Below the Equator
Borders. Colonial South. Plutocracy North. South America. Africa. SE Asia. Antarctica?
CASE STUDY: BORDERS, VICTIMS AND VICTIM THINKING
Emma Lazarus’ 1883 sonnet The New Colossus is engraved on the base of the Statue of Liberty. The poem depicts the “Mother of Exiles” who lifts her lamp in hospitality and invokes: “Give me your tired, your poor, your huddled masses yearning to breathe free.”
Her words represent the best of our country: a commitment to the values of diversity, equity, and inclusion. America has not often lived up to those principles, even when they are inscribed on our monuments and in our founding documents. Today — as news surfaces that women under ICE custody may be receiving forced hysterectomies — we seem farther from this welcoming and inclusive vision than ever.
Most school-aged children can recite the Pledge of Allegiance, but it has become increasingly clear that the US is not an indivisible nation promising liberty and justice for all, but a country divided into “us versus them.” Over the past few months, we have witnessed instances of racism, xenophobia, and misogyny. Now we confront all three together in the recent reports of the appalling treatment of immigrant women at ICE detention centers.
Human Right Abuses of Immigrants
This latest news has been brought to light by Dawn Wooten, a licensed practical nurse employed by Irwin County Detention Center (ICDC) in Georgia, a protected whistleblower. Wooten’s complaint purports “jarring medical neglect at ICDC, including refusal to test detained immigrants for COVID-19 who have been exposed to the virus and are symptomatic, shredding of medical requests submitted by detained immigrants, and fabricating medical records.”
Her claim also “raises red flags regarding the rate at which hysterectomies are performed on immigrant women under ICE custody at ICDC” and alleges that immigrants who attempted to speak out against these injustices were punished with solitary confinement. These charges follow previous reports detailing other injustices immigrants in America face: children, separated from their parents, are held in cages; four-year-olds are forced to testify in court and in English to validate their refugee status; and both children and adults face rampant sexual assault.
Adding forced sterilization to this litany of alleged human rights abuses, Wooten maintains that several female detainees have had their uteruses removed without cause or consent.
Detailing the specifics of this horrific violation, the nurse tells of women who were informed they needed hysterectomies to treat medical conditions (such as cancer) that they did not have. Others were instructed about the procedure in English when they spoke only Spanish and did not understand what was happening. Others underwent hysterectomies for no apparent reason. The very fact that these women are detained raises questions about whether or not they can truly consent to such procedures. While we do not yet know the full story, Wooten’s report demands attention.
Great Divide Between Powerful and Powerless
Physicians have the responsibility to uphold the values stated in the Hippocratic Oath: to “First, do no harm” and maintain the highest ethical standards of the profession. This includes caring for the sick and vulnerable.
Reports of hysterectomies being performed on detained immigrant women without cause or informed consent are antithetical to the foundations on which the medical profession was built and to the aspirations upon which our country was founded. This Great Divide between the powerful and the powerless lies at the heart of the moral debate raging in our country.
Who gets to be considered “one of us,” and who is relegated to the status of “one of them?”
Many of the current administration’s immigration policies harken back to previous eugenics policies upheld in the United States, including immigration quotas and the public charge rule. Much as early 20th-century eugenics attempted to differentiate between those considered “fit” and those deemed “unfit,” current policies have framed immigrants as outsiders who threaten the health and wellbeing of our country.
Removing the uteruses of detained immigrant women evokes the forced eugenic sterilization programs of the 20th century, which remain legal in the US today. While forced sterilization is now considered a human rights violation, the US Supreme Court decision, Buck v. Bell (1927), legally sanctions the sterilization of those considered “unfit” in Virginia and, by precedent, in other states. This ruling has never been overturned.
Politics Over Patients
What is the purpose of ICE’s alleged sterilization of detained immigrant women? Does the (mal)practice protect the health of American citizens by detaining immigrants until they are given medical clearance?
Multiple studies have proven that, despite lower socioeconomic status and unequal access to health care, immigrants consistently exhibit better health than those who are native-born when assessing mortality, heart and circulatory disease, obesity, and smoking. Does the violation protect the “purity” of America, a nation built on the backs of immigrants and those stolen into slavery?
Do we add to the need to regulate the movement of human capital via slavery, immigration bans, and detention centers the need to regulate the bodies of immigrants via forced sterilization? To become one of “us,” are these women being forced to sacrifice any future offspring who would be considered one of “them?”
Whether the reasons are economic, racist, xenophobic, or misogynistic, this reported sterilization places political motives ahead of the care of the individual. Prioritizing politics over patients is dangerous, leading to the disregard of the most vulnerable and marginalized by the medical establishment. Medical professionals must uphold the ethical values of the field and refuse to allow outside forces to take precedence over health care.
Dr. Ada Rivera, the medical director of the ICE Health Services Corps overseeing health care in the agency’s detention system, has affirmed there will be an investigation into these reports, even as she downplays the number of hysterectomies performed. Rivera claims “only” two detainees had been referred for hysterectomies since 2018. ICE has also refused to comment on the number of referrals that resulted in action or how many tubal ligations or other forms of sterilizations have been performed.
Harming Women of Color
America has a sordid medical history of harming, not healing, women of color. The number of non-white women who have been experimented on and sterilized in the United States underscores the systemic, racist, and misogynistic nature of the problem. But whether thousands or hundreds or dozens of women are mistreated, the instances are too many. One woman, detained and sterilized, is one too many. And that woman is not even “one woman,” as she stands in line with countless others who have suffered abuses by doctors and government officials in the name of science, medicine, and progress.
As Speaker of House Nancy Pelosi argues, “This profoundly disturbing situation recalls some of the darkest moments of our nation’s history, from the exploitation of Henrietta Lacks, to the horror of the Tuskegee Syphilis Study, to the forced sterilization of Black women that Fannie Lou Hamer and so many others underwent and fought.”
Promoting systemic inequities through eugenic policies was unethical in the past, and it is unethical now.
Ignore, Negate, and Forget
Too often, we ignore, negate, and forget. A recent study revealed that 63 percent of young Americans do not know that 6 million Jews were murdered in the Holocaust. This ignorance persists, despite the brave work of survivors to testify and the campaigns to “Never Forget.”
Regarding reports of the forced sterilization of immigrant women, another case of eugenics, people are already saying that we should “wait and see” or that “a few” instances are “not so bad.” What will they say next month, next year, or in 50 years? Will these injustices be relegated once more to myth or political bias, as is all-too-often the case? Will these stories, too, be forgotten?
The New Colossus calls us to lift our collective lamps to shine light in the darkness. In the wake of these disturbing reports and the death of Supreme Court Justice Ruth Bader Ginsberg, who fought valiantly to preserve the rights of women in the face of continued injustice, we cannot stand statuesque with silent lips.