Victor Arcos spent four months inside of a Houston immigration detention facility, where he said he routinely saw examples of medical neglect.
Arcos said he remembers a fellow detainee complaining about a bullet lodged close to his spine, who was denied treatment. He also watched his own kidney disease deteriorate from stage one to stage three because of what he said was a lack of treatment.
“There's a lot of stuff (nurses) get away with,” he said, “There's nothing you can do. You're a convict. You're a prisoner. You're nobody when you're inside.”
Arcos is from Mexico and works maintenance jobs in Houston. In an August interview, he said the lack of medical care in detention was so bad he wrote a will.
He told his pastor: “If anything happens to me, help out my kids."
Former President Donald Trump’s hardline immigration policies and emphasis on detention have shed light on poor conditions and medical treatment inside many detention facilities.
Now, President Joe Biden has promised to make immigration more fair and humane, and advocates have said they’re optimistic about this new chapter of immigration policy. But the administration is inheriting an expanding, increasingly privatized system that has been widely criticized for its poor conditions and medical treatment.
Twenty-one people died in immigrant detention centers last year. And scrutiny has only grown amid a global pandemic, according to ACLU attorney Eunice Cho.
“What we've seen under the Trump administration is that there have been record death tolls in immigration detention,” Cho said. “Last year it was a 15-year high.”
Despite human rights concerns, the immigrant detention system has become increasingly privatized — and Cho said she's watched it grow.
In 1994, there were less than 10,000 people per day held in detention, according to ACLU research. That number reached more than 50,000 people per day under the Trump administration.
According to Cho, cost-cutting measures from privately run detention facilities have led to a degradation in the standard of medical care.
“This is a private prison corporation and the corporation is ultimately accountable to its shareholders, not to people who are being detained or to the government,” she said.
Victor Arcos was in a privately run detention facility in Houston, operated under contract with ICE by the company CoreCivic.
In a statement, a CoreCivic spokesperson said: “We care deeply about the people entrusted to us and work hard to provide them with a safe, humane and appropriate environment while they prepare for the next steps in their immigration process. It’s important to note that we don't provide the healthcare in the majority of our immigration facilities. In most cases, comprehensive medical, mental health and dental care is provided for by the ICE Health Services Corps.”
Not only have harsh conditions inside come under scrutiny, but immigration detention infrastructure has grown more than 50% under Trump, according to an ACLU report.
Texas will be ground zero for any sweeping changes President Joe Biden tries to make, as the state has more facilities than any other part of the country. About 25% of the country's migrant detainees are currently being held in Texas facilities, according to data from the ACLU.
At their height, Immigration and Customs Enforcement detention centers in fiscal year 2019 held an average 50,000 people per day. And under Trump, at least four new immigrant detention centers have begun operations in Texas.
It’s a system that grew considerably under President Barack Obama and even more so under President Donald Trump, according to ACLU research.
Now, there are signs President Biden could reverse course.
For one, advocates said COVID-19 has made it clear long-term detention isn't essential. Immigration authorities have released thousands of people from detention to prevent the spread of coronavirus.
ACLU immigrant advocacy director Naureen Shah said this moment is the opportunity to stop and ask the question: “Do we need all these facilities?”
She said ICE detention centers are now holding thousands fewer people than before the pandemic — less than 15,000 people nationwide.
“If you're able to reduce the size of ICE detention by that much,” Shah said, “why did you need to detain so many people in the first place?”
Two major private prison companies running these facilities — CoreCivic and GeoGroup — saw their stocks fall in late October when it became clear that Biden was strongly favored to win.
And Biden has already sent a sweeping bill to Congress that would give immigration status to millions of undocumented immigrants in this country, enacted a moratorium on deportations, and has promised he would "end prolonged detention."
Executive Director of the Detention Watch Network Silky Shah said she's optimistic about the incoming administration — and said she hopes Biden uses his power to keep detention populations low for good.
“I think actually detention is the place where there's a lot of room to move,” Shah said. “The executive has an incredible amount of authority as we've seen with the way Trump has operated and previous presidencies have operated around detention.”