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C.O., an asylum-seeker, suffers from severe headaches and other lingering effects of a gunshot wound – remnants of an incident that forced him to flee Guatemala. His ears and eyes bleed sporadically.
When C.O. has sought medical treatment for the bleeding at the Otay Mesa Detention Facility where he’s being held, he’s been given ibuprofen, said Anne Rios, a staff attorney at Al Otro Lado, an organization that provides legal aid to immigrants.
Rios said she had to file a complaint with the California medical board because the facility wouldn’t even let her access her client’s medical records.
“A lot of people will get particular conditions when they are traveling from their home country and that’s how this happened,” Rios said. “People are unsure about what exactly it is.”
C.O. has also been held in medical segregation – meaning solitary confinement – for roughly five weeks. No one’s sure what’s causing C.O.’s bleeding, and Rios said he’s been separated from others in the facility in case the condition is contagious.
Rios tried to persuade Immigration and Customs Enforcement to release C.O. from detention, which she argues is aggravating his health problems. She found a shelter in Texas where he could stay and that would provide legal support. She laid out how he had no criminal history or immigration violations in the United States, and noted he sought asylum through a designated port of entry, rather than crossing illegally, to show that he wouldn’t be a flight risk if he was released.
It didn’t work.
An ICE officer denied C.O.’s parole request. He’ll likely stay in detention until his asylum proceedings are finished, Rios said.
C.O. can’t read or write. He had been relying on other detainees to help him with paperwork for his asylum application.
“Now he’s placed in segregation and he can no longer get any help,” Rios said. “So it’s really, really affecting him to be placed alone. Not only because psychologically it’s detrimental, but because of the fact that he can no longer ask for help in preparing his case.”
C.O.’s case is one of many in which detainees at the Otay Mesa Detention Center allege serious medical conditions are being ignored or treated insufficiently, according to court documents and other public records obtained by Voice of San Diego. What’s more, lawyers say they’re having a harder time lately securing parole for detainees with serious medical conditions. As a result, they’re being left to deteriorate in detention.
Long-Standing Medical Concerns
The Otay Mesa Detention Center has long faced criticism over its medical care.
Back in 2007, the ACLU filed a lawsuit alleging that detainees were “routinely subjected to long delays before treatment, denied necessary medication for chronic illnesses and refused essential referrals prescribed by medical staff.” The case settled in 2010 and ICE said it would change some of its medical policies.
In February 2016, Gerardo Cruz, who was being held there, died from pneumonia. His family filed a lawsuit alleging that staff ignored his requests for medical care.
The California attorney general in a February report cited problems with medical and mental health care in ICE detention centers in the state, including medical record accuracy and accessibility, nurses practicing outside their legal scope of practice, superficial medical examinations, delayed or inadequate medical care, inadequate mental health staffing and services and unsafe suicide watch and solitary confinement practices.
Years of medical complaints from Otay Mesa obtained in a Freedom of Information Act request by Voice of San Diego echo the issues in the report. Several individuals in 2018 complained that medical staff hadn’t changed their colostomy bags in a timely manner. One man reported “the acid leaking onto his skin is burning him and the leaking of excrement is highly unsanitary.”
Another said in 2017 that they were on a hunger strike, since staff at the facility wouldn’t provide a special diet to accommodate their high blood pressure that a doctor at a different facility had prescribed. In 2016, one individual reported a dentist in the facility refused to see him after a metal plate in his jaw cut open his jaw and cheek, causing excruciating pain.
ICE said in a statement that its health services comply with national detention standards. Detainees are all screened by medical providers within their first 12 hours in ICE custody to determine their medical, dental and mental health status. Following the initial screening, detainees are referred to outside primary care doctors and specialists as needed and continue to have daily access to medical, dental and mental health services, according to the statement. ICE said its standards also require that detainees receive three daily meals using menus developed by a registered dietician, who ensures individuals’ unique health (including allergies), dietary and religious needs are met.
HIV-Positive Detainees Face Significant Risks
L.E., an asylum-seeker from Honduras who is HIV-positive, was detained at Otay Mesa for 25 days before receiving his medication.
Even then, the medication he received was inappropriate, according to one expert.
A doctor from UNITY Health Care, a network of community health care clinics, evaluated L.E.’s medical records from the facility. A letter written by the doctor and included in L.E.’s bond hearing materials called the HIV medication he was being given “antiquated.”
“This medication in fact is many years old and rarely if ever prescribed in the United States,” the doctor wrote, noting that the medication has an “unacceptably high” rate of depression attributed to it. “This particular medication also has poor efficacy in treating HIV.”
L.E. was also exposed to mumps during an outbreak and had to spend 30 days in solitary quarantine, where he stopped eating, according to court documents.
“Currently, [L.E.] is suffering from continuous diarrhea and runs debilitating health risks should he remained detained,” Rios wrote.
L.E. was eventually released from custody by an immigration judge.
In the spring, Rios worked on getting A.Y., a transgender asylum-seeker from Mexico, released from detention.
A.Y. is HIV-positive and was suffering from a rectal tear due to a sexual assault. She developed infections in her rectum “due to the poor sanitary conditions at Otay Mesa Detention Center,” according to her parole request. She, like L.E., didn’t receive the HIV medication she needed for weeks upon first arriving, Rios said.
Otay Mesa experienced several mumps outbreaks, which placed people with HIV like A.Y. at particular risk.
“Her immune system and general health are at serious risk if she remains detained at this facility,” according to documents in A.Y.’s parole packet.
A.Y. was released after requesting parole in May, Rios said. She had spent nearly six months in the facility.
Another transgender woman with HIV from Honduras, R.A., was denied parole after requesting it in July. Her attorney expressed concerns about her remaining in the facility, due to the mumps outbreaks.
“Should [R.A.] continue to be held in detention, she faces the possibility of irreversible health deterioration due to her seriously compromised immune system,” her attorney wrote.
She remains in detention.
Rios said that in the past month, it’s become more difficult to get people whose health is deteriorating in detention out on parole.
Whether a detainee is able to successfully secure release on parole hinges on “what the fad is for that month,” said Jonathan Montag, the president of San Diego American Immigration Lawyers Association.
“One person gets released, while another person may be similarly situated and you’ll hear nothing until you get no,” he said. Sometimes citing medical concerns can help a detainee’s case, he said, but not always.
“They pride themselves at Otay in having medical facilities and psychological care, so they’ll say people can get the medical care they need here,” Montag said.