A 23-year-old asylum seeker from Nepal has not eaten voluntarily in more than 100 days and has been force-fed for most of the last three months, the latest and longest in a series of hunger strikes at the Immigration and Customs Enforcement detention facility in El Paso.
The man, who asked that El Paso Matters identify him only by the initials KC because he fears persecution in his home country, last ate on Nov. 19 and has been force-fed through a nasal tube for all but a few days since Dec. 6. An independent physician who reviewed his medical records said he came close to dying around Christmas because of poor medical care at the ICE facility.
In a phone interview Wednesday, KC said through a Nepali interpreter that he would continue his hunger strike until ICE released him. His voice was weak and raspy.
When asked if he might die during the hunger strike, KC said, “I’m not willing to die. I don’t know.”
Spokespersons for ICE and the U.S. Attorney’s Office declined to respond to questions about KC’s case.
A federal judge in El Paso last week signed an order allowing continued force-feeding of KC, but he expressed concern about the medical care ICE was providing.
U.S. District Judge David Guaderrama said government attorneys “barely” proved that ICE was not using medical treatment as a form of punishment for KC. Guaderrama relied heavily on a scathing affidavit from a Los Angeles-based doctor with extensive experience providing medical care in detention facilities.
“I am horrified at the dramatically substandard care being provided at the ICE El Paso Processing Center. This sort of care would never be tolerated in any other setting,” Dr. Parveen Parmar, associate professor of clinical emergency medicine at the University of Southern California, wrote in a January affidavit after reviewing KC’s medical records.
Parmar said ICE relies on nurse practitioners and nurses to provide complex medical care that should be supervised by a physician. Records showed that the ICE physician, who has been identified in previous court hearings as El Paso family practitioner Dr. Michelle Iglesias, rarely visited KC in the first months of his hunger strike. The medical workers didn’t provide monitoring and treatment required for a man with extremely low blood pressure. And medical personnel rarely provided a Nepali-language interpreter during treatment, even though such interpreters are readily available by phone, Parmar said.
On Dec. 23, KC lost consciousness at the ICE El Paso Processing Center on Montana Avenue. ICE medical personnel described it as a routine fainting episode at the site of a needle during a blood draw.
But Parmar said records indicated KC had blood pressure of 50/30, a heart rate of 40 beats per minute and a respiratory rate of nine breaths per minute, which she described as “a near-death condition.”
“While ICE frames this as ‘fainting,’ in fact looking back at the days before, this episode was caused by inadequate attention to repeatedly low blood pressure and a 5-pound weight loss in 5 days, likely due to severe dehydration and inadequate use of court-ordered IV fluids and nasogastric feeding,” Parmar said in her affidavit, written at the request of the hunger striker’s attorney, Joe Veith.
In his Feb. 27 order allowing the force-feeding to continue, Guaderrama said ICE’s explanation that KC had fainted at the sight of a needle “seems highly unlikely” because he had several previous blood draws without incident.
After losing consciousness, KC was taken to El Paso’s Del Sol Medical Center, where his condition and vital signs improved, Parmar said in the affidavit. He was returned to ICE on Christmas Day and his condition again deteriorated, she wrote.
A Del Sol nutritionist gave ICE recommendations on his feeding, but ICE didn’t follow the recommendations, Parmar said.
Guaderrama wrote “that while these instances of inattention raise some concern, they still do not amount to punishment so as to result in an effective denial of care and render the application of the ICE policy to Respondent unconstitutional.”
He allowed the force-feeding to continue, though he required ICE to take additional steps, such as including a nutritionist in KC’s treatment.
ICE medical staff “SHALL follow all such recommendations from the nutritionist consulted,” Guaderrama wrote.
Veith said ICE has the discretion to release KC, who has no criminal history.
“Our goal is to have KC released immediately. More so than anything, we believe that this type of treatment is very painful and raises a number of issues based on how it’s being implemented,” he said.
KC is due back in court March 11. Parmar is scheduled to testify at that hearing by video from Los Angeles.
Rep. Veronica Escobar, D-El Paso, has been critical of ICE’s handling of hunger strikers over the past year.
“Once again, ICE is using the cruel and inhumane practice of force-feeding at the El Paso Processing Center,” Escobar said. “This shameful pattern of government-sanctioned torture must end. We must stop treating immigrants as criminals and detention as the only solution.”
History of hunger strikes
More than a dozen Indian men were force-fed at the El Paso ICE detention facility last year under court orders. They were on hunger strikes to protest their detention, often for more than a year, while courts decided their immigration cases.
Some of the hunger strikers described a painful, bloody process of inserting a feeding tube through their nose, down their esophagus and into their stomachs.
Although the force-feedings were done under judicial order, the cases were usually sealed at the request of government lawyers, meaning the public had no way of seeing the reasons for the orders or even knowing of their existence.
In his Feb. 27 decision, Guaderrama ruled that sealing hunger strike cases was inappropriate and ordered the government to end the practice.
Immigrant-rights advocates brought some of the El Paso hunger strike cases to public attention. Most of the men gave up their hunger strikes after several days or weeks of force-feeding and were eventually deported. But four men were released after staging hunger strikes of more than 70 days. They are still free while pursuing their asylum claims.
The United Nations has warned that force-feeding detained asylum seekers could violate the Convention Against Torture. The World Medical Association has said force-feeding of inmates or detainees “is unethical, and is never justified.”
El Paso federal judges have increasingly expressed concern about how ICE is handling force-feeding of detained asylum seekers.
In a Sept. 12, 2019, court order that upheld the legality of ICE force-feeding, U.S. District Judge Frank Montalvo criticized ICE’s medical treatment of hunger striker Ajay Kumar.
“It is the duty of the government to provide adequate medical care, not just to keep (Kumar) alive,” Montalvo wrote. He also relied on an affidavit from Parmar in his criticism of ICE’s treatment of hunger strikers.
Veith said El Paso federal judges are applying more scrutiny to ICE’s force-feeding practices of detainees, and pushing for improved care.
“So we have these little baby steps that are leading toward better care for those that are detained and undergoing this type of treatment,” he said.
Detaining asylum seekers
ICE and immigration judges have the discretion to release asylum seekers and others with immigration cases if they’re not a flight or security risk. They can set bonds with supervised release conditions. Immigrant advocates say bonds have become increasingly rare since President Trump took office in 2017.
Frustration from long detention has led to hunger strikes in El Paso and at other ICE facilities, said Nathan Craig and Margaret Brown-Vega of AVID in the Chihuahuan Desert, part of a network of immigration detention visitation organizations.
“The government is pursuing a program of (immigration) enforcement through deterrence, and detention is part of that program of deterrence. The act of detaining asylum seekers is basically to try to punish them, to get them to quit and give up,” Craig said. “And that’s the situation that’s creating the hunger strikes to begin with.”
The battle of wills between asylum seekers and ICE carries huge risks, Craig said. “ICE is going to have to decide if they’re willing to kill someone to not let them out.”
He and Brown-Vega have communicated with many of the El Paso hunger strikers, including KC. Brown-Vega said the hunger strike has taken a physical and emotional toll on him.
“In one of the recent messages he sent, he expressed in English that he didn’t know if God would help him or not. I don’t know if that means that he’s kind of doubting his faith. Because before on prior occasions, he would say that he believed that God would help him,” she said.
Court records show that KC entered the United States illegally near El Paso on May 23, 2019. Brown-Vega said he had been held at an ICE detention facility in Sierra Blanca, Texas, and moved to El Paso when that facility was shut down in October because of water problems.
KC said he fled Nepal because political opponents wanted to kill him.
“It’s dangerous for me to get back to my country because I will be killed if I go back. And I know this is a country of human rights,” he said of his decision to flee to the United States.
An immigration judge ordered KC deported to Nepal on Nov. 4, a ruling that is under appeal. It’s unknown when the Board of Immigration Appeals will consider KC’s case.
KC said he began his hunger strike on Nov. 19 after learning that his political rivals in Nepal had burned down his family’s house, increasing his fear of being killed if he was returned.
KC said an ICE detention officer told him this week that he was about to be put on a plane and sent back to Nepal. Veith said he knows of no such plans and said it was unlikely a detention officer would learn of a pending deportation before an asylum seeker’s lawyer.
“I have been given torture,” KC said of the detention officer falsely telling him he was about to be deported.
In interviews, Craig, Brown-Vega and Parmar all said ICE should release detainees under supervision if they don’t represent a public safety risk. Craig pointed to data showing that 99 percent of asylum seekers show up for court hearings.
“They should release them because they are ending up going to great lengths and spending a lot of resources to do this extreme sort of treatment of them to continue to keep them detained. I just don’t understand why they make that calculation,” Brown-Vega said of the treatment of hunger strikers.
All three said that force-feeding is unethical and a form of torture.
“The bottom line is that if somebody is in a detention setting, they should still have a basic right to determine what is done to their body,” Parmar said.
KC’s feeding tube was inserted initially on Dec. 6 and replaced in January. It was taken out last week after he had gained about 10 pounds in a month, then reinserted on Tuesday after he continued to refuse food and lost weight.
In his Feb. 27 ruling, Guaderrama said the hunger strikes and force-feedings are putting judges in difficult situations. The law prevents them from ordering ICE to free immigration detainees. Federal judges have no way of knowing how long force-feeding could last while immigration courts determine whether an asylum seeker should be deported or allowed to stay in the United States.
“This dilemma places federal courts in an untenable predicament that offers two equally bleak options: either to continue extending authorization for indefinite force-feeding or to deny authorization and let detainees, whose removal date might be imminent, starve to death. Realistically, the first option is the only one that sensibly endeavors to preserve detainees’ lives,” the judge wrote.
He described a situation akin to a high-risk game of chicken.
“In other words, the Court’s hands are tied: it must continue to extend the Government’s authorization indefinitely until either the Government gives in and releases a hunger striker on bond, or the hunger striker gives in and starts eating. But still, it only takes one misstep, either from the Government or the detainee on hunger strike, for the detainee to be at a critical state and die.”