How Detention Endangers the Health and Lives of Migrants

by Arcelita Imasa, MD

In the piece I wrote last August about migrant healthcare amid intensified immigration enforcement, I briefly touched on the harsh experiences of migrants who are detained.

I must again emphasize this reality because it deserves continued attention.

Across the United States, overcrowded immigration detention centers routinely fail basic health and hygiene standards.

Meals are inadequate and nutritionally deficient, while medical care is often delayed or denied. Detained migrants endure trauma, depression, and family separation, leaving many children and women in need of therapy.

Tragically, people continue to die in custody, often from preventable causes; 2025 is the deadliest year on record, and with President Trump’s pledge of “the largest domestic deportation operation in American history,” targeting “millions” or even “tens of millions” of migrants, more deaths are likely ahead.

This is what happens when health is neglected and is treated as secondary to enforcement.

What we are witnessing is not a series of isolated incidents but a pattern of medical neglect built into the design and operation of the detention system.

This neglect is defined by the failure of agencies and contracted providers to deliver timely, appropriate, and standard‑of‑care health services to people under their custody.

The consequences are serious and sometimes fatal.
The most common elements of medical neglect experienced by migrants include:

Delayed or denied care: Symptoms ignored or treatment postponed—such as chest pain left untreated for days or months‑long waits for diagnostic procedures.

Substandard or incorrect treatment: Inadequate assessments, medication errors, missed referrals, and poor management of chronic conditions like diabetes, heart disease, or asthma.

Structural barriers: Lost or unshared medical records between facilities, lengthy waits for prescriptions, limited access to specialists, and use of isolation instead of proper mental health care.

Numerous investigations by journalists, watchdog groups, and medical experts have documented credible cases of serious neglect and preventable deaths in U.S. immigration detention centers.

These reports describe consistent patterns of delayed care, poor oversight, and unsafe conditions.

Under international law and medical ethics, states have a duty of care for those they detain. When that duty is ignored, it becomes not only a policy failure but a human one.

One example that hits close to home is the experience of Nanay Rebecca Pinyerd, a Filipina migrant who was detained by ICE. Her son, Patrick Lowe, has spoken out about her experience and what it reveals about the cost of neglect. His reflections can be found here: https://www.instagram.com/reel/DS3UO5ngIxy/

As a provider, I had a personal opportunity to write a medical testimony for Nanay Rebecca, highlighting her need for medical care instead of deportation. I wrote:

“Therefore, it is absolutely critical that the community that supports Rebecca continue to call for her essential medical care and support. These include regular consultations with a nephrologist, a primary care physician and an effective medical care team, ongoing laboratory monitoring, daily maintenance medications, nutritional support, and a safe and stable living environment. When I say safe, stable living environment, I mean OUTSIDE OF THE DETENTION CENTER. And, she should receive these care services NOW.”

Nanay Rebecca was deported last January after nine months of detention, without ICE informing her family and her advocates and the community that loves her.

I constantly think about Nanay Rebecca because I know in my heart that if she is denied the proper medical care that she needs, her kidneys could worsen to the point that she will soon require dialysis.

Dialysis in the Philippines cost P5,000-6,000 per session. Nanay Rebecca does not have support systems in the Philippines.

Here in Hawai‘i, Filipino and other migrant communities contribute so much to our healthcare system, agriculture, and service industries. Many of us health workers have cared for patients with uncertain immigration status, or have family who once stood in similar lines.

We can support the migrants in detention by insisting on transparency, supporting humane standards of care, and reminding the public that health and dignity know no borders.

ARCELITA IMASA, MD, is a family physician in Hawai’i and a member of the National Alliance for Filipino Concerns,a national alliance of Filipino organizations, institutions, and individuals that responds to the concerns of Filipinos in the US and in the Philippines by creating an action-oriented platform that brings people together through culture & heritage, education, health & wellness, and advocacy.