Do No Harm: Why Health Care Needs to Divest from ICE
By Nathan Kim, Juliana E. Morris, MD, EdM, and Rupa Marya, MD
This month, medical students will don fresh white coats and take an oath to do no harm. At the same time, many of the academic institutions and hospitals where these students train are contributing to the public health crisis at the border. Healthcare institutions hold multi-million dollar contracts with corporations that are integral to the operations of U.S. Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE), including warehousing asylum seekers, supporting family separations, and expediting deportations. The healthcare industry has a duty to divest from companies such as Amazon, Microsoft, Palantir, Salesforce, and Aramark that are profiting from the criminalization of immigration and exacerbating the public health crisis in detention facilities. We cannot continue to work for the health of our patients while our institutions are supporting structures that create poor health outcomes for vulnerable people. Because of this, we are a part of a large coalition of healthcare and public health workers calling for an end to these inhumane camps and for our institutions to divest from companies profiting from contracts with ICE and CBP.
Since its inception, ICE has wreaked havoc on public health. Now, Trump administration policies targeting immigrants are fueling an escalating public health emergency, felt acutely by more than 70,000 people in ICE or CBP detention. At least 33 people have died in custody since Trump took office, including 7 children this past year. Conditions are abysmal; people sleep on concrete floors, food is moldy, there is overcrowding and inadequate hygiene facilities. As one doctor visiting a children’s detention camp told CNN, there is “an overwhelming smell of sweat, urine, and feces.”
Family separations — which is a longstanding tactic by the U.S. to debilitate Black and Brown communities — are accelerating these harms. Children as young as 5 months old and their parents suffer the stress and trauma of being separated, leading to physical and mental health problems including depression, abnormal weight loss, insomnia, and PTSD. These harsh experiences have ripple effects far beyond detention; in addition to the potentially lifelong health effects for detainees, an awareness of these conditions stokes fear and anxiety in communities across the U.S., exacerbating mental health and chronic diseases such as hypertension and diabetes. For people ultimately deported, the result can be fatal. More than sixty murders of deportees have been confirmed by journalists. The actual rates are likely much higher. Those in detention have fled violence and sometimes certain death in their own countries, often the result of decades of U.S. foreign policy. They arrive seeking the same opportunities we all desire — to thrive, to build community, to support and love our families.
Corporations working with ICE make this dire public health crisis possible and profitable. According to a report from Mijente, the National Immigration Project, and the Immigration Defense Project, DHS’ information technology spending alone totaled $6.8 billion, enriching key collaborators like Palantir and Amazon Web Services (AWS). Palantir enables ICE to surveil and track migrants; AWS is ICE’s cloud database. Salesforce helps CBP recruit agents while ICE uses Microsoft’s data processing and AI software. Aramark, which delivers food to many hospitals and universities, handles ICE’s food logistics and deliveries. These companies also provide a range of services, including some listed above, in exchange for lucrative contracts from healthcare institutions. In doing so, hospitals and health systems feed into these companies’ overall operations, including work with ICE.
If our healthcare institutions divest, taking their million-dollar contracts out of these companies, their overall capacity to fuel the public health emergency at the border will be weakened. There are also viable and ethical alternatives, such as cloud storage companies like Kualo and Netcetera or the Ubuntu operating system. Similarly, a hospital or medical school who divests from Aramark can reinvest in more ethical and local food companies, bolstering their role as an economic anchor in a community, a visionary goal of many healthcare institutions.
While the data on divestment is conflicting on its effectiveness as a strategy of decreasing the profitability of corporations, what divestment offers us is the chance to train and work at healthcare institutions that do not hypocritically create poor health outcomes by reinforcing structural violence through their economic partnerships. There is a growing divestment movement and lessons learned from prior healthcare efforts to divest from fossil fuels and tobacco can advance current strategy.
As people dedicated to healing and caring for others, we must do everything possible to abolish ICE and ensure the health, safety, and human rights of all people seeking refuge in the U.S. To truly follow our oath to “do no harm,” we must look beyond the doctor’s office to our own institutions and use our privilege to ensure that we are all contributing to health and well-being, rather than feeding the root of the problem.
For more photos, visit Brooke Anderson Photography: Stills of Our Stories & Struggles
This page is organized by Public Health Justice Collective, Public Health Awakened, Do No Harm Coalition, Medicine for Migration at UCSF, and #WhiteCoats4BlackLives.
Stay connected at @healers4justice on Twitter.
ACTIONS YOU CAN TAKE NOW
- SUPPORT AB32 in California! End the use of all private prisons — including immigrant detention centers, such as Mesa Verde — in California! Follow California Immigrant Youth Justice Alliance for up-to-date information.
Tweet at @GavinNewsom @CAgovernor to remind him he made a commitment to end private prisons! It is urgent he pass and sign AB32! #CommunityNotCages
2. Urge the University of California to divest from corporations that support ICE & DHS
3. Urge your representative to support HR3222 No Federal Funds for Public Charge Act of 2019
