Editor’s Note: Dr. Katherine McKenzie has been on the faculty at Yale School of Medicine for more than 20 years and is the director of the Yale Center for Asylum Medicine. Dr. Homer Venters is the former Chief Medical Officer of New York City’s Correctional Health Services System and author of “Life and Death in Rikers Island.” View more opinion at CNN.
Since President Donald Trump has taken office, 24 individuals have died in ICE custody, according to federal data analyzed by NBC News.
At least one more migrant held in the custody of ICE has died since the June report.
NBC says its report does not include migrants known to have died in the custody of other federal agencies.
This includes six migrant children who have died in less than a year.
One of the migrants was a 16-year-old Guatemalan boy who died while being held in custody by US Customs and Border Protection. He was diagnosed with the flu after complaining about feeling poorly. An official with the agency said that Border Patrol agents picked up Tamiflu, the prescribed treatment. But later he was found unresponsive at the Weslaco Border Patrol Station in Texas, although his cause of death is still unknown.
Individuals die with alarming regularity while detained (migrants also died while Obama was president), and too often from treatable illnesses. An exclusive CNN report outlined, in graphic detail, the risks these people can face when their medical needs are ignored or overlooked.
Related: CNN’s investigation into preventable deaths and dangerous medical care in jails and prisons
This is not a surprise when we consider the conditions in US jails and detention centers. Facilities are often bleak, over-crowded and under-resourced, while those held in custody are frequently separated from their loved ones.
Whether individuals are charged with a crime or waiting for a decision on asylum, they have a constitutional right to adequate medical care while in US custody.
As physicians who have spent time in these institutions, whether in our work overseeing the medical needs of inmates at Rikers Island or evaluating asylum seekers in detention centers, we’ve witnessed the need for adequate health care firsthand. As a result, we are dedicated to advocating for improved conditions in these facilities.
The patients we’ve seen include a young man in his mid-20s, who says he was tortured in his home country of Togo for protesting peacefully against the government. His life was in danger, so he fled and sought asylum in the US. When he landed in New York, immigration officials sent him to a nearby detention center. Over the months he spent in detention awaiting adjudication of his claim, he developed intractable headaches, abdominal pain, nausea and vomiting.
This was all in addition to severe depression. He sought medical care while in detention, but an evaluation by an independent physician determined that the treatment he’d received in detention was sporadic and ineffective. The trauma the young man experienced before arriving in the US was compounded by the harsh conditions of detention. He was granted asylum, but during the year while he waited, his health deteriorated dramatically.
Then there’s the case of a prisoner who was detained in New York City’s jail system because he couldn’t afford $750 bail set for his misdemeanor charges (drug possession and child endangerment). There, health staff determined that he was suffering from opiate and alcohol withdrawal and ordered he be housed in a special unit for such patients. But while waiting in the medication line his behavior became erratic, which is common in alcohol withdrawal. He was removed from the medication line, restrained and taken to a jail intake area, where other inmates said that security staff beat him brutally. He later died from his injuries. One fellow inmate reported that he heard cries of “no mas!” and others recalled the sickening sound of batons repeatedly striking his body. Due to concerns by prosecutors in the Bronx District Attorney’s office about the strength of the legal case against security staff, nobody was ever prosecuted his death. One of us (Homer Venters) wrote about this case and others in “Life and Death in Rikers Island.”
There are significant health risks of incarceration – including death – and these fall disproportionately on people of color, people with behavioral health problems and the LGBTQ community.
Insufficient or negligent medical care is a violation of human rights, according to the World Health Organization. But basic human rights should be afforded to all. And, in the case of prisoners, “a deliberate indifference to serious medical needs” violates the Eighth Amendment’s prohibition against cruel and unusual punishment.
Incarceration can make people sicker, or kill them, even those who enter prison in good health. Poor health outcomes affect individuals, the confidence we have in facilities, and the public health of society at large – and undermine the goal of humane treatment of prisoners. And yet incarcerated individuals have a higher incidence of HIV, tuberculosis and hepatitis than the general US population.
Appropriate treatment of these illnesses in prisons will prevent their spread into society after an affected prisoner is released into the general population. The US prison and jail population was almost 2.2 million adults in 2016. As incarcerated individuals return home after release, the health risks of incarceration do, too. The physical and emotional trauma of injury, sexual abuse and exposure to solitary confinement stand in the way of employment, family reintegration and the many conditions placed via parole or probation.
It’s easy to overlook incarcerated or detained people. Some may feel that they don’t deserve adequate care because they’ve committed a crime or because they aren’t citizens.
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While providing prisoners with medical care is a matter of human rights, efficient and effective health care in prisons can be fiscally sound as well. Whether treating an acute medical problem or managing chronic illness, intervening early and consistently usually saves money in the long term. We are all tragically aware of the short-term risks that come from overly aggressive detention policies of asylum seekers, but we can also predict the future lasting impact.
The time has come for policymakers to heed the call of physicians who are in direct contact with the harmful effects of medical deficiencies in jails and detention centers. We should ensure that there is sufficient funding and the political will to provide adequate and appropriate medical care to inmates who are in our government’s custody. We need to act now, before another child dies while in US custody.