An asylum-seeking migrant detained by Immigration and Customs Enforcement was pulled off life support after his relatives said they requested that doctors continue the lifesaving measures.
More than a month later, the man's body remains in the USA, his relatives said they have been given little information about his death, and his brother has twice been denied a visa to travel to the USA to identify the body and accompany it back home to Cameroon.
Nebane Abienwi, 37, a father of six who fled his embattled country this summer, died Oct. 1 after suffering a "medical emergency" while being detained at the Otay Mesa Detention Center, a U.S. Immigration and Customs Enforcement (ICE) facility in San Diego, according to ICE.
Ever since, Abienwi's youngest brother said he has been scrambling between U.S. embassies in South Africa and Cameroon, pleading for a visa to travel to California to get some answers.
He said he wants to make sure it's really his brother's body and to perform cultural rites on the body before the casket is sealed. He wants to know why doctors removed the ventilator that kept his brother breathing after he asked them to keep it in place until a relative could arrive.
"We did not approve that," said Abienwi's brother Akongnwi, who requested he be identified only by his last name out of fear that his family would face repercussions in Cameroon. "One hundred percent, we did not."
Akongnwi, speaking from a hotel room in Cameroon on Monday, said he spoke by phone with ICE officials several times Sept. 30, when they first called to say his brother had become critically ill and was on a ventilator. He said the ICE officials passed the phone to Sharp Chula Vista Medical Center officials, who explained that his brother was bleeding profusely in his brain and a ventilator was the only thing keeping him breathing.
Akongnwi said he shared the information with his brother's wife and others in the family, and they all agreed Abienwi should be maintained on life support until a relative could be by his side.
"The family spoke and said, 'We believe in miracles. It has happened to other families, why not ours?' " Akongnwi said. During the next call with ICE, "I made clear that he should remain like that and the family would decide if we want to take him off that machine or not."
A report released by ICE detailed what happened next.
On Oct. 1, at 12:05 p.m., two doctors analyzed Abienwi's examination results, concluding they "were consistent with brain death and pronounced him dead." Thirty minutes later, Abienwi's family was notified, according to the report. Two hours later, hospital staff "discontinued Mr. Abienwi's ventilator support," the report said.
Akongnwi, who was in the process of submitting his passport information to U.S. officials and planning to fly to California, said he was never informed that his brother was taken off life support. He said he learned of that decision only when contacted by a reporter who shared ICE's summary of the case.
"They said, 'It's very unfortunate, but your brother didn't make it,' " he said.
Though much of the nation's attention has focused on the plight of migrants crammed into overcrowded Customs and Border Protection facilities along the southern border, Abienwi's case highlights concerns over the immigration detention system in the interior of the U.S.
ICE detains more than 52,000 migrants a day in a sprawling network of 225 detention centers and jails spread throughout the country. Government watchdogs have highlighted problems in those facilities, including nooses found in cells, detainees on hunger strikes and substandard medical care.
Abienwi is the ninth migrant to die in ICE custody over the past year, according to ICE data. His family and supporters said they want to know how that could've happened to a healthy man who had no medical problems before his confinement in the USA.
In a statement, ICE said it was reviewing Abienwi's death, as it does all other deaths in ICE facilities, to ensure that officials acted in accordance with all of its policies and standards.
The agency would not elaborate on the details of Abienwi's death and his brother's claim that he asked for life support to continue. ICE stated that when detainees are admitted to a hospital, the agency works with relatives "to the extent possible to ensure they can participate in decisions."
The ultimate decision on how to treat each detainee is in the hands of hospital staff, the agency said.
A spokesman for Sharp Chula Vista Medical Center said he could not comment on Abienwi's case.
Akongnwi said his older brother set off from Cameroon over the summer as his country devolved into a series of armed conflicts that threatened his village.
Sylvie Bello, founder of the Washington-based Cameroon American Council, a group that advocates on behalf of Cameroonians in the USA, said conflicts have led to countless deaths and a growing refugee crisis.
In 2010, fewer than 500 Cameroonians requested asylum in the USA, according to data from the United Nations High Commissioner for Refugees. That number has been steadily increasing, topping 1,800 in 2017, the last full year of data available.
"People are fleeing that area," Bello said. "Five hundred villages have been destroyed."
That's why Abienwi decided to leave his home, his wife and children, to try to make it to the USA, according to his family. He flew from Cameroon to Ecuador, his brother said, and made the long trek through Colombia, the countries of Central America and Mexico before finally reaching the California border.
There, he did what U.S. officials have urged migrants to do – he presented himself at the San Ysidro Port of Entry rather than trying to illegally cross the border. Akongnwi said his brother told him he planned to request asylum.
"He wanted to go to the United States, get his documents, start to work, open a business and bring his family, so they can be safe and the kids could go to school," Akongnwi said.
Customs and Border Protection confirmed that Abienwi presented himself at the San Ysidro Port of Entry and was "screened and cleared by medical professionals."
"CBP makes all efforts to ensure those in our care are treated with humanity and compassion, and this case was no different," the statement says.
CBP did not confirm whether Abienwi requested asylum. U.S. Citizenship and Immigration Services, the federal agency that handles asylum requests, also refused to confirm whether Abienwi requested asylum, saying the agency "does not release or comment on individual cases."
The Trump administration has sought to keep asylum-seeking migrants in detention until an immigration judge decides their case. Abienwi did not have a criminal record, according to an ICE summary of his case, but was held in detention as he awaited his day in immigration court.
Abienwi stayed in CBP custody for two weeks until he was turned over to ICE, which is responsible for long-term detention. He was then taken to Otay Mesa Detention Center.
Federal records show that the 896-bed facility is operated by the private prison contractor CoreCivic, and medical services are provided by the ICE Health Service Corps, which provides care at 21 detention facilities around the country.
Shortly after Abienwi's death, ICE released a statement that he died at the Chula Vista hospital "where he was undergoing treatment for a brain hemorrhage." The statement said he was rushed to the hospital after experiencing "a hypertensive event" in the middle of the night Sept. 26. Abienwi was nonresponsive, according to the statement, appeared to be paralyzed on the left side and was pronounced dead Oct. 1.
ICE published a Detainee Death Report that provided more details. According to that report, at around 3:24 a.m. Sept. 26, Abienwi suffered a "medical emergency" after falling off the top bunk in his cell, "landed on blankets on a chair, and sat on the floor." A registered nurse found him confused, sweating, experiencing "jerky movements" in all extremities and complaining of thirst.
The nurse documented Abienwi's ability to speak and respond to questions, but he was responding only to his name. At 3:50 a.m., detention center staff contacted emergency services, and he was taken by ambulance to Sharp Chula Vista Medical Center.
He was admitted to the intensive care unit with severe "bleeding within the brain."
According to the ICE report, he stayed there for the next few days, experiencing "declining neurological examinations."
On Oct. 1, two doctors "confirmed Mr. Abienwi's clinical examination results were consistent with brain death and pronounced him dead." He remained on the ventilator.
About 30 minutes later, the ICE report says, officials contacted Abienwi's wife. Akongnwi said that is somewhat inaccurate. ICE officials tried calling the wife the day before, but she couldn't deal with speaking to them and asked ICE to speak with Akongnwi instead from there on out, he said.
According to the ICE report, hospital staff removed Abienwi from the ventilator nearly two hours after officials talked to Abienwi's wife.
In the days that followed, his brother tried to reach the USA. On Oct. 21, he applied for a visa at the U.S. Embassy in Johannesburg. Akongnwi lives in South Africa, where he has a 5-month-old son and runs a company that fixes, buys and sells cars. After a short interview, he was denied under Section 214(b) of the Immigration and Nationality Act, which requires people seeking temporary visas to prove they will not remain in the USA.
"Unfortunately, because you either did not demonstrate strong ties outside the United States today, or were not able to demonstrate that your intended activities in the U.S. would be consistent with the visa status, you are ineligible for a nonimmigrant visa," according to the letter, which Akongnwi shared with USA TODAY.
He said he decided to try again in his native Cameroon. He flew there and applied for a visa Oct. 24. This time, the interview was longer, but Akongnwi said the questions shocked him.
"They asked me, 'Are you going to apply for asylum like your brother was doing?' " he said. "I could not believe it. I explained why I was going, that I'm running around to see that my brother is put to rest."
Again, he was denied.
In a statement, the State Department said it could not provide details about specific U.S. visa requests because of confidentiality laws.
Akongnwi said he doesn't know what else to do. He told his brother's wife to get a passport so she could try her luck at a visa. He borrowed money to pay for all the traveling he's doing in his quest to reach his brother's body.
The Bafut Manjong, a cultural group from Abienwi's region of Cameroon, created an online fundraiser to help the family pay for travel costs and other expenses.
Akongnwi arranged for a California funeral home to take the body out of the San Diego County Medical Examiner's Office, but he doesn't know how to get it home from there. ICE told him to reach out to the Cameroonian Embassy, but Akongnwi said it has not been any help and stopped taking his calls.
Akongnwi said he and his relatives are lost without Abienwi, whom they affectionately called Neba. He was the oldest of four children, quitting college after their parents died to work and help the family.
"We lost our parents when I was young, and Neba has been taking care of us since then," Akongnwi said. "Every day, I receive 30 phone calls from family members asking what's happening, and I don't know. I don't even know if I'm OK. I don't know if something is wrong with me.
"I don't know if I'm dead or still living."
This article originally appeared on USA TODAY: Migrant in ICE custody removed from life support, family objected