Week 49: Whistleblower and detainees allege medical mistreatment at Georgia detention facility
Immigration news, in context.
This is the forty-ninth edition of BORDER/LINES, a weekly newsletter by Felipe De La Hoz and Gaby Del Valle designed to get you up to speed on the big developments in immigration policy. Reach out with feedback, suggestions, tips, and ideas at BorderLines.News@protonmail.ch.
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This week’s edition:
In The Big Picture, we examine a recent complaint that among other things alleged women at a Georgia detention facility were receiving unnecessary hysterectomies.
In Under the Radar, we look at the arrests of indigenous activists who were protesting the construction of the border wall at the southern border.
In Next Destination, we review a recent appeals court decision concerning the Trump administration’s efforts to terminate Temporary Protected Status designations.
The Big Picture
The news: A formal complaint from about an ICE detention center in Georgia alleges that several women in the facility had hysterectomies performed on them without proper informed consent, setting off a firestorm of attention on medical care among the agency’s detainees.
What’s happening?
The report utilized the testimony of former facility nurse Dawn Wooten and several detained people to claim that detainees at the Irwin County Detention Center (ICDC) in Georgia were not being protected from COVID-19, not receiving necessary medical care, being misled by medical staff, and, most explosively, that they were being subjected to non-consensual hysterectomies.
That said, talk of a mass sterilization scheme in ICE detention and the notion of systematic non-consensual hysterectomies is inaccurate. There is absolutely no evidence that hysterectomies of dubious medical necessity are being performed on a large scale across the country, and claiming that there is just muddies the waters. There is plenty of evidence of widespread medical neglect in ICE detention generally; both of us, along with pretty much every other reporter on this beat, have covered instances of horrific mismanagement and indifference that have cost detainees their health and in some cases their lives. While the occurrence of any non-consensual hysterectomies at all is appalling, the complaint also draws attention to the systems of care in detention more broadly.
First, some background: as we’ve noted before, the government has a constitutional responsibility under the Fifth and Eighth Amendments to safeguard the well-being of detainees in its custody (though the Eighth is written to apply to criminal detainees, which immigration detainees are not, courts have ruled that its protections must also extend to civil detainees). This includes providing all necessary medical care.
ICE detention itself is actually not a unified system, but a patchwork of different types of facilities falling into a couple general categories: contractor-run facilities operated by private prison companies like GEO Group and CoreCivic either under direct ICE contracts or subcontracts from localities which themselves have ICE contracts; or government-run jails and detention centers, mostly county jails under intergovernmental service agreements to house ICE detainees but including a small number of federal facilities as well. The private facilities operate under a set of standards known as the Performance-Based National Detention Standards (PBNDS), while the others must adhere to the National Detention Standards (NDS).
Both standards have detailed sections on medical treatment. It’s Section 4.3 in the PBNDS, and it stipulates among other things that detainees will have 24-hour access to emergency medical and mental-health services; that prescriptions will be ordered and dispensed in a timely manner; that detainees with chronic conditions will receive appropriate treatment; and that “Informed consent standards shall be observed and adequately documented. Staff shall make reasonable efforts to ensure that detainees understand their medical condition and care.” The word “consent” appears 14 times in that section, and 5 times in the NDS. ICE has its own medical corps, but care at the private facilities is provided by either the detention companies themselves, or medical services subcontractors.
Anyone who has covered ICE detention knows that these end up being guidelines that are flimsily adhered to rather than universal practices. While ICE does have oversight personnel who visit facilities and prepare reports on compliance, noncompliant staff rarely face consequences. There’s been no shortage of complaints and lawsuits involving medical treatment in ICE detention, usually involving the failure to provide treatment or medicine, though sometimes dealing with the performance of incorrect or unnecessary procedures (see this BuzzFeed News report on a whistleblower complaint from last year).
The complaint at issue here was prepared by the research and advocacy organization Project South and the whistleblower protection nonprofit Government Accountability Project (GAP). It is based on interviews with Wooten, a former nurse at the facility, as well as several detainees at ICDC, which is run by the relatively small contractor LaSalle Corrections. The allegations on improper hysterectomies were one of a litany of concerns about medical care at the facility, including a lack of preparedness and effort to prevent the spread of COVID-19 infections. Beyond the inability to distance, detainees said there were still transfers in and out of the facility, there was a dearth of testing, and they were being misled and retaliated against by medical staff when they raised concerns.
With regards to the hysterectomy issue, the complaint relies on an interviews with two detainees, one of whom says she has spoken to five other women who all had hysterectomies without necessarily understanding why, and another who was slated to have the procedure (though was turned away because she had COVID-19) with conflicting explanations about what it as and why she needed it. This was backed up by Wooten’s testimony, with the former nurse saying it was known among the medical staff that hysterectomies were performed at an alarmingly high rate by an outside provider. The doctor involved is never named in the complaint, but was quickly identified by Prism’s Tina Vasquez as Georgia gynecologist Mahendra Amin. (Vasquez subsequently reported that detainees at the facility also viewed Wooten herself as sometimes abusive and complicit.)
How we got here
Given the United States’ history of eugenics in general and forced sterilizations of women of color in particular, it’s not hard to understand why the whistleblower report made people speculate over whether ICE is conducting mass hysterectomies of immigrant women in its custody.
The immigration restrictionists of the early 20th century were primarily motivated by eugenics, a budding pseudoscience—then considered actual science—at the time. They believed that the United States was under siege from hordes of Eastern and Southern European immigrants who, in their eyes, were genetically and morally inferior to those of so-called “Nordic” stock. (The term “Nordic” was coined by Madison Grant, a lawyer and lobbyist who helped push for restrictive immigration laws; it didn’t originally just refer to people from Scandinavian countries, but also to those from England, Germany, and other parts of northwestern Europe, who Grant believed were the “purest” subset of white people.)
Restrictionists’ efforts culminated in the Immigration Act of 1924, also known as the Johnson-Reed Act, which implemented national origins quotas for immigrants. Each country’s cap was based on the total number of immigrants from that country who lived in the U.S. in 1890—before migration from Southern and Eastern Europe began peaking—as per the census. Eugenicists didn’t just believe that supposedly “undesirable” immigrants were culturally distinct from those descended from Western Europeans; they believed that they were genetically inferior and thus unassimilable, and that any attempts to integrate them into the population would dilute the purity of the white race.
Limiting immigration was seen as one way to stop this from happening; controlling the reproduction of people already in the United States was another. As Natasha Lennard noted for The Intercept, 32 states had federally funded eugenics boards in the twentieth century. More than 20,000 people were sterilized in California alone.
Immigration restriction has always been about more than jobs or cultural cohesion: it’s often been an explicitly white supremacist project with roots in eugenics. Today’s big three anti-immigration groups—the Federation for American Immigration Reform (FAIR), the Center for Immigration Studies, and Numbers USA—can all be traced back to one man, a deceased eye doctor obsessed with overpopulation. FAIR founder John Tanton had ties to the eugenicist Pioneer Fund, an organization whose stated goal is to encourage “race betterment.” He himself believed in “passive eugenics” and often commented on the fertility of women from Africa, Asia, and Latin America.
This history is important, and it has undoubtedly influenced popular perceptions of what is alleged to have happened at Irwin, but we need to reiterate that there is no evidence that ICE is conducting mass sterilizations of the thousands of people in its custody. There is, however, significant evidence that ICE detention is rife with medical neglect, another key aspect of the whistleblower complaint that has received scant attention.
Medical negligence in ICE detention is nothing new. In March, BuzzFeed News’s Hamed Aleaziz reported on a pattern of medical neglect at the Cibola County Correctional Center, the only ICE detention facility with dedicated space for transgender women. Per the report, one woman who was bleeding from her rectum had to wait nearly two weeks for medical care. And last December, BuzzFeed News reported that substandard medical care at multiple ICE facilities led to two preventable surgeries and contributed to the deaths of four detainees. A class-action lawsuit filed last year alleged widespread medical neglect in more than 100 ICE detention centers across the country.
What’s next?
It’s not clear at this time exactly how many women have undergone medically unnecessary hysterectomies at this or any other ICE detention facility. As of now, no evidence has emerged that this situation goes beyond one unscrupulous practitioner, whose personal motivations remain unclear. There certainly is no evidence that there is some sort of top-down sterilization directive at ICE. What is clear is that this situation fits neatly into a pattern of extreme apathy towards the health of the individuals that the agency is legally responsible for.
Based on the facts laid out in the complaint, it would appear that this facility, like ICE facilities around the country, is saturated with people suffering or recovering from COVID-19 infections. Every week we’re learning more and more about the long-term health consequences of the virus, even for people who have technically recovered, and this reality is going to run headlong into the broken system of care and oversight that permeates the detention infrastructure. Unless more is done to shift this paradigm, we can unfortunately expect to see more downstream deaths and chronic afflictions.
We may learn of more cases of unnecessary or non-consensual hysterectomies and other procedures leading to sterilization, but it’s unlikely that this will ultimately emerge as a latent nationwide pattern. Nonetheless, the horrific and particularly evocative nature of these allegations—including a detainee’s use of the term “concentration camp” in the complaint— have captured public attention in a way that the hundreds of other heinous claims of medical mismanagement and abuse have not. That’s a double-edged sword, in the sense that it has the potential to make the public more aware of the other mistreatment, but could also overshadow everything else in a sort of “kids in cages” redux. (The image of kids being separated from their parents and thrown into wire cages has dominated liberal immigration discourse, even though this situation is now virtually nonexistent; instead, most migrant children and families are immediately expelled from the country, without even the chance to present an asylum claim.)
For now, Homeland Security’s Inspector General has opened an investigation into the allegations, and House Democrats are demanding that Congress investigate as well, which is already more than most ICE medical mistreatment allegations net. More reporting will also take place, spurred by the public focus, and hopefully that can spread out to the totality of the charges. ICE has recently resumed its at-large arrests after pausing them in response to the pandemic, which means the detainee population could start climbing again after having dropped precipitously (the policy of expelling asylum seekers at the border has also played a big role in reducing the detention numbers).
Under the Radar
Indigenous women arrested for protesting border wall
Federal authorities arrested two indigenous women who were trying to block construction of Trump’s border wall at the Organ Pipe Cactus National Monument in Arizona, The Intercept reports. The women were arrested while praying at Quitobaquito Springs, where construction is ongoing—both hurting the environment and destroying sacred sites for the Tohono O’odham and Hia Ced O’odham people—and were reportedly shuffled between federal agencies before ending up at a private prison. Per the Intercept’s report, they were charged with misdemeanors: violating a lawful order of a government officer and violating a closure order.
For months, the Tohono O’odham and Hia Ced O’odham have been sounding the alarm about the Trump administration’s border wall and the damage it will do to both the fragile desert ecosystem and to ancient indigenous sites. But the current situation isn’t solely a Trump phenomenon: the 1996 Illegal Immigration Reform and Immigrant Responsibility Act, signed by Bill Clinton, includes a statute authorizing the attorney general to waive the National Environmental Policy Act and the Endangered Species Act to facilitate “expeditious construction of the barriers and roads” along the border. The Trump administration has relied on that law to get the wall built quickly.
The damage has already been done. Internal government emails obtained by High Country News in August show that DHS is using water from a local aquifer to mix concrete for the wall, affecting both water levels and the endangered fish native to the lakes and ponds of the Sonoran Desert. In February, a construction crew blew up part of a sacred burial site to facilitate construction of the wall.
Next Destination
Appeals Court permits administration to move ahead with TPS terminations
A panel of the Ninth Circuit Court of Appeal ruled that the administration’s attempts to end Temporary Protected Status (TPS) for nationals of several countries were not reviewable and could move forward.
TPS was created in order to provide protections from deportation and work authorization to people whose countries of origin had been rendered unsafe by man-made or natural disasters. The status cannot be turned into permanent residency and was designed to provide temporary protections, but some countries have been designated for decades, allowing people to establish lives in the United States without a path to permanency.
The Trump administration has attempted to end the TPS designations for El Salvador, Haiti, Nicaragua, Nepal and Sudan, but these efforts have been blocked by the courts. In litigation, plaintiffs have argued that the decisions were not arrived at by the normal evaluative process but rather compelled by racial animus. Indeed, evidence has emerged that political officials ignored information prepared by career officials about conditions on the ground, and were focused instead on ending TPS at all costs.
Nonetheless, the three-judge panel overturned a district court injunction, finding that the plaintiffs had not established that the decisions were a clear product of such racial animus, and were otherwise agency determinations that the courts had no power to review. The decision puts the future of about 400,000 people living in the U.S. with TPS at risk. The protections are slated to end in November of next year for Salvadorans and March for everyone else.
Attorneys with the ACLU of Southern California have said that they will seek an en banc decision of the whole Ninth Circuit, or take the case to the Supreme Court.