By Linda Nwoke, A Journal Exclusive

In September 2020, the news broke on a class-action lawsuit filed by former detainees at the Irwin County Detention Center in Ocilla, Georgia, against several parties, including the United States Immigration and Customs Enforcement (ICE), the Center, Dr. Mahendra Amin, and the Irwin County Hospital.

The facility, under the management of the for-profit company LaSalle Corrections, was cited as the location where Dawn Wooten, a nurse at the Ocilla detention facility, committed the atrocities against detainees. She revealed that immigrant women kept at the facility were forced to undergo medical proceedings – precisely several hysterectomies without consent and, in some cases, without their knowledge.

The gynecologist, Dr. Mahendra Amin, was identified as the professional performing unwanted and unnecessary procedures on detained female immigrants in custody at the ICDC from 2017 – 2020.During that period, the agency had commissioned the medical treatment of over 90 women by Dr. Amin based on an acclaimed need for medical intervention.

Moreover, advocates complained that the women had endured careless coronavirus mitigation policies, medical neglect, and questionable procedures conducted without the patient’s consent. Following the allegation, the facility, which was still running under a contract with the U.S. Marshals Service. However, in May 2021, President Joe Biden’s administration stopped housing detainees at the facility under the leadership of Homeland Security Secretary Alejandro Mayorkas. He explained that it was part of the effort to reform immigration detention.

Congressional Investigations and Findings
For more than two years since the whistleblower’s revelation, many governmental investigations were initiated, including the one under the supervision of the U.S. Senate Subcommittee on Permanent Investigations. The team, led by a Democrat from Georgia, Senator Jon Ossoff, and other members like the Republican from Wisconsin, Senator Ron Johnson, supervised the process.

They released a 100-page plus report from the eighteen-month bipartisan investigation that examined the allegations made by the nurse, victims, and the advocacy group. Georgia’s Senator Jon Ossoff formally presented the report at a hearing. The document contained testimonies from various stakeholders – including officials of the ICE, the Inspector General of Homeland Security, and representatives from LaSalle Corrections. Responses from discussions with physicians and a former immigrant detainee were also included in the report.

Among several conclusions, the subcommittee’s report debunked the case of unnecessary hysterectomies as untrue. They confirmed that ICE approved only two important hysterectomies by Dr. Amin for detainees.

Hence, the report concluded that ‘no mass hysterectomies’ were conducted. However, they uncovered other disturbing medical policies and procedures at the Georgia facility, including the conduct of the accused medical doctor.

The Issues and Evidence
One major conclusion from the investigation is that some female detainees underwent unnecessary, excessive, and invasive gynecological procedures.

The Medical Practitioner: During the investigation, an obstetrician-gynecologist, Dr. Peter Cherouny, was assigned to review the medical records of the procedures conducted on the women by his colleague Dr. Amin. Studies revealed that he found the surgical procedures too forceful and his care outdated. Dr. Cherouny found that 40 of the 94 records he examined had patients whose benign ovarian cysts were surgically removed by Dr. Amin. A procedure that was medically unnecessary as surgical interventions can result in bleeding, pain, infection, and sometimes infertility.

The Victims: The report reveals that half a dozen former detainees said Dr. Amin treated them without regard during medical procedures. He kept them uninformed about their medical diagnoses and treatment plans. Many still feel afraid, confused, and violated after his treatment.

One of the victims who testified during the hearing, Karina Cisneros Preciado, a 23-year-old woman detained at Irwin between July 2020 to January 2021, recalled the unhygienic conditions they lived in during her detention. However, her greatest nightmare was enduring an invasive gynecological procedure by the doctor, who treated her shabbily during the process.
Worst of all, she was asked to sign a paper that she didn’t understand and was offered no explanation.

In her testimony, Karina, a mother of two, one of which was a 4-month-old baby at the time of the incident, relived her ordeal. It all started when she got arrested after reporting domestic violence, and her immigration status became known. While she was in ICE’s custody and awaiting deportation proceedings, she had to be taken for a postpartum checkup in 2020.

The Subcommittee’s Conclusion
The Senators found that Dr. Amin only carried out two hysterectomies within the period under investigation (2017 and 2019), contrary to the allegations. However, he also conducted too many other reproductive procedures on the detainees within three years.
Among the women held within the period at the Irwin County detention center by ICE, Dr. Amin performed more than 75% of various procedures. They include pelvic scans, laparoscopies, and administering Depo-Provera injections.

To balance the findings, investigators tried to contact the doctor for an interview, but they were denied any interview. His lawyers countered the request with other claims, and Dr. Amin invoked his Fifth Amendment right not to testify to avoid self-incrimination.
Investigators said Dr. Amin was being investigated by the federal government earlier in the year. The subcommittee also noted an ongoing internal investigation by the Department of Homeland Security (DHS) against him related to medical procedures for immigrants.

The case against ICE: The committee reported that the agency lacked a policy that secures immigrants’ consent for medical procedures performed by a third-party facility overseen by them. Furthermore, the investigations revealed over 600 grievances by the detainees on medical care issues between 2018 and 2020, which were largely inadequately addressed. According to the bipartisan Senate panel report, women held at the privately run immigration jail in Georgia were subjected to unnecessary gynecological procedures. ICE authorities did not halt the years-long patterns of acclaimed unethical and aggressive treatment.

ICE and La Salle Corrections agencies only acted in 2020 after the whistleblower’s revelations in the news. They also questioned the agency’s oversight and supervision of medical providers. They said ICE appears unaware that the doctor had an impending federal lawsuit against him before the 2020 complaint, nor was he not board certified, among other distressing findings.

In defense, the officials claim that it is not their responsibility to obtain informed consent from the professional medical body’s patients. Additionally, they provided evidence of treating the allegations against the center and Dr. Amin as a priority by stopping any referral of detainee patients to his clinic and, eventually, preventing the use of the Irwin County facility.

ICE’s Assistant Director, Stewart D. Smith, reported that the agency commenced the improvement of its management of off-site providers. The agency established policies and guidelines, such as national care guidelines and review processes, before the public’s knowledge.
He explained that the agency conducted a review of the allegations of involuntary medical procedures in September. However, they did not find any evidence to substantiate the allegation, yet they stopped sending patients to Dr. Amin.

In her response, the representative from LaSalle Corrections, Pamela Hearn, the medical director, claimed her organization was not actively involved in the detention and transfer of immigrants to healthcare providers authorized by ICE. She explained that the agency was solely in charge of screening and authorizing all off-site medical providers that render medical services to detainees. Despite various defenses, the panel, through the report, concluded that the federal government failed to respect the fundamental human rights of the detained immigrants.

They observed that within three years, a single medical practitioner performed more surgeries on patients than usual. In particular, he performed a lot (more than eighty percent) of “dilation and curettage” surgeries. He also administered over ninety percent of contraceptive injections. Not to mention, more than ninety-three percent of laparoscopic surgeries remove lesions. Senator Ossoff concluded that ICE should have noticed the anomaly if the agency had conducted the necessary background check on the medical personnel. In his view, the data was apparent, but the agency was not paying attention and hurt many people in the process.

  detainees, detention, ICE, immigrants, immigrants in the U.S., Immigration and Customs Enforcement (ICE)