Meet Freida. She is a transgendered Salvadoran woman who was diagnosed with AIDS in July 2007. Freida did not know she was HIV+ until symptoms landed her at Mission Hospital, at which point the infection had depleted her immune system and she had an intense bout of pneumonia. After engaging in treatment for a few months and taking better care of herself, Freida is as healthy as she can be, and she returns to work.

Freida is an illegal immigrant, and though her job doesn’t pay much, it covers her bills and food, and her medications come through community health centers.

One day, Freida is returning home with groceries, and she is stopped at a police checkpoint. Since undocumented individuals can no longer have driver’s licenses, Freida is given a ticket, and Immigration and Customs Enforcement is notified. Freida is jailed in Asheville, and when she informs officials that she needs her medications because she has AIDS, the officials mock her condition, her feminine attire, and tell her that she can only bring the medications she has in her purse.

All of Freida’s friends are undocumented, and none want to bring her the rest of her medications to the detention center for fear that they themselves will be deported. It is only through Freida’s Social Worker that she is placed back on the complete regiment of antiretroviral drugs, antibiotics, and nutritional supplements.

Freida has now been detained for a month. She has been evicted from her apartment, her possessions were divided among her friends. She has lost her job and her car, and she has no money with which to make phone calls to anyone in El Salvador, or her Social Worker. Access to translators is minimal so she finds it difficult to notify medical staff that she is running out of medicine, and she has no idea when she will be deported.

One morning, Freida is taken out of her cell and loaded into a van carrying several other undocumented individuals to a detention center in Charlotte, NC. Space is tight in many detention centers and it is common to shuffle detainees around to maximize capacity. However, since the court system is backed up, it is also common to hold detainees indefinitely, or to temporarily release those who are inconvenient to keep jailed. Since Freida’s medications are expensive and the detention center is obligated by law to provide adequate medical care to those in its charge, it is more convenient for them to release Freida into the streets of Charlotte, NC and have her come back to trial in six weeks.

So here she is, in a completely alien city, unable to speak the language, with no money, no cell phone, no car, a few day’s worth of medications, one change of clothes, and no home. Her nearest friends are two hours away, and none have driver’s licenses. It is getting dark, and Freida is hungry and desperate. What could she do to get money, to find food? Well, there was a time when Freida sold her body for sustenance, so…

And in this situation (which is a true account with names and details changed to protect Freida’s identity) we finally get to the only relevant question regarding proper medical treatment for ICE detainees: does the policy and its execution ensure the safety of the detainee as well as the community around her?

The Human Rights Watch report titled Chronic Indifference released in December 2007 faults the Department of Homeland Security (of which ICE is a part of) for failing to adhere to the standards of care that International and US law dictate. The report, which can be found at www.hrw.org/ reports/2007/us1207/index.htm, contains accounts of numerous cases of neglect, including the harrowing story of a transgendered Mexican woman, Victoria Arellano, who was continually neglected and treated with the callousness one expects in concentration camps, not in our own nation today:

On the night of July 12, 2007, her condition appeared critical to her cellmates, who were cleaning her and disposing of her bodily fluids [emphasis mine]. The “leader” of Pod 3 asked for an ICE representative to come to the pod. An ICE Captain responded to this request. He walked over to Victoria’s bunk, placed his shoe on her pillow and asked rudely,

“What’s wrong with you?” The detainees were shocked. “They were treating her like a dog.”

The detainees began chanting “Hospital! Hospital!” A nurse came down and said “Oh it’s Victoria! There’s nothing we can do. She just needs Tylenol and water.”[…] The following morning she was taken to the hospital again, where she died a week later of meningitis, a condition often associated with advanced AIDS. (“Chronic Indifference,” Dec. 07, HRW)

As a world leader, as a “beacon on a hill,” our country cannot continue this inexcusable treatment of undocumented detainees. It diminishes us as a nation, and it smacks of hypocrisy when addressing human rights issues around the globe. The leverage we once had as a paragon of fairness and compassion has been severely damaged by the current administration, and the treatment of undocumented persons as second-class human beings only adds to our now ruined international image.

Immigration is a polarizing issue that is difficult to address thoroughly and with clarity, but let it suffice to say that whether or not one agrees with the motivations of immigrants, or security and entitlement program policies, the protection of the community’s health should trump all other ideological positions. The Department of Homeland Security’s negligence places the entire population at risk.

When untreated, HIV+ individuals are more contagious, which makes the spread of the disease within jails much more likely. Not to mention Freida is only one of thousands who are thrown out into our country’s streets in equally dire situations where, motivated by desperation, an individual can make poor choices. Those choices affect not only their lives, but also those of you and everyone you know. Decades from now, history’s unforgiving eye may look back at the extent to which we as a nation unnecessarily placed at risk scores of human beings simply due to demagoguery, hatred, and ignorance. Hopefully, DHS will heed HRW’s recommendations and our nation will have less reason to feel ashamed.