“Doctor Smith” goes to Washington: An NGO effectively deploys volunteer health professionals to reform health care for indigent immigration detainees

Health professionals who have “hands-on” experience in health systems often struggle to engage effectively in advocacy for systemic reform. Physicians for Human Rights (PHR) operates a project that recruits, deploys, and supports health professional volunteers to play key roles in reform of the immigration detention health care system operated by the US Department of Homeland Security (DHS). Each night the DHS detention system holds 32,000 civil immigration detainees, the majority of whom are indigent and low-income individuals from Mexico and Central America, within a system of over 300 prisons. Despite DHS's $2.6 billion detention budget, detention health services are seriously deficient. The system's failings have been implicated in many of the 104 deaths in immigration detention since 2003. To address these issues, PHR is turning to volunteer health professional members in our Asylum Network, who, since 1992, have provided pro bono forensic evaluations to indigent asylum seekers. PHR is making a key contribution to detention health care reform by recruiting and supporting these volunteer health professionals to participate in policy-reform working groups with federal government officials. This DC-oriented effort is amplified by health professionals' outreach to local immigration officials and efforts to bring health professionals' expertise on the detention health crisis to both “new” and “traditional” media. Expected outcomes include new policies requiring immediate medical treatment for sexual assault survivors arriving in detention centers, uniform and early screening of incoming detainees for potentially life-threatening conditions, and release on safeguards for torture survivors and other highly vulnerable detainees.