Released 22 November 2017  By Charles Bethea – The New Yorker
A Medical Emergency, and the Growing Crisis at Immigration Detention Centers
Charles Bethea – The New Yorker
September 13, 2017
Stewart Detention Center, in Lumpkin, Georgia, is a hundred and forty miles southwest of Atlanta. Past razor-wire fences and security checkpoints, there’s a small, hot room where visitors who’ve received permission can meet with detainees. A few weeks ago, I waited for two hours—the daily count of the facility’s approximately sixteen hundred detainees was under way—before sitting down in this room, with a translator, to speak with Nelson Francisco Perdomo-Vaidez, a thirty-four-year-old undocumented immigrant from Honduras, who had been held at the center since mid-April.
Georgia has the fourth-largest number of immigrant detainees in the country, with more than two thousand typically held on a daily basis—nearly as many as Arizona. In May, Project South, a Georgia-based nonprofit focussed on immigrant advocacy, released a report, co-authored with Penn State Law’s Center for Immigrants’ Rights Clinic, detailing a twelve-month study of Stewart and another Georgia facility, Irwin County Detention Center. Both are run by private companies. The report declared that conditions in both are in violation not only of Immigration and Customs Enforcement’s own guidelines but of those established, in 2012, by the office of the United Nations High Commissioner for Refugees. The report recommended shutting down the two centers immediately.
On the afternoon that I visited Perdomo-Vaidez, he had just seen a doctor for only the second time since entering Stewart. (This second appointment had been arranged by the Southern Poverty Law Center.) Perdomo-Vaidez sustained a serious injury to his left arm prior to being detained; while we spoke, he held the arm aloft, above his heart, to prevent it from swelling and turning purple. He had begun to fear that he would lose all or part of it. “Nobody tells me what might happen to my arm or hand,” he told me. “They just offer more pills that don’t help.” Heval Kelli, the Atlanta-based doctor who was allowed to voluntarily assess him that day, concluded in his medical evaluation that, without specialized orthopedic care and rigorous rehabilitation, Perdomo-Vaidez could expect “further complications, including serious infection, clots and the inability to use his left arm and hand.” (Bryan Cox, a spokesman for ice, denies that Perdomo-Vaidez requires orthopedic treatment, and told me that the detained man has received “all appropriate necessary medical treatment while in ice custody.”)
Less than two weeks after Project South released its May report, two detainees died in custody at Georgia detention centers, one of them at Stewart. A Panamanian detainee who was held in isolation for nearly three weeks committed suicide; days later, an Indian detainee died, reportedly from congestive heart failure. A hundred and seventy-seven people have died in U.S. immigration detention centers since October 1, 2003, according to the nonprofit Community Initiatives for Visiting Immigrants in Confinement. Six of those deaths have occurred in Georgia. “Subpar medical care has contributed to nearly half of the death cases we have analyzed nationally, and substandard medical care has been evident in nearly ninety per cent of the cases,” Christina Fialho, the co-executive director of the group, told me.
Stories abound. Ariel Prado, who has helped provide pro-bono legal services to detainees at the South Texas Family Residential Center, the largest immigration detention center in the U.S., recalls Vicks VapoRub being used “as a kind of ‘cure-all,’ ” he told me. “The liquid version was even poured into a child’s ear to ‘treat’ an earache.” The Project South report describes a Chinese man with a broken leg who waited a month for X-rays, and a Nigerian man with “lumps in his chest,” who told a Project South interviewer that “blood had begun discharging from my breast. When I requested medical care, sometimes no one would reply. I was not given medical care until ice later approved it. When I reached out for medical help, I was placed in solitary.”
According to Azadeh Shahshahani, the legal director of Project South, “nothing has changed for the better” in Georgia since the report’s publication. Detainees continue to be denied daily health services and timely follow-ups with a medical professional, as established by ice’s standards of practice. “Those standards seem to mean even less under the Trump Administration than they did under Obama,” Shahshahani told me.
Perdomo-Vaidez left Honduras when he was twenty-three, he said. His mother had died when he was fourteen, and he left the care of relatives at fifteen. He got work as a bus driver in San Pedro Sula, the second-biggest city in Honduras, but he couldn’t support his family.Pandilleros were regularly extorting him. “They said they’d kill me and burn my bus if I didn’t pay,” he told me. In 2006, with his wife pregnant, he left Chiapas on a freight train, then took a bus to Monterrey. A coyote helped him cross the border into Texas. An aunt picked him up and drove him to Atlanta the next day.
He sat behind a plate-glass window as he spoke, wearing a beige prison jumpsuit. He said that he’d lost twenty pounds in detention. He had a scraggly goatee and a missing tooth. His left arm is heavily scarred from surgeries that were done prior to his detention. In Atlanta and surrounding areas, he worked in carpentry, for a subcontractor, for eleven hours a day, earning four hundred to six hundred dollars per week. This occupied him for most of the next decade. “I worked very hard,” he said. He sent back all but a hundred dollars each week. For years, he felt alone and secluded. There were a few close calls with immigration, including an incident, in 2011, when he was pulled over without car insurance. But he was let go.
Just over a year ago, he was working on a house in Athens, Georgia, measuring trim atop a ladder twenty-four feet high, when the ladder tipped. “I jumped off and made a little prayer,” Perdomo-Vaidez said. He broke his left wrist, shattered his left radius, fractured a rib, and punctured a lung. “They put me in a neck brace and brought me to a hospital,” he said. “The doctor was surprised I survived the fall.”
Three days later, Perdomo-Vaidez received his first check for workers’ compensation. Insurance paid for transportation, an interpreter, a therapist, a doctor. A case worker accompanied him to doctor’s visits. After five surgeries over the following six months—there’s now a metal plate with seven screws in his forearm and wrist—he began to improve, taking oxycodone for the pain. On April 15th of this year, he and his roommate, a U.S. citizen, got into an argument. Perdomo-Vaidez says the man called him a “wetback.” He returned the insult. The man called the cops, who arrested Perdomo-Vaidez for disorderly conduct. “When he put me in handcuffs, he tightened them hard around my injured wrist. The pain was so bad that, at the police station, I could barely lift my head for the photo,” Perdomo-Vaidez told me.
He spent three days in jail before he was moved to an immigration processing center. A week and a half later, he was driven two hours to Stewart. On that final transport, a guard put toilet paper under his cuffs. “But it didn’t do anything,” Perdomo-Vaidez told me, describing the agony. Cox claims that Perdomo-Vaidez indicated no pain upon his arrival at Stewart. Two weeks later, Perdomo-Vaidez told me, the pain reached “a ten out of ten.” He would bury his head in a pillow to scream. “My palm feels like pins and needles all the time,” he told me. “Two of my fingers, too.” Often, the pain prevents him from sleeping. The medical ward gives him acetaminophen and ibuprofen, he said. “At first, I got four hundred milligrams of ibuprofen each day. That did nothing. Now I get eight hundred milligrams of acetaminophen each day. That does nothing, too. The nurses are afraid when they see my hand: the dark purple color, cold to the touch. They ask me, ‘Why?’ I don’t know.” On July 9th, according to Cox, Perdomo-Vaidez complained of “intermittent wrist pain” and was subsequently diagnosed and treated for a “wrist sprain.”
In late July, Perdomo-Vaidez said that he was finally taken to St. Francis Hospital in nearby Columbus, Georgia. (Cox confirms that Perdomo-Vaidez was “referred to a private medical facility for additional treatment” at this time.) Perdomo-Vaidez said the doctor told him that he needed to see a specialist. He was returned to Stewart. Three days later, he said, he was told that a specialist was coming to Stewart. Perdomo-Vaidez went to the medical area to wait. “A nurse told me, ‘No, of course not. We don’t have specialists here. You leave for those.’ ”
On Thursday, September 14th, Perdomo-Vaidez will go to court for an immigration hearing. He’ll be represented by an attorney from the Southern Poverty Law Center, who will ask for Perdomo-Vaidez’s immediate release so that he may receive urgent medical care in the U.S. In the meantime, according to Cox, Perdomo-Vaidez “has a scheduled consult with a vascular surgeon for further evaluation.” But an order for his deportation, the lawyer believes, is most likely. Back in Honduras, Perdomo-Vaidez told me, his injury would continue to worsen, absent first-world care, and likely result in amputation. “I’m not letting myself hope anything,” he said.
Shahshahani, of Project South, told me, “My fear is that, with the further explosion of the immigration detention system, which we’re definitely going to see—unless Congress really takes a stronger step in denying funding to the Trump Administration—I think that will result in even worse conditions.”
* Charles Bethea is a contributing writer for newyorker.com, and has written for The New Yorker since 2008.