On any given day, U.S. Immigration and Customs Enforcement's (ICE's) Enforcement and Removal Operations (ERO) can house around 33,000 detainees at its approximately 260 detention facilities throughout the country. These individuals, who are awaiting removal from the United States, are just a small fraction of the nearly 400,000 people who make their way through an ICE detention facility each year. Detainees are from all across the world and may have been exposed to contagious diseases like tuberculosis (TB). Often times, they have had limited access to health care. When they enter ICE custody, the ICE Health Service Corps (IHSC), the agency's medical staff, must overcome those challenges to protect the health and safety of the detainee population.
Recently, representatives from federal law enforcement and public health agencies came together for a two-day conference to discuss how to stop the spread of TB among individuals in federal custody. This event was the first time that operational and legal components have come together for comprehensive discussions on how to address this complex issue.
Dr. Diana Schneider was a driving force behind the conference and said that inter-agency communication is vital in order to effectively deal with the challenges that arise from TB. Affected individuals must receive six to 24 months of supervised, directly observed therapy. If a patient interrupts or stops treatment, or takes treatment at irregular intervals, then he or she may return to a contagious state. That person could transmit TB to others, acquire resistance to the infection or drugs, or even die.
Gary Mead, executive associate director of ICE ERO, says the issue of TB is more pertinent today than ever before. Not only are detainees from across the world, but their movement among agencies has become more fluid over the past several years. These days, Mead said, it is not uncommon for detainees to be transferred among ICE, the Bureau of Prisons and the U.S. Marshals Service. With each transfer, a detainee could come in contact with an entirely new set of individuals.
Dr. Schneider says that although identifying concrete solutions was the biggest challenge of the seminar, she is hopeful that the public health agencies gained a better understanding of the complexity of the federal law enforcement mission and legal considerations, and vice-versa. She hopes that this event will help ICE ERO, and other federal agencies, develop strong solutions for the future.