Alleged unwanted hysterectomies and other abuses at ICE facility prompts investigation

Members of Congress are pressing the administration for further inquiries after the Department of Homeland Security announced this week it is looking into a whistleblower complaint that claimed federal immigration detainees underwent unnecessary gynecological surgeries — including full hysterectomies — without their consent.

Immigration attorneys said they were interviewing detainees this week to determine how widespread the problem might be, with some clients describing experiences where parts of their Fallopian tube and their ovaries had been removed while in custody.

More than 170 Democratic members of Congress dispatched a letter Tuesday to Homeland Security's Inspector General, urging the office to open "an immediate investigation."

The allegations stem from a 27-page complaint compiled by Project South, an Atlanta-based advocacy group, as well as Georgia Detention Watch, Georgia Latino Alliance for Human Rights and South Georgia Immigrant Support Network. The complaint lists Dawn Wooten, a former nurse at the Irwin County Detention Center, as a whistleblower who details medical neglect such as refusal to test detainees for COVID-19 and an alarming practice of subjecting female detainees to hysterectomies without them fully understanding what was happening. The detention center is run by private prison company LaSalle Corrections and overseen by U.S. Immigration and Customs Enforcement,

Dawn Wooten, a nurse at Irwin County Detention Center in Ocilla, Georgia, speaks at a Tuesday, Sept. 15, 2020, news conference in Atlanta protesting conditions at the immigration jail. Wooten says authorities denied COVID-19 tests to immigrants, performed questionable hysterectomies and shredded records in a complaint filed to the inspector general of the U.S. Department of Homeland Security.

Officials at LaSalle Corrections, which runs the center, did not return several requests for comments.

The complaint doesn't name the doctor who allegedly performed the procedures, but several attorneys representing the women have identified him as Dr. Mahendra Amin, of Douglas, Georgia.

A person answering the phone at Amin's office Thursday declined to answer questions or locate Amin for comment. In an earlier interview with The Intercept, the doctor confirmed he has treated immigration detainees and said he had performed "one or two" hysterectomies on patients in recent years, but said all procedures on immigration detainees are approved by officials at the detention center.

According to ICE data, two individuals at the Irwin County facility have been referred to medical professionals for hysterectomies since 2018. But in a statement, Dr. Ada Rivera, medical director of the ICE Health Service Corps., said she "vehemently disputes the implication that detainees are used for experimental medical procedures" and vowed a full investigation.

"Detainees are afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will," the statement said.

A hysterectomy is the surgical removal of a woman's uterus, which eliminates any possibility of conceiving a child. Other procedures — including the removal of an ovary or a Fallopian tube — can significantly reduce a woman's chances of conceiving.

The whistleblower complaint alleges that immigration detainees were routinely sent outside the detention center to a gynecologist who performed full hysterectomies, partial ones, and other surgical procedures without their full understanding or consent. In one case, Wooten said a detained young woman was supposed to have her left ovary removed because of a cyst but the doctor remover her right ovary instead. The doctor still had to remove the left ovary, Wooten said, leaving the detainee completely infertile.

"She still wanted children — so she has to go back home now and tell her husband that she can't bear kids," Wooten said in the complaint.

Attorneys representing detainees at the Irwin County Detention Center said they didn’t realize the extent of the problem until they started talking with each other about their clients after the whistleblower complaint was filed. National organizations have since asked attorneys around the country to review their cases and talk to their clients to see if the allegations out of Georgia have been seen elsewhere.

Sarah Owings, an Atlanta-based immigration attorney, is working with a team of lawyers to identify women who have received medical care from the doctor mentioned in the complaint. By Wednesday, the team had identified more than 15 cases of women who underwent questionable surgeries at the hands of the doctor, including the removal of parts of the Fallopian tube and removal of the ovaries.

Protesters gather at a news conference Tuesday, Sept. 15, 2020, in Atlanta decrying conditions at Irwin County Detention Center in Ocilla, Georgia. Nurse Dawn Wooten says authorities at the immigration jail denied COVID-19 tests to immigrants, performed questionable hysterectomies and shredded records in a complaint filed to the inspector general of the U.S. Department of Homeland Security.

"We are still in the process of comparing notes," she said. "I wouldn’t say there is a systemic pattern, but based on people who have gotten in touch, it points to a lack of informed consent and full understanding by people of these medical treatments."

Benjamin Osorio, a Virginia immigration attorney, read about the allegations Monday night on a social media site shared by other attorneys and immediately thought of two clients he recently served at the Irwin facility.

One of them, Maria Nuñez de Rosales, of El Salvador, was at the facility in 2018 when doctors told her she had cancer and needed a hysterectomy, Osorio said. De Rosales, who only speaks Spanish, had the procedure done without entirely realizing what had happened, he said. De Rosales has since been returned to El Salvador.

"There was no explanation to her and no interpreter," Osorio said. "She woke up and didn’t even know what had happened."

Another client, who didn't wish to be named because she's still in removal proceedings, also had a hysterectomy done at the facility, he said. After complaining of abdomen pain, doctors at the center performed a biopsy and told her she had cervical cancer. Amin performed a hysterectomy on her in August 2019, Osorio said.

After leaving the facility, she had a follow-up exam done by her primary doctor in Charlotte, North Carolina, who told her she was cancer-free. Osorio said he doesn't know if the 2019 procedure cleared out the cancer or if his client ever had it in the first place.

"Obviously, there are real questions here: whether this doctor’s giving the best medical advice, if he's getting informed consent," Osorio said. "All these questions are out there. Hopefully, these investigations could figure out what was going on."

Katie Shepherd, national advocacy counsel with the American Immigration Council, a group that advocates for immigrants and files lawsuits on their behalf, said they're hoping to learn more about the allegations through attorneys because ICE’s historic "lack of transparency" makes it hard for them to truly know what’s happening inside immigration detention centers.

"I would not be surprised if there are similar fact patterns in other corners of the ICE detention system," she said. "But obviously we want to learn more."

U.S. Rep. Pramila Jayapal, D-Wash., who has been leading the congressional response to the allegations, said the complaint also raises questions about how ICE ensures that detainees consent to medical procedures. She said Homeland Security agents have a long history of forcing immigrants to sign all kinds of documents — dropping immigration court appeals, submitting to voluntary deportations — without having a translator present or fully understanding what they’re signing. Those questionable consent procedures would be even more disturbing, she said, if they led to partial or full hysterectomies.

"I'm concerned that the stories that the women tell may be quite different from what the medical records say," Jayapal said. "Even if the medical record says, 'We did x, y and z,' if the women haven't been informed or much less consented to (a procedure), where they don’t have any clue what they’re signing…that is significant."

A 2019 USA TODAY investigation into the federal government’s increasing use of private prison companies and local jails to house civil immigration detainees revealed systemic problems in the medical care provided to those detainees. An analysis of inspection reports highlighted problems at several facilities and court documents showed multi-million dollar settlements paid to detainees who were mistreated while in custody.

Most of the complaints focused on a lack of access to medical care, with one detainee saying her breast cancer returned after she was unable to get cancer medication while in custody and a civil rights organization creating a specialized medical team to respond to the growing medical complaints from ICE detainees.

"People who need life-saving medical treatment don’t get the care they deserve," said Lorilei Williams, a senior staff attorney for the Southeast Immigrant Freedom Initiative in Georgia. "But it is interesting we have seen a lot of folks who receive gynecological care."

Immigrant attorneys and advocates have been flagging concerns about medical mistreatment at the Irwin center for years. The center is located in Ocilla, Georgia, a city of roughly 3,000 residents almost 200 miles south of Atlanta. It housed about 650 detainees under ICE custody as of Sept. 8.

In April, a group of eight medically vulnerable detainees at the Irwin detention center and the Stewart Detention Center in Lumpkin, Georgia, sued DHS claiming a lack of medical care and deplorable conditions at these facilities made them vulnerable to COVID-19. The people named in the lawsuit, filed by the Southern Poverty Law Center, had preexisting medical conditions, including diabetes, high blood pressure and asthma, among other conditions.

They described living in very close quarters that made social distancing and recommended hygiene measures impossible. The conditions were described as "flagrantly unsanitary and dangerous to the health of detained individuals."

At Irwin, detainees said they were punished if they requested medical attention, sometimes by being placed in solitary confinement, according to the lawsuit. One man at Irwin reported that a guard told him "medical staff would only take him to the hospital if they see him dying."

Others said that the Irwin center lacks a medical alert system to notify guards of an emergency. The lawsuit also claims that a 2017 inspection of the facility found that medical unit cells were so dirty, that "floors need to be mopped, walls wiped down, toilets cleaned, and trash and refuse removed."

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This article originally appeared on USA TODAY: Allegations of hysterectomies of ICE detainees spurs investigation