In recent weeks, a migrant toddler and a grandmother died after being in custody of the U.S. Immigration and Customs Enforcement (ICE) agency, prompting advocates to warn others about the subpar facility conditions and inadequate medical services in many detention centres across the country.
"What we continue to find over and over again is the sad reality that ICE has not been able to keep people safe in the detention centres where they operate. We've seen cases of medical neglect, people being threatened or ignored when they ask for medical attention, and the consequences of those behaviours and attitudes," Victoria Lopez, senior staff attorney at the American Civil Liberties Union (ACLU) National Prison Project, told Refinery29.
News of the migrant child's death, first reported by Texas-based immigration attorney Mana Yegani, spread like wildfire on social media. The toddler, whose identity has not been revealed, allegedly died shortly after being released from the for-profit South Texas Family Residential Center in Dilley, TX. Refinery29 was unable to independently verify the death.
"Reports that a child died in ICE custody at Dilley are false," an ICE spokesperson told Refinery29 via email. She added: "We are looking into the report of the death after custody, but without any specifics about who this was we are unable to provide anything further at this time."
The toddler is not the only immigrant that has died after going through the federal immigration custody system. On Friday, ICE confirmed that Augustina Ramirez-Arreola, 62, died while awaiting deportation at the Otay Mesa Detention Center in California. According to a press release, "hospital staff identified the preliminary cause of death as complications from surgery."
Ramirez-Arreola is the ninth detainee to die while in ICE custody during fiscal year 2018, which began in October 2017.
A recent report by Human Rights Watch, the ACLU, the National Immigrant Justice Center, and other groups found that ICE had reported a total of 74 deaths in immigration detention between March 2010 and June 2018.
As part of the study, independent medical experts analysed the reviews for the cases of 15 immigrants who died in ICE custody between December 2015 and April 2017. The experts said that in 8 out of the 15 cases the immigrants had received inadequate medical care, likely contributing to their deaths. They added that the medical care detainees obtained was "substandard" in most cases.
Some of the preventable deaths outlined in the report included a 23-year-old man who was not medically evaluated after several seizures, a 54-year-old woman whose hypertensive cardiovascular disease was not properly followed-up on, and a 54-year-old man suffering a heart attack whose symptoms were ignored by a nurse who "did not want to get sick."
For Grace Meng, senior U.S. researcher at Human Rights Watch, ICE should be offering proper medical care to detainees, regardless of their immigration status.
"When someone is locked up by the government, the government has the responsibility to provide medical care for them," she said. "But they are spending billions [of dollars] locking people up without offering them adequate medical care. Ordinary Americans should care about where the taxpayer money is going."
According to the report by the human rights groups, more detainees died during fiscal year 2017 than any year since 2009.
Lopez, the ACLU attorney, said that there are many ways complications can arise when someone in detention tries to request medical care, particularly because ICE deals with migrants from all around the world.
"One of the questions is whether the detention facilities have information in the languages people can understand [so they are] able to request medical attention when they need it," she said. "But what we've seen is that even when people have access the medical form to request help, they’re ignored. Sometimes people have reported that they are even threatened with being put in solitary confinement or even deported for asking for medical care."
It also doesn't help that there's not an universal standard for requisite medical care across detention centres, many which are for-profit and managed by different corporations.
"People are sometimes transferred from jail to jail, from one state to another state," Lopez said. "Because of those transfers and the difference in the detention practices in each of those facilities, people might have additional problem accessing the physical and mental health care that they need."
Family detention centres like the one at Dilley, where the migrant toddler was detained, also have its fair share of issues. In 2015, a group of ten migrant mothers filed complaints because of the "substandard medical care" they and their kids received while in custody. Some of the allegations in the complaints included: waiting up to 14 hours under the sun to be attended by medical staff, a mother who was told to "drink more water" when she sought care for two broken fingers, a patient with breast cancer who was denied treatment, and a child vomiting blood who waited three days before being referred to external medical care.
When it came to the toddler's death, Lopez pointed out at the children are especially at risk when they're in detention. For example, the Trump administration had been administering psychotropic medication to migrant children detained in Texas without first obtaining consent from their parents or guardians. On Monday, a federal judge ordered officials to stop the practice.
"Medical care for children in particular can be highly specialised," she said. "There are serious questions about whether the Department of Homeland Security and the Human and Health Services Department, which detain immigrant children, are in a position to provide the level of medical and mental health care that immigrant children might need in detention."
She added: "Of course, these children shouldn’t be detained at all because we already know that there are such significant, negative consequences for children in these conditions."
Despite an ICE spokesperson telling Refinery29 she would look "into the report of the [toddler's] death after custody," the reality is that when immigrants died after detention they are not counted in the agency's data. Take the case of Teka Gulema, an Ethiopian migrant who acquired a bacterial tooth infection while at the Etowah County Detention Center in Gadsden, AL. The infection spread through his body and he became paralysed. ICE released him from custody in November 2015, while he was still in the hospital. He died two months later, but the agency didn't investigate his death.
The deaths of immigrants because of inadequate medical care are not the only issues plaguing the agency. A report recently found more than 1,200 sexual assault complaints made by detainees, with half of the alleged perpetrators being ICE officials. Pregnant women in ICE custody have also alleged officials denied them medical care, even when they were facing a miscarriage.
Though the poor conditions at ICE detention centres predate President Donald Trump, his administration has been planning to extend the agency's detention capacity. In his budget request for FY2019, the president asked for an allocation of $2.5 billion so an average of 47,000 immigrants can be detained in ICE facilities. That would be a record high number of detainees for the agency.
Both Meng and Lopez insisted that detention is not the only solution to deal with immigrants who are waiting for their cases to be processed by the federal government, particularly because there are alternatives such as community-based supervision and electronic monitoring.
"Children [like the migrant toddler] are especially vulnerable. But generally, anyone with a history of medical or mental health conditions shouldn’t be detained," Meng said. "These facilities simply can't secure them."