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‘Not Safe’: Medical advocate urges release of all people held by ICE, especially amid COVID-19

In this Q&A conducted by SPLC Staff Writer Liz Vinson, Dr. Amy Zeidan, an assistant professor at Emory University School of Medicine in Atlanta and co-director of the Georgia Human Rights Clinic and the Society of Asylum Medicine, discusses the urgent need to free detained immigrants from custody, especially in light of the COVID-19 pandemic. Zeidan recently signed on with 86 other physicians and health care professionals to call for Immigration and Customs Enforcement (ICE) to release people from the Irwin County Detention Center (ICDC) in Ocilla, Georgia, and to close the facility.

SPLC: What does ICE often overlook in terms of providing medical care to people who are detained?

Dr. Amy Zeidan
Dr. Amy Zeidan

Zeidan: What I most commonly see is unaddressed medical problems, including mental health problems. Detained individuals with complicated psychiatric or psychological disorders very rarely receive standard of care. Most ICE detention centers simply cannot provide proper health care. There are not enough nurses, doctors or behavioral health providers who work at ICE facilities and have the appropriate resources to provide treatment. Further, detention facilities are not appropriate facilities for individuals with complicated medical and psychiatric diseases to reside.

Detained individuals with serious mental health problems are often placed in solitary confinement, which, in my opinion, constitutes torture. I have also reviewed cases in which ICE withholds medications from individuals residing in ICE facilities long-term, including life-sustaining medications like those for cancer and HIV. Frequently, people do not get routine medication that they desperately need.

SPLC: Why did you decide to sign the letter urging the Department of Homeland Security to release people in ICE detention from the Irwin County Detention Center in Georgia?

Zeidan: Primarily, I don’t see a rationale to detain people who are fleeing persecution and, secondly, even if that wasn’t my position, the risk of detaining people during a pandemic is so high – the risk of becoming sick is so great – that I simply cannot justify keeping individuals at ICDC locked up.

Furthermore, ICE lacks the capacity to provide proper medical care to the individuals it detains, and the agency simply cannot follow through with the Centers for Disease Control and Prevention recommended guidelines to effectively control the virus in detention facilities. Facilities are perpetually understaffed and in many states, facilities are located much too far away from proper medical facilities, like hospitals, where they could receive proper medical treatment should they become infected.

People in detention have died from the virus, and these people – including detention center staff – can become ill from the virus really quickly. You can be fine one day, and the next day you’re critically ill.

These facilities are not built to be health care settings, especially for those subject to COVID-19 or other medical problems that are aggravated while in detention.

SPLC: How is the pandemic affecting individuals in ICE facilities not only at ICDC but across the nation?

Zeidan: What we’ve seen is [that] those who have COVID-19 in detention settings are at a much higher risk than those of the general population.

In terms of public health, the situation is terrible. The only way you can truly prevent the spread of COVID-19 is to test everyone residing in the facility and anyone who leaves and comes back, including staff. But this doesn’t often happen.

From a community perspective, it appears that ICE is sadly not providing appropriate resources including protective equipment to their employees. And for those detained, there aren’t appropriate measures in place to treat them; they cannot socially distance, and when they are transferred – which happens frequently – they are potentially bringing the virus with them to a new detention center.

With the pandemic, it’s affected our nation badly. Evidence-based data shows us that the percentage of people in detention facilities who have been diagnosed with the virus is greater than those outside of detention.  

SPLC: Why do you feel that, nationwide, ICE must release all of its people in detention during this pandemic?  

Zeidan: The medical argument is that immigrant detention is not safe for people, end of story. We don’t need a pandemic to illustrate that to us. It is not a safe environment for people to be living in. Most people who have been detained have worsening medical mental health problems, and we still have much to learn about the long-term effects of the virus. There are ongoing side effects for those who have survived COVID-19, but we don’t know how that will impact longer-term health outcomes. In these detention facilities, there is no access to proper medical treatment for COVID-19.

Only time will tell what the downstream effects are for inadequate access to treatment or medical care. But it is certainly concerning that many facilities are located so far from an appropriate medical facility, with some hospitals over two hours away.

SPLC: What is your opinion regarding the release of all people in ICE detention not specific to the virus itself, but in general?

Zeidan: Detained people are often fleeing persecution. So by detaining them, you’re essentially taking someone who has been victimized and retraumatizing them. Detention in and of itself is traumatizing. It leads to worsening medical and mental health conditions, and there’s certainly a link between mental health and physical health.

The facilities, as I said, are understaffed, and they don’t have access to appropriate medications or referrals to specialists. The conditions in detention are not adequate for exercise, appropriate nutrition and overall a healthy lifestyle. There’s also the moral argument – stripping people of their rights who are fleeing terror at home is simply something that I cannot understand.

These facilities were first put in place for those who were true flight risks. Most individuals residing in the facilities are not. By that standard, we are violating the 1987 United Nations Convention Against Torture. We signed on to say we would be a place of refuge. What we are doing with detention violates human rights, so I believe this is not only the medical perspective but a human rights-based approach. We shouldn’t leave this type of law open to interpretation. If our law says we will open our arms to people fleeing persecution, then we should.

SPLC: What type of plan do you foresee that could be rolled out nationwide to release people in ICE detention safely?

Zeidan: Many detained individuals have sponsors or people who would come forth to help them integrate or reintegrate back into society. The challenge or barrier is that some of the policies the Trump administration put in place severely challenge those sponsors to be able to do just that.

You could make the argument that, well, what if detained individuals are released and have COVID-19, and then they spread it? What we’d recommend, just like any other setting, is that they isolate for 10 to 14 days before meeting their sponsor to protect themselves and their sponsor. Detention is a new thing. Arriving to our country and fleeing persecution is not. There are strategies for relief that are safe.

SPLC: When you say a “safe” setting, what do you mean?

Zeidan: There are incredible community organizations and faith-based organizations who provide refuge for people. Data shows that when you criminalize people, they become more exposed to violence and their health problems worsen. So these organizations could provide support for those in transition, and we can continue to use these resources.

It’s hard to say, “release them all, and they’ll figure it out.” But it is possible. We just need infrastructure to support those transitions, and that may mean a sort of staggered approach to reintegrating back into society. I think any release should be in direct partnership with community- or faith-based organizations. If ICE can work with those organizations, then we’ve come full circle. And I think these organizations who would like to see the end of immigrant detention would gladly work with the release of individuals if this were considered as a solution. Many could poke a hole in this and say it’s not possible, but it’s feasible if detention centers are willing to try.

SPLC: To those who disagree with your opinions, what would you say?

Zeidan: At the end of the day and as a physician and expert in my field, the argument is black and white. There is no good evidence to show us that detention facilities are good for people, no matter what. I would hope that people can understand the negative health impacts and risks that detaining people have over wanting to criminalize someone for wanting a better life.

*Learn about the campaign to close the Irwin County Detention Center and other facilities from our allies at Detention Watch Network and their Communities Not Cages campaign. Sign a petition to shut down the Irwin County Detention Center here

Read about the SPLC’s efforts to support women in immigrant detention who have been abused by unnecessary and unwanted gynecological procedures.

Photo by AP Images