Olga Arellano sobs as she recalls how her HIV-positive daughter spent two months succumbing to infections in a U.S. migrant detention center, complaining that she didn't see a doctor or get the right medicine.
Fellow inmates also begged for help after Victoria Arellano started vomiting blood in their holding cell, where her lawyer said 105 detainees were crammed onto bunks and mattresses in a space designed for 40.
She died three days later, chained to a hospital bed.
The death of the 23-year-old transgender Mexican immigrant is at the forefront of discussions at this week's international AIDS conference in Mexico City. Rights activists say it shows the failure of immigration officials to deal humanely with HIV-positive inmates among the 30,000 migrants held in detention centers across the United States.
New York City–based Human Rights Watch surveyed detention center officials and inmates after Arellano's death and found 14 cases in which it said HIV-infected immigrants were not given proper care while in custody of U.S. Immigration and Customs Enforcement.
Presented with details of the allegations by the Arellano family and the rights group, ICE spokesman Brandon A. Alvarez-Montgomery told the Associated Press that he couldn't comment since Arellano is suing the agency. When Human Rights Watch first presented its report in December, ICE spokeswoman Virginia Kice said ''ensuring the welfare and safety of those in our custody is one of our top priorities.''
Activists say many HIV-infected migrants in U.S. detention centers are not given their medicine regularly, which is crucial to their survival. People with HIV can live otherwise healthy lives if they take a strict regimen of specific medications each day and closely monitor their blood cells to be sure their immune systems are working.
That's difficult to do for people being deported, particularly in overcrowded detention centers. When the regimen is interrupted, the virus rebounds and the immune system crashes.
The family's lawyer, Steven Archer, says Arellano never got proper medical attention after she was stopped for drunk driving and handed over to immigration officials in June 2007.
''They never gave her any of the proper medications for her AIDS diagnosis. They did give her a prescription for a urinary tract infection, but even then, they filled her prescription with the wrong strength, and they never diagnosed the meningitis, even though she had been complaining about headaches, sweats, and generalized pain for weeks. That is what killed her in the end,'' Archer said. ''It was so advanced that it involved her brain, her liver, her lungs, her heart, and a couple of other organs. She died in terrible pain.''
ICE spends nearly $100 million annually on medical services for its detainees, including dental, chronic, and mental health care. A June 11 report on deaths in ICE custody by the Homeland Security Department's internal watchdog found that ICE's overall standards have equaled those of other detention agencies.
Since ICE was formed in 2003, 71 people out of 1.5 million have died in the agency's custody. Officials also note that such deaths have declined to seven last year even as the detainee population grew. But the watchdog report recommended that the ICE do more to improve oversight and screening procedures and to fill clinical staff shortages at detention facilities.
Human Rights Watch says detention centers do not collect essential information to monitor HIV cases. It also accuses ICE of failing to complete antiretroviral regimens consistently, failing to prescribe prophylactic medications to prevent infections and failing to ensure continuity of care when HIV-infected detainees transfer facilities.
Still, some HIV-positive Mexicans complain that they don't get proper care until after they are deported.
Victor Manuel Serrato, 43, was deported in May after living 24 years in California. He said he told U.S. immigration officials when he was detained that he is HIV-positive. ''I told them I needed my medicine, but they didn't give me anything,'' he said.
Interviewed by the AP at a shelter in Tijuana, he said he missed out on nearly a week of taking the drugs he needs to keep his immune system from weakening, until his mother brought medication to the shelter in Mexico.
In Victoria Arellano's case, her mother was powerless to help.
''She told me after a month in detention that she still hadn't seen a doctor,'' Arellano said. ''I told her I could send her more medicine, but she said they would not give it to her. They were mostly giving her Tylenol.''
Other inmates at the San Pedro facility outside Los Angeles yelled ''Hospital! Hospital!'' when Victoria started vomiting blood, Arellano said. At one point, a guard came in and turned her head toward him with his boot so as not to touch her, fellow inmates told Arellano.
When Victoria's fever spiked and she could no longer go to the bathroom alone, a fellow inmate phoned her mother.
''He told me that Victoria wasn't eating and was urinating blood, but that the officials still were not paying her any mind,'' Arellano said. ''He told me: 'Get outside help, but try not to worry. We'll take care of your daughter.'''
A U.S. immigration officer soon called saying Victoria was hospitalized and gravely ill. Arellano spent three days by her side.
''Her foot was chained to the bed and when she tried to turn over, it would hurt her,'' Arellano said. ''That made it twice as hard. It was so humiliating. No human should have to live their last days like that.''
Arellano said she pleaded with the immigration guard to remove the chain. It was finally taken off minutes before she died.
Scientists and immigration experts are discussing the challenge of dealing with HIV in an increasingly mobile world at the conference, the first in Latin America, attended by 25,000 people. (AP)
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