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Editor’s Note: Due to safety concerns for mixed-status families affected by ongoing ICE raids, we are not publishing the full names of sources for this piece.
Since September, federal immigration agents kept showing up to a Home Depot in Signal Hill. Still, Josué, a day laborer from El Salvador, kept showing up to look for work.
Then, just days before Christmas, a video captured by a Long Beach Rapid Response patroller and shared with LA Public Press shows masked federal agents violently pinning Josué to the ground, leaving him struggling to breathe.
“What made the situation worse was that I have a heart condition,” Josué said in Spanish on a call with LA Public Press from inside the Adelanto Detention Center in San Bernardino County.
In 2019, he had two heart attacks, leaving him with chronic health complications, including persistent difficulty breathing, according to his partner, Maria.
Immediately after his detention, Josué said his thoughts turned to his family and his dog, Queso, whom he used to cradle in bed each night. “He was like my child,” Josué said.
On the phone, Josué’s voice was weak, punctuated by coughing attacks if he spoke too forcefully.
After his arrest in Signal Hill, Josué was moved through several immigration processing centers, including facilities in San Pedro and Santa Ana, as well as the Metropolitan Detention Center in downtown LA, where he said he went at least six days without his prescribed heart medication.
He was ultimately transferred to Desert View Annex in Adelanto. He remains there today, seeking to retain an immigration lawyer to petition the judge for bond.
“I’ve been sick at least six times since I’ve been here,” he said, describing how frigid temperatures and constant night lighting have disrupted his health and sleep. About a week after the phone interview with LA Public Press, Josué said via a separate phone call that he experienced a medical emergency with severe chest pain and difficulty breathing.
The Department of Homeland Security said in a statement to LAPP that on Feb. 10, Josué reported chest pain and was evaluated by medical staff. “He reported improvement of symptoms and was cleared,” the statement said.
Josué described a more unsettled episode. In an interview with LAPP after he was released from medical care, he said the chest pain and shortness of breath lasted around four minutes. He was taken in a wheelchair to a clinic inside the facility immediately after fellow detainees alerted staff to his distress.
“I was never seen by a doctor. A nurse is the one who did what I think is a cardiogram,” said Josué.
When the pain subsided, Josué said he was sent back to his housing unit with Tylenol. “I was still worried about my heart,” he added. “I felt like I had experienced a heart attack.”
An EKG is usually among the first tests performed when a patient experiences the warning signs of a heart attack, but the test is not definitive, said Dr. Martha Gulati, a Houston-based cardiologist who helped write the nation’s first chest pain guidelines. Dr. Gulati did not directly review Josué’s medical condition or provide specific observations about his health.
“An EKG is not perfect,” she said. “Sometimes it can be normal even while somebody is having a heart attack.” A normal reading, she added, should never be the final word if symptoms persist. “If the patient is still symptomatic, our job isn’t done.”
LA Public Press reached out to over 10 medical institutions, including UCLA, USC, and Kaiser Permanente, for comment, but only the American College of Cardiology was able to provide a cardiologist expert in time of publication. Many declined to provide a cardiologist expert.
Josué’s ordeal, marked by worsening symptoms and repeated pleas for help, is a window into a broader pattern. At Desert View Annex, where a sprawling immigration detention facility sits on the high desert’s edge, access to medical care remains uncertain and, for many detainees, dangerously out of reach, according to several reports, including one from CalMatters. Advocates and former detainees describe a system in which urgent conditions can languish untreated for days.
The annex, which has a capacity of 750 people, is part of the Adelanto ICE Processing Center, a private detention complex operated for ICE by The GEO Group, Inc.
Adelanto held 1,802 people — 93 percent of its capacity — as of Feb. 5, 2025. It has the second-highest number of individuals placed in administrative or disciplinary segregation nationwide. A federal lawsuit filed in January alleged “inhumane” conditions at the facility, including inadequate access to medical care, unsanitary facilities, and insufficient food and water.
“I also experienced chest pain and difficulty breathing in Los Angeles,” Josué said, referring to the Los Angeles Metropolitan Detention Center. On those occasions, he said, he was also seen by a nurse and given Tylenol, without being examined by a doctor.
In response to hearing about Josué’s experience, Dr. Gulati said the United States possesses one of the most sophisticated medical systems in the world, but its capabilities are undermined when people are denied basic care.
“The American medical system is amazing — the things we can do, the diagnoses we can make, the treatments we have, and the access to so many medications,” she said. But it’s deeply troubling, Dr. Gulati said, when preventable suffering occurs despite those resources.
“I don’t think we should be depriving people of health care,” Dr. Gulati said, arguing that medical treatment should not hinge on political debates.
Medical neglect and systemic barriers for LA immigrants
The issues in Adelanto and MDC are not isolated. On Feb. 10, the U.S. District Court for the Northern District of California issued a preliminary injunction ordering improvements to conditions at California City Detention Facility, the state’s largest immigration detention center.
In a press release, Kyle Virgien, senior staff attorney at the ACLU, said the preliminary injunction, “affirms that ICE’s conduct at the California City Detention Facility is inhumane, dangerous, and a direct violation of the Constitution.”
The preliminary injunction directs ICE to overhaul medical care at the facility, including adequate staffing, timely medical screenings, and access to specialists and medications. The court also ordered independent oversight by a third-party monitor for at least 120 days, at ICE’s expense, and required additional non-medical improvements to detention conditions.
Improved medical care in immigration detention could have prevented one man from the Philippines from developing a serious disability while in custody. Earlier this month, a judge cited “unreasonable failures of care” at an ICE processing center in Tacoma, Wash., saying those lapses contributed to a medical emergency that ultimately led to the detainee’s amputation.
Physical and mental health often deteriorate rapidly in immigration detention, according to Richard Diaz, a senior attorney in the investigations unit at Disability Rights California.
Even after release, many former detainees continue enduring lasting health consequences, according to a cross-sectional study of 200 immigrants first published in January 2025 in the peer-reviewed journal JAMA Network Open, which the American Medical Association publishes.
The study used data on detainees released between 2020 and 2021 from U.S. immigration detention facilities. It found high rates of poor physical health, mental illness, and post-traumatic stress disorder after discharge. Researchers concluded that detention itself is associated with significant health harms, with longer periods of confinement linked to more severe outcomes.
According to the study, for those already medically vulnerable, prolonged detention can both worsen existing conditions and precipitate new health challenges.
Josué’s health has stabilized since his recent medical emergency, but he continues to face persistent physical and emotional challenges, according to Carlos Ovalle, a rapid responder from Long Beach Rapid Response who has been assisting Josué and his family with resources since Josué was detained. The rapid-response network has organized a GoFundMe fundraiser to help him obtain legal representation and navigate an immigration process that will shape his future.
While some detainees and their families have successfully sued private operators like GEO Group for medical neglect, many cases remain confidential or pending. For people who are still detained, the most immediate recourse is often the facility’s internal grievance system.
“We always recommend submitting grievances,” Diaz said. “It creates a paper trail and forces facilities to respond.” But detainees like Josué must weigh the risk of retaliation, and the ACLU has called such grievance processes an “illusion of justice.”
The ACLU tracked grievances from detention centers from 2023 through 2024, but stopped in 2025. Even then, the number of grievances was strikingly low, which is likely less an indication of conditions inside than of detainees’ reluctance to file complaints. Fear of retaliation has long shadowed the process, making it difficult to gauge how people in custody are treated.
Immigration detainees in federal detention centers face extra challenges
While California law provides a clear framework for holding private detention operators accountable for health and safety in all private detention facilities, federally run facilities operate under different rules. Oversight is often limited, access to legal counsel can be inconsistent, and the mechanisms that allow detainees to report neglect or abuse are less defined.
For people like Josué, this regulatory gap can mean the difference between receiving timely medical care and facing life-threatening delays. While both federally and privately run detention centers have procedures for administering medication, oversight gaps at federally operated facilities remain a concern, according to Diaz.
Josué experienced this reality firsthand. His partner told LA Public Press she made repeated attempts to deliver his medication to the Los Angeles Metropolitan Detention Center, which the Bureau of Prisons runs, but each time, the staff refused to accept it. In addition to not having access to medication during his time at MDC, he was also denied basic hygiene, unable even to shower, she said.
Since being transferred to Desert View Annex, Josué said he has been able to access his heart medication. In a statement to LA Public Press, the Department of Homeland Security confirmed that Josué has access to medication, but did not specify which type. Josué confirmed via a text message from inside Desert View Annex that he is taking Lipitor, Losartan, and aspirin to address some of his health issues. He also stated that he thought Losartan was an antidepressant, underscoring gaps in how medications are explained to detainees. According to the Mayo Clinic, Losartan is taken for high blood pressure.
“Access remains a gray area, particularly in federally run facilities,” Diaz said, referring to oversight in federally run detention centers. “Clarifying oversight may require court challenges.” He added that timing is critical since these cases could reach the Supreme Court and have far-reaching consequences.
While ICE detainee reporting shows two deaths so far for 2026, at least nine deaths have been reported in news accounts. In 2025, more than 30 people died in ICE custody, the highest number recorded in more than two decades.
Compounded mental trauma for immigrants in detention
Josué said he fled El Salvador to escape the civil war that raged from 1979 to 1992, a conflict that tore communities apart and claimed countless lives.
“He left the army because it was killing members of his own community,” said Maria. “He carries trauma from that experience, and it stays with him every day.”
The weight of detention has compounded that trauma, leaving a mark on Josué and his family. Maria’s 18-year-old daughter, Sara, described the emotional toll: “It’s hard to watch someone who has already endured so much now suffer the trauma of being locked in a detention center.”
She spoke of Josué as a father figure, a steady presence in her life whose absence has created a palpable void.
“The two of us would take Queso on walks every day,” Sara said, tears welling in her eyes. “Now I walk him alone. It breaks my heart to see him waiting by the window for Josué to return.”
