Dead detainee's family alleges medical mistreatment

Victor Arrelano's relatives say the AIDS patient was denied medical treatment while in federal immigration custody in San Pedro.

By Greg Krikorian, Los Angeles Times Staff Writer
August 11, 2007
The family of a 23-year-old AIDS patient who died in custody at an immigration detention center in San Pedro will file a wrongful death claim against the U.S. government on grounds that Victor Arrelano was improperly denied vital medical treatment.

The allegation of mistreatment comes three weeks to the day after Arrelano, an undocumented immigrant from Mexico, died at a San Pedro hospital.

"What happened here is simply an outrage," Roman Silberfeld, the family's attorney, said Friday. "This is someone who never should have been permitted to get to this state of decline when relatively simple meds, if available and properly administered, would have avoided this tragedy."

The death was one of three to come to light this week involving immigration detainees across the U.S. And the fatalities underscore what prison reform advocates have decried as an inadequate, even dangerous, medical system for the nearly 30,000 undocumented immigrants in custody nationwide.

"Based solely on what I have heard so far about the Los Angeles case, I am incredibly disturbed but unfortunately not surprised," said Tom Jawetz, staff attorney for the National Prison Project of the American Civil Liberties Union in Washington, D.C. "We have been in touch with detainees, advocates and attorneys around the country and there is no question that the No. 1 complaint my office receives about detention facilities is poor medical care."

Although they would not discuss individual cases because of privacy issues, immigration and health services officials Friday defended the level of medical care provided to detainees at dozens of facilities in the country.

A Washington spokeswoman for the Division of Immigration Health Services said that on an average day, about 15,000 detainees are screened by division staff, while thousands of other detainees receive contracted medical care at county jails and other detention facilities.

Virginia Kice, spokeswoman for the regional office of Immigration and Customs Enforcement, meanwhile, said the agency spends more than $98 million annually providing medical and dental care to detainees. "We want to emphasize the fact that when illegal aliens are in ICE custody, they receive an array of healthcare services," Kice said.

But attorneys and others familiar with the Arrelano case said it is only the most egregious and recent example of a pattern of medical neglect at immigration detention facilities.

Arrelano, a transgender person who went by the name Victoria, had been deported to Mexico in 2003 and was in detention since mid-May pending an immigration hearing to determine whether she would again be returned to Mexico.

During her stay, according to attorneys involved in the case, Arrelano's physical condition deteriorated to the point that her fellow detainees implored the staff to provide medication and other care. One source close to the case recalled how other detainees repeatedly saw Arrelano vomiting blood and were left to clean it up themselves.

Eventually, when her condition became critical, Arrelano was transferred to a San Pedro hospital and died several days later. At the time of her death, according to attorneys in the case, Arrelano was shackled to her bed.

Kice said she could not discuss specifics of the case but explained that when immigration detainees are taken to outside medical facilities for treatment, the security measures are determined by the circumstances of a case, including the condition of a patient and prior criminal history.

Family attorney Silberfeld said the poor treatment of Arrelano was evident in that more than 70 detainees signed a petition urging that she receive immediate medical care. "These are people who are on the verge of being deported and have their cases pending and yet they stand up to the government that could kick them out and say, 'This is wrong,' " Silberfeld said. "To me, that is a pretty powerful statement."

Lorri L. Jean, chief executive of the Los Angeles Gay and Lesbian Center, said her office was "heartbroken" by word of Arrelano's death because she had been a patient at its AIDS clinic as recently as two years ago and was "certainly nowhere near death" when she was being treated at the facility.

"Given today's medications, people with HIV at the stage that Victoria was at do not decline that quickly," Jean said. "And I have no doubt in my mind that Victoria died because she was denied the medications that she needed to stay alive."

Jean said she and her staff will raise their concerns about Arrelano's death and the San Pedro facility with U.S. Rep. Henry Waxman (D-Los Angeles) during a meeting with him Monday.

greg.krikorian@latimes.com

Brazil to provide free sex-change operations

Brazil's public health system will begin providing free sex-change operations in compliance with a court order, Health Ministry officials said Friday.

Ministry spokesman Edmilson Oliveira da Silva said the government would not appeal Wednesday's ruling by a panel of federal judges giving the government 30 days to offer the procedure or face fines of $5,000 a day.

''The health minister was prompted by the judges' decision,'' Silva said. ''But we already had a technical group studying the procedure with the idea of including it among the procedures that are covered.''

Federal prosecutors from Rio Grande do Sul state had argued that sexual reassignment surgery is covered under a constitutional clause guaranteeing medical care as a basic right.

On Wednesday the 4th Regional Federal Court agreed, saying in its ruling that ''from the biomedical perspective, transsexuality can be described as a sexual identity disturbance where individuals need to change their sexual designation or face serious consequences in their lives, including intense suffering, mutilation and suicide.''

Health Ministry leaders said it would be up to local health officials to decide who qualifies for the surgery and what priority it will be given compared with other operations within the public health system.

Patients must be at least 21 years old and diagnosed as transsexuals with no other personality disorders and must undergo psychological evaluation for at least two years, the ministry said.

Gay activists applauded the decision.

''Transsexuals represent about 0.001% of the Brazilian population, but for this minority, sexual reassignment surgery is a question of life and death,'' said Luiz Mott, founder of the Bahia Gay Group. ''It is unjust and cruel to argue that the health system should concern itself with other priorities.''

So far the measure has not prompted any opposition.

Brazil's public health system offers free care to all Brazilians, including a variety of surgeries and AIDS medications. But long lines and poorly equipped facilities mean that those who can afford it usually choose to pay for private hospitals and clinics.

The health ministry said that since 2000, about 250 sexual reassignment surgeries considered experimental have been performed at three university hospitals.

Brazil is generally more tolerant of homosexuality than other Latin American countries, and transvestites are featured prominently in celebrations like Carnival, but discrimination still exists. (Michael Astor, AP)

Justice Now's statement about Tumi McCallum

It is with great sadness that we write to our allies
and friends about the recent death of one of our
former interns, Tumi McCallum. We hope to shine some
light on the person Tumi was, particularly given the
extremely limited discussion of her life in media
coverage of her death.

Tumi came to Justice Now through a class she took with
Julia Sudbury at Mills College.
While working with us, she provided invaluable
assistance to people in women?s prisons in a number of
extremely important ways. As an advocate, she provided
a vital lifeline to the outside for people in prison.
She corresponded with people in women?s prisons facing
severe and life-threatening medical problems,
providing them with crucial information and advice.
Even after completing her required hours for school
credit, Tumi
continued her work with Justice Now, far surpassing
what was initially required. Her commitment combined
with her skills allowed her to take on more complex
work.

Tumi advocated on behalf of a woman in prison who was
in need of medical treatment but had been told by
prison staff that nothing could be done for her.
Tumi?s strong conviction that this was untrue led her,
as an undergraduate, to research the law and determine
that the prison was in fact unfairly denying
treatment. Tumi also
advocated for a women in prison suffering extreme
medical neglect and identified her as a person who
might qualify for alternative sentencing. If
successful, this is a process that would allow the
woman to be resentenced and released from prison.
Because of Tumi?s identification of this woman?s
situation, Justice Now currently is working to secure
her release.

Tumi was a brilliant writer and a passionate advocate,
all of which was tucked behind a humble and patient
demeanor. She always had a smile on her face, and she
approached all of her work with tremendous energy and
careful attention. Through our Human Rights
Documentation Program, she focused on the issue of
hepatitis C and collaborated with a woman inside to
write an opinion-editorial to accompany the upcoming
release of our report on the pandemic of hep C in
prison. As an example of her dedication and
sensitivity, though the California Department of
Corrections refused to allow her to visit the prison
because she possessed a South African passport, she
took on the challenge of taking the words of a woman
with whom she could not visit face-to-face and turning
them into a powerful article. Because she took great
care to consider all available information from the
woman inside, even without meeting her she was able to
write a piece that our colleague inside felt fully
represented her.

As someone who had experienced living under a police
state as a child in South Africa, she had a
long-standing understanding of policing and
imprisonment, which, she argued, ?worked at oppressing
my community instead of making it safe and protecting
it.? She was born at the end of the Apartheid system
and was on the run with her family from the police,
who were pursuing her mother for her activism against
Apartheid for many years. She drew parallels between
those experiences, the prison industrial complex in
the United States, and the treatment of Black people
in the aftermath of Hurricane Katrina, all of which
fueled her passion for racial justice. She was fully
committed to social justice work, in particular the
struggle against the PIC. As she wrote in the last
line of her letter requesting an internship at Justice
Now, ?[this] is the ideal place for me to begin my
activism against the policing system and to end
violence against our communities.?

Tumi had plans to come back to Justice Now in the fall
and had expressed her conviction that this was to be
her life?s work. Her sharp political insights, her
intense commitment to social justice, her quiet
assuredness, and her generous spirit are a great loss
to all of us. She will be greatly missed, and we join
her family, friends, and the larger community of
social justice activists of which she was a part, to
honor her life.

In solidarity and in hope for a world without violence
in all its forms,

all of us at Justice Now