Three weeks ago Dawn Wooten, formerly a nurse at Irwin County Detention Center, came forward with accusations that a doctor had performed medically unnecessary hysterectomies on many women who were at the Irwin Center under the custody of Immigration and Customs Enforcement. Irwin is run by a private, for-profit company, LaSalle Corrections. From a story in Vice, “In interviews with Project South, a Georgia nonprofit, multiple women said that hysterectomies were stunningly frequent among immigrants detained at the facility. ‘When I met all these women who had had surgeries, I thought this was like an experimental concentration camp,’ said one woman, who said she’d met five women who’d had hysterectomies after being detained between October and December 2019. The woman said that immigrants at Irwin are often sent to see one particular gynecologist outside of the facility. ‘It was like they’re experimenting with their bodies.’”
The Associated Press did a follow up investigation after these reports surfaced. They were not able to confirm all of Dawn Wooten’s accusations, but did find a pattern of issues including a lack of consent for surgeries and medical procedures performed by Dr. Mahendra Amin:
An Associated Press review of medical records for four women and interviews with lawyers revealed growing allegations that Amin performed surgeries and other procedures on detained immigrants that they never sought or didn’t fully understand. Although some procedures could be justified based on problems documented in the records, the women’s lack of consent or knowledge raises severe legal and ethical issues, lawyers and medical experts said.
Pramila Jayapal, Representative from Seattle, led a letter to the Department of Homeland Security signed by 170 members of Congress that demanded an investigation into these reports.
In covering this story, The Guardian recalled the history of forced sterilizations in the United States - something that is not exactly ancient history. “In the 1960s and 70s an increase in federal funding for reproductive health procedures combined with racist and anti-immigration sentiment led to “tens of thousands” of women of colour being sterilized, including Native Americans…And by the 1970s, a third of all women in Puerto Rico had undergone sterilization procedures, the majority of which were involuntary, as part of US attempts at ‘population control’....In California prisons, between 1997 and 2013 about 1,400 people were sterilized.”
Alexandra Minna Stern, professor of history at the University of Michigan and director of the Sterilization and Social Justice Lab told The Guardian, “Anyone who’s studied the history of sterilization abuse would look at this detention center and say this is the kind of place where sterilization abuse is likely to occur because all of the conditions that enable such medical malfeasance and reproductive oppression, they’re all in place.”
The allegations have brought all eyes onto the Irwin County Detention Center and LaSalle Corrections. However, the issue of medical neglect in ICE custody is a systemic issue. Two weeks ago two different House committee reports on ICE detention practices made this point. Both reports included damning evidence of a history of neglect and malpractice.
The first report came from the House Committee on Homeland Security. Noting that “ICE appears to prioritize obtaining bed space over the wellbeing of detainees in its custody”, the Committee “discovered a concerning pattern of ICE contracting with facilities that are poorly equipped to meet ICE’s own detention standards. This includes facilities, particularly in Louisiana [home of LaSalle Corrections], that had a well-publicized history of abuses prior to contracting with ICE. It also includes those facilities that have had longstanding contracts with ICE but have demonstrated an inability to comply with standards that affect the health and safety of detainees even after being repeatedly called out for violating those standards by DHS’s own inspection processes.”
The primary findings of the committee was that ICE’s oversight of private contractors was inadequate. Oversight was poorly conceived, advance warning was given of inspections, the contractors hired to do inspections were ill prepared, problems, when found, went uncorrected and contracts continued to be extended regardless of patterns of abuse. On medical neglect in particular,
The Committee repeatedly heard from detainees that their medical complaints were frequently dismissed. The most common complaint was that, whatever the issue, detainees would be given common pain relievers unless the symptoms were emergent. At LaSalle, migrants described a system that depended on non-medically trained people to make health care decisions. For example, if a person was experiencing pain, the guard in the housing unit might tell them to wait to go to the doctor until the morning. Even if they made it to see health professionals, migrants at LaSalle described medical personnel making fun of their complaints. Migrants held at Otay Mesa also recalled being told to prioritize “one problem at a time” and not raise multiple concerns when visiting health professional. And they had to wait days for a trip to the hospital for treatment or examinations. Sixty Migrants at Adelanto similarly complained about having to wait months to receive medical care for medical issues.
The second report came from the House Committee on Oversight and Reform. This report contained more recent developments, particularly regarding ICE’s medical neglect as it applies to COVID-19 prevention. The findings, however, were largely the same. ICE facilities fail to provide adequate medical services, and yet ICE continues to contract with the same companies. Commenting on a review of audits of detainee deaths, the Committee notes, “[t]hese documents reveal serious and widespread violations of ICE’s health and safety standards, negligent medical care, unsanitary living conditions, understaffing, poor record keeping, and critically delayed emergency care.” In relation to infectious diseases, the track record is truly damning: For example, in 2018 and 2019, an outbreak of the mumps infected nearly 900 detainees in 57 ICE detention facilities across 19 states. Documents also contain examples of improper treatment for tuberculosis, HIV, and in one case, an allegation of “grossly negligent” medical care when an ICE detainee died of meningitis in 2018.
These persistent deficiencies could aggravate the spread of coronavirus in DHS facilities. ICE has confirmed more than 6,000 detainees and 45 ICE staff have been infected with coronavirus at over 95 detention facilities. Information obtained by the Committee shows that as of mid-July 2020, more than 600 GEO Group and CoreCivic employees working in at least 29 facilities also tested positive.
Many ICE facilities, including those that house children, have had repeated sanitation problems, including dirty and moldy bathrooms, insufficient clean clothing, unsanitized dishes, dirty food preparation and service areas, and a lack of soap, toilet paper, paper towels, clean razors, and other hygiene items. During fiscal year 2020, twenty-one people have died in ICE custody. Eight of the eleven people who have died since May have died of COVID-19.
So, over the last two weeks we’ve witnessed a damning whistleblower report on an ICE facility, alongside several follow up investigations supporting parts of this report, while exposing even more abuses. We’ve also seen two congressional committee reports that detail repeatedly how ICE is negligent in the care it provides. Further, the negligence in medical care has led to deaths, and the explosion of COVID-19 in its facilities. The reports this last week note that ICE private contractors are not held accountable. Indeed, the oversight regime in place now is a complete failure.
I have no idea what it will take to move members of Congress to actually act. There is a bill circulating in the House, unlikely to make it out of committee within the time span left to this Congress. The Dignity for Detained Immigrants Act. The bill calls for minimizing the use of detention overall, phasing out of the use of contractors (private and governmental) in order to keep all detention facilities under one clear authority that is then tightly monitored based on a comprehensive set of standards. It was introduced last year. If not this bill, then something at least as comprehensive must be moved in the next Congress. This is not something that really needs to be studied any more. Detention is unnecessary, and private detention facilities are brutal. Period. We have known this for years. Enough is enough.