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How to Make an Asylum-Seeker Request Her Own Deportation

Brenda Menjivar Guardado is scared to go back to El Salvador, but she's even more afraid of dying in custody.

As undocumented immigrants contend with a new directive from the upper echelons of Immigration and Customs Enforcement (ICE) that calls for the apprehension of all immigrants without proper paperwork—not just those with criminal records—one detainee is hoping simply to stay alive as her case winds its way through the U.S. immigration system.

Brenda Menjivar Guardado, a 21-year-old El Salvadoran national, asked a federal immigration judge to deport her last month. She doesn't actually want to go back to El Salvador, according to her attorney. In fact, when she was initially detained in May of this year by Customs and Border Protection, she requested asylum.

But Guardado's priorities changed when Immigration and Customs Enforcement took away the insulin she'd been using to treat her type-1 diabetes. As her blood glucose skyrocketed, the U.S. suddenly became a more dangerous place than the country she fled.

"Brenda is convinced she's going to die," Whitney Drake, her attorney, told me last week. "She's terrified."

Guardado's ordeal began May 30, when she was detained by U.S. Customs and Border Protection. For the four days she was in CPB custody, she was allowed to keep the insulin medication she'd brought to the United States. Like all type-1 diabetics, Guardado was using a combination of fast-acting and long-acting insulin drugs to mimic a normal pancreas and manage her blood glucose levels. Without access to both formulations, it would be nearly impossible to keep her glucose from going too high, leading to a potentially fatal condition called diabetic ketoacidosis.

The problems started when Guardado was transferred into the custody of ICE on June 3. "They threw out her medication," Drake says. She was processed at Laredo Processing Center, and then transferred to Hutto on June 8. After tossing her medication, someone at either Laredo or Hutto began giving Guardado a long-acting insulin, but not the short-acting formulation type-1 diabetics generally take before and after meals to counter whatever sugars are in their food.

Drake, who works for an immigration nonprofit called American Gateways, visited Hutto, which exclusively houses immigration detainees, on June 22. Guardado approached her asking for help. By this point, her glucose was out of control. A healthy person's blood glucose floats between 75 and 100. Diabetic ketoacidosis can start with an elevated blood glucose level of 250. The day after she appealed to Drake for help, Guardado's blood glucose was in the upper 400s.

Drake immediately began contacting medical professionals outside ICE, which provides medical care at Hutto, for advice. An endocrinologist she spoke to said Guardado was in mortal danger. So Drake request that ICE release Guardado. That request was denied.

By June 29, which is the last time Drake spoke to Guadardo, the young woman had dropped her asylum request and asked her immigration judge to deport her. She didn't want to go home, but she also didn't want to die in a U.S. immigration detention facility.

Hutto Detention Center and Laredo Processing Center are both operated by CoreCivic (formerly known as Corrections Corp of America). According to a spokesperson, CoreCivic doesn't provide medical care at Hutto; ICE Health Service Corps does. While CoreCivic does provide medical services at Laredo Processing Center, a CoreCivic spokesman told me to take my query to ICE.

"[Ms. Guadardo] is receiving medical care that is consistent with the requisite standard of care for people with her condition," an ICE spokesperson told me via email on July 7. On July 8, an outside observer met with Guadardo in Laredo on Drake's behalf.

"Brenda said she's being treated well and is starting to feel better," Drake told me on Sunday. "Brenda saw a nurse and doctor immediately upon arriving at the Laredo ICE facility. She's being given fruits and vegetables, and her blood-sugar levels are coming down. I do not have updated information on what type of insulin she is currently receiving or her actual blood-sugar levels, and obviously her long-term health remains a concern."

While Guadardo's case may sound uniquely harrowing due to her immigration status, type-1 diabetics do not fare well in U.S. prisons and jails, regardless of their nationality or who manages the detention center. In Arkansas, a jail employee is standing trial for manslaughter in the 2016 death of a detainee who suffered diabetic ketoacidosis. (The staffer who found 20-year-old Morgan Angerbauer unconscious mistakenly gave her even more glucose rather than insulin.) Last year, a federal grand jury indicted an employee of the McClain County Jail in Oklahoma for civil rights violations after he deprived a diabetic detainee of insulin and then accused him of "faking" when he developed ketoacidosis (the inmate died as a result). A diabetic Missouri man arrested for not paying child support recently died in jail with a blood glucose level of 2,500. The district attorney for Irving, Texas, investigated city jail staff in 2013 after an insulin-deprived diabetic died in custody. In 2012, the family of a diabetic prisoner, who died in the custody of Sheriff Joe Arpaio, sued Maricopa County.

Considering the U.S. prison system's track record with type-1 diabetics, Guadardo is lucky to be alive.

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  • Rhywun||

    While Guadardo's case may sound uniquely harrowing due to her immigration status

    Actually, it sounds uniquely harrowing because they're basically torturing her. What does her immigration status have to do with it?

  • Unlabelable MJGreen||

    One might expect this kind of negligence or lack of services to occur with immigrants awaiting deportation, but not the general prison population that are locked up for extended sentences.

  • Rhywun||

    I don't expect that at all. I expect that the State is responsible for providing all necessary care to anyone it chooses to lock up for any reason. You might as well try to say "one might expect we don't feed immigrants awaiting deportation".

  • BYODB||

    It shouldn't take anywhere near as long as it does, unfortunately, and the longer it takes the more expensive it becomes (not to mention the bigger violation of human rights it becomes, locking people up for the gross misdemeanor of crossing the border being something of a bullshit crime after all by itself).

    It should be a simple matter to say 'nope, not a citizen, GTFO'. Expensive to transport? Probably. Hell, there's a lot of expense across the board. Far too much of it, and I really wish none of it was necessary.

    But since there is absolutely zero desire to cut back or bring to heel wayward and expansive welfare state programs this is where we end up. We are told that we are goat fuckers if we don't let them in, and we're told we're goat fuckers if we cut the welfare state. Well, then I guess we're going to fuck goats then folks.

  • Bubba Jones||

    It would be fast if they didn't contest it.

    But there is no excuse for withholding medication.

  • BYODB||

    Read the article, their medication was not withheld. They were administered a different type of insulin, and either the patient misused it or it was the wrong type of medication. Either is probable, I wouldn't doubt a misdiagnosis but I also wouldn't be surprised if the patient used the medication incorrectly either on purpose or accidentally. Probably accidentally, I would readily admit, but it's hard to say since the article is relatively fact free. Cubans risk a worse death on rafts coming to the U.S. IMO, so it's hard to draw a line in the sand that says 'sane people won't do this to get citizenship/asylum'.

  • BYODB||

    Oh, and keep in mind that this type of medication is administered with a needle (if memory serves) and think to yourself what else an inmate might use one of those for. It isn't hard to understand why they went with a longer-lasting non-emergency version of insult for a prisoner in a prison setting where I would wager their caloric and sugar intake are probably rationed. But I'm sure their system, as in most prisons, is shitty and run by idiots so...there is always that. I strongly suspect the reason for the switch was because they insist on administering the insulin themselves as to not allow them to have their very own shiv.

  • pan fried wylie||

    Read the article, their medication was not withheld.

    "Do not change insulins without consulting a doctor.", paraphrasing what it says on the insulin. I would argue that giving someone a different medication without proper medical supervision is witholding Their Medication.

  • Qsl||

    Iffy.

    Change of insulin is usually in regards to formulation (moving from standard insulin to Lantus for example), not long acting vs. short acting.

    Several prisons have moved to long acting exclusively as there is less risk of a sentinel event (low blood sugar is far deadlier than too high).

    The other part is the refugee can regulate their own blood sugar by not eating as much or spacing their meals.

    This is a non-story.

  • Dan S.||

    The correct medication was withheld. She needed to take two kinds of insulin, and was only allowed to take one. Yeah, that's withholding the medicine she needed to have (and did have, but the detention center disposed of).

  • Mark22||

    "The correct medication was withheld"

    There is no "correct" insulin, there are different choices for different lifestyles. She's in an institutional setting for a short time, and long-acting insulin should be OK for that.

  • Cynical Asshole||

    What does her immigration status have to do with it?

    Apparently for some people the amount of compassion or sympathy that they have for others is directly related to that other person's immigration status.

  • Crusty Juggler - Obama momma||

    I have no sympathy for anyone who BROKE THE LAW. When you BREAK THE LAW, you must deal with the consequences.

  • Malvolio||

    Obviously, someone who hasn't read "Three Felonies A Day". https://goo.gl/VrGpAs

  • hackajar||

    Wow, someone on a libertarian forum ignoring the 8th amendment, because "criminal". Not sure how you landed here on Reason.

  • ImanAzol||

    "undocumented immigrants "

    ILLEGAL FUCKING ALIEN.

  • SQRLSY One||

    "Illegal human".

    When humans are outlawed, only outlaws will be human!

  • Scarecrow Repair & Chippering||

    Maybe Crusty means cops who break laws and is seeing who rises to the bait of jumped-up conclusions.

  • Diane Reynolds (Paul.)||

    Considering the U.S. prison system's track record with type-1 diabetics, Guadardo is lucky to be alive.

    This doesn't sound like a single jerk-off employee who's just engaging in a little dereliction of duty, this sounds like she hasn't been seen or properly diagnosed by a caregiver. Surely people get medical treatment while detained by ICE. Something feels wrong about this. Either that or i'm not cynical enough today.

  • Unlabelable MJGreen||

  • Rhywun||

    Well, that was... unpleasant. F--k.

  • loveconstitution1789||

    That was not right and that was clearly negligence by the federal government.

    That still does not change the fact that he should have been deported. The solution would have been to deport him in 24 hours after the ICE detainer was fulfilled.

  • Bra Ket||

    Given this scary list of anecdotes we can conclude that statistically the most-likely outcome is for all type I diabetics to be killed immediately.

  • chemjeff||

    Wow. That's awful.

  • Hugh Akston||

    And this is the civilization that people want to save from the immigrant hordes?

  • Azathoth!!||

    The immigrant hordes that Guadardo was fleeing.

  • Rhywun||

    Like these ones? They're already here.

  • notJoe||

    Without access to both formulations, it would be nearly impossible to keep her glucose from going too high, leading to a potentially fatal condition called diabetic ketoacidosis.

    Just a minor correction: It's perfectly possible to survive on short-acting insulin alone.

  • Unlabelable MJGreen||

    Unfortunately, there is no mandate in the US for speedy trials.

    Good luck to this woman.

  • Hugh Akston||

    hoho, that's where you're wrong retard. If you'll direct your attention to the text of the Sixth Amendment:

    In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial IF THEY ARE CITIZENS, by an impartial jury FOR CITIZENS ONLY of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation AFTER PROVING CITIZENSHIP; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defence, BUT AGAIN ONLY IF THEY ARE CITIZENS WHAT PART OF ILLEGAL DON'T YOU UNDERSTAND.

    So you see she is screwed, but only because God cursed her to fall out of her mother outside the US borders. As such, she definitely deserves whatever she gets and worse.

  • Rhywun||

    From the article:

    type-1 diabetics do not fare well in U.S. prisons and jails, regardless of their nationality or who manages the detention center

    As you can see, her citizenhip has nothing to with this problem.

  • Hugh Akston||

    So then why was she in jail?

  • Rhywun||

    Oh FFS you're insufferable.

  • BYODB||

    Further into the story, I have to wonder what the shit is going on when they were giving this person insulin, just not the kind she was 'used to'. So I suspect there is more to the story in that they either were unable or failed to communicate how the new medication is intended to function and thus this woman continued her standard behaviors which, FWIW, would be deadly with a different medication.

    I'm not making excuses for ICE or anything like that, it's just not as clear that she was 'neglected' so much as she was 'misdiagnosed', and of course this assumes this individual was ever actually diagnosed as a type 1 diabetic in the first place. A fact, by the way, that isn't actually confirmed anywhere whatsoever in the story. I don't particularly doubt it, but it would be nice to have at least the baseline facts of the story confirmed by someone that isn't the subject of the story.

  • Mark22||

    So you see she is screwed, but only because God cursed her to fall out of her mother outside the US borders.

    She is cursed because she broke US law.

    In all criminal prosecutions,

    Immigration proceedings are not criminal prosecutions, hence the 6A doesn't apply. US immigration officials can deny entry or detain people for pretty much arbitrary reasons; that's the deal when you come to the US as a non-citizen. Either live with it or don't come here. Incidentally, it's the same deal immigrants get pretty much anywhere else.

    As an immigrant myself, I really have little tolerance for people who break US immigration law and then whine about the predictable and unpleasant consequences.

  • retiredfire||

    Yes!
    To correct the article: Guardado's ordeal didn't begin May 30, when she was detained by U.S. Customs and Border Protection. It began when she took the voluntary decision to break US immigration laws and enter the country, illegally.
    Once you do that, you should accept whatever consequences occur.
    The real "crime", here, was that she wasn't deported, once it was determined she was an illegal, or as soon as she said she wanted to be.

  • loveconstitution1789||

    Actually, there is a right to speedy trials.
    Amendment VI:
    In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the state and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the assistance of counsel for his defense.

  • Bra Ket||

    think he was being sarcastic

  • retiredfire||

    The adjudication of immigration cases is civil, not criminal - third word in the 6th Amendment.

  • Dillinger||

    seems if an El Salvadorian wants to gtfo we shouldn't stand in her way...

  • Juice||

    So you're in favor of her walking out of the ICE facility and going freely on her way then?

  • Dillinger||

    silly to keep her from meds by incarcerating her for "being illegal" *and* silly to keep her in America if she's asking for the out...

  • retiredfire||

    Probably in favor of her crossing the border, from where she is illegally present, to anywhere else, and going freely on her way, or as freely as that country will permit.
    She managed to get here, from El Salvador, it isn't up to us to figure out how to get her back, just out.

  • Juice||

    El Salvador must really suck. Native population still living there? About 6.3 million. Number of Salvadoran expats in the US alone? About 2 million. Probably about another 2 million in other countries.

  • retiredfire||

    Maybe so, but asylum is reserved for those who show an individualized threat from their home country, not just because it sucks, back there.
    If that was the criterion, almost everyone could make an asylum claim, when comparing their home to the US.

  • Juice||

    Just commenting on how many Salvadorans live outside El Salvador.

  • JeremyR||

    So you're saying that while US citizens shouldn't get health care, illegal immigrants should?

    Treatments don't come from the sky. Someone has to pay for it. Why should it be taxpayers?

  • Juice||

    No, the woman should be released from incarceration so she can buy her own insulin.

  • Hugh Akston||

    Good point. The government should save taxpayers money by not locking up immigrants.

  • hackajar||

    This!

  • loveconstitution1789||

    Same day deportations would be good too.

  • Juice||

    But expensive. Pay for your own deportation goons.

  • Jordan||

    Um, because when you lock somebody in a cage, you kind of have a duty to care for their wellbeing?

  • Dillinger||

    not if they shoot dogs.

  • Ken Shultz||

    Is this article about how diabetic illegal aliens should receive better treatment while in custody, or is it about how we shouldn't enforce our immigration laws because some of them are diabetics?

  • BYODB||

    Both?

  • ImanAzol||

    "undocumented immigrants "

    ILLEGAL FUCKING ALIEN.

  • Bubba Jones||

    Whoever aided or abetted the confiscation of her insulin should be fired.

  • loveconstitution1789||

    Not sure how guards are supposed to know that is actually medicine or an illicit drug.

    If she was not taken to a medical facility and given proper treatment then there is an issue. She was diagnosed and given insulin. I don't see a cruel situation here.

    A better solution is to deport her ass quick! Like tomorrow and let her get the fast acting insulin.

  • Reverend Draco||

    Is that all it takes to make them want to go back where they belong?

    Great! Keep up the good work!

  • hello.||

    Gotta love libertarianism. No government health care! Unless you're an illegal immigrant.

    How about we just send the illegals to the nearest VA medical center?

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