Julie L. Myers
Assistant Secretary
Immigration and Customs Enforcement
Department of Homeland Security
425 Eye Street, NW
Washington, DC 20536
Re: Victoria (a.k.a. Víctor) Arellano [A: 77991267]
Dear Ms. Myers,
We, the undersigned organizations, write to you today to express our
outrage over the July 20, 2007 death of Victoria (a.k.a. Victor)
Arellano in the San Pedro detention center. Victoria's death was
excruciating and needless. Her requests for her AIDS medication were
deliberately and repeatedly denied, as were her fellow detainees'
increasingly desperate pleas to staff to take her to the hospital.
When Victoria was sent to San Pedro in May, she was taking the
antibiotic dapasone to prevent pulmonary infections from developing
into pneumonia. At San Pedro, she was denied the medication despite
the known consequences of discontinuing this antibiotic: the onset of
treatment-resistant pneumonia within a few weeks. Indeed, Victoria's
health deteriorated rapidly to the point where the pain was so great,
she would scream if anyone tried to move her. She complained of severe
nausea, headaches, cramps, and back pain. She was vomiting and
suffering from diarrhea. Her care was left to the men detained with
her. They administered cold compresses to bring down her fever and
took turns taking her to the bathroom when she was too weak to get
there by herself. Seventy of them signed a petition appealing for
medical care for Victoria.
A week before her death, she was taken to the infirmary and given
amoxicillin. Again, the standard of care for people living with AIDS
was ignored. Amoxicillin is ineffective against meningitis and
AIDS-related lung infections. When Victoria returned from the
infirmary, she began vomiting blood. Once again, her fellow detainees
put themselves on the line to demand medical attention for Victoria.
She was finally taken to a hospital, but was returned to the detention
center less than 24 hours later. By the time she was taken to another
hospital, it was too late. She died shackled to her bed in the ICU.
Her mother reports her body was wracked by pneumonia and meningitis.
With everything to lose - with their own futures uncertain - the men
detained with Victoria Arellano met the brutality and the calculated
negligence of ICE with profound humanity. They cared for her; they
advocated for her; they even consoled her mother when she lost her
child. We have credible information that some of these men have been
transferred out of San Pedro, possibly to prevent them from
participating in an investigation and/or in retaliation for their role
in trying to save Victoria.
Although she was born male, Victoria had been living and identifying
as a woman for years. It is not appropriate to house women, such as
Victoria, in a male dormitory. ICE must revise its policies to ensure
that transgender women are placed with other women in female
facilities. While we are grateful for the care given to her by the men
she was housed with, other transgender women have not been so lucky.
It is widely known that they are at increased risk of assault when
placed with the male population. In Victoria's case, it was the guards
who harassed her. Further, another transgender testified at the
National Prison Rape Elimination Commission in Los Angeles in December
2006 that she had been raped by an official at San Pedro.
Victoria's was not the only foreseeable, preventable death to have
occurred in ICE detention. Hers wasn't even the first in San Pedro.
Media reports indicate that since 2004, at least 65 people have died
in ICE detention. The guidelines for medical care contained in the
Department of Homeland Security's Detention Operations Manual (DOM)
are insufficient and unenforceable. Far from providing a recognized
standard of care, ICE fails to meet even its own standards of
providing "primary medical care, and emergency care." Facilities the
size of San Pedro are required to make medical personnel available to
see detainees who request medical services in a clinical setting at
least five days per week. Victoria, like many others, was not given
this access and had to wait much too long before she received any
care.
The DOM further states that following a clinical evaluation, if an
HIV-positive person in detention "manifests symptoms requiring
treatment beyond the facility's capability, the provider will
recommend the detainee be transferred to a hospital, or other
appropriate facility for further medical testing, final diagnosis, and
acute treatment as needed?HIV positive detainees should be
hospitalized until any acute treatment deemed necessary is completed."
In response to the glaring violations of current DHS/ICE guidelines
and of Victoria Arellano's human rights, we seek the implementation of
new policies that meet appropriate standards of care and that are
reviewable and transparent to the public.
We, the undersigned organizations, call on the Department of Homeland
Security and Immigration and Customs Enforcement to:
* Implement revised standards that are enforceable and legally
binding in all ICE/DHS detention facilities, regardless of whether
said facilities are operated by the federal government, private
companies, or state/county/local agencies. Detainees, their families,
and their representatives must have legal recourse when these
standards are violated.
* Provide effective internal and external oversight of
detention conditions and treatment of detainees. This would include
the establishment of an ombudsman, ongoing monitoring and frequent
inspections with subsequent reports released to Congress and made
available to the public.
* Immediately rectify any and all breaches of detention
standards, including denial of medical care.
* Increase the availability of medical personnel to see
detained individuals who are in need of care, regardless of whether or
not a detainee has made a formal request for care. Currently,
facilities with over 200 detainees are only required to schedule "sick
calls" five days a week, while facilities with fewer than 50 detainees
need only provide access to medical personnel one day a week. This is
grossly insufficient.
* Strengthen the DHS/ICE national detention standards to comply
with human rights principles.
* Ensure that treatment regimens, including medication for
HIV/AIDS and related infections and hormone therapy for transgender
detainees are not interrupted.
* Adhere to international covenants and treaties mandating the
humane treatment of all detainees, including the International
Covenant on Civil and Political Rights and the Universal Declaration
of Human Rights.
* Pursue non-custodial alternatives (e.g., parole, supervised
release to family members, regular reporting requirements, bond
options) for immigration detainees, particularly for those individuals
whose health or personal safety would be imperiled by detention.
* End the practice of prolonged and indefinite detention, which
is a violation of both international and U.S. law.
* Publicly report all deaths that occur in ICE custody, refer
them immediately to the Office of the Inspector General for
investigation, and make the results of each inquiry available to the
public as soon as it is complete.
* End the practice of placing immigration detainees with the
general inmate population.
* Ensure that the safety of detainees, particularly transgender
detainees is the paramount consideration when deciding whether to
place an individual with the male or female population. Solitary
confinement must not be considered a viable option.
* Grant transgender detainees the right to choose to be housed
in a facility that corresponds with their gender identity, regardless
of which sex is listed on their legal documents and/or regardless of
their birth-sex.
* Revise the DOM to address the particular needs of gay men,
lesbians, bisexuals, and transgender men and women, including health
and safety issues.
* Train all staff in all facilities where ICE detainees are held to
comply with these standards and safeguard the inherent dignity of
all persons.
We are bringing this matter to the attention of our elected
officials and we urge you to take prompt and necessary action to prevent
further threats to health and loss of life among immigrants in ICE
detention.
Sincerely,
African Services Committee
AIDS Action Council
amfAR
Bienestar
Gay Men's Health Crisis
Immigration Equality
Latino Commission on AIDS
Less AIDS Lesotho
National Association of People With AIDS
National Center for Lesbian Rights
New York Immigration Coalition
Sylvia Rivera Law Project
Transgender Law Center