New allegations of mass hysterectomies inside US detention centres are the 'echoes of an awful past'

Historians and lawyers say recent allegations of mass hysterectomies at a US immigration detention centre are part of a long and troubling history of forced sterilisation in the US.

Dawn Wooten, left, a nurse at Irwin County Detention Center in Ocilla, Georgia, speaks at a Tuesday, 15 September, 2020 news conference in Atlanta

Dawn Wooten, left, a nurse at Irwin County Detention Center in Ocilla, Georgia, speaks at a Tuesday, 15 September, 2020 news conference in Atlanta Source: AAP

When US lawyer Regina Jeffries heard recent allegations of immigrants in US detention centre being subject to "jarring medical neglect", she wished she could say she was surprised. 

On 14 September, several legal advocacy groups filed a whistleblower complaint on behalf of a nurse who worked at the privately-run Irwin Country Detention Centre in Georgia.

The nurse, Dawn Wooten, alleged a variety of health and safety violations at the facility during the COVID-19 pandemic, including refusing to test detainees with symptoms of the virus, fabricating medical records and performing hysterectomies on immigrant women without informed consent. 

Politicians are calling for an investigation, while a US immigration spokesperson has stressed the need for "appropriate scepticism" of "anonymous, unproven" allegations. 

Ms Jeffries spent 10 years working in asylum and immigration law in the US before moving to Australia to undertake a PhD three years ago. She says she has had clients who have been "caught up in that system". 

"Unfortunately, these allegations were not surprising. I think it's a continuation of a system in the US that was already broken," Ms Jeffries told SBS News. 

"There is a long history of poor medical services and a lack of appropriate medical care in detention facilities, along with a lack of transparency and accountability for those failures." 

Dr Prudence Flowers, an Australian historian and senior lecturer at Flinders University, agrees the recent allegations are part of a long history of forced sterilisation and reproductive injustice in the US. 

"This seems to be a horrible repetition of American behaviour," Dr Flowers told SBS News. 

"It calls to mind so many incidences, particularly in the 20th century, around the forced sterilisation of people who were seen as 'undesirable'."

In the complaint, Ms Wooten alleges a high rate of hysterectomies - a procedure which removes part or all of the uterus - were being performed on immigrant women under the custody of US authorities at the centre.

She said one doctor appeared to perform the surgeries on women who complained of heavy menstrual cycles, but many of them did not appear to understand why they had undergone the procedure.

According to the complaint, nurses obtained consent from the women "by simply Googling Spanish". 

"I've had several inmates tell me that they've been to see the doctor and they've had hysterectomies and they don't know why they went," Ms Wooten said.

“Everybody he sees has a hysterectomy – just about everybody. That’s his specialty, he’s the uterus collector. Everybody’s uterus cannot be that bad.”

Azadeh Shahshahani, director of Project South - one of the human rights groups that filed the complaint - said on 17 September the group had documented conditions at Irwin for many years. 

"The treatment of immigrants at this prison has always been horrid," Ms Shahshahani said.

"These new shocking revelations further highlight the extent of the egregious abuses at the facility."

Ms Jeffries said it wasn't "entirely surprising" to hear the allegations come out of the Irwin facility. 

She said they should be considered within the current lens of "a very clear move by the Trump administration to crack down on certain types of immigration". 

"It's really disturbing that women are potentially being subject to medical procedures they haven't properly consented to.

"You have to view it in that context, and I think that’s part of the reason why it’s so disturbing to hear these allegations, which have echoes of a really awful past in the US."

Donald Trump has a well-documented history of denying climate change and seeking to roll back environmental measures.
Source: AAP

A long and troubling history

It is estimated more than 60,000 people were sterilised in the US during the 20th century, after the country became the first to pass "eugenic laws".  

The term, coined by Sir Francis Galton in 1883, applied emerging theories of biology and genetics to human breeding.

"In the early 20th century, a lot of eugenics thinking was about encouraging reproduction among the 'fit', which was people who were seen as having 'desirable' qualities, and then often forcibly discouraging it among those seen as 'unfit' or had 'undesirable' characteristics," Dr Flowers explained. 

"You could be sterilised for reasons of mental attributes, but of course in practice, a lot of the people who end up being targeted are minorities, either in terms of class and/or race."

In 1907, Indiana passed the first sterilisation law that was upheld by a Supreme Court decision, known as Buck v. Bell, in 1927. 

"After that decision, 32 states had passed eugenic laws allowing for the forcible sterilisation of people the state saw as not being appropriate to reproduce," Dr Flowers said. 

Women and people of colour became the targets

Experts say this practice went on as being part of US law for quite some time, with states approaching the practice in different ways.

At least 20,000 people were forcibly sterilised in California, many of who were described as "inmates" in prisons, mental hospitals or asylums. The Third Reich's 1933 Law for the Prevention of Offspring with Hereditary Diseases was later modelled on California's laws, and those out of Indiana.

"Certainly the fact the US was a model for Nazi Germany is one of those things that historians point out, and people are shocked by. It's not part of how the public wants to understand the States," Dr Flowers said. 

Over time, women and people of colour were disproportionately targeted. 

Dr Flowers said in the southern state of North Carolina, where African Americans made up 25 per cent of the population, they accounted for 65 per cent of the almost 8,000 people who were sterilised. Many of them were women or minors. 

"A lot of what was happening - particularly in the south - was young Black women were not told they were receiving a sterilisation. It was referred to after the fact as a 'Mississippi appendectomy' where you would go in for an appendectomy or some other kind of surgery and you would have your uterus removed," she said. 

"It's incredibly intrusive. People were often not told they had been sterilised."

Meanwhile, Dr Flowers said other 'layers' of forced sterilisation were taking place on US territory, such as in Puerto Rico, where up to one third of all women were sterilised in the 1960s. 

"Again, these women weren't told the procedure was irreversible," she said. 

"The issue of meaningful consent I think has real parallels with what is potentially happening in the US right now."  

Where are we now? 

The Supreme Court decision of 1927 has never been officially overturned. 

In 1978, however, a victim of forced sterilisation sued the state of Oklahoma and won, creating legal obstacles that essentially put a stop to mass forced sterilisation. 

Ms Jeffries says the practice has continued. 

"There is this issue of people continuing to undergo these types of sterilisation procedures outside of that formal ban who may have been coerced," she said. 

With much of the US immigration detention centre system being privatised, Ms Jeffries said poor oversight and transparency among facilities is part of the problem. 

"All facilities have differing standards in terms of what medical care is provided, so it's actually quite difficult to tell from one facility to another what practices actually happen - not to mention the failures of the complaint mechanism that detainees have to raise issues they're experiencing," she said. 

What now?

Over the last week, Democratic politicians have exposed the country's history of forced sterilisation as they called for an investigation into the whistleblower's allegations. 

"If true, the appalling conditions described in the whistleblower complaint - including allegations of mass hysterectomies being performed on vulnerable migrant women - are a staggering abuse of human rights," House Speaker Nancy Pelosi said in a statement on 15 September. 

"This profoundly disturbing situation recalls some of the darkest moments of our nation's history... The DHS Inspector General must immediately investigate the allegations detailed in this complaint."  

In a statement to the Associated Press on Friday, ICE Acting Director Tony Pham said, “If there is any truth to these allegations, it is my commitment to make the corrections necessary to ensure we continue to prioritise the health, welfare and safety of ICE detainees". 

ICE officials had earlier declined to comment in detail on the broader allegations in the complaint, but casted doubt on its use of anonymous testimony from detainees. 

“In general, anonymous, unproven allegations, made without any fact-checkable specifics, should be treated with the appropriate scepticism they deserve,” the agency said in a statement to The Washington Post

LaSalle Corrections, which operates the jail, said in a statement that it “strongly refutes these allegations and any implications of misconduct". 

Ms Jeffries agreed the recent allegations need to be investigated. 

"There is obviously a problem with the way medical care is - or is not - delivered in immigration detention," she said. 

"It is absolutely critical that people who are detained civilly are able to give informed consent in those circumstances - and for people not to have given informed consent should concern everyone."

Published 23 September 2020 at 11:21am, updated 23 September 2020 at 11:26am
By Emma Brancatisano