Pauline Binam asked to see a doctor because she was having abnormalities with her period. After nearly two years in immigration detention, she was worried that it was having an adverse effect on her health.
The doctor told her that she had a cyst on her ovary and she agreed to a dilation and curettage (D&C) procedure, her lawyer said. But when she awoke from surgery, the doctor told her that one of her fallopian tubes had been removed – a procedure she is adamant she did not give consent for – and that as a result she may no longer be able to conceive naturally. At the time she was just 29.
Her immigration attorney Vân Huynh, told the Guardian: “When she first learned about it, the way that she described it to me is that she was sitting in this wheelchair post operation and the doctor’s telling her that she may not be able to conceive children in the future and it was very upsetting for her. She was sobbing in this wheelchair, not understanding why this was happening.”
Her account is in one of multiple harrowing allegations of women held by US Immigration and Customs Enforcement (Ice) at Irwin county detention center in Georgia who have been forced to undergo unwanted hysterectomies and other unnecessary gynaecological procedures. Their stories have come to light in recent days following the release of an explosive whistleblower report.
Binam, a 30-year-old national of Cameroon who has lived in the US since she was two, was narrowly saved from deportation on Wednesday and is now in custody in Texas.
Since her operation in 2019, she has since developed amenorrhea, which means her period has stopped, and is dealing with mental health issues as a result, says Huynh. “There’s a lot of questions that she has that’s gone unanswered and I don’t know that she’s going to be able to have a clear answer to some of the questions as to like ‘Why was this done to me?’ But she’s clear about the fact that this was something that was done to her without her consent.”
The whistleblower report, filed on behalf of nurse Dawn Wooten, a former employee of the center, claims an alarmingly high rate of hysterectomies performed on Spanish-speaking women who she and other nurses feared did not understand what they were undergoing. Wooten claims the doctor, who has since been identified as gynaecologist Dr Mahendra Amin, was so notorious for performing such procedures that she referred to him in the report as the “uterus collector”.
“Everybody he sees has a hysterectomy – just about everybody,” Wooten said in the complaint. “I’ve had several inmates tell me that they’ve been to see the doctor, and they’ve had hysterectomies, and they don’t know why they went or why they’re going.” Other alleged failures by the center included dangerous and unsanitary conditions and poor safety precautions around coronavirus.
House speaker Nancy Pelosi said on Tuesday that if true, the whistleblower claims represented “a staggering abuse of human rights”.
Amin told The Intercept that he had only performed “one or two hysterectomies in the past two [or] three years” and did not specify whether they were performed on Irwin detainees. His attorney, Scott Grubman, said in a statement: “We look forward to all of the facts coming out, and are confident that once they do, Dr Amin will be cleared of any wrongdoing.” Ice said its records show just two referrals for hysterectomies at the jail. “Detainees are afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will,” said Dr Ada Rivera, medical director of the Ice Health Service Corps.
On Friday, senior Ice official Tony H Pham said the recent allegations “raise some very serious concerns that deserve to be investigated quickly and thoroughly”. He said he “welcomes” an official review, adding: “If there is any truth to these allegations, it is my commitment to make the corrections necessary to ensure we continue to prioritise the health, welfare and safety of Ice detainees.”
LaSalle Corrections, which operates Irwin, has said it “strongly refutes these allegations and any implications of misconduct.”
But since the complaint became public, Seattle Democrat congresswoman Pramila Jayapal says she has found at least 17 examples of unnecessary medical procedures, including hysterectomies, being performed on women at the center. “It has become painfully clear to me that the initial reports … are likely part of a pattern of conduct,” she said on Wednesday.
Many politicians, immigration lawyers and advocates fear that these practices are not isolated to one center or one doctor.
A letter, led by Jayapal and signed by more than 170 Democrats, to the inspector general of the Department of Homeland Security calling for an immediate congressional investigation into the center, warned that the allegations had echos of “a dark time in US history” when eugenics laws meant that forced sterilisation was legal in 32 states.
Project South, one of the groups that filed the complaint on Wooten’s behalf, has been monitoring conditions at the Georgia center for several years. In 2017 the group released a report in which they recommended that Irwin, along with Stewart Detention Center, also in Georgia, should be shut down.
Legal and advocacy director Azadeh Shahshahani says they “routinely” hear from women who are deeply depressed by the procedures they have undergone.
“These are women, in some cases, I would say most cases, who have fled horrible circumstances of persecution, of torture, of rape, threats of murder, and are seeking refuge in this country and then they’re placed in a facility like Irwin and subjected to these abuses. And then when they raise their voices about it they are placed in solitary confinement.
“So the whole picture is very disturbing and there is need for fundamental change. The call for accountability goes beyond this one individual doctor, it’s about the system.”
She said some of the alleged violations and abuses “may never come to light” because some of the women may have already been deported.
Elizabeth Matherne, an immigration attorney who has had multiple clients at Irwin says she was “not surprised at all” by the revelations. She has heard from several women at the center that “multiple people” there went to the doctor only to be told they needed to have an ovary removed. The wrong ovary was subsequently removed so they ended up having both taken out.
“That is a piece by piece sterilization, but it’s a sterilization,” she said.
While Matherne said it is impossible to know the doctor’s intention, the system, and a lack of oversight, “creates space for someone to have bad intentions. It also creates space for other people who may have bad intentions to enable or to be willfully blind to the actions of one person.
“We think we’re going to find even more women who have had basically their fertility limited or taken away altogether because of the actions of this doctor and the facility to continue to take immigration detainees to him and for Ice to continue to foot the bill and approve their requests.”
Matherne also believes the problem could be wider than Irwin because she says the system “is built to allow things like this to happen and women especially are vulnerable for this kind of victimization.”
The allegations about the center have drawn comparisons to America’s history of eugenics. Between 1907 and 1937 two-thirds of US states passed laws that allowed for involuntary sterilization – leading to the sterilization of more than 60,000 people.
Alexandra Minna Stern, professor of history at the University of Michigan and director of the Sterilization and Social Justice Lab there, said: “Sterilization practices really started as an assault on people with perceived disabilities and mental health issues.”
She added: “In the US in the 20th century, given that this was then Jim Crow America, intense anti-immigration sentiment at the time, xenophobia at the time that was going on in the teens and 20s as eugenics emerged, meant that these disability frameworks became the lenses through which racism and sexism played out.”
In the 1960s and 70s an increase in federal funding for reproductive health procedures combined with racist and anti-immigration sentiment led to “tens of thousands” of women of colour being sterilized, including Native Americans, she said. And by the 1970s, a third of all women in Puerto Rico had undergone sterilization procedures, the majority of which were involuntary, as part of US attempts at “population control”.
Despite having been since made illegal, it has continued in very recent history. In California prisons, between 1997 and 2013 about 1,400 people were sterilized. Today Stern says it is “not a coincidence” that it may be happening under the Trump administration which has “breathed new destructive breath” to these systems.
Detention centers, she said, create “the perfect storm of conditions for sterilization abuse”.
“Anyone who’s studied the history of sterilization abuse would look at this detention center and say this is the kind of place where sterilization abuse is likely to occur because all of the conditions that enable such medical malfeasance and reproductive oppression, they’re all in place.”
• This article was amended on 21 September 2020. About 1,400 people were sterilized in California between 1997 and 2013, not between 2006 and 2010 as we originally said.