IHSC is particularly challenging.

HRW’s investigation revealed the extent of IHSC’s inability to administer basic medical care.

In one case, a man experiencing abdominal pain so severe he could not walk wasn’t attended to until a full month after he sought care. In another, a licensed vocational nurse attempted to document a patient’s vital signs “from memory,” after recording them four weeks prior. Rampant medical misconduct ensures greater trauma to a population already facing the potential for displacement.

Ultimately, the solution to systemic mistreatment of detained immigrants isn’t a better IHSC health policy, but rather the deconstruction of the U.S.’s obsession with immigrant criminalization.

In the 80s, there were approximately 30 immigrants detained per day. Today, 41,000 people on average are detained per day. The federal government currently provides a $2 billion budget for detention centers, and that budget is expected to grow by an additional $1.2 billion following President Donald Trump’s request for supplementary funding.

With over 200 detention centers around the country in various forms of public and private ownership, it’s impossible to institutionalize true transparency and accountability. Mass immigration detention must be radically defunded, and a system must be instated for the public to ensure federal agencies are providing the health care and attention they publicly claim to provide.