Physician Who Cares for Torture Survivors: How U.S. Detains Refugee Women and Children is a Disgrace

September 07, 2016
Web Exclusive


Allen Keller

director and a co-founder of the Bellevue/NYU Program for Survivors of Torture and serves as a primary care physician for many patients in the program. He is also member of the international advisory board of Physicians for Human Rights and an assistant professor at New York University’s School of Medicine.

Bridget Cambria

immigration lawyer who represents many of the families detained at the Berks County Residential Center in Pennsylvania.

We continue our conversation with Dr. Allen Keller, an expert in the evaluation and treatment of detained immigrants and asylum seekers, who was disturbed by what he saw when he visited the Berks County Residential Center in August where women and children are on hunger strike to protest their prolonged detention. We are also joined by Bridget Cambria, who represents many of the women held at Berks.

Watch Part 1: Exclusive: Migrant Mother Says She Was Pushed to End Hunger Strike to Win Release from Detention

Watch Part 2: Trauma, Then More Trauma: How Long is Too Long for Immigrant Children to Be Detained?

Watch Part 3: Activists Sit In at Sen. Kaine’s Office to Demand Release of Families Detained at Berks for 1+ Year


This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!,, The War and Peace Report. I’m Amy Goodman, with Juan González.

JUAN GONZÁLEZ: Well, how long is too long for a child to be held in detention? We turn now to look at an ongoing protest by mothers and their children who have been held indefinitely in a family detention center—in some cases for more than a year. Last week, more than 20 immigrant women at the Berks County Residential Center in Pennsylvania resumed their hunger strike to call for their release. This followed a suspension of their protest when officials said they would take away their children if they grew weak.

Immigration and Customs Enforcement has detained the families at Berks since they arrived in the United States seeking asylum from violence in El Salvador, Honduras and Guatemala. Most have been denied asylum and are being held while they appeal their cases. Their protest has raised questions about whether ICE is flouting a federal judge’s mandate that puts a 20-day limit on the time that children can be detained.

AMY GOODMAN: In a moment, we’ll be joined by a physician who just spent a week at Berks observing the families who have been held there indefinitely. But first let’s turn to an excerpt of this exclusive interview taped on Tuesday—that was yesterday—with a woman who was participating in a hunger strike until she was released from Berks after nine months in detention with her four-year-old daughter. They’re in a similar legal position as the other families at Berks. But as it turns out, all she had to do to win her freedom was eat an apple, end her hunger strike.

MARIA: [translated] Look, they would put big servings of fruit—of watermelon, of grapes, of all different types of fruit—around where we were to entice us to eat. I met with Mr. Thomas, and I sat there with him, and he said, "I don’t want to see anyone who is not eating. I want you to eat something. If I bring an apple, will you eat it? I’m going to bring an apple, so I want you to eat it." And so he sent out for an apple. So, then, they brought the apple in, and he saw that I was eating it. I ate the apple in front of him. He looked at me. And he only made two questions for me. I told him that I couldn’t stand the food, that if I ate that food, the only thing that would happen, I would go straight to the bathroom. And I couldn’t take it anymore, so I could not eat any of that food. And then I told him also that I wanted my freedom and that that’s the other reason I was doing this, because I wanted my freedom, and so I would stop—I stopped eating because of that. And so, he told me that this was not going to do any good if I stopped eating, that I was not going to get freedom that way. So then I kept eating. I kept eating, just as he asked.

But that following week, I did not get any result. I did not get any answer from him. So then I went, and I decided to write some things to Mr. Thomas. And so I wrote some things. Immigration picked it up. They sent it to him. And then, that’s when he followed through. He said he looked at what I wrote to him then, and he said—he replied to me that in one or two days he would send me back a reply. A Wednesday arrived, and my immigration official called me in, and he asked me if I was still on a hunger strike. And then he asked me if I had the address for here, and I told him that I did. And he said, was I going to come here? And I said I would. And he asked me, did I have people here? And I said, yes, I did. And then he told me that he would take that to his boss. And so, then, the following day, they called me, and that day they gave me my freedom. But he said that I still would go out—even though I had my freedom, I would still go out with deportation orders.

JUAN GONZÁLEZ: That was Maria, just released from Berks with her four-year-old daughter. Well, for more, we’re joined by Bridget Cambria, an immigration lawyer who represents Maria and many other families detained at the Berks County Residential Center in Pennsylvania, and Dr. Allen Keller, an expert in the evaluation and treatment of detained immigrants and asylum seekers, who visited Berks in August to observe the families there. He’s the director and co-founder of the Bellevue/NYU Program for Survivors of Torture and serves as a primary care physician for many patients in the program. He’s also a member of the international advisory board of Physicians for Human Rights.

Bridget, I wanted to start with you. The interview with Maria, who is now in Texas, where her family—where some of her family members who reside in the United States live—this whole issue of someone who is being detained in Pennsylvania, and their family lives in Texas, that’s basically—how frequent is this that immigrant detainees are housed thousands of miles away from their family members, and the impact that that must have on them in addition to them being, in effect, incarcerated?

BRIDGET CAMBRIA: The effect of detention on the mothers and children for such a prolonged period of time is so extreme that it’s even hard to explain sort of what’s going on with especially the children that are there. In the case of Maria and everyone at Berks, they all were detained initially in Texas, where they were detained for a period of about 20 days, which is the requirement under the Flores settlement. Then, instead of releasing them to family, who, by the way, is in Texas, where they are, they flew them to Pennsylvania to this detention center to keep them indefinitely in detention, rather than abide by what the judge in the Flores settlement said.

AMY GOODMAN: How are they allowed to do that?

BRIDGET CAMBRIA: That’s a good question. It’s not a question for me, because I don’t understand it, but immigration should certainly be answering that question, why they’re in detention for such a prolonged period of time. In the instances of the women at Berks, they’re all contesting their removal, because they want to seek asylum. They’ve never been denied asylum on the merits of their cases. They’ve been denied procedurally from even being able to apply for asylum. And that’s the right that everyone in Berks is contesting, the ability to apply for asylum and seek protection for their children.

AMY GOODMAN: Bridget Cambria, you represented an infant in Berks?

BRIDGET CAMBRIA: I did. The youngest child I’ve ever seen in immigrant detention, she was 11 days old when she arrived in Berks. And it was—it was something to see, because she was beet red—and that’s a picture of her. She’s now a year and a half old. She is no longer in detention. It was—but it was something so extreme that when I initially saw it, I couldn’t even believe that she was there. I saw her on a weekend. And I immediately started to make calls to try to get her out of detention. She was released at 3:00 in the morning on a Sunday, because of just outrage that a child so young was in detention. But she’s still fighting her case in Kansas.

AMY GOODMAN: Now, Dr. Allen Keller, you went and you monitored at Berks. Tell us how the families get there. What about the journey?

DR. ALLEN KELLER: Right. Well, as a health professional who’s cared for survivors of torture and trauma for over 20 years, I must say this whole chapter in our nation’s history of how we are treating this group of women and children is one of the greatest disgraces I’ve seen. This is the refugee crisis of our time on our borders. And I ask a fundamental question to President Obama and Secretary Johnson, both of whom I think are decent men, but how can one expect the world to treat the Syrian refugees with decency when we are treating these women and children, who come here not because they want to, but because they are fleeing violence, for their lives and those of their children?

So, the children cross into our country after having fled horrific things. The way they’re first greeted is by agents from the Border Patrol. And for many woman I’ve interviewed, they are constantly accused of having lied and made up stories. They’re then held in these facilities, which have been nicknamed by the women hieleras, iceboxes, where they literally sleep on cold floors for days. Some are paroled, many more in the past, but the way we’ve chosen to address it, rather than a humanitarian crisis, is by building thousands and thousands of beds to detain these women. So then they’re transferred to facilities, many in Texas, and then some are transferred here to Berks.

And the impact of this detention, this indefinite detention, on the health and well-being of the women and the children is profound. One, they—the incidence of profound, severe depression, hopelessness and post-traumatic stress is off the charts. You’re taking women and children who have been traumatized to begin with, and then you’re putting them in indefinite detention, where they don’t know whether or if they’ll be released. And then, while in detention, they’re basically treated like criminals. At the Berks facility, which the staff that I interacted with were pleasant to me and professional, but I hear over and over from the women that every 15 minutes a light is shined in their room to make sure that everybody is there. There’s a term for that.

JUAN GONZÁLEZ: Even in the middle—in the middle of the night.

DR. ALLEN KELLER: It’s called sleep deprivation. Yes. So, there are women who I’ve spoken—who I spoke to—and I went at the request of the attorneys to prepare affidavits and conduct objective evaluations. And my findings are really awful, that the women, one, are suffering from sleep deprivation, one, because lights are shined in their room as part of a prison-like, you know, routine, and then also because they have suffered horrific things, and their prolonged imprisonment is exacerbating that. And as you mentioned, it’s so ironic because all of these women and children have family that they could and should be staying with.

And the impact on the children, I’ve heard from many of the mothers that the children are regressing. Children who had been normal and happy are now bed-wetting, are clinging to their moms. And it’s not surprising, because, as was mentioned, many of the women told me, who are on the hunger strike—and they’re doing this for their kids—to the women, they told me, that they are informed that if they become weak, their children can be taken away from them.

JUAN GONZÁLEZ: And, Bridget, I wanted to ask you about the needs of the children—the health needs, the educational needs. What happens while they’re in detention? Are these being met by the—by the jail authorities?

BRIDGET CAMBRIA: The facility itself is doing what the regulations provide. There is a sort of a one-room schoolhouse for two different age groups. They do get education. There is medical providers on site. The question is the sufficiency of that. So, the prolonged detention that Dr. Keller talks about comes with a lot of consequences. The children—he described what happens to the mothers. It similarly happens to their children. There’s suicidal ideations. There’s complete hopelessness in a lot of the children. They’re not meeting milestones or goals. They’re not gaining weight. Because it’s not meant to be somewhere where children are for more than a year. So, are they being—

AMY GOODMAN: And how long are they there for?

BRIDGET CAMBRIA: Right now, the longest family was detained a year as of August 23rd. And these are two teenage girls, a 14- and a 16-year-old, who are fleeing severe sexual violence in El Salvador, the most dangerous country in the world. And their father is here. So, it makes the—

AMY GOODMAN: Father is here living—


AMY GOODMAN: —outside of Berks.

BRIDGET CAMBRIA: Outside of Berks. And so, the detention is completely inappropriate and unnecessary.

AMY GOODMAN: I want to ask Dr. Allen Keller, in addition to doing evaluations at Berks, you are the co-founder and director of the Bellevue/NYU Program for Survivors of Torture. How do the survivors of torture you treat at Bellevue compare to the women and children at Berks?

DR. ALLEN KELLER: Well, sadly, many of the symptoms I’ve seen among the thousands of individuals we’ve cared for at Bellevue and NYU mimic what these women and children are going through. And they’re going through it not only because of what they endured in their country, but because of what they’re enduring here in the greatest democracy in the world. And over and over again, I heard from the women saying, you know, "I came here seeking safety. I never thought I’d be treated like a criminal."

And so, yes, there are concerns about the conditions. But the real concern is the construct itself. We need to end family detention. Family detention—make no mistake about it—is harmful, dangerous to the health and well-being of these women and children. And we need to stop this. This is no way for us to treat women and children fleeing persecution, because if there’s one thing I’ve learned in my over 20 years of caring for torture survivors, it’s that we need to provide a safe environment, a humane environment, and help individuals rebuild community. And—

AMY GOODMAN: You spoke to Secretary Jeh Johnson, the head of the Department of Homeland Security, under which Berks is—falls?

DR. ALLEN KELLER: I have had the opportunity, on several occasions, to speak with the secretary. And I will say, to the administration’s credit, there’s ongoing meetings that happen between the NGOs and the leaders of the Department of Homeland Security. And I really give them credit for that dialogue. And those meetings are off the record, and so I’m not going to get into the specifics of that, but my opinions are well known—namely, I believe both the secretary and the president are decent men, and I believe they need to look themselves in the mirror and say, "Why in God’s name are we detaining these women and children?" It is inhumane. It is cruel. It—I wouldn’t call it "torture," but it certainly almost rises to the level of cruel and inhuman punishment. And the health consequences, both while they’re in detention and potentially even after they’re released, are really quite alarming.

JUAN GONZÁLEZ: Well, Bridget, I wanted to ask you—there is a habeas lawsuit, I guess, winding its way through the courts, that some of your clients here at Berks are involved in. What’s the status of that lawsuit? Can we expect any kind of decision in the near future?

BRIDGET CAMBRIA: There was a decision on the habeas from the Third Circuit Court of Appeals this past week. It was negative for the mothers. But it is a very extreme decision. It’s something that departs from over 200 years of constitutional law. It’s something that absolutely must be appealed, because it affects everyone in immigration detention and every aspect of habeas corpus. So, it is—it is being filed by the ACLU. That’s—they’re running with it. It will be appealed.

AMY GOODMAN: What is the case?

BRIDGET CAMBRIA: The case is—it’s called Castro v. The Attorney General. And the case is basically arguing, in the instance of these 21 individuals that are now at Berks—there’s 28 total petitioners, but there’s 21 that are at Berks right now, families—that when they had their initial screening for asylum when they approached the border, there were legal deficiencies or procedural deficiencies. These are things that prevented them from being able to ask for asylum in the United States. So, in the cases of the women at Berks, they have never had the opportunity to see a judge and explain the merits of their case or have an attorney present. And these are the things that the ACLU is seeking federal court review for, and our government is saying, "We’re not going to allow any federal court review for any women in expedited removal and immigrant detention."

JUAN GONZÁLEZ: So, since the circuit court has already ruled, this would now have to be appealed to the Supreme Court, right?

BRIDGET CAMBRIA: There is a step in between that. You can request an en banc, which means a full panel petition before the Third Circuit. That’s what the ACLU intends to do. In the event that that is not effective, they intend to take it to the Supreme Court.

AMY GOODMAN: Bridget Cambria, this prison, this detention facility at Berks, which is not for—not a for-profit private prison, but it’s run by the county, is that right?

BRIDGET CAMBRIA: The county still does make money off of the facility, not the detention of the immigrant families themselves, but immigration is housed within the same building, and they do make a substantial profit.

AMY GOODMAN: It’s unlicensed?

BRIDGET CAMBRIA: The license was revoked and not renewed by the state of Pennsylvania, because the license is solely for a child residential facility, not for a facility where parents and children are housed together. The county themselves have appealed that decision and are operating the facility despite having the license revoked during the appeal period.

AMY GOODMAN: Let me just ask you, as we wrap up, a question about this presidential election year. You know, immigration, everyone would say, is a key topic. And many people are revolted by the way Donald Trump talks about immigrants and banning immigrants and who immigrants are—rapists and criminals—which makes it look like Hillary Clinton, the Obama administration is very different from all of that. So, Dr. Keller, can you talk about this? You’re describing a situation, both of you, that is occurring under the Obama administration. Is the actual practice under the Obama administration actually—is it that different from what Donald Trump would like to see?

DR. ALLEN KELLER: Well, sadly, it goes back further. It goes back to the first Clinton administration. Immigration detention was a product of the 1996 immigration reform, which happened under President Clinton. So, if there is a second President Clinton, my hope is that they will correct this. But we went from, you know, a couple of thousand individuals in detention to what’s been considered a mandate of, on any given day, I believe, of 30,000 or more individuals detained. And as Bridget pointed out, I think the only people that are benefiting from this are the for-profit organizations, whether they’re county jails or private companies, who are detaining these individuals.

And for the women and children and men who are detained, it is nothing but suffering. And while being released with what’s called euphemistically an ankle bracelet is far better than being held in one of these warehouses, I mean, that—we should use terminology correctly. Those are ankle shackles. And I’ve evaluated a number of individuals who have worsening of their nightmares, who have severe leg pain, because of these. So, I think, as we look at immigration reform, we need to say, "Why? Why in God’s name are we treating these noncriminals as criminals?"

And, you know, one of the—one of the women at Berks—and, you know, they do keep their sense of humor—you know, she pointed at her child and said to me, "You know, we’re—we came here seeking safety. We’re not dangerous." And then she said, with a twinkle in her eye—I guess she’s watched the news—"Now, Donald Trump, he’s dangerous."

So, I hope President Obama can find common ground with that and release these women, and that I really do encourage whoever is the next president will make fair and appropriate reforms, including an end to this disgrace that we know as family detention.

AMY GOODMAN: And, Bridget Cambria, if a person is coming over the border—a mother, let’s say, with her daughter—and one of them has just been sexually abused, talk about the interview at the border and what a mother or child is willing to say, or even can say, after such an experience.

BRIDGET CAMBRIA: Well, that’s actually the experience of several of the women at the Berks County Residential Center. They approach the border. They’re detained in these hieleras, as the doctor had described before.


BRIDGET CAMBRIA: An icebox, where they’re kept for days. Then they’re sent to a detention center, where they’re placed in front of an asylum officer for about an hour interview, maybe. And at that time, a lot of them have their children with them. So, in one of the cases at Berks, it was a mother who was interviewed with her 12-year-old son. And she was not comfortable, because, one, it was a male officer, and, two, her son was with her, and she did not want her son to know that she had been raped repeatedly. So she did not disclose that. She talked more generally, the way women do; they expect that the person that they’re talking to is helping them. And because she was not specific enough, she did not pass that initial threshold. And despite getting evaluations talking about how sexual trauma is difficult to talk about with somebody that you just meet, despite all of that, she is not given an opportunity to actually explain her full case with an attorney and to be able to disclose that outside of the presence of her son. So, for me, the initial screenings are failing these women and failed the 21 women at Berks.

And I think, just to talk a little bit about what Dr. Keller had just said, Trump would be a very different president. We have to support getting rid of family detention, which is really the stain on the administration. The mass deportation policies of the Obama administration and this family detention has to end, because, in the reality, what we have to understand, and what I see every day, is that what we’re dealing with are human beings. And if we humanize them, which is what the women have done by hunger striking, we start to care about them. We realize they’re children. They just need an opportunity to be heard. And the mothers did it themselves, which was so powerful. We’ve spent a year, a year fighting their legal cases, trying to get their voices heard. And they did it all themselves by deciding "We’re not going to eat until you take care of our kids." And they’re my heroes, and I love them.

AMY GOODMAN: And this hunger strike has gone on for?

BRIDGET CAMBRIA: It’s since August 8th. There was a week where they did fast, where they ate one meal a day, because they wanted some kind of result, some kind of answer as to "Why are you continuing to detain us, when you say you can only keep us for 20 days?" And they got no answer. So they did return on the strike.

AMY GOODMAN: Well, we want to thank you both for being with us. This is a story that must be told through the lives of these women and children. Bridget Cambria is an immigration lawyer who represents many of the families detained at the Berks County Residential Center in Pennsylvania. And Dr. Allen Keller is an expert on these issues. He visited Berks in August, expert in evaluation and treatment of detained immigrants and asylum seekers, director and co-founder of the Bellevue/NYU Program for Survivors of Torture, serves as primary care physician for many patients in the program. He’s also a member of the international advisory board of Physicians for Human Rights and an assistant professor at New York University’s School of Medicine. I’m Amy Goodman, with Juan González. To see Part 1 or our interview, as well as the extended interview with, well, the woman who goes by the name Maria, done by Democracy Now!’s Renée Feltz, go to Thanks for joining us.

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