Amy Maxmen
Rebekah Stewart, a nurse on the U.S. Public Health Service, bought a name final April that introduced her to tears. She had been chosen for deployment to the Trump administration’s new immigration detention operation at Guantánamo Bay, Cuba.
This posting mixed Donald Trump’s longtime ardour to make use of the offshore base to maneuver “some bad dudes” out of the United States with a promise made shortly after his inauguration final yr to carry hundreds of noncitizens there. The naval base is thought for the torture and inhumane treatment of males suspected of terrorism within the wake of 9/11.
“Deployments are typically not something you can say no to,” Stewart stated. She pleaded with the coordinating workplace, which discovered one other nurse to go in her place.
Other public well being officers who labored at Guantánamo previously yr described situations there for the detainees, a few of whom realized they have been in Cuba from the nurses and docs despatched to take care of them. They handled immigrants detained in a darkish jail referred to as Camp 6, the place no daylight filters in, stated the officers, whom KFF Health News agreed to not identify as a result of they worry retaliation for talking publicly. It beforehand held folks with suspected ties to al-Qaida. The officers stated they weren’t briefed forward of time on the main points of their potential duties on the base.
Although the Public Health Service just isn’t a department of the U.S. armed forces, its uniformed officers — roughly 5,000 docs, nurses, and different well being employees — act like stethoscope-wearing troopers in emergencies. The authorities deploys them throughout hurricanes, wildfires, mass shootings, and measles outbreaks. In the interim, they fill gaps at an alphabet soup of presidency companies.
The Trump administration’s mass arrests to curb immigration have created a brand new sort of well being emergency because the variety of folks detained reaches record highs. About 71,000 immigrants are presently imprisoned, in response to Immigration and Customs Enforcement data, which exhibits that the majority haven’t any prison document.
Homeland Security Secretary Kristi Noem has stated: “President Donald Trump has been very clear: Guantanamo Bay will hold the worst of the worst.” However, several news organizations have reported that many of the men shipped to the base had no criminal convictions. As many as 90% of them were described as “low-risk” in a May progress report from ICE.
In matches and begins, the Trump administration has despatched about 780 noncitizens to Guantánamo Bay, according to The New York Times. Numbers fluctuate as new detainees arrive and others are returned to the U.S. or deported.
While some Public Health Service officers have supplied medical care to detained immigrants previously, that is the primary time in American historical past that Guantánamo has been used to deal with immigrants who had been dwelling within the U.S. Officers stated ICE postings are getting extra widespread. After dodging Guantánamo, Stewart was instructed to report back to an ICE detention middle in Texas.
“Public health officers are being asked to facilitate a man-made humanitarian crisis,” she stated.
Seeing no choice to refuse deployments that she discovered objectionable, Stewart resigned after a decade of service. She would hand over the prospect of a pension supplied after 20 years.
“It was one of the hardest decisions I ever had to make,” she stated. “It was my dream job.”
One of her PHS colleagues, nurse Dena Bushman, grappled with an analogous ethical dilemma when she bought a discover to report back to Guantánamo a couple of weeks after the capturing on the Centers for Disease Control and Prevention in August. Bushman, who was posted with the CDC, bought a medical waiver delaying her deployment on account of stress and grief. She thought of resigning, then did.
“This may sound extreme,” Bushman stated. “But when I was making this decision, I couldn’t help but think about how the people who fed those imprisoned in concentration camps were still part of the Nazi regime.”
Others have resigned, however many officers stay. While they’re alarmed by Trump’s ways, detained folks want care, a number of PHS officers instructed KFF Health News.
“We do the best we can to provide care to people in this shit show,” stated a PHS nurse who labored in detention services final yr.
“I respect people and treat them like humans,” she stated. “I try to be a light in the darkness, the one person that makes someone smile in this horrible mess.”
The PHS officers conceded that their energy to guard folks was restricted in a detention system fraught with overcrowding, disorganization, and the psychological trauma of uncertainty, household separations, and sleep deprivation.
“Ensuring the safety, security, and well-being of individuals in our custody is a top priority at ICE,” stated Tricia McLaughlin, chief spokesperson for the Department of Homeland Security, in an emailed assertion to KFF Health News.
Adm. Brian Christine, assistant secretary for well being on the Department of Health and Human Services, which oversees the Public Health Service, stated in an e mail: “Our duty is clear: say “Yes Sir!”, salute well, and execute the mission: present up, present humane care, and defend well being.” Christine is a recent appointee who, till just lately, was a urologist specializing in testosterone and male fertility points.
“In pursuit of subjective morality or public displays of virtue,” he added, “we risk abandoning the very individuals we pledged to serve.”
Into the Unknown
In the months earlier than Stewart resigned, she mirrored on her earlier deployments, throughout Trump’s first time period, to immigration processing facilities run by Customs and Border Protection. Fifty girls have been held in a single concrete cell in Texas, she recalled.
“The most impactful thing I could do was to convince the guards to allow the women, who had been in there for a week, to shower,” she stated. “I witnessed suffering without having much ability to address it.”
Stewart spoke with Bushman and different PHS officers who have been embedded on the CDC final yr. They assisted with the company’s response to ongoing measles outbreaks, with sexually transmitted an infection analysis, and extra. Their roles turned essential final yr because the Trump administration laid off droves of CDC staffers.
Stewart, Bushman, and some different PHS officers on the CDC stated they met with center managers to ask for particulars concerning the deployments: If they went to Guantánamo and ICE services, how a lot energy would they’ve to offer what they thought of medically vital care? If they noticed something unethical, how may they report it? Would or not it’s investigated? Would they be protected against reprisal?
Stewart and Bushman stated they got a PHS workplace cellphone quantity they may name if that they had a grievance whereas on task. Otherwise, they stated, their questions went unanswered. They resigned and so by no means went to Guantánamo.
PHS officers who have been deployed to the bottom instructed KFF Health News they weren’t given particulars about their potential duties — or the usual working process for medical care — earlier than they arrived.
Stephen Xenakis, a retired Army normal and a psychiatrist who has suggested on medical care at Guantánamo for twenty years, stated that was troubling. Before well being employees deploy, he stated, they need to perceive what they’ll be anticipated to do.
The penalties of inadequate preparation could be extreme. In 2014, the Navy threatened to court-martial one in all its nurses at Guantánamo who refused to force-feed prisoners on starvation strike, who have been protesting inhumane therapy and indefinite detention. The protocol was brutal: An individual was shackled to a five-point restraint chair as nurses shoved a tube for liquid meals into their abdomen by means of their nostrils.
“He wasn’t given clear guidance in advance on how these procedures would be conducted at Guantánamo,” Xenakis stated of the nurse. “Until he saw it, he didn’t understand how painful it was for detainees.”
The American Nurses Association and Physicians for Human Rights sided with the nurse, saying his objection was guided by professional ethics. After a year, the military dropped the charges.
A uniformed doctor or nurse’s power tends to depend on their rank, their supervisor, and chains of command, Xenakis said. He helped put an end to some inhumane practices at Guantánamo more than a decade ago, when he and other retired generals and admirals publicly objected to sure interrogation methods, such as one called “walling,” wherein interrogators slammed the heads of detainees suspected of terrorism in opposition to a wall, inflicting slight concussions. Xenakis argued that science didn’t help “walling” as an efficient technique of interrogation, and that it was unethical, amounting to torture.
Torture hasn’t been reported from Guantánamo’s immigration operation, however ICE shift reports obtained by means of a Freedom of Information Act request by the federal government watchdog group American Oversight observe considerations about detainees resorting to starvation strikes and self-harm.
“Welfare checks with potential hunger strike IA’s,” quick for unlawful aliens, says an April 30 observe from a contractor working with ICE. “In case of a hunger strike or other emergencies,” the report provides, the PHS and ICE are “coordinating policies and procedures.”
“De-escalation of potential pod wide hunger strike/potential riot,” says an entry from July 8. “Speak with alien on suicide watch regarding well being.”
Inmates and investigations have reported delayed medical care at immigration detention services and harmful situations, together with overcrowding and a scarcity of sanitation. Thirty-two folks died in ICE custody in 2025, making it the deadliest yr in twenty years.
“They are arresting and detaining more people than their facilities can support,” one PHS officer instructed KFF Health News. The most prevalent drawback the officer noticed amongst imprisoned immigrants was psychological. They apprehensive about by no means seeing their households once more or being despatched again to a rustic the place they feared they’d be killed. “People are scared out of their minds,” the officer stated.
No Sunlight
The PHS officers who have been at Guantánamo instructed KFF Health News that the boys they noticed have been detained in both low-security barracks, with a handful of individuals per room, or in Camp 6, a darkish, high-security facility with out pure mild. The ICE shift experiences describe the 2 stations by their place on the island, Leeward for the barracks and Windward for Camp 6. About 50 Cuban men despatched to Guantánamo in December and January have languished at Camp 6.
A Navy hospital on the bottom primarily serves the army and different residents who aren’t locked up — and in any case, its capabilities are restricted, the officers stated. To cut back the prospect of costly medical evacuations again to the U.S. to see specialists rapidly, they stated, the immigrants have been screened earlier than being shipped to Guantánamo. People over age 60 or who wanted day by day medication to handle diabetes and hypertension, for instance, have been usually excluded. Still, the officers stated, some detainees have needed to be evacuated again to Florida.
PHS nurses and docs stated they screened immigrants once more after they arrived and supplied ongoing care, fielding complaints together with about gastrointestinal misery and melancholy. One ICE month-to-month progress report says, “The USPHS psychologist started an exercise group” for detainees.
Doctors’ requests for lab work have been typically turned down due to logistical hurdles, partly as a result of variety of companies working collectively on the bottom, the officers stated. Even a routine take a look at, an entire blood depend, took weeks to course of, versus hours within the U.S.
DHS and the Department of Defense, which have coordinated on the Guantánamo immigration operation, didn’t reply to requests for remark about their work there.
One PHS officer who helped medically display screen new detainees stated they have been typically stunned to be taught they have been at Guantánamo.
“I’d tell them, ‘I’m sorry you are here,’” the officer stated. “No one freaked out. It was like the ten-millionth time they had been transferred.” Some of the boys had been detained in varied services for 5 – 6 months and stated they wished to return to their dwelling international locations, in response to the officer. Health employees had neither a solution nor a repair.
Unlike ICE detention services within the U.S., Guantánamo hasn’t been overcrowded. “I have never been so not busy at work,” one officer stated. A army base on a tropical island, Guantánamo offers activities akin to snorkeling, paddleboard yoga, and kickboxing to those that aren’t imprisoned. Even so, the officer stated they might fairly be dwelling than on this task on the taxpayer’s dime.
Transporting employees and provides to the island and sustaining them on-base is enormously costly. The authorities paid an estimated $16,500 per day, per detainee at Guantánamo, to carry these accused of terrorism, in response to a 2025 Washington Post analysis of DOD knowledge. (The common price to detain immigrants in ICE services within the U.S. is $157 a day.)
Even so, the funding has skyrocketed: Congress granted ICE a document $78 billion for fiscal yr 2026, a staggering improve from $9.9 billion in 2024 and $6.5 billion practically a decade in the past.
Last yr, the Trump administration additionally diverted more than $2 billion from the nationwide protection funds to immigration operations, in response to a report from congressional Democrats. About $60 million of it went to Guantánamo.
“Detaining noncitizens at Guantanamo is far more costly and logistically burdensome than holding them in ICE detention facilities within the United States,” wrote Deborah Fleischaker, a former assistant director at ICE, in a declaration submitted as a part of a lawsuit introduced by the American Civil Liberties Union early final yr. In December, a federal decide rejected the Trump administration’s request to dismiss a separate ACLU case questioning the legality of detaining immigrants outdoors the U.S.
Anne Schuchat, who served with the PHS for 30 years earlier than retiring in 2018, stated PHS deployments to detention facilities might price the nation by way of safety, too. “A key concern has always been to have enough of these officers available for public health emergencies,” she stated.
Andrew Nixon, an HHS spokesperson, stated the immigration deployments don’t have an effect on the general public well being service’s potential response to different emergencies.
In the previous, PHS officers have stood up medical shelters throughout hurricanes in Louisiana and Texas, rolled out covid testing within the earliest months of the pandemic, and supplied disaster help after the lethal capturing at Sandy Hook Elementary School and the Boston Marathon bombing.
“It’s important for the public to be aware of how many government resources are being used so that the current administration can carry out this one agenda,” stated Stewart, one of many nurses who resigned. “This one thing that’s probably turning us into the types of countries we have fought wars against.”