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by Tom Jawetz

Jailed Immigrants Face Conditions Worse Than U.S. Prisons

(PNS) -- On October 4, the House Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law held a critically important hearing to explore a growing problem in immigration detention: horribly inadequate medical care that leads to unnecessary suffering and death.This issue is one of our country's most basic principles: entitlement to fair and humane treatment. Our Constitution guarantees all persons the right to due process, including adequate medical care, when they are deprived of their liberty.

Members of Congress heard testimony from Francisco Castaneda, who was repeatedly denied necessary medical attention for a painful lesion on his penis during his more than 10 months in immigration custody. When he was released from detention after vigorous advocacy by the ACLU, Castaneda was quickly diagnosed with metastatic penile cancer and underwent immediate surgery to remove his penis. He has since undergone six aggressive rounds of chemotherapy, though his cancer continues to spread throughout his body.

Castaneda was joined at the hearing by his 14-year-old daughter. "She is here with me today because she wanted to support me," he told members of Congress. "I wanted her to see her father do something for the greater good, so that she will have that memory of me."

Congress also heard testimony from critically acclaimed author Edwidge Danticat and June Everett, whose loved ones died in immigration custody. Danticat and Everett testified powerfully about the pain that their loved ones experienced in detention, and their own struggle to become advocates for others now caught in the system.

Hopefully this hearing marks the beginning of congressional oversight into a problem that has been shrouded in secrecy for far too long. Immigration and Customs Enforcement (ICE) detains nearly 300,000 people each year, approximately one quarter of whom are identified as suffering from some chronic health condition. Yet recent reports from the Department of Homeland Security Office of Inspector General and the Governmental Accountability Office confirm that there are nationwide problems with medical care in detention.

The system for providing necessary medical care suffers from several fatal flaws. First, detainees may not receive services such as a biopsy or an MRI unless on-site medical personnel obtain authorization from off-site Managed Care Coordinators (MCCs) with the Division of Immigration Health Services (DIHS) in Washington, D.C. This results in unreasonable delays in medical care, and unjustifiable refusals to provide authorization. In York County, Pennsylvania, where detainees have been housed for years, the deputy warden wrote in a letter to a local ICE officer that DIHS had, "[S]et up an elaborate system that is primarily interested in delaying and/or denying medical care to detainees. There is nothing easy about working with DIHS. If something can be delayed, it is delayed. If it can be denied, it is denied. If something can be made difficult, it is made difficult."

Second, the treatment authorization decisions made by the MCCs -- who are in fact nurses, not doctors -- are made in accordance with deeply flawed policies. Those policies emphasize that detainees primarily receive emergency care only -- literally when life or limb are at stake. This is blatantly inconsistent with established principles of constitutional law and basic notions of decency.

The terrible consequence of poor medical care for ICE detainees is that it can result in death. At the October 4 hearing, ICE reported to Congress for the first time that 66 detainees have died in their custody since 2004. Although some of these deaths may not have been preventable, others were undoubtedly the result of poor health care.

This grossly deficient care is inexcusable and immoral. Yet, detention facilities are not regulated and have little oversight, so unfortunately, such treatment is common and goes unchecked. While ICE has issued 38 standards for the treatment of immigration detainees, they are not enforceable regulations. The standards do not apply to detainees held in Federal Bureau of Prisons facilities, and ICE has been incredibly slow to ensure compliance at other facilities. Recently, Assistant Secretary Julie Myers announced that the standards will be replaced by new "Performance Based Standards," but despite a history of collaborating with NGOs and the public in designing detention standards, ICE has now chosen to work behind closed doors. All the while, detention is on the rise. Privately-run facilities in Raymondville, Texas, and Aurora, Colo., are set to expand their capacity by 1,000 beds each, and new facilities are expected in Florida, Louisiana and Nevada, to name just a few.

Congress must understand that while comprehensive immigration reform may have stalled in the Senate, lawmakers cannot sit idly by while innocent people detained by the federal government continue to suffer unnecessary pain and even death. In order to fix a broken health care system that has caused people to die, Congress must take action.

Rep. Zoe Lofgren, chair of the House Immigration Subcommittee, understands what is ultimately at stake here. "This is just another way of murdering people and it cannot be tolerated," she recently told one newspaper. Now is the time to make sure that other members of Congress get the message and do something about it.

Tom Jawetz, staff attorney with the American Civil Liberties Union's National Prison Project. The ACLU National Prison Project is a member of the Detention Watch Network, a national coalition of organizations and individuals working to reform the U.S. immigration system

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Albion Monitor   November 1, 2007   (

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