The 911 call reported an apparent suicide. 

A 55-year-old Cuban “tried to hang himself,” a federal contractor alerted emergency responders last month from a sprawling El Paso immigrant detention center. 

By the next day, records show that Geraldo Lunas Campos had died at the facility, marking the second fatality in weeks at the hastily constructed Fort Bliss Army tent structure known as Camp East Montana. Immigration and Customs Enforcement officials attributed his death to “medical distress.” 

But the medical examiner ruled his death a homicide — he was suffocated. The autopsy found that Lunas Campos became “unresponsive while being physically restrained by law enforcement.”

His death, which has so far prompted no criminal investigation or charges, has renewed scrutiny not only on that camp, but on conditions at the nearly two dozen ICE detention sites in Texas. 

In the span of just six weeks between December and January, six people died while detained by ICE in Texas — three of them at Camp East Montana. The deadly period began with a 48-year-old Guatemalan, Francisco Gaspar-Andres, who ICE said died on Dec. 3 of liver and kidney failure after being hospitalized for more than two weeks following detention. 

Detention facilities are seeing more overcrowding and understaffing as the Trump administration ramps up enforcement in the interior of the country, experts said. Unlawful border crossings have plummeted due to the administration’s restrictions. Federal data shows that most current ICE detainees are not accused of crimes beyond civil immigration offenses. 

The expansion of ICE detention is “coupled with a dissolution of oversight, a reduction in detention standards, and draconian restrictions on releases,” said Claire Trickler-McNulty, a former senior ICE official during the last three administrations. “That appears destined to lead to more deaths, medical issues and trauma for detainees.”

Thirty-two people died in ICE custody nationwide last year, surpassing the previous high of 20 in 2005, according to federal data. Nearly a quarter of last year’s deaths occurred in Texas. 

Scott Shuchart, a former head of policy at ICE under Biden and senior adviser under Trump’s first term to DHS’ Office of Civil Rights and Civil Liberties, said the agency “struggled to ensure adequate medical care” when its detainee population was 35,000. Now it is more than doubling that number.

The government last October also temporarily stopped paying many medical providers due to bureaucratic changes under the administration. As a result, ICE for months has been unable to reimburse health care officials, including for prescription medication, dialysis and chemotherapy, according to redacted ICE documents first reported by Popular Information. 

Spokespeople for the Department of Homeland Security and ICE did not respond to detailed questions.

Texas is the last stop for most immigrants caught in the administration’s dragnet, with more than 18,700 people detained in the state’s ICE facilities as of February the nation’s highest share, according to federal data analyzed by the Transactional Records Access Clearinghouse, a nonprofit that analyzes government data obtained via public records requests. Over the past six months, an average of four deportation flights have departed the state daily, the most in the country, according to ICE Flight Monitor, a nonprofit that tracks them. And a significant percentage of growing unlawful detention cases filed in federal courts stem from Texas. 

The state is the “blueprint and the epicenter of the country’s immigration enforcement system, acting as the deportation funnel,” said Kristin Etter, director of policy and legal services at the statewide advocacy group Texas Immigration Law Council, “Texas is where immigration enforcement begins, where it ends, and sometimes, where it does both.”

What’s happening at Camp East Montana?

The massive East Montana tent camp is currently the country’s largest ICE detention center, holding more than 3,000 men and women on a military base that’s seen as a model for what the administration plans to build.

Constructed in a record two months last summer after the government granted a $1.2 billion contract to Acquisition Logistics, a small Virginia corporation with no listed experience running detention facilities, the camp has been plagued with problems since it opened. Claims of medical neglect, spoiled, insufficient food and unsanitary conditions are rife and advocates call it an “unfolding humanitarian crisis.” 

More than 45 people detained there alleged abuse and serious injuries to attorneys, according to a letter advocacy groups sent to DHS and ICE supervisors in December. Those allegations included a teen hospitalized after he accused staff of slamming him to the ground and beating him. The detention staffers blocked the security cameras, he said, and “grabbed my testicles and firmly crushed them.” 

ICE’s own inspectors found at least 60 violations at the facility shortly after it opened, the Washington Post first reported in September, including that the contractors had employed little more than a half of the security personnel it had promised. DHS spokesperson Tricia McLaughlin, who did not respond to repeated requests from The Texas Tribune, said in a statement that “any claim that there are ‘inhumane’ conditions at ICE detention centers are categorically false.” She said detainees are provided “proper meals,” medical treatment and clean clothing. 

Two officials who viewed that ICE investigative report or were briefed by the agency additionally told the Tribune that the facility had no policy detailing when or how contractors can use force. It lacked a compliance manager designated to oversee sexual assault allegations, required under federal regulations. Contractors were also provided only 40 hours of training, a fraction of at least 42 days typically required of regular ICE agents, according to those officials who were not authorized to speak publicly.

Acquisition Logistics and two of its contractors in charge of detention and medical care did not respond to questions so it is unclear if those conditions have since improved and if new policies were instituted. 

U.S. Rep. Veronica Escobar, an El Paso Democrat who has visited the site at least a half dozen times, said the conditions at East Montana are rapidly “deteriorating.”

After tuberculosis and COVID-19 cases, both highly infectious contagions, were confirmed there, Escobar said that employees told her not to enter a certain area because detainees had yet to be tested. Few people wore masks.

“All it takes is one major public health issue where there’s not been enough oversight, where human life and safety and welfare is not prioritized, for there to be a massive health impact on the community,” Escobar said in an interview. “Americans should care when these massive tent cities or massive warehouses are very quickly put up and filled with thousands of human beings and are run by corporations that are prioritizing profits, not people.”

What happened to Lunas Campos?

Despite the crescendo of complaints at East Montana, none have resonated publicly as much as the death of Lunas Campos.

Six El Paso detainees described in federal court statements that the father of three, who lived in Rochester, N.Y., for nearly 20 years before ICE detained him in July, begged for days to receive his asthma medication. Detention staff refused and threatened him with solitary confinement, inmates said. 

After Lunas Campos was dragged in shackles to an isolation unit, detainees recalled “what sounded like the slamming of a person’s body against the floor or a wall.” They said they heard him gasp that he could no longer breathe. Then, “silence.” 

Chris Benoit, a lawyer for his children suing the government, said they “want to establish the truth about what the guards did to their father and demand accountability for his death.”

Local and federal prosecutors have yet to say whether they would seek criminal charges following the medical examiner’s ruling that the death of Lunas Campos, who had long–standing previous criminal convictions including child sex assault, was a homicide. Experts said that state prosecutors have precedent to pursue such charges despite the death occurring on military property, which is under federal jurisdiction. It remains under internal investigation. 

The federal government tried to deport detainees who witnessed Lunas Campos’ last moments. A federal judge in Texas so far has blocked that attempt.

Trickler-McNulty, the former senior ICE official, said that instance was the first immigrant death linked to a homicide involving ICE staff that she could recall in at least 15 years. 

Fatalities in ICE custody are typically the result of poor medical care or suicides, said Shuchart, the former Trump oversight official. 

“Deaths from staff violence are another level,” he said, calling them “preventable, and the result of training and supervision failures.”

What about the other ICE detention deaths?

Eleven days after Lunas Campos died, 36-year-old Victor Manuel Diaz marked the third fatality in six weeks at the El Paso tent camp. 

The 911 call was similar: “We got a situation here,” a contractor told emergency responders. “They found someone who tried to commit suicide.” Guards, he added, found the Nicaraguan man with pants tied around his neck. 

Unlike Lunas Campos, Diaz’s body was sent to a U.S. Army hospital rather than the local medical examiner, where a military spokesperson said that the agency would not make his autopsy public.

His family does not believe his death was a suicide, according to their attorney Randall Kallinen. 

Of the nine people who died in Texas ICE facilities since Trump’s second term, many were in their mid-forties. Although the agency declared that they mostly died of natural causes, investigations are pending in several cases and many autopsies have not been released.

Tien Xuan Phan, a 55-year-old Vietnamese man held at the Karnes County Immigration Processing Center outside San Antonio, for example, died last July. ICE claimed he experienced seizures and vomiting, then became unresponsive. 

Eight months later, the Bexar County District Attorney’s office declined to release Xuan Phan’s autopsy, citing a “pending” federal investigation. 

What is supposed to happen if someone dies in ICE custody?

Congress imposed strict rules on how deaths in ICE custody should be reported, which include publicly posting “relevant details” within two business days and requiring ICE’s Office of Professional Responsibility to investigate each death and provide a report to senior management. Within 90 days, ICE must make the reports public. 

But under Trump’s second term, experts said, death reports from ICE detention have often been delayed.

After Lunas Campos died at East Montana, for example, ICE waited nearly a week to issue the release claiming he died from “distress.” Only after the medical examiner advised his family that it might be a homicide, did ICE officials allege a suicide attempt.

Authorities without ties to the federal government should investigate ICE deaths and conduct autopsies, said Angélica César, a Human Rights Watch official monitoring ICE deaths in Texas.

Doing so “would ultimately protect both the families and the integrity of the investigative process,” she said.

ICE lacks protocols for how and when to conduct autopsies after a detainee’s death, according to a 2024 analysis of thousands of government records and interviews obtained and conducted by the American Civil Liberties Union, Physicians for Human Rights, and American Oversight, an investigative nonprofit group.

The agency, for example, did not initially order an autopsy on Ronald Cruz, a 39-year-old Honduran who died in 2018 while at the South Texas Port Isabel Detention Center. Only when his family said that they would pay for one, did ICE reveal that Cruz had died of bacterial meningitis. Whistleblowers called his medical care “grossly negligent” and experts later said Cruz could have survived with appropriate care, according to the ACLU’s report. If he had been given antibiotics or sent to the emergency room sooner, he “likely” would not have died,” according to a doctor who specializes in correctional health and reviewed the evidence.

ICE at times fails to preserve evidence needed for required death investigations, said Andrew Free, a lawyer and researcher who specializes in such detention deaths. Civil lawsuits have revealed that detention officials at times destroyed relevant video footage that would aid investigations, he said.

Attorneys and whistleblowers said that appeared to be the case with Gourgen Mirimanian, a 54-year-old Armenian who died in 2018 at the Prairieland Detention Center, 44 miles south of Dallas, according to the ACLU report. Found unresponsive in his bunk, his death was ruled due to hypertensive and cardiovascular disease. But ICE officials later reported that some security footage of his last hours was hard to see clearly and other crucial video “not retained.”

At Camp East Montana, officials there have so far refused to release video related to Lunas Campos’ death, his lawyer said.

What medical care do ICE detainees receive?

Although claims of abuse and poor medical care have plagued ICE detention facilities for years, conditions for immigrants there under this administration are deadlier, according to half a dozen former officials who oversaw ICE under Trump’s first administration and the Biden administration.

Historically, many deaths in ICE custody likely could have been avoided with better medical care, experts and advocates said, a pattern that sparks concerns given the government’s skyrocketing detention.

The ACLU examined the deaths of 52 people in ICE custody between 2017 and 2021 and found that 49 of them were “likely preventable,” most often resulting from faulty medical diagnoses by detention staff. In 40% of those deaths, ICE staff failed to provide timely care, the report found.

Lawyers and congressional representatives say conditions have worsened at such centers, including the South Texas Family Residential Center in Dilley, 70 miles south of San Antonio, which drew widespread attention after photographs of 5-year-old Liam Conjeo Ramos went viral following his detention last month in Minneapolis. More than 1,300 parents and children are currently at that facility and at least 1,000 complaintsof poor medical care have been lodged since the administration reopened the detention center last April, according to Thaís Rodrigues Silva-Marques, a spokesperson for the Refugee and Immigrant Center for Education and Legal Services, a San Antonio nonprofit that works in that facility. Last month, at least two cases of measles were confirmed at the facility.

Among the many cases of alleged medical neglect is a 2-month-old boy detained there for three weeks who was hospitalized in the past few days after “choking on his own vomit,” according to U.S Rep. Joaquin Castro, a San Antonio Democrat. The infant had bronchitis, he said, and was unresponsive for hours before being discharged. Late Tuesday, he and his family were suddenly deported despite attempts by Castro and lawyers.

“To unnecessarily deport a sick baby and his entire family is heinous,” said Castro, who in recent weeks has escalated concerns about the nation’s only facility currently holding parents with their children. He called ICE’s decision “monstrous,” pledging to seek details. DHS officials said on X that the mother “chose to take her child into custody with her” and “enter and remain in the country illegally.”

Attorneys, echoing complaints in an ongoing lawsuit seeking to prevent the Trump administration from terminating a decades-old settlement governing the rights of children in detention, describe at Dilley impotable water, barely any schooling and detainees forced to sleep under fluorescent lights. Medical care is lacking even for those with terminal conditions such as a 6-year-old with leukemia who was detained along with his family last year. He had little access to care, his lawyers said, before they were able to free him.

Brian Todd, a spokesperson for CoreCivic, the private company that runs ICE facilities in Texas including the one in Dilley, said allegations of poor medical care “do not reflect the hard work our staff does every day to help people in our facilities get the care they need.” 

“Comprehensive, around-the-clock care is delivered by licensed physicians, dentists, advanced practice providers, nurses, and mental health professionals,” Todd added.

He said claims of poor drinking water at Dilley are “patently false” because detainees and staff consume the same water as the community.

 At the Prairieland detention center outside Dallas, a New Jersey woman who was arrested after a 2024 Columbia University Gaza protest was hospitalized this month following a fall in the bathroom. Leqaa Kordia, 33, said in a statement through her lawyers last week that the facility’s “filthy” conditions made her ill and that the fall induced a seizure. Her lawyers and family did not know where she was as she remained chained for days to the hospital bed. 

Detained alongside her are pregnant women and those with terminal cancer and severe disabilities, said Travis Fife, an attorney with the Texas Civil Rights Project, a statewide advocacy group. “Overcrowded, inhumane” conditions threaten what he called a “civil rights disaster.”

Although the ICE Health Service Corps is responsible for detainees’ medical care, it provides direct treatment at just 17 of more than 200 facilities across the country, including six in Texas. The majority of immigrants held by ICE are in facilities where private prison companies or their contractors provide medical care at profit.

During this administration, more ICE health staffers and their government liaisons have quit, citing concerns about the quality of care they are able to provide, according to NPR.

Charlotte Weiss, an El Paso attorney for the Texas Civil Rights Project, said that poor medical treatment forces immigrants into choosing between grave health conditions in hopes of staying in the U.S. or giving up and returning to danger “just so they can get out.”

Are there more detention centers coming to Texas?

Despite growing resistance from some state and local leaders, the administration seeks to open additional ICE facilities in warehouses across Texas and the country to handle an exploding detainee population.

Several of the state’s ICE centers were at or near capacity last year, according to ICE data.

The government needs more detention space in part because a bottleneck of nearly 4 million immigration court cases hamstrings the administration unless it incites or forces people to leave on their own. It has offered $2,600 to those who voluntarily depart. After a 5th Circuit Court of Appeals ruling this month upheld a Trump policy seeking to deny bonds for detained immigrants, many in Texas will remain locked up throughout their deportation proceedings, which can take years, unless they choose to return.

Some cities have protested ICE’s expansion. Residents vehemently denounced ICE’s plan to lease a warehouse in Hutchins, outside Dallas, that was slated to hold more migrants than the city’s 8,000 residents. This weekend, the real estate company owning the building said that it “will not enter” into any ICE agreement.

The administration is also pursuing an El Paso County site expected to hold up to 8,500 people, although city officials last week approved a motion seeking to prevent that. At least two facilities are planned in McAllen and San Antonio, In the latter, U.S. Rep. Tony Gonzales, a Laredo Republican who represents a sliver of the city, promised that it would bring “good paying jobs,” although San Antonio Mayor Gina Ortiz Jones, argued otherwise in demanding more transparency.

The mounting concerns at the El Paso camp are just a fraction of what will occur as the administration multiplies its detention capacity, said Escobar, the El Paso Congress member.

Such an expansion would be problematic to “not just the people in custody,” she said, “but to the communities that are going to have to grapple with the health risks, with the demands on their emergency services, the impact to their hospitals” as a result of the increased needs.

“Rapidly proliferating the problem,” Escobar added, “will be a nightmare.”