A 23-year-old illegal immigrant died recently while in federal custody. It happened at a U.S. detention facility in Los Angeles. The detainee had AIDS -- and the case is raising questions about the quality of medical care available to immigrants during their time in custody. From Los Angeles, Rob Schmitz of station KQED has the story.
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Victor Arellano was used to being treated badly. He was transgender - he'd changed his name to Victoria, and Victoria was sometimes ridiculed for her appearance. But her mother Olga says this was tame compared to how she was treated by the government. Arellano, who came here illegally from Mexico, was detained in May. She was held at the San Pedro Federal Detention Facility in South Los Angeles, where she awaited a deportation hearing. It's one of dozens of centers nationwide that house illegal immigrants.

Olga says Victoria had been suffering from AIDS for two years. According to Olga, staff at the San Pedro facility denied Victoria medication crucial for her survival. Olga remembers receiving a call from a very ill Victoria after she was detained for a month and a half. Olga says Victoria had just seen a doctor at the facility.

Olga Arellano: "The doctor told her she needed to be on medication, because her immune system was weak. And I asked her why they hadn't given her this medication immediately upon arriving there, because they should have. She didn't know."

Olga Arellano with pictures of her child

Immigration officials won't release Arellano's medical records, so it's not clear what medication she got and when. But those who were in detention with Arellano say they raised concerns earlier. Walter Ayala is an illegal immigrant from El Salvador and was one of dozens detainees who shared a living space with Arellano.

Walter Ayala: "We made requests to the infirmary asking for help because she was so sick. She wasn't eating, she had constant diarrhea, and she was vomiting blood. The nurse who responded was totally inhumane. She said, ‘Oh is that the same person you complained to us about before? The doctor hasn't approved any medication. Just give her Tylenol and water, and it'll go away.' This happened each time we made a request for six days."

Ayala says it got so bad that he and other detainees began chanting ‘hospital' until staff treated Arellano. Later, 55 detainees signed a petition, demanding better care for Arellano. A spokeswoman for Immigration and Customs Enforcement, or ICE, says she wasn't aware of such a petition.

Prior to her detention, Victoria Arellano was taking Dapsone, a prescription antibiotic given to AIDS patients to prevent pulmonary infections. Dr. Homayoon Khanlou is chief of medicine for the LA-based AIDS Healthcare Foundation. Khanlou was not treating Arellano, but he says stopping Dapsone for even a brief period of time could have serious consequences for AIDS patients.

Homayoon Khanlou: "If they don't take them, their immune system itself is not able to maintain an adequate level of defense sytem for the pathogens. They'll develop pneumonia, diarrhea, meningitis, and they will basically die."

Again, Arellano's medical records have not been made public, so it's unclear if she was given Dapsone while in detention. The ICE spokeswoman said she couldn't talk about the case because of privacy provisions and that the government is referring Arellano's case to its office of professional responsibility, a routine step whenever someone dies in custody.

In mid-July, Olga Arellano, the mother, says she got a call from an immigration official who gave her the address of a hospital where Victoria was transferred. When she arrived, Olga says, Victoria tried to embrace her, but lacked the strength to lift her arms. She was breathing through a respirator and her foot, says Olga, was chained to the bed. She says two guards stood watch outside the door.

Olga Arellano: "I don't think any human being deserves that. At times, my Victoria wanted to reposition her body, but she couldn't because she was shackled."

Olga says she asked the guards if they could unchain her daughter, but she says they refused. Victoria Arellano died two days later.

Megan McLemore: "This is the most extreme case that I've come across in the months that I've investigated this so far."

Megan McLemore is with Human Rights Watch. She's investigating the Arellano case as part of a report on the treatment of HIV/AIDS patients at federal detention centers.

Megan McLemore: "We're finding basically that the medical care systems are just not set up for people with chronic health conditions. There are delays in getting medication and interruptions in the care itself."

A month before Arellano's death, the American Civil Liberties Union filed a class-action lawsuit on behalf of detainees in California, claiming the government wasn't providing appropriate medical care at another federal detention facility in San Diego.

Last year, a report by the Inspector General at the Department of Homeland Security showed that four of the five facilities it inspected failed to comply with their own standards for timely medical care. The San Pedro facility was not among those inspected.

Dr. Timothy Shack is the Medical Director of the Department of Immigration Health Services, a federal agency that oversees medical care in the nation's detention centers. He disagrees with the Inspector General's findings. He wouldn't discuss Arellano's case, but he admitted that at times, there are delays in care for some detainees.

Timothy Shack: "This is common throughout healthcare, lapses in care generally occur in times of transition. Someone's transitioning from one hospital to another, the medical records should transfer, medications should transfer, but there are a lot of steps and people in between. This occasionally falls short."

Back at her small apartment, Olga Arellano fumbles with a cassette player. After Victoria died, Olga found a tape of her singing along to her favorite songs.

Olga Arellano: "When I'm here alone, I just put the cassette in a tape player and turn it on and put it in her room, and I imagine she's here."

Olga says she's speaking out about Victoria's death, hoping it won't happen to anyone else. The family of Victoria Arellano is now planning to file a wrongful death claim against the U.S. government.

For The World, I'm Rob Schmitz, in Los Angeles.