Death by Delay, Disease, and Design

ICE facilities across the U.S. are producing preventable death at scale. Alexandria is just the latest.

In mid-September 2025, The Guardian published a four-month investigation into the ICE staging facility in Alexandria, Louisiana, situated in permanent buildings on airport tarmac. On September 12, the piece revealed that this facility, meant for 72‑hour holds, was routinely keeping people far longer, neglecting medical needs, denying access to legal counsel, all while operating under a waiver of key medical screening standards.

The report noted that from January through late July 2025, more than 28,000 people passed through Alexandria; 20% stayed longer than 72 hours, despite the facility’s capacity being 400 men. Some have been held over ten days.

Nora Ahmed, the legal director of the ACLU of Louisiana, said, “Louisiana is where people go to be disappeared.” She continued, “My concern about the Alexandria facility is [that] it is a black box.” She noted that visitors are not permitted, providing “a convenient excuse to wrongly deport people.”

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A Moment of Shock Already Long Overdue

The Alexandria Staging Facility is a 400-bed ICE detention center located on the grounds of the Alexandria International Airport in central Louisiana, formerly an Air Force base. Unlike the tent cities seen elsewhere, Alexandria is made up of permanent, concrete, windowless dorm-style buildings. Designed as a short-term processing hub intended to hold individuals for no more than 72 hours, it has instead become a site where many are held for over a week, isolated from legal resources, families, and timely medical care.

Imagine being cut off from everything you know, isolated by language and distance, in a windowless brick holding facility for over a week in the heat of Louisiana.

Detainees described being held for extended periods in cramped, concrete rooms without proper medical attention, despite serious health issues. Some reported vomiting from heat, and others suffered visible infections or untreated chronic conditions. Legal access was minimal to nonexistent, with one man reportedly deported without ever speaking to an attorney. The Guardian report also highlighted that individuals were frequently moved in and out without clear communication, creating chaos for legal advocates and families trying to locate them.

When you first read the Alexandria story, perhaps you feel both startled and resigned. Shocked because the accounts are horrifying — concrete dorms with rusty showers, detainees too sick to move, people shackled and moved without legal notice. Resigned because these reports echo stories we’ve heard before, for decades, but rarely with this breadth, this level of detail, and this urgency.

That’s the thing: Alexandria is not new. It’s new in our headlines, but the pattern — the decay, the cruelty, the deaths — has been accumulating since at least the early 2000s.

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Tracing the Decades: Data You Can’t Ignore

Back in 2014, family detention centers in Texas were already being documented for medical neglect, undignified and traumatic housing, and legal invisibility. Converted prisons in rural Louisiana reported similar complaints: untreated infections, delays in air‑conditioning, barriers to lawyers. Administrations shifted. Politics shifted. However, the outcomes for many didn’t.

In 2024, the ACLU published a report analyzing 52 deaths in ICE custody from 2017 to 2021. Their conclusion: 95% of those deaths were likely preventable with timely medical intervention. These were not extreme edge cases. They were people dying of infections that could have been treated, cardiovascular symptoms ignored, and mental health collapse after basic denial of care. The cruelties were known. The patterns were documented.

Then came 2025. The detention numbers are rising, and the facilities are multiplying, many of which have been hastily built or expanded. By June 2025, ICE had already confirmed 13 deaths in custody, a number that by itself had already exceeded the total for all of 2024. That doesn’t count those who died after transfer, or in facilities that don’t properly report. It doesn’t count those whose complaints never reached the press.

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Alexandria, but Also East Montana, Alcatraz, and More

Alexandria’s concrete and metal walls look different from the vinyl tents of Alligator Alcatraz in the Florida Everglades. Camp East Montana, a tent facility in El Paso, sits in the desert heat at Fort Bliss. Repurposed permanent prisons in various states have cold, concrete winter nightmares. But whether tent or brick, swamp or dry earth, one constant returns: deteriorating health, delayed care, deaths that shouldn’t happen.

In Alexandria, The Guardian found a waiver that exempted the facility from required medical screening for a time before an inspection in February 2025. That waiver remained in force from February through May, during which detainees were not guaranteed medical, dental, or mental health intake screenings within 12 hours, a standard intended to protect individuals arriving in custody. During those months, new detainees entered with unknown medical concerns and possible contagions.

See our reporting on Camp East Montana here:

Detention in the Desert: Fort Bliss’s Water Crisis Waiting to Happen

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When Systemic Failure Becomes Fatal

Imagine the worst imaginable ripple. A detainee with a contagious infection shows up in a tent or concrete dorm. Due to understaffing or delayed screening, it may not be identified. The disease spreads. Because the facility is remote, ambulances or medical staff are often far away, resulting in delayed care. Sanitation is poor; people share toilets, food lines, and sleeping quarters. A single outbreak can become a death toll in just days.

This is not science fiction. These conditions are already in place. The only variable is how many lives will be lost before it becomes undeniable in public consciousness.

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The Numbers We Know And What They Hide

The ACLU’s “95% preventable” is based on fewer people, fewer individuals held in precarious camps, and fewer extreme conditions. Yet even then, nearly all deaths were judged avoidable. Now we're adding stressors, including overcrowding, heat, remoteness, makeshift facilities, and waiver of standards. The death count this year (13 by June) is already higher than last year, and that’s just what is confirmed.

But confirmation lags. Many deaths are invisible: unreported, misclassified, delayed. Those who die in transit or shortly after release often fall off ICE’s official casualty statistics. So every number you see is almost certainly less than the truth.

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Why Alexandria Matters, Why It Demands Action

The reporting from Alexandria is new, significant, and disturbing enough in its documented cruelty to capture attention. However, it only works as a wake‑up call if we see it not as a singular horror, but as the tip of a mountain hundreds of feet high.

We have the names, we have the dates, we have the documented deaths. We have had over two decades of warnings. What we do not yet have is sufficient outrage, sufficient accountability, sufficient reform.

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A Question That Should Haunt Us

How many more will die before we can no longer pretend these are acceptable costs of detention policy?

How many more will get sick before health departments, courts, Congress, and local media demand transparency?

How many — not as political talking points — but as human beings whose names matter — how many must die before we act?

Sources:

• "COVID-19, suicide and substandard medical care driving high rate of death among ICE detainees" — Keck School of Medicine, USC

• “Deadly Failures: Preventable Deaths in U.S. Immigration Detention” — ACLU

• “Two more Ice deaths put US on track for one of deadliest years in immigration detention” — The Guardian

• “Trump’s deportation hub: inside the ‘black hole’ where immigrants disappear” — The Guardian

• "ICE death rate under Trump spiked, analysis finds" — AIMS Public Health