Investigation: Substandard medical care in ICE detention is killing immigrants, endangering lives

Code Red—that’s the name of this explosive Human Rights Watch report released this week that exposes dangerously substandard medical care in ICE detention facilities around the country. More people died in immigration detention in 2017 than any year since 2009. Physicians reviewed 15 deaths in immigration detention from December 2015 to April 2017, determining that substandard medical care contributed or led to eight of the 15 deaths. Here is a video Human Rights Watch produced to accompany the report. You hear first from the report’s author, our guest Clara Long, then Dr. Robert Cohen, who investigated ICE medical reports of deaths in custody. This is Clara Long.

CLARA LONG: Moises Tino Lopez had first one and then a second seizure in immigration detention. Our medical expert said that the first seizure and certainly the second seizure should have prompted a high level of care and concern. That did not happen, and he ultimately had a third seizure that was fatal.

DR. ROBERT COHEN: My task was to say, “Was this death preventable?” And in the majority of cases that I reviewed, the deaths were preventable if the medical and correctional staff had done the right thing.

CLARA LONG: In the seven-year period 2010 to 2017, 74 people have died in immigration detention. In 52 of those cases, we been able to examine some government records. In 23 cases, poor medical care contributed to the fatal outcome.

DR. ROBERT COHEN: The major problems were inadequate staffing, not having doctors on site as often as you might need to, not having medications available, delays in diagnosis and delays in access to emergency care.

CLARA LONG: Back in 1994, 6,800 people were locked up on any given night in immigration detention. But that number has rapidly increased over the last two administrations. Right now, over 40,000 people a night are in detention centers around the country. The Trump administration has asked for funding to increase that number to 52,000 people a night by the end of 2019. They hope to use the system to deport people rapidly and without due process. Unfortunately, even short periods of time inside detention centers with dangerous conditions like poor medical care can lead to very serious consequences.

AMY GOODMAN: That’s Clara Long, senior researcher at Human Rights Watch, the author of the report Code Red: The Fatal Consequences of Dangerously Substandard Medical Care in Immigration Detention. Clara, continue with what you’re saying in this report. It is terrifying.

CLARA LONG: It’s terrifying. What we found is that ICE, the agency that is detaining, as we said, now 40,000 people a day and wants to expand, cannot provide adequately for the safety of the people that it holds. These deaths are really the tip of the iceberg. One thing I want to emphasize is that although our medical experts found that eight of the 15 deaths—these recent deaths that we were able to review—were ones in which poor care contributed or led to the fatal outcome, in 14 of the 15 cases, there was clear evidence that ICE facilities and medical care professionals were involved in dangerous practices that could have caused death.

AMY GOODMAN: Like?

CLARA LONG: Like in many of these facilities, you have licensed practical nurses, people who have had about 18 months of training post-high school who are charged with making medical diagnoses and managing very serious conditions. In one of the cases we reviewed, a man had new onset congestive heart failure. He wasn’t able to see a doctor. Instead, he saw one of these licensed practical nurses who told him to drink more water—something we hear a lot from people who are detained, as the—it’s the panacea. In the case of congestive heart failure, that can actually make it worse and lead to a fatal outcome, because your heart is not able to clear the fluid out of your body.

In other cases, we saw this botched emergency response, these indifferent attitudes. For example, Mr. Jose Azurdia, who died in Adelanto Detention Facility in 2015, began to have the symptoms of a heart attack. He had chest pain. He was sweating. A nurse actually entered the unit for another reason and was told, “This man is sick. He’s vomiting.” She said, “I don’t want to see him because I don’t want to get sick.” And that started this two-hour delay for him to get to the hospital, to get care for this heart attack. Our medical expert said, “When you’re having a heart attack…”—this is probably obvious to everyone—”…time is muscle.” So the more time that you don’t get treatment for a heart attack, the more of your heart muscle dies and the harder it is to survive.

AMY GOODMAN: Tell us more of these stories of the people who you found whose deaths were directly a result of the lack of medical care or the horrible medical care within the ICE detention facilities.

CLARA LONG: Sure. We mentioned in the video a man named Moises Tino Lopez. He was 23 years old. Has a family, children. And he had a seizure in Hall County Jail in Nebraska. The staff there just took his mattress and put it on the floor. That’s all they did. They didn’t send him to a doctor. He ended up seeing a nurse and was prescribed seizure medication, but there seemed to be some sort of—there was a language barrier. There was sort of unexplained reasons why nurses didn’t follow up on him not taking that seizure medication. He had another seizure. They again did not respond, instead putting him in an isolation cell where he seized again and died.

These are people who are beloved members of communities, who are swept up into this dangerous system. And if you’ll allow me, one of the things that is really worrying about this executive order and the moment we’re in now in terms of the end of so-called mass family separation is that we’re starting a family incarceration crisis. We’re putting more and more vulnerable people into this dangerous system.

Already the Trump administration has begun doing the generalized detention of pregnant women, detaining people who are seeking asylum, even people who are coming in at ports of entry trying to do everything right, keeping them in prolonged periods throughout the pendency of their cases. The exposure is just growing and growing to this dangerous system, which makes these findings so very worrying, because more and more people will be exposed to conditions that very predictably, in words of our independent experts, cause death.

AMY GOODMAN: And how long on average were these people being held in ICEdetention?
And explain the facilities. I think very few people understand all the different layers of prisons, detention centers, tent cities. You have mothers who have been brought up from the border separated from their children—they are in a Washington state prison, yet these are not criminals.

CLARA LONG: Yeah. It is a patchwork of facilities that are flung out across the United States, often times in very isolated areas where it is difficult for medical professionals or lawyers to reach. As you say, they include county jails. A majority of them are private prison companies that have been stood up sometimes specifically for immigration detention. And in recent weeks, we’ve seen the Trump administration put about 1,500 people now into federal prison, which raises a whole other set of concerns about how ICE is supposed to ensure oversight of those conditions and have access to those people when it can’t even keep its own house in order.

You asked about the range of detention. It’s interesting because we see these dangerous conditions affect people at many different amounts of time in detention. One case that comes to mind is a man named Igor Zyazin. He was a Russian national who crossed into the U.S. in 2016. He carried with him in his backpack—he came with his wife—he carried with him his heart medication and some information about his condition. But they put that—locked it up in his property, never examined it and did not allow him to access it.

When he was detained at the San Luis Regional Detention Center, he began to have, again, chest pain. A nurse, a licensed practical nurse, said, “OK, well I’ll give you some nitroglycerin.” Chest pain in someone with heart trouble should prompt nitroglycerin and a call to 911. She did not do that. Instead, some correctional officers there said, “Actually, I don’t know if we want to have this really sick guy in our facility.” So they decided to sort of pack him up and actually put him in a van and drive him four hours to another facility, where they thought there was better medical care. There, he did get an EKG. He did see a doctor. But even before that EKG was read, he had had another heart attack and died in his cell there.

AMY GOODMAN: Wow. Well, on Thursday, dozens of parents and kids protested at the offices of Thomas R. Decker, the new New York field office director for ICEEnforcement and Removal Operations in protest of the Trump administration’s “zero tolerance” policy. This is some of the voices of the kids and parents there.

ISABEL VALERA: My name is Isabel Valera, and I’m here because I think that it is unfair that children are getting locked up for no reason when they’re not even breaking the law.

ALEZA SUMMIT: I think this is clearly a moment when many, many people have gotten outraged about the family separation issue. It is so emotional. I think the big question is now, how can we take that wave of outrage and redirect it or continue to focus it on U.S. policy around immigration more broadly?

JAMARI BURROWES DAVIS: I’m Jamari Burrowes Davis and I’m eight years old. Young immigrants should be free to stay with their parents and their parents should be free to stay with their kids. No kid should be in jail.

MYRNA HAIDAR: My name is Myrna Haidar. Last week, I was here for my own immigration interview in this same very building, and it’s really—I’m feeling intensely to be here again, vulnerable, where my application is not really fully approved yet. But I am with my American children, and in some weird way, they are giving me strength to be here, so we can fight for other children and other families. Incarceration in general sucks, and it usually impacts only people of color or people who don’t have citizenship or who are poor.

JOJO GELMAN: My name is Jojo Gelman and I’m 10 years old. I am protesting that people and their kids are getting sent to jail because they’re from a different country. My sign says “Get your tiny hands off our children.” And the tiny hands person means Donald Trump.

AMY GOODMAN: Those are the voices of children and parents protesting outside the ICE offices in New York and inside as well. Special thanks to Democracy Now‘s Nat Needham. It is very important to hear these voices because these are the voices that are changing national policy in this country, as the corporate media interviews the politicians. And they’re critical and making decisions. It is the protests around this country this week, the enormous outcry, that has clearly forced President Trump into retreat.

Now, I want to turn to Virginia Governor Ralph Northam, who has called for an investigation after the Associated Press exposé about conditions at the Shenandoah Valley Juvenile Center. The AP reported immigrant children as young as 14 say they were beaten while handcuffed and locked up for long periods in solitary confinement, left nude and shivering in concrete cells. Clara Long, can you respond to this?

CLARA LONG: This is a detention center that’s within the Office of Refugee Resettlement network. So it’s a detention center that’s holding unaccompanied children, including children who would be separated—it is called a staff-secure facility. So that means it looks a lot like juvenile detention, juvenile criminal justice detention in the United States.

You were saying the power of these protests—I have to tell you, the allegations in that complaint have been a matter of public record for over a year now, and something that we have been following and been very concerned about, but this is the moment in which people can hear them, and that is hopeful to me.

The allegations are terrible. I feel particularly impacted by them because I actually met a child in Mexico who had been in that center, independent of—before I knew of this lawsuit—and told me exactly the same thing. That he had seen children shackled and beaten and tased while he was detained there.

AMY GOODMAN: And what about this news that we were reporting on yesterday about children in detention facilities being injected with drugs and being forced to take drugs?

CLARA LONG: That, again, is of a piece of these serious concerns, particularly with the staff—what they call staff-secure portions of the ORR facilities, in which there does not seem to be adequate oversight, accountability, investigation of conditions. The most important thing to recognize here also is that under human rights law, children should not be detained for immigration reasons. It is simply too harmful for the countervailing governmental interest.

AMY GOODMAN: The story about Shiloh Treatment Center in southern Houston where kids held there forcibly injected with medications that make them dizzy, listless, obese, even incapacitated. This according to reports by Reveal. Meanwhile, according to another Reveal investigation, taxpayers have paid more than $1.5 billion over the past four years to companies operating immigration youth facilities despite facing accusations of rampant sexual and physical abuse.

CLARA LONG: Right. Correct.

AMY GOODMAN: What kind of control is there over this immigration industrial complex—the private corporations that are running these facilities? Some are also nonprofit.

CLARA LONG: This is why it is so incredibly important that people who are outraged by the family separation do not look away now, because there needs to be increased public pressure, increased attention to exactly that question, Amy. What kind of control is there over these facilities? Because no one seems to be minding the store in terms of making sure that people’s rights are respected.

AMY GOODMAN: Clara Long, thank you for being with us, senior researcher at Human Rights Watch, author of the report that we’ll link to, Code Red: The Fatal Consequences of Dangerously Substandard Medical Care in Immigration Detention. This is Democracy Now!. When we come back, the harrowing story of an Eritrean man who was held in detention in Broward County, Florida, terrified if he was returned to Eritrea he would be killed. The U.S. deported him. On his way back, at Cairo airport, he took his own life. Stay with us.