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Alexandra Arriaga: Hello everyone, and welcome back to I AM GPH. My name is Alexandra Arriaga, and today we will be talking to Benjamin Wagner. Ben is in his last year of the NYU Gallatin and GPH accelerated dual degree program concentrating in public health policy. Ben's studies focus on understanding the nexus of medical practice, ethics, social determinants of health, and cultural impediments to improved health outcomes, particularly among refugees and migrants. As a Gallatin Global Human Rights fellow in 2018, Ben conducted research on access to healthcare in US immigration detention facilities. Alongside his studies, Ben serves as the policy and advocacy coordinator at the Bellevue-NYU program for survivors of torture. A non-profit that provides comprehensive medical, mental health, social and legal services to victims of torture and other human rights abuses. In this role, Ben is currently managing a campaign in New York state, advocating for legislation prohibiting healthcare professionals from participating in torture and prisoner abuse. If you'd like to learn more, please stay tuned.
Alexandra Arriaga: Hi, Ben, how are you doing today?
Ben Wagner: I'm good. How are you doing?
Alexandra Arriaga: I'm doing great. Thank you for asking. So first of all, congratulations for becoming a Gallatin Global Human Rights fellow. Can you please tell us about your background, what you're doing right now, and what led you to the fellowship?
Ben Wagner: Thanks. So I actually had a pretty unique experience here at NYU. I was able to participate in the four plus one program through Global Public Health and NYU Gallatin. Meaning I was able to start taking courses towards my MPH during my undergrad career. And one of the reasons I chose to go to Gallatin and participate in this program, I was pre-med at Gallatin. But one of the unique things about it is that you could create your own individualized major. And the major I decided to create for myself was in global health and human rights. And I chose that because I want to be a doctor and excel in the technical aspects of medicine, but I believe that being a physician is more than that. I believe that questions of ethics, law, and just social determinants of health are equally important to providing health care. So doing that, I actually had my first human rights course taught by Vasuki Nesiah in my freshman year, and it was titled Human Rights and Human Wrongs. And she was absolutely fantastic, and it introduced me to the field of human rights. And slowly as I progressed through Gallatin and I was combining all these different disciplines, human rights, public health, medicine is the hard science and chemistry. I was also working at Bellevue Hospital at the program for survivors of torture. And that program is led by Dr. Allen Keller. And working with him at Bellevue and caring for those who were survivors of torture and experienced other forms of trauma and human rights abuse really opened my eyes into what medicine can achieve and do for these populations. So taking Vasuki's class, she also leads the seminar for the global human rights. And she mentioned it to the class and I was also working at PSOT, the Program for Survivors of Torture at the time, and was looking for ways to fund my research in immigration detention work. And it was just the perfect match. The fellowship provides a select number of students with $5,000 to pursue an extended year long project in their selected field of human rights.
Alexandra Arriaga: That's amazing. So why immigration detention?
Ben Wagner: So, I was first introduced to it while I was working at Bellevue. And a number of our patients who had experienced torture ended up being put through the immigration detention system. From some way or another they ended up detained in a detention center in Texas even though they were traveling all the way from Africa to get here. And I remember having a conversation with one of our patients at PSOT, and what he told me, I'll still remember to this day. He was an African student who had fled because of persecution and torture, and he was placed in immigration detention. And he said, "I came to the United States seeking safety and freedom after what I suffered, but never did I expect to be treated like a criminal." And he told me about the nightmares that he had from his time in immigration detention. And just hearing about his story and what he went through, I was so upset with how our country decided it was going to treat people yearning to be here seeking freedom. And I knew I needed to do something about it.
Alexandra Arriaga: Yeah, absolutely. I think it's interesting whenever I hear these cases as an immigrant myself, I think it's ridiculous that people in the US grew up with so much privilege and they're in a country that is mostly safe and mostly works for them. And how can you explain to everyone that you don't flee your country and you don't leave your country and your comfort, your family, your home, because everything is great. You obviously leave because something is very wrong. So something to think about. And now that we're talking about immigration detention, what are the main health consequences of immigration detention in the US, and how large is the problem?
Ben Wagner: So I think the best way to answer that question is to just first context give a brief overview of how big the detention system is in the US. And it's important to note that the US immigration detention system happens to be the largest national detention system in the world. And it holds roughly 400,000 people there each year at a cost of roughly $2.5 billion per year. And actually, detained immigrants represent the fastest growing segment of the US prison population as a whole. With more than 40,000 people detained in immigration detention centers on any given day. And just to put that accelerating trend in perspective, in 1994 there were only about 5,000 people in immigration detention on any given day.
Alexandra Arriaga: That's ridiculous.
Ben Wagner: Yeah. And I mean, just this past August, the Trump administration transferred about $116 million from other agencies in DHS to pay for additional ICE beds. And now ICE is expected to lock up a daily average of 52,000 immigrants per day. Which is going to be a record number representing a nearly 30% increase over the previous year.
Alexandra Arriaga: I don't even know what to do with those figures. What's a benefit of having all those people in detention?
Ben Wagner: It's a question that I'm often conflicted with myself. And especially when you consider that among the tens of thousands of people who are detained each day are asylum seekers, are those who have been found to have a credible claim to protection. They're women and children fleeing violence and persecution from Central America. And a lot of them now recently have been long term residents here and have been picked up and been thrown into detention.
Alexandra Arriaga: I'm getting worked up.
Ben Wagner: Right.
Alexandra Arriaga: And so while you were doing your research as a Gallatin Global Human Rights fellow, what were some of your findings in regards to preventable deaths in detention centers?
Ben Wagner: So one of the things you have to realize is, when you're dealing with a highly vulnerable population, so people that are coming to our borders physically exhausted and psychologically stressed, and they enter facilities that are wholly unprepared for them is just completely conducive to further mistreatment. So what I did with my research is along with some physicians at the Program for Survivors of Torture at Bellevue, we reviewed these detainee death reports that were prepared by ICE Office of Detention Oversight, and they've released a number of reports since 2010, and we systematically reviewed them to see if subpar care in these detention facilities contributed to any of these deaths and could they have been preventable. And what we found was that unreasonable delays in providing care, failed emergency responses, and placing people with a history of mental illness in isolation contributed to many if not a majority of the death reviews that we conducted.
Alexandra Arriaga: So what this got me thinking is from an ethical point of view, where do you draw the line between giving someone what they deserve because of the crimes they've committed and actually getting into the point where it's a human rights violation? Have you thought about this?
Ben Wagner: Yeah. So the thing that I think people don't realize is that the people in these detention centers and the ones that I looked at were civil detainees. Meaning, most of the people, if not all of them, didn't commit a crime. Rather, their only crime was the fact that they came here and they're undocumented. So, they haven't committed a crime in their entire life and they're now put into jail and essentially treated like prisoners. They're dressed in orange jumpsuits, they're given the prison meals, the stale looking hamburgers that you wouldn't want to come even close to touching, let alone eating. So when you think about that and the fact that in some of these detention centers that ICE uses a contract to the county jails, these detainees, these immigrants are put into a real prison population with criminals who've been convicted and it's the same guards who are watching over these civil detainees and the criminals who have been placed in the county jails.
Alexandra Arriaga: How does that make any sense? It's not illegal to seek for asylum.
Ben Wagner: Right. It's not. But the problem is, seeking asylum here in the US is an incredibly difficult process. And it's become exceedingly difficult under the current administration. And one of the problems that these immigrants in detention face is they aren't guaranteed the right to an attorney under the sixth amendment the same way that the general US population is.
Alexandra Arriaga: Sounds like a catch 22 right there.
Ben Wagner: Right. They're put into a system that it just makes it harder and harder and harder for them to ever get out. And it's because deportation and removal proceedings aren't seen as a criminal act or violation. It's a civil hearing. And these people don't have access to the attorneys and there've been numerous studies about, what are the consequences of not having someone to represent you at your asylum hearing? What's going to happen overall? You can be approved, or you could be granted asylum or you're not going to be granted. And they found out that the vast majority of detained immigrants don't have access to attorneys. And those who don't have access to attorneys are less likely to be granted asylum. But on the other side, the government always has an attorney representing them in these hearings. So you have someone who can't speak the language sometimes. There might not be interpreters there, so that's another stumbling block. They don't know the legal system. They've never had to represent themselves before, and now they're going up against a judge and a trained attorney trying to justify the reason for being here.
Alexandra Arriaga: I think I also read some interesting figures about the rate at which asylum seekers get approved for asylum. And I think that depending on the state where the hearing happens, the rate of it occurring is close to non-existent. But the rate at which they deport people is very, very high. I think especially in Texas. And so to me the interesting thing is that I've also seen cases in which for example, the person that has their hearing is a six year old boy. And it doesn't matter that they're six, they just go out there and they don't have any representation. So obviously there's something not working in this whole system.
Ben Wagner: Right. It's a really broken system.
Alexandra Arriaga: That's ridiculous. So, another thing that you did that I think is really interesting is you visited the Hudson County Correctional Facility. And my question is, what did you see there and what are some economic incentives that ICE provides?
Ben Wagner: So for those who are unfamiliar about Hudson County Correctional Facility, it's a county jail located in Kearny, New Jersey, and it's one of the principle facilities ICE uses to detain non-citizens in New Jersey. And ICE houses roughly 800 civil detainees there. Filling two thirds of the jail that would otherwise be vacant and paying the county over $35 million per year.
Alexandra Arriaga: So basically ICE is sponsoring a lot of the budget of these jails.
Ben Wagner: Exactly. These jails have unfilled beds and would be forced to close if it wasn't for the detainees that are now currently occupying them.
Alexandra Arriaga: Conflict of interest, much?
Ben Wagner: Yeah, you would think. So what I did, I went to the jail accompanied by Dr. Keller, Congressman Donald Payne Jr., and a staff from Human Rights First. And the purpose of the visit was to find out what if any changes had occurred in the six month period since Human Rights First released its report ailing justice, which documented the inadequate conditions at Hudson County. Now when I visited the detention center last summer, I expected to see detainees held in miserable conditions. Deprived of adequate healthcare, cut off from their family and the community. But nothing prepared me for the suffering, misery and complete dehumanization I witnessed. Dressed in orange jumpsuits, the detainees, young and old were treated just like prisoners. And like I mentioned, these are civil detainees. Meaning they haven't necessarily committed any crimes. They're in these detention centers because they're simply undocumented. And on that last visit, one woman was using her bra as a sling for a clavicle fracture. And another woman who had miscarried in jail and hemorrhaged badly was merely given antibiotics and sanitary napkins for weeks instead of being taken to an appropriate medical facility.
Alexandra Arriaga: How is it even happening?
Ben Wagner: It's really mind boggling and so upsetting to see. And the real kicker is, as we were given the tour of the detention center by the warden and his staff, the warden proudly showed us the location of their recently installed dialysis machines.
Alexandra Arriaga: Oh no.
Ben Wagner: And you have to think to yourself, people with chronic or end stage kidney failure that require dialysis machines clearly don't belong in a detention center with absolutely zero appropriate care to address their needs. And after seeing all of this, we actually had an opportunity to sit down with the warden and his staff alongside with Dr. Keller, staff from Human Rights First, and the congressman. And we spoke about what it would take to improve detention conditions. What would it be like to let the detainees wear their own clothes instead of the orange jumpsuits? What would it be like to allow them more time with their kids and their families?
Alexandra Arriaga: Like humanizing it a little bit.
Ben Wagner: Exactly. And what we were met with and what the warden responded with was that there's room for improvement and the situation is difficult for us all around. That essentially, he was giving me this idea that, "Hey, it's hard for me too." And these euphemisms just infuriated me because it revealed a systemic lack of accountability and responsibility.
Alexandra Arriaga: What was the attitude of the warden? Or when you were talking to the staff at this correctional facility, were they proud? Were they happy about everything that was...? You can't see Ben, but he's nodding. Yeah.
Ben Wagner: Yeah. No, they were, they were proud of what they were doing.
Alexandra Arriaga: So do you think that it might also be beneficial to educate the people that run these correctional facilities? Do you think there could be any change there or do you think they're too biased?
Ben Wagner: No. I think not everyone there is doing this out of mal-intent. And I'm sure a lot of them probably don't even know about some of the stories that these people have about how they got here. And I think educating them about the population that are being held in these detention centers, what they've gone through can go a long way in terms of improving detention conditions. But ultimately the problem was that the detainees were seen as a problem and not as a people, right? They weren't seen as human. And they're going to continue to be treated less than human until they are seen as a people and not just a problem.
Alexandra Arriaga: So obviously this is very hard work. I can't even imagine the things you saw at the correctional facility. And I wonder, how do you protect your own mental health while you're working on such an emotional topic every single day?
Ben Wagner: I think that's such a great question. And as a matter of fact, it was a really crucial component of a lecture that I helped organize for NYU medical students and clinicians in an effort to set up an asylum clinic that will ultimately qualify these students to write medical affidavits for asylum seekers in need. And this part of the lecture was actually given by Dr. Hawthorne Smith, who's the director of the Program for Survivors of Torture and also a psychologist. And he spoke about how the ability to truly listen, attend, and empathize with someone who is suffering is a powerful tool, but it comes at a price.
Alexandra Arriaga: Yeah. Because you start feeling everything. And I guess one story might not bring you down or depress you, but if you're constantly empathizing with people who are at their worst state of suffering, how do you deal with that?
Ben Wagner: Right. It can often mean pain and discomfort to that caregiver. Sometimes resulting in fatigue, sadness, and depression. But one of the things that he spoke about and something that I found really helpful for myself doing this type of work is being able to establish supportive relationships with colleagues, friends and family. Telling them what you're doing and making sure that they're there for you and being open with them. And also to be able to have realistic expectations. It can be really frustrating viewing this type of work and feeling like nothing's happening. Right?
Alexandra Arriaga: Yeah.
Ben Wagner: Me conducting research on the consequences of immigration detention and then publishing those results is not going to fix the problem overnight. And that can be really hard. But setting realistic expectations for yourself and knowing that forward progress and momentum is the way forward, that I think goes a long way. Keeping yourself sane when doing this type of work.
Alexandra Arriaga: Absolutely. Well the thing is that I think it's great work. It needs to be done, and I'm just happy that you have a support system that allows you to keep on doing this because it's extremely important. And like you said, this is a vulnerable population and they need a voice. And I hope that actually this podcast also helps tell their stories to an extent. And speaking about the legislative aspect of things, what legislative changes do you think would be instrumental in preventing any further human rights abuses?
Ben Wagner: So I think at the bare, bare minimum there needs to be more policies in place that ensure adequate and humane conditions in detention centers. So making sure that detainees have adequate access to healthcare, that there's an appropriate number of health professionals, qualified doctors and nurses on staff, and also like we spoke about, having a lawyer. Just being able to be given a lawyer when they can't afford one to help them represent themselves in an asylum hearings. Having a lawyer has been shown to be instrumental in terms of getting people out of detention and ultimately getting them citizenship. But I think that ultimately we need to stop placing people in detention.
Alexandra Arriaga: I was about to say. I was like, that seems like the most obvious thing.
Ben Wagner: Yep. That really is, we need to think about alternatives to detention. And one of the things that I often think about is that many of the people who are placed in detention have family and friends already living here in the US. And instead of letting them stay with their friends or family, we decide to lock them up. And I'm looking for-
Alexandra Arriaga: That costs money.
Ben Wagner: Yeah, it costs money and it's dangerous. It's got consequences on their health, their physical and mental health, and in the most egregious cases it results in death. And I think we should think about parole and release on one's own recognizance.
Alexandra Arriaga: So here's a crazy idea. In my utopic perfect world, we would grab the, what was it? $2.5 billion. So we would grab the $2.5 billion that it costs to keep these people locked up and we would invest it in things like expediting asylum seeking reports or helping people go through the process faster. Maybe lawyers, I don't know. How about better systems to just get people where they need to be in terms of maybe getting a citizenship, getting a work visa, getting whatever it is that they need, especially if they're not criminals.
Ben Wagner: Right. You'd think there'd be better uses for the money that would support those who are yearning to be here, asylum seekers and refugees, and would empower them to fil their dreams alongside our own. But instead we resort to locking them up. And that's been shown to just have really, really awful consequences. And I think there's still hope. Recently California just passed a bill to ban private detention centers and ICE facilities within the state. And I think that's tremendous. Realizing that these for-profit facilities, some of the big names like GEO Group and CoreCivic, that what's going on in these detention centers, what's happening with detainees and the complete lack of support and inadequate care is having real consequences. And making sure to eradicate that is a really good thing. But you have to realize that without these detention centers, at least right now, that they're going to be placed into the county facilities that are just as bad, if not worse. So we need to come together, I think, as a nation and rethink about what it means to be an American. What our core values are. We need to go back to this approach that this country was founded by immigrants and take pride in that cultural melting pot. And I'm just not seeing that today.
Alexandra Arriaga: Me neither, honestly. And it's a shame I think that the country would be way better if the immigrants you just mentioned that are being locked up could actually contribute to society by maybe sharing their skills or sharing whatever work ethic they have.
Ben Wagner: Right. And we see that they do contribute to the society. Many people who have work authorization are paying taxes and they're filling jobs in the job sector that would be otherwise unfilled.
Alexandra Arriaga: Right. Exactly. I mean, it would be a shame if no immigrants were accepted. I know that there's a lot of people here that are doing great work that are not American. And I think it's also a thing about changing the rhetoric a little bit. Like you said, humanization is so important and it seems like a lot of people are just clinging to that idea of, "Oh, if you're here and you don't have papers, you're just an illegal and that makes you a bad person, it makes you a criminal." I think that having a more honest discussion about what the implications of not having papers really means, and maybe humanizing these cases. Because if you just say, "Oh, this is so and so, and she doesn't have any papers. But if maybe you explain, well, this person actually fled from central America because she and her kids were at huge risk of being killed by the gangs that are in their town. Or they are fleeing political revolt or whatever it can be. I mean, I'm from Venezuela, there's so many... I feel like there's no Venezuelans left in Venezuela. We all had to leave. So I just feel for these people.
Ben Wagner: Right. And I think the problem is with a lot of the news these days and some of the research around immigration is it's focused on numbers. How many people are coming to our borders? How many people are in detention even? And there's power in the numbers when you're trying to convey an idea to someone. But I think the most powerful thing is, like you said, the stories. And humanizing them. And humanizing the issue, right? When you talk about a woman who was forced to flee with her two young kids because her husband was murdered by gangs and she ended up receiving death threats, you have to, instinctively, as humans we feel for these people. They're not the drug dealers and murderers that the media makes them out to be.
Alexandra Arriaga: Exactly. So I'm very glad that you're invested in this topic. It makes me happier there's people fighting the good fight. But I'm wondering, what drives you to do this work? Even when you're facing difficult challenges, where does that motivation come from for you?
Ben Wagner: So, in my work with immigrant detainees and survivors of torture at Bellevue Hospital, I'm certainly reminded of the darker side of humanity and the potential for cruelty in this world. But I'm also reminded of the extraordinary resilience of the human spirit. And the ability to make a real difference in the lives of others. Especially all these people have suffered such tremendous abuse and persecution is really what keeps me motivated.
Alexandra Arriaga: That's great. And do you have any advice for students who are passionate about human rights but they don't know where to start their advocacy journey?
Ben Wagner: So my advice is to pick a human rights issue that you're really passionate about solving, and surround yourself with others who share that passion with you. Whether that be through a club on campus, like the Health and Human Rights Association, or a local grassroots organization, or even chapters of the APHA. There's real power in numbers when it comes to human rights advocacy work. And when we're united, we're powerful.
Alexandra Arriaga: Absolutely. I love that. Thank you.
Ben Wagner: Okay.
Alexandra Arriaga: So for those of you that are listening and are interested in learning a little bit more about immigration, specifically in the South border of the US, we also invite you to listen to our episode named Undeterred. This is with film producer Eva Lewis and human rights advocate, Carlota Wray and her son. So if you would like to learn more, we invite you to check that out. Thank you so much, Ben Wagner, for joining us today.
Ben Wagner: Thank you for having me.