Jorge Rivas/Splinter

On November 6, Karla Aranda picked up a frantic phone call from an inmate in an immigrant jail in the California desert. Aranda’s husband was in that jail, too, and the inmate told her an ambulance had taken him away.

Aranda called the Adelanto Detention Center—85 miles from her home in Maywood, CA—but she says an operator told her everything was fine. Aranda was told that her husband, Alfredo Aranda-Holguin, was still in the facility.

That same day, another detainee, who found Aranda’s contact information written on a sheet of paper amongst Aranda-Holguín’s belongings, called and said he saw paramedics performing CPR on Aranda-Holguín as they took him away. The second caller had some harrowing details: He told Aranda he saw medical staff place a white sheet over Aranda-Holguín.

Aranda called the detention center a second time and was again told her husband was fine. She felt helpless. A thousand different scenarios raced through her head.

“If it wasn’t for his cellmates, I wouldn’t know anything,” said Aranda, who spoke Spanish throughout several interviews with Splinter.


According to Aranda, Aranda-Holguín’s health issues were under control before Immigration and Customs Enforcement took custody of him on August 8. He was convicted of possession of a controlled substance and possession of a controlled substance for sale, both felonies that, according to an ICE spokesperson, “make him subject to possible deportation.” (Aranda-Holguín disputes these charges and says he was framed by police.)

When he entered Adelanto, Aranda-Holguín was being treated for several health issues, but the primary concern was his chronic kidney disease. His kidneys were functioning at 22 percent capacity when he entered Adelanto and was set to start dialysis, but in a matter of weeks his kidney function dropped to 18 percent. His latest hospitalization that day in November revealed they were operating at 16 percent now, according to Aranda-Holguín’s attorney.


This latest hospital visit was the fourth time he was hospitalized since entering the Adelanto Detention Center in August, according to Aranda.

The Adelanto Detention Center in the Southern California high desert has been dubbed “the deadliest detention center of 2017” by immigrant rights activists. This year three detainees died while they were in Adelanto custody—more than any other detention center this year.

Aranda is worried her husband will be next.

“Alfredo’s kidneys aren’t working, he’s not getting dialysis he’s been prescribed, and he’s still getting the same food everyone else is getting,” Aranda said. “I know if he doesn’t receive the adequate treatment, he’s going to die.”


When he arrived this summer, Aranda-Holguín quickly built close relationships with other inmates at the detention center. His cellmates saw his health deteriorating and started taking shifts looking after him. Aranda-Holguín also has a heart condition and when he was in bed sick, it was his cellmates who made sure he was still breathing. When he passed out, it was also the cellmates who alerted guards to call medical personnel.

When ICE took Aranda-Holguín to Adelanto in early August, Aranda faxed the detention center his medical records that same day. She has receipts showing she paid $28 to fax medical documents detailing that her husband was treated for chronic kidney disease, hypertension, and diabetes. Aranda said she called the detention center immediately after faxing the documents to confirm they received the medical records, but was told they destroyed them because they were not faxed directly from a doctor’s office.


ICE did not confirm or deny they destroyed these records, but in an email ICE spokesperson Lori K. Haley wrote that “it would be standard procedure for medical staff to not provide medication to a detainee based on prescriptions that cannot be properly verified.” Haley said Aranda-Holguín’s medical intake evaluation conducted when he was taken to Adelanto discovered “several serious pre-existing medical conditions,” including Type 2 diabetes, hypertension, and depression. “The facility’s medical personnel have provided a thorough and ongoing course of treatment,” the ICE spokesperson told Splinter.

But 10 days after Aranda-Holguín arrived at Adelanto, he ended up in the intensive care unit at a nearby hospital because he had trouble breathing. He was released a few days later and sent back to the detention center. Weeks later, on November 6, his cellmates found him passed out and not responding. They alerted guards and Aranda-Holguín was taken back to the hospital.

He “was transported by paramedics to a local hospital after being found nonresponsive in his dorm,” ICE told Splinter—essentially repeating what the detainees told Aranda.


Aranda-Holguín was discharged from his most recent stay at the hospital on November 17. He was given heart medication but, according to his lawyer, those pills have made his kidney condition worse. ICE did not provide details about any diagnosis during the hospital, visit but Aranda is convinced her husband’s kidneys are the source of his problems. She said her husband desperately needs dialysis.

During Aranda-Holguín’s most recent 11-day hospitalization, Aranda said ICE never once initiated a call with her to provide an update on her husband’s condition.

“The detention center doesn’t call me, no emails, no letter. Nothing,” Aranda said.


Karla Aranda had to call the Adelanto Detention Center 23 times in one day to finally get someone to return her call and tell her that her husband was still alive. Credit: Jorge Rivas/Splinter

After not hearing about her husband for a week, she was exasperated. A conversation with a detainee call didn’t help her anxiety, either. That detainee had called to ask how Aranda-Holguín was doing, since detention center staff had taken his belongings away and a new inmate was in his bed. This time, Aranda was afraid her husband had died.

Phone records show she made 23 calls in one day, starting at 8am, before the Adelanto Detention Center called her back around 4pm. It was the Monday after Veteran’s Day and the ICE official who called said the officer in charge of her husband’s case wasn’t in the office, so he couldn’t provide details beyond saying Aranda-Holguín was “fine.”


ICE did not comment when Splinter asked if the agency had ever initiated a call to inform Aranda about her husband’s wellbeing, but said agency policy does not require loved ones be informed when a detainee is hospitalized.

“The decision to notify, and when to notify, is made on a case-by-case basis depending on the details of the individual case,” said the ICE spokesperson. “The disclosure of medical information is often extremely limited due to HIPAA rules and [Department of Homeland Security] privacy guidelines.” But Aranda said she sent ICE medical power of attorney documents that would allow her to access her husband’s medical information.

Before getting locked up, Alfredo Aranda-Holguín worked as a forklift operator at a local storage warehouse. He was born in Mexico and legally entered the U.S. when he was three years old. He’s had permanent resident status since then.


Aranda provided Splinter a handwritten letter signed with Aranda-Holguin’s name. The letter claims he wasn’t getting all the drugs he took before entering Adelanto—and the medicine he did get was different than what he took when he was a free man. “All have been giving negative reaction,” the letter reads.

Aranda-Holguin’s attorney told Splinter the new insulin provided at the detention center gave his client balance issues and made him feel like his heart was going to pop out of his chest.

Alfredo Aranda Holguin has been detained at the Adelanto Detention Center since August 8. (Photo provided by the Aranda family)


Medical records reviewed by Splinter show that last June he was prescribed six different drugs, including a daily shot of insulin to treat his diabetes. He was also taking a drug to reduce the amount of water his body stores and another pill that acted as a blood thinner. Aranda said the last time she spoke to her husband, he told her he wasn’t getting all the drugs.

During his most recent hospitalization, ICE approved a 15-to-30 minute visit that would allow Aranda to visit her husband in the hospital. Aranda doesn’t have a car but she found an advocate on Facebook who agreed to drive her 90 minutes from Maywood to Adelanto. But Aranda said officials at the St. Mary Medical Center told her there was no patient with her husband’s name.

Aranda waited hours before she and the advocate left the hospital. As they were driving away, an ICE official called to say Aranda-Holguín was indeed a patient at St. Mary. But hospital officials still insisted there was no one there by that name.


“It’s a terrible feeling to be in this situation to have the hospital tell you your husband isn’t there when you know he’s in the building,” Aranda said.

Ultimately Aranda called the ICE officer on her cell phone with the advocate and placed the call on speaker while hospital security officials listened. That’s when Aranda and the advocate heard the hospital representative tell the ICE officer hospital policy is to deny that any patient who’s been transferred from a prison has been admitted to the facility, because visitors can introduce “contraband.”

After arguing with St. Mary Medical Center officials, Aranda was finally allowed to visit her husband as long as she kept her hands raised above her shoulders. She entered the room with her hands up and was not allowed to touch her husband. She said the visit lasted about two to three minutes.


“I entered and walked out. Hands in the air,” Aranda said. She told herself she wouldn’t cry, but when she saw her husband, she broke down in tears.

St. Mary Medical Center did not respond to Splinter’s multiple calls and emails. St. Joseph Health, which operates the St. Mary Medical Center, also did not respond to requests for comment. ICE does not require visitors to keep their hands above their heads, according to the spokesperson.

Aranda-Holguín’s attorney also said it took ICE officials from November 6 to November 15 to clear his visit to the hospital. Once the attorney was able to get inside the hospital, there were three officers surrounding them. The couple was never left alone to privately discuss his case and medical needs.


Aranda said her husband looked “puffy,” and his skin color wasn’t the same. “It was like he wasn’t there,” she said. Aranda-Holguín told Aranda his blood pressure was at dangerously high level, considered to be “hypertensive crisis” according to the American Heart Association.

Aranda said her husband’s ankles were handcuffed to the bed.

During her short hospital visit, Aranda-Holguín asked about their 14-year-old son. Their son was downstairs waiting in the hospital lobby because ICE didn’t approve his visit.


Karla Aranda hugs her 14-year-old son.

Aranda said she walked away in tears asking herself, If he’s so sick, why do they have to have him tied to the bed? He didn’t have access to a phone, either. “It’s like they kidnapped him,” she said. “I don’t even think they treat El Chapo Guzman like they have my husband.”

Aranda is not the only family member who’s gotten stuck in the crosshairs between ICE, private prisons, and hospitals. The confusion has led to ICE detainees dying in hospital rooms while family members wait in hallways.


But local immigrant rights advocates and attorneys say the couple’s experience also points a finger at the care provided at the Adelanto Detention Center.

“We’ve had longstanding concerns,” said Michael Kaufman, an attorney at the ACLU of Southern California who’s been tracking medical complaints at the Adelanto Detention Center since it opened in August 2011. The facility is owned and operated by The GEO Group, Inc., the nation’s largest for-profit private prison company. Less than a year after it opened, in March 2012, the first detainee was pronounced dead. A detainee died of alcoholic liver disease, sepsis, multi-organ failure, and bronchopneumonia after being transported to a nearby hospital, according to ICE records.

ICE’s own Office of Professional Responsibility conducted a compliance inspection in 2012 and found the Adelanto facility “medical staff failed to provide adequate health care to the detainee, and failed to comply with the requirements of the ICE Performance Based National Detention Standards.”


The investigation revealed “several egregious errors,” the most damning of which was in ICE’s conclusion: “The detainee’s death could have been prevented” and he “received an unacceptable level of medical care while detained at Adelanto Correctional Facility.”

GEO Group claims conditions have improved since 2012.

“We take all reviews and audits with the utmost seriousness and when necessary implement prompt corrective actions. During its most recent annual audit, the Adelanto Center was found to be in compliance with 100% of the mandated ICE standards,” Pablo E. Paez, GEO Group’s vice president of corporate relations, told Splinter. Paez provided the report he references.


“The safety and wellbeing of those entrusted to our care have always been and remain our paramount priority,” Paez said.

ICE notes that no in-custody deaths occurred in Adelanto in fiscal years 2011, 2013, 2014, or 2016. But there were deaths in 2012 and 2015, including one that a subsequent investigation found “could have been prevented.”

There have been three deaths so far this year.

And the issues identified in 2012 report sound eerily familiar to Aranda’s. She said she knows something’s not right and fears her husband will die in detention.


“We’ve seen little improvement there and that’s been most manifested in the tragic series of deaths at Adelanto,” said Kaufman, the ACLU attorney. He said the way Aranda has “been treated is unconscionable.”

Christina Fialho, co-executive director of CIVIC, an immigrant rights group that tracks medical complaints in detention centers said, “the medical abuse Alfredo Aranda [Holguin] has experienced in Adelanto is indicative of a systemic problem.”

Aranda said she started recording every detail because some of the things she’s experienced no one would believe. Getting help for her husband has become her full-time job. She’s unemployed and is behind on rent for three months.


Aranda-Holguín was released from his last hospitalization on November 17. On Sunday evening, November 26, Aranda got yet another call from a detainee who said her husband had passed out was taken to the hospital.

The last time Splinter spoke with Aranda, she said she would call Adelanto in the morning in hopes of getting an update on her husband’s condition.

“I’m doing what I wish my husband would do for me,” Aranda said. “I just don’t want my husband to die waiting for the right medical attention.”


Due to an editing error, a previous version of this piece stated Aranda-Holguín had been charged with possession of a controlled substance and possession of a controlled substance for sale. In fact, he was convicted, and the piece has been updated to reflect this.