The Washington PostDemocracy Dies in Darkness

Migrant detention centers have a long history of medical neglect and abuse

The link between medical abuse, racism and immigration runs deep.

Demonstrators protest conditions of detainees being held by Immigration and Customs Enforcement outside of the Broward Transitional Center in Florida on May 1. (Lynne Sladky/AP)
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The recent allegation that a doctor has performed hysterectomies on immigrant women at the Irwin County Detention Center in Georgia has sparked calls for investigation. The disturbing allegation is only the latest case of systemic medical neglect and mistreatment in immigration detention settings. The spread of the novel coronavirus has been particularly devastating for people in migrant detention centers. The difficulty of social distancing within these centers has led to outbreaks at facilities throughout the country — including most recently at an ICE detention center in Adelanto, Calif., where six people have been hospitalized.

These stories may be appalling but are not surprising. Migrant detention centers have been violent places of medical neglect and death since they first became operational. Detention facilities were designed to be instructive and punitive by discouraging unauthorized migration, and as a result, have long been conduits of harm and death. Across the country, migrants in custody and detention face medical mistreatment, poor sanitation, overcrowding, physical and psychological abuse and poor nutrition — all practices the state has long condoned or embraced.

The link between medical abuse, racism and immigration runs deep. In 1914, the U.S. States Public Health Service (USPHS) allied itself with the eugenics movement, working with eugenics organizations and producing reports that supported eugenics drives to restrict immigration. The goal was to regulate the reproductive capacity of people deemed mentally defective, undesirable and harmful to society, including those labeled sexual or criminal deviants, people of color, poor, disabled and immigrants. In this case, as historian Alexandra Minna Stern has shown, the USPHS and the Bureau of Immigration disinfected arriving migrants from Mexico believed to be dirty and contagious as early as 1916.

Perceptions of immigrant women of color as dirty, diseased and hyper-fertile continued to be used to justify anti-migrant violence across the 20th century. These stereotypes have had violent ends for decades. For instance, in 1978 the infamous court case Madrigal v. Quilligan revealed that medical professionals coerced and at times forced Latinas to undergo sterilizations in Los Angeles. Ten Mexican women, represented by Antonia Hernandez, filed a lawsuit against USC L.A. County Medical Center arguing that they provided consent under inappropriate conditions and after being harassed. They did not understand the forms they signed as no Spanish translation was provided. The plaintiffs requested financial compensation for coercive sterilization and demanded that the U.S. Department of Health, Education and Welfare incorporate sterilization counseling and consent forms in multiple languages. In the end, the judge agreed that the county hospital should not be held responsible, arguing that the doctors did not have bad intentions.

These views, based on White supremacy, also flourished alongside the development of an intricate system of immigration control throughout the 20th century. Immigration authorities declared that detention was not intended as punishment, yet prisoner testimonies and government sources suggest that mistreatment served as one of the primary ways to maintain order.

The state used dominant constructions about race and gender inside detention centers to discipline, surveil and punish immigrants. Immigrant detention increased within the context of World War II, national security fears and the Bracero Program (1942-64), a Mexican guest worker program.

In fact, from the moment the El Centro Immigration Detention Camp became operational in California in 1945, local Immigration and Naturalization Service (INS) agents and officials used detained Mexican migrants to labor in their private homes and farms, maintain the immigration detention camp and construct buildings throughout the region.

The number of immigration detention facilities grew between the 1950s and the 1970s as immigration agents increased the policing of Mexican migrants along the U.S.-Mexico border. During this period, immigration officials used DDT and other sterilizing agents on migrants held in detention centers across the United States to rid their bodies of lice.

Detention conditions were so appalling that on Dec. 28, 1973, Albert R. García, president of the Mexican American Association, wrote a letter to INS Commissioner Leonard F. Chapman. García requested that Chapman respond to several concerns, including the physical and sexual abuse inflicted by INS guards; agents breaking into and entering private residences, churches and schools to seek out unauthorized migrants; the deportation of legal permanent residents; the killing of migrants; and the inhuman treatment of migrants inside detention centers.

And yet the United States has only expanded its systems of immigration detention in the years since, with conditions continuing to be deplorable. In the year 2000, 10 percent of the women detained inside the Krome Detention Center in Miami declared that guards raped them. Their claims became news when two of the women became pregnant while still in detention.

In 2009, The Washington Post reported that since 2003 there had been 83 deaths of people in immigration custody, many from HIV and AIDS complications. More recently, the world learned of Elsa Guadalupe-Gonzales, a 24-year-old Guatemalan migrant who hung herself in a cell at the Eloy Detention Center in Arizona on April 28, 2013. More than 24 migrants have died in the custody of Customs and Border Protection during the Trump administration, including 7-year-old Jakelin Caal Maquin, 2-year-old Wilmer Josue Ramírez Vásquez and 16-year-old Juan de Léon Gutiérrez. These examples of anti-migrant violence not only demonstrate the widespread brutality within the system; they also reflect the geographic spread of migrant detention throughout the entire country.

The allegation of medical violence committed against women held inside the Irwin County Detention Center should be investigated. But this complaint should direct our attention to the broader system that made such an allegation plausible — because it routinely breeds violence in detention. Immigration detention facilities were designed to inflict abuse not prioritize the health of migrants. This is part of a much broader and deeper story of associating migrants as inferior, dirty and other.