On an average day, more than 40,000 noncitizens are held in some 200 Immigration and Customs Enforcement detention centers around the country — a mix of private prisons and county jails with federal contracts. The overwhelming majority do not have lawyers, and there is little in the way of government oversight at the facilities. It’s an overburdened, under-scrutinized system ripe for exploitation and, on Monday, a whistleblower came forward alleging abuse of a particularly horrific nature at one facility in Southern Georgia.
On Monday, the Irwin County Detention Center in rural Georgia, a private facility operated by LaSalle Corrections, became the subject of intense national scrutiny when Dawn Wooten, a nurse at the detention center, came forward and accused LaSalle of, among other failings, allowing a doctor to perform unnecessary gynecological procedures, including numerous hysterectomies, on immigrant women being held there. The claim was one in a long list of alleged abuses at Irwin collected by a group of nonprofits — Project South, Georgia Detention Watch, Georgia Latino Alliance for Human Rights, and South Georgia Immigrant Support Network — in a complaint lodged with the Department of Homeland Security’s inspector general.
In the complaint, first reported by The Intercept, Wooten accuses LaSalle Corrections of underreporting the number of coronavirus cases, failing to test detainees and otherwise neglecting their medical needs. Similar complaints have been previously documented not just at Irwin, but other LaSalle facilities, and other ICE detention centers since the outbreak of the Covid-19 virus this spring. The accusations of hysterectomies, though, are new and they are being taken seriously by Congress, where 173 legislators have demanded an immediate investigation by the Department of Homeland Security’s Inspector General. “We are horrified to see reports of mass hysterectomies performed on detained women in the facility without their full, informed consent and request,” lawmakers, led by Rep. Pramilla Jayapal (D-WA) wrote in a letter Tuesday that acknowledged the U.S. history’s of eugenic-sterilization laws.
Five days after Wooten’s whistleblower complaint became public, the claims of mass hysterectomies have yet to be fully verified. The Intercept has followed up their initial report with confirmation from multiple anonymous women who said they felt pressured into procedures by the doctor, but, as others have pointed out, it’s still unclear whether or not the procedures took place. Rep. Jayapal said after a briefing by lawyers representing detainees, she believes at least 17 women were subject to the procedures; a civil rights lawyer in Atlanta who represents three women previously detained at Irwin says he has knowledge of as many as 35 other detainees at the facility who have complained about gynecological care.
Speaking to lawyers deeply familiar with the conditions at ICE detention centers broadly, and at Irwin specifically, it’s clear that the system as it stands not only opens up the possibility for such abuses to occur — it makes it difficult to establish, in the aftermath, what exactly happened. ICE lacks an integrated system that tracks exactly what medical procedures are performed on immigrants in custody, and many of the women detained at Irwin were detained prior to deportation, and there is no way to track them down in their home countries.
“The allegations Ms. Wooten made in her whistleblower complaint are shocking, but unfortunately not surprising, given everything that we know about healthcare in ICE detention facilities specifically at Irwin, and nationwide,” says Eunice Cho, a senior staff attorney at the ACLU, who wrote about Irwin in 2016 report for the Southern Poverty Law Center, and investigated other LaSalle facilities for an ACLU report this year.
Lorilei Williams, an attorney at the Southern Poverty Law Center, tells Rolling Stone, “There was nothing in that complaint that made me think ‘Oh, wow, I’m surprised that would happen there’ — no. Everything tracks.”
In the complaint, Project South reports that one detainee interviewed recalled at least five women who told her they had hysterectomies performed on them while at Irwin; the women were said to be confused about why the operation was done, raising questions about whether they were able to give informed consent for the alleged procedures. That second-hand account is supported by Wooten, who says in the complaint that she and other nurses at Irwin were alarmed by the rate of hysterectomies, and suspicious of whether or not they were necessary. “We’ve questioned among ourselves, like: Goodness, he’s taking everybody’s stuff out…That’s his specialty, he’s the uterus collector.” The doctor is not named in the complaint, but subsequent reports have identified him as Dr. Mahendra Amin.
In a statement provided to Rolling Stone, Amin’s lawyer, Scott Grubman, “vehemently” denied the allegations. “Dr. Amin is a highly respected physician who has dedicated his adult life to treating a high-risk, underserved population in rural Georgia,” he wrote. “We look forward to all of the facts coming out and are confident that, once they do, Dr. Amin will be cleared of any wrongdoing.” ICE has likewise insisted that the allegations were false, saying in a statement that “only two individuals at Irwin County Detention Center were referred to certified, credentialed medical professionals at gynecological and obstetrical health care facilities for hysterectomies in compliance with National Commission on Correctional Health Care (NCCHC) standards.”
A 2016 study by Congress’s Government Accountability Office suggests ICE’s records may not be accurate. The watchdog found that ICE uses two different systems — one to approve procedures for detainees and a different one to track payments for those procedures — making it difficult to link the two. And, in fact, in the preceding years, the number of claims paid for did not match the number of approvals for requested services in the same period — suggesting that doctors performed unapproved procedures or ICE approved procedures that were never done. That report went on to call for establishing a system “to more fully ensure that payments for off-site care are supported by the appropriate authorizations.”
“In the context of lax oversight and regulation of ICE’s medical care, it’s easy to see how easy it would be for a doctor to, perhaps, see patients who are approved for one thing and then, in the midst of the procedure, perhaps, bill for something else or add on different procedures,” Cho says. “It is quite easy to see how that would happen.”
Amin, the doctor in question, has a history of questionable billing practices, having been implicated in a federal Medicare fraud investigation five years ago. In 2015, Amin and several other doctors agreed to a $520,000 settlement with the Justice Department to “resolve allegations they caused false claims to be submitted to Medicare and Medicaid.”
The number of referrals that were allegedly made to this particular doctor for gynecological procedures raises red flags for lawyers familiar with Irwin because of how difficult they know it usually is to get any kind of medical attention. “One of my clients had an aneurysm, for example,” says Lorilei Williams, an attorney at SPLC. “And we can’t get any semblance of basic, bare minimum follow up that would protect his life and health.”
During Cho’s time investigating Irwin, detainees at the facility told her they were often denied basic diagnostic tests and treatment for chronic and life-threatening conditions, including cancer, heart disease, infections, and broken bones. In lieu of appropriate treatment, detainees were offered only Tylenol or ibuprofen. At the time she says very few of the detainees in Georgia facilities had lawyers — less than two percent, and those lawyers are typically only representing detainees in immigration proceedings, not advocating on their behalf to improve conditions at the jails. In the 2016 SPLC report said detainees described finding cockroaches, flies, hair, and plastic in their food, and blood on their utensils. And they reported retaliation by employees of the detention center when they complained or filed official grievances.
Without advocates agitating for better treatment, conditions at the detention centers have remained abysmal, and abuses have gone unreported. “That is another reason that these types of abuses are so rampant in detention — because there is so little oversight there, so little checks and balances,” Cho says.