After the ICE arrests come fears for the health of detainees

from George B. Sanchez-TeloCalMatters

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After five months in Adelanto, an immigration detention center in the high desert of Southern California, Emma Marcella Crespin de Paz is coming home to Los Angeles. The 58-year-old food vendor was released in October after multiple hospitalizations while in federal custody.

Before her arrest, De Paz had been dealing with high blood pressure and diabetes, serious, chronic conditions. Her arrest without a warrant and her bail show that she should not have been detained at all.

De Paz’s ordeal highlights both the public component of Trump-era immigration policy— racial profiling — and a growing public health concern that is hidden from view: The immigration detention system is ill-equipped for the health needs of the people in its care.

Deaths in custody draw public attention, said Dr. Altaf Saadi, Ph.D associate professor at Harvard Medical School and a neurologist at Massachusetts General Hospital in Boston, where she is associate director of its Asylum Clinic.

Less attention is paid to those with chronic diseases whose health needs worsen through indefinite detention in a network, she said. People like de Paz.

At least twice, de Paz had to be hospitalized while detained by immigration officials; both times she was admitted without notifying her family. Because ICE detained her without her medication, she began receiving her pills only after family and lawyers advocated for her well-being.

Saadi’s five-year study of the health and well-being of immigrant detainees in California has continually raised concerns about detention facilities.

“Detention center medical systems have limited health services, are often understaffed, and are focused on addressing acute care needs rather than chronic medical problems, resulting in medical neglect, delayed diagnoses and care, and severe negative outcomes, particularly among trauma-exposed individuals,” Saadi and other researchers wrote in Health and Human Rights Journal. in 2020

Surviving ICE Detention Despite Illness

“The reality is that there is harm that happens on a daily basis people survive because they are resilient” Saadi said in an interview in July.

The disruptions to detainees’ regular medicine and procedures and the resulting physical injuries are likely not being reported and discussed in local media and communities, Saadi added.

Emma de Paz arrived in the United States in 2001 from Chiquimulilla, Guatemala’s Santa Rosa state, her brother Carlos Barrera de Paz said.

In Guatemala, her family worked in agriculture as well as construction and street vending. The trip from Guatemala to Los Angeles took about 25 days, Carlos explained, including a four-day trek through the Sonoran desert.

In the United States, De Paz established himself as part of the informal economy of Los Angeles, becoming a regular vendor outside the Hollywood Home Depot. She was known for her favorite Guatemalan dishes – black beans, hoof soup and Guatemalan barbecue.

She also became part of a movement to legalize street vending in Los Angeles, explained Sergio Jimenez of the Community Power Collectivea grassroots collective of renters, street vendors, and transit riders working for what they call a “solidarity economy.”

Recently, around the time de Paz returned from detention, Gov. Gavin Newsom signed legislation that de Paz helped advocate for prevent immigration officials from accessing street vendors’ personal information from the licensing process.

De Paz’s brother, Carlos, described his sister and his family’s struggles with immigration authorities.

Searching for a family in the silence of hospitals

It began on June 19, less than two weeks after federal agents launched aggressive raids at a downtown Los Angeles warehouse and nearby Home Depot. Agents picked up De Paz and took her to the Metropolitan Detention Center. She didn’t have her medicine with her.

De Paz ended up hospitalized nearby at White Memorial Hospital in Boyle Heights. Neither the hospital nor immigration officials notified de Paz’s family. Instead, they found out through a network of immigrant advocates working to alert communities to raids, identify those taken and track their welfare.

Carlos called the hospital in Boyle Heights and asked in English if his sister was there, if she was doing well or if she needed help. But hospital staff did not confirm she was there or comment on her well-being, he said.

Jimenez and her family later learned that ICE agents had been in de Paz’s room and in the adjacent hallway. Jimenez met with doctors, nurses, surgeons and nutritionists who raised ethical concerns about ICE’s presence.

Throughout the summer, the LA media reported the presence of ICE in hospital lobbies and patient rooms. To the nation the nurses union advocates on the rights of immigrant patients in detention. Even the White Memorial released ICE guidancethough doctors and advocates said they were falling short.

“This is a violation of patients’ rights,” Jimenez said. “Medical professionals are questioning the presence of ICE and the lack of (patients’) access to their medications.”

Mistreatment of sick immigrants

After 10 days in downtown Los Angeles, de Paz was transferred to the Adelanto Detention Center, a private prison run by GEO Group.

During her first week there, she was again off medication and given food considered harmful to diabetics and high blood pressure patients. For example, de Paz was fed Capri sun and sandwiches for lunch, Jimenez and her family said.

“All of this is putting her health at risk,” Jimenez said. “Conditions don’t change.”

While in Adelanto, de Paz was hospitalized again. The family is still unsure where, as again hospital staff have not confirmed her visit. The family received no explanation or documentation of the hospitalization.

De Paz told her family that the hospital did not provide translation services so she could communicate with the doctor or nurses.

Cases of poor treatment and health care for immigrants in Adelanto have long been documented.

A 2018 Homeland Security Inspector General Report titled “Management Alert – Issues Requiring Action at the ICE Adelanto Processing Center in Adelanto, California,” includes a subsection titled “Failure to provide timely and adequate medical care to detainees increases health risks.”

The report states that detainees are not provided with adequate or necessary medical and dental care. Investigators noted that the doctors spoke in English to the Spanish speakers, who did not understand what was being said. The report also noted that inspectors found nooses made from sheets hanging from air vents; detainees in interviews gave various reasons for the sheets, including for failed suicide attempts.

A year after that report, the California Department of Justice published a overview of immigration detention centers in californiain accordance with a law passed in 2017. The review said inspections of 10 facilities — including county jails, private prisons and Adelanto — revealed universal problems with medical record-keeping, nurses practicing outside their legal scope, inadequate exams, inadequate medical care, inadequate mental health staffing and unsafe practices for suicide monitoring and seclusion.

The report noted that Adelanto was the most difficult source to obtain medical records. Also, California DOJ has requested a two-week review of Adelanto, but ICE only allowed investigators in for one day and did not allow them to speak with detainees or officers.

Evidence of medical disability

Detention facilities and staff are not prepared to adequately address the health needs of detainees and are harmful, Saadi reported in 2021 in Journal of Racial and Ethnic Health Disparities.

The same year, in Journal of Immigrant and Minority HealthSaadi and another researcher reported on the health needs of immigrant detainees during the COVID-19 pandemic. Noting the lack of public data on detainees with chronic health needs, they identified a 2013-2014 study of 565 detainees at four California facilities — three prisons and one private prison.

The researchers found that 42.5% of respondents had at least one diagnosed illness and 15.5% had multiple chronic illnesses. About 28% of detainees reported a combination of heart disease and type 2 diabetes, about 17% had neuropsychiatric conditions, and nearly 9% reported lung disease.

Of those with known health conditions and treatment, about 21% had a break in care upon entering custody, as did almost 32% of those with two or more conditions.

In January 2025, in two peer-reviewed journals – the Journal of the American Medical Association and on Journal of Migration and Health — Saadi and her colleagues again warned of the health dangers of migrant detention, concluding, “The most effective harm reduction policy would be to end the use of detention in immigration court proceedings.”

Treatment at home

It will take more attention to research like Saadi’s and the stories of detained immigrants like de Paz for the public to understand the extent of the medical damage resulting from the raids and arrests of the Trump era to ensure it doesn’t happen again.

Meanwhile, de Paz said she did not want to talk to reporters about her experience. When he returned home in October, Los Angeles Times noticed a tremor in her hands that had not been there before her arrest.

“She’s been through a lot of trauma and has been asked to take time off while she heals,” Jimenez explained.

Since then, she has made progress. On Thanksgiving Day, de Paz returned to the Home Depot parking lot where she was taken into custody. She gave plates of homemade turkey in pipian, a traditional Guatemalan dish, to the workers there.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.