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An unidentified woman from Guatemala stands inside a dormitory in the Artesia Family Residential Center, an Immigrations and Customs Enforcement detention center in New Mexico, in 2014.

Treating Cancer with Ibuprofen

Medical care is already bad for immigrant detainees. Will Trump policies make it worse?

Even as the Trump administration prepares to loosen oversight over immigrant detention facilities, medical care already can be so substandard that cancer is treated with ibuprofen, schizophrenia with Benadryl and serious mental illness with solitary confinement, two new reports found.

Human Rights Watch, along with the nonprofit Community Initiatives for Visiting Immigrants in Confinement, asked outside medical experts to review 18 deaths in immigration facilities between May 2012 and June 2015 — and found alleged medical neglect contributed to the early deaths of seven detainees, according to their joint report released Monday. The nonprofit organizations also interviewed 90 current and former detainees for the report.

Their findings come on the heels of a survey of 83 detainees about conditions in two for-profit detention centers in Georgia, released last week by a separate group of nonprofit organizations. The detainees claimed, among other grievances, that their requests for medical care were often ignored and even landed some in segregation.

A spokeswoman for Immigration and Customs Enforcement said the agency will review the Human Rights Watch and CIVIC report to determine if any changes needed to be made.

“ICE is committed to ensuring the welfare of all those in the agency’s custody, including providing access to necessary and appropriate medical care,” said spokeswoman Jennifer Elzea, who added that all detainees had access to licensed mental health providers. “At no time during detention will a detainee be denied emergent care.”

ICE spokesman Bryan Cox in Georgia said both centers there — Stewart and Irwin — were in compliance with ICE’s detention standards and subject to regular inspections. “The Department of Homeland Security Office of the Inspector General and ICE’s Office of Professional Responsibility investigate all allegations of abuse,” he wrote in an email.

Immigrants can be held in ICE-funded facilities or in local jails that are paid contract fees. As it ramps up enforcement against undocumented immigrants, the Trump administration has been hunting for more jailers to hold detainees — and perhaps lowering the bar to find them. The New York Times reported last month that the Department of Homeland Security was planning to loosen requirements for county jails that hold immigrant detainees. Three of the deaths identified by Human Rights Watch happened in a local facility.

The Department of Homeland Security has also closed the Office of Detention Policy and Planning, which was tasked with leading ICE’s effort to reform its detention facilities. Elzea, the ICE spokeswoman, noted that oversight is still provided by on-site detention service managers, as well as several other offices within the agency.

Advocates fear conditions will worsen. “The records revealed ICE’s failure to monitor and correct problems even when they themselves identified them,” said Grace Meng of Human Rights Watch, one of the authors of the report. In three deaths at Eloy Detention Center in Arizona, for example, staffers delayed calling 911 because they weren’t sure who was allowed to make the call under the facility’s protocol, Meng said.

“I’m even more concerned now that we have an administration that wants to cram more people into these broken detention centers,” Meng said.

Human Rights Watch and CIVIC detailed the suicide of another woman who was repeatedly held in solitary confinement without mental health treatment. “The medical staff kept doing the same thing, expecting a different outcome. That she finally killed herself should not have come as a surprise,” wrote one of the doctors reviewing ICE’s records.

In both reports, multiple immigrants reported seriously inadequate mental health care; one detainee in Georgia told advocates that the mentally ill were locked in a segregation cell in handcuffs and a helmet.

Immigrants and their families have few outlets for relief. Immigrants told Human Rights Watch that the grievance forms are written only in English and Spanish and that grievances, once filed, often disappeared without any response. “I have no idea if there are mental health services here, nor do I know how to file a grievance,” an immigrant at Stewart Detention Center told Georgia advocates. Others alleged they were punished, even put in solitary confinement, for complaining. Few detainees have access to an attorney, which means filing a lawsuit is generally beyond their reach.

“By not properly tracking and investigating each complaint, our government sends a message that medical neglect of immigrants will be tolerated,” said Christina Fialho, co-executive director of CIVIC.