In Custody, in Pain

Even with hot water, they said, she couldn't have had the procedure that day: As usual, no one at the jail had told her ahead of time that she would be having a medical appointment, so she didn't get the instructions not to eat or drink after midnight the day of surgery. When the guards woke her at 5 a.m., she ate a honey bun, a treat she had been saving from the jail canteen.

In response to questions from The Washington Post, ICE officials said last week that, "based on standard medical protocols," Harvill's records document that she has been "appropriately diagnosed and treated."

"I feel like I'm on a merry-go-round, round and round and you don't really get nothing done," Harvill said, her voice husky with just a trace of an Asian accent, during one of three interviews she gave The Post by telephone and in person, without the knowledge of federal officials. "I feel like an animal in a cage here. Sometimes I'm afraid I'm not going to wake up."

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At night, to anyone driving southeast from Phoenix through the dark Sonoran Desert, the sky over Florence glows white with prison floodlights.

This county seat, once a center of copper mining and cotton, greets motorists today with road signs that say "State prison. Do not stop for hitchhikers." Every February, motorcyclists roar through town for the Hells Angels Florence Prison Run. And the first business along Butte Avenue, the main street leading into the small downtown, is E&E Outfitters, with its "UNIFORM" sign in the window and, inside, racks of guards' outfits in khaki, black and olive green. "Detention polo shirts from $28.50," says the sale sign over one circular rack.

Of the 25,500 people who live in Florence, about 17,000 are behind bars. The incarcerated included an average of more than 700 immigration detainees in fiscal 2007, divided among a federal compound, two private prisons and the county jail. An additional 1,500 were housed nearby in a compound outside the town of Eloy, giving Pinal County the largest concentration of foreign detainees in the nation.

At the town's northern edge, just beyond an RV park for retirees, rows of concertina wire surround the federal Florence Service Processing Center. During World War II, it was the site of a prison camp for Italian and German POWs. Now it is a tidy brown-brick compound with cactuses and giant crests of the Department of Homeland Security out front. This is where Harvill arrived last May after a flight from Florida, panicky, her nose bleeding, her stomach upset, an officer on each side.

The day after she arrived, Harvill saw a nurse and a doctor for a checkup that all new detainees are supposed to have, but don't always get. "Numerous issues," they wrote in her medical chart. History of sarcoma. Hepatitis C. High blood pressure. The nosebleeds. Panic attacks. "Borderline bipolar." And lymphedema, painful fluid buildup in her left leg.

Elizabeth Fleming, a lieutenant commander in the U.S. Public Health Service who was Florence's clinical director, showed concern about Harvill. She noted that Harvill needed a leg pump -- a compression device that inflates and deflates -- to help the circulation in her leg. She also requested records from Harvill's longtime cancer doctors in Tampa. And she managed to persuade administrators in Washington to let Harvill have three outside consultations at Maricopa Medical Center, the public hospital in Phoenix.

"Will likely need to order . . . pump and may require transfer to [another immigration detention center] with infirmary," the doctor wrote in her patient's chart.

The pump never arrived. Still, Fleming saw Harvill a dozen times over the next month, records show. By mid-June, the doctor wrote, her patient was "smiling, cheerful," and her nausea and leg pain were "much improved."