Government Agencies Shouldn't Be Allowed to Destroy Their Paper Trail of Medical Abuse and Neglect

Last year, Anadith Reyes Alvarez, a medically vulnerable 8-year-old girl, died in Customs and Border Protection (CBP) detention after contract medical staff failed to review her medical records or consult with a physician and refused her emergency medical transport and care. As a court monitor concluded, Anadith’s death was a “preventable tragedy” pointing to an “urgent need” to improve “CBP medical oversight.” Sadly, this kind of medical abuse and neglect is not an anomaly in CBP facilities. Last month, CBP employees blew the whistle, indicating that CBP’s contract oversight office has long been aware of serious violations in the provision of medical care at CBP detention facilities, including significant understaffing, and providing medical services without appropriate medical licenses.

In the midst of these disturbing developments, CBP has requested permission from the National Archives and Records Administration to destroy “medical case files of persons in the custody of U.S. Customs and Border Protection” after 20 years.

The medical records slated for destruction by CBP have long-term value for legal, research, historical, and accountability purposes. That’s why the ACLU and 71 organizations, including the American Immigration Council and the Texas Civil Rights Project, as well as 165 academic scholars, filed a regulatory comment today to challenge CBP’s proposed destruction of these records.

The medical records in question are often the primary evidence of medical care (or lack thereof) received by people in CBP custody, and are key to government accountability efforts to address systemic medical neglect in CBP detention. These records are also critical to legal claims by individuals or their surviving family members — including people who may still have live legal challenges long after the incidents occurred, such as people with disabilities or those who were minors when the abuse or neglect occurred.

These medical records are also of significant historical importance: Historians have frequently turned to the National Archives for primary sources regarding the treatment of immigrants, including the use of health-based criteria as a basis for entry or exclusion, and access to medical care by migrants at the border. Scholars have also examined records from government agencies that provided medical care to immigrants, including the U.S. Public Health Service — a precursor to CBP’s current medical care providers.

Destruction of CBP’s medical records would eliminate an important primary source developed during CBP’s nascent period as an agency — from its establishment in 2003, to a time marked by policies of family separation, and the use of Title 42, a purported public health measure to expel millions of immigrants during the COVID-19 pandemic.

CBP’s plans to destroy medical records will only serve to obscure its tragic record of medical neglect and inhibit efforts to hold the agency accountable. Each day, CBP holds approximately 15,000 migrants in short-term detention facilities while processing them at the border. CBP policy maintains that people should not be detained for longer than 72 hours in these facilities, often small, frigid holding cells commonly referred to as hieleras (“freezers” in Spanish). CBP, however, regularly detains people for as long as 10 days, and in many cases, for over 30 days. Government oversight agencies and advocates have detailed numerous incidents of negligent medical care to people in CBP custody, including denial of care to people with broken bones, a damaged testicle due to injury by a Border Patrol officer, and a ruptured appendix.

An ACLU investigation also highlighted multiple cases of medical neglect in CBP detention, including the denial of care to a pregnant person, which preceded a stillbirth; and withholding of prescription medication for a child detained after undergoing spinal surgery resulting from a car accident. At least five people died in CBP custody in FY 2021 after having a medical emergency.

CBP’s treatment of migrants in its custody needs more transparency and documentation — not less. Like former challenges to the destruction of documents related to immigration detention, government agencies should not be allowed to destroy the paper trail of their incompetence and wrongdoing.