THE SUBSTANDARD health care to which immigrant detainees are subjected in U.S. government custody has given rise to a cascade of hair-raising stories.

About 6,000 detainees have tested positive for the coronavirus, some of whom, at a facility in Southern California, were initially advised to gargle with salt after being informed that their illness arose from poor air quality. At a detention center in New Mexico, some 300 sick calls by migrants went unanswered. In Louisiana, a detainee went into anaphylactic shock four times in four months before anyone thought to administer blood tests that determined he was allergic to peanuts. And at a detention center in Georgia, women were apparently pressured into gynecological surgeries they did not understand and may not have needed.

Through it all, officials from Immigration and Customs Enforcement, the agency that oversees the archipelago of detention centers, have issued routine pronouncements — that the detainees’ health care is among the agency’s highest priorities; that they are concerned about the latest reports; and that they are mounting investigations.

The government has an ethical and legal duty to provide care to migrant detainees. It has fallen short.

The pandemic’s toll in detention centers has been devastating; much of it was avoidable. At ICE’s Mesa Verde facility, in Bakersfield, Calif., officials initially decided it would be too difficult to quarantine detainees who tested positive for the virus — so they decided not to test them all. That was the policy until a federal judge in August ordered everyone there, migrants and staff alike, tested immediately. “There’s no question that this outbreak could have been avoided,” said U.S. District Judge Vince Chhabria, who cited ICE’s “deliberate indifference.”

A report by Democrats on the House Homeland Security Committee, based on interviews with some 400 detainees at eight private and county-run detention facilities, found similar evidence of indifference. In some instances, guards who grew annoyed at detainees’ complaints and medical requests threatened to lock their charges away in isolation cells, according to the report.

At the Irwin County Detention Facility, in rural Georgia, lawyers and advocates for migrant women detained there have described what they call a pattern of invasive gynecological procedures that some of the women did not understand, to which they did not consent — and that, in some cases, may not have been needed. A review by the New York Times, which consulted independent outside medical experts, found that a doctor who served as the facility’s principal gynecologist appeared to have conducted numerous questionable operations, including the removal of apparently benign cysts.

The Irwin facility, like the vast majority of ICE detention centers, is operated by a private prison company; in Irwin’s case, the operator is LaSalle Corrections. At such centers, the American Civil Liberties Union has documented a pattern of poor medical care involving understaffing, lack of responsiveness and, frequently, communication breakdowns.

Those problems might be addressed by rigorous oversight, but ACLU lawyers found that ICE inspectors do not visit detention facilities when they undertake annual assessments. That’s a sign of the very institutional apathy to which Judge Chhabria referred.

A government investigation is needed to provide a full and clear picture of the shortcomings. The Government Accountability Office is equipped to perform such investigations. It should start now.

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