OAKLAND, California — Immigrant patients at Highland Hospital, Oakland's largest public hospital, are cancelling and postponing medical appointments, switching to telephone visits or simply not showing up, nearly a month after U.S. Immigration and Customs Enforcement (ICE) agents brought a handcuffed detainee to the hospital and stayed at his bedside for six days, according to detailed new reporting published on Friday, November 13, by El Tímpano, the Bay Area newsroom that interviewed patients directly through a Spanish-language listening project.

Source: El Tímpano

One of them is Maricela, a resident of Oakland's Fruitvale neighbourhood who is battling a rare genetic condition that has produced cancerous and non-cancerous tumours throughout her life, and who asked to be identified by her first name only because she is undocumented. Days after hearing that ICE had brought a detainee into the hospital, she cancelled an appointment connected to a jaw surgery she had last year. Doctors have recently found three new lumps on her neck, and she is due to see her specialist in January to decide on treatment. She told El Tímpano she is not sure she will go: “I was terrified. They're so close to you. It's one thing to be told they're in some area [in the city], but quite another to almost run into them in the hospital… To be honest, I'm scared to go.”

The October 16 arrest that started it

The case at the centre of the fear began on October 16, when ICE agents arrested Eduardo Antonio Ruiz-Garcia in Emeryville and brought him to the Wilma Chan Highland Hospital Campus in Oakland for medical care. According to his attorney, Nikolas De Bremaeker, managing attorney at the Alameda County Immigration Legal and Education Partnership, Ruiz-Garcia was treated for six broken ribs and remained hospitalised for six days. De Bremaeker alleges — and this remains an allegation, not a finding — that an ICE agent guarded the patient inside his room, tried to direct his medical treatment and tried to obstruct his access to legal counsel, and that the same officer who had tackled Ruiz-Garcia and, the lawyer alleges, fractured his ribs sat at the foot of the bed grinning at him. Oakland North, reporting on protests over the same incident on October 28, likewise recorded the legal partnership's accusation that agents used excessive force in the Emeryville arrest.

Source: Oakland North

The warrant question has become a public dispute between the county and its own hospital system. Immigration agents are required to present a signed judicial warrant to enter private areas of the hospital. Alameda Health System (AHS) officials initially told County Supervisor Nikki Fortunato Bas that the agents had presented a warrant; De Bremaeker later revealed that no warrant — judicial or administrative — had been provided, and an AHS representative later acknowledged that hospital security had requested documentation from the agents and received none. “I am very upset to hear today that the information I thought was true on Monday, that this was an arrest with a warrant, is not true,” Fortunato Bas said at the October 27 Board of Supervisors meeting. “That is extremely upsetting.” No ICE response to the warrant allegation appears in the reporting reviewed for this story.

Appointments cancelled, doses halved

The clearest measure of the damage came at last month's Board of Supervisors meeting, where Carrie Schiff, a nurse practitioner at La Clínica de la Raza's San Antonio Neighborhood Health Center, testified that after the Highland incident, half of her patients did not show up for their appointments. “Every time there's an ICE surge, my patients don't come to their appointments,” Schiff said. El Tímpano's November text-message outreach drew dozens of replies: one Oakland subscriber switched a gastroenterology appointment to a phone call out of fear; a Berkeley subscriber wrote that her mother, a Highland patient, had asked her to cancel her appointment altogether.

Rosa G., a Hayward resident who asked to be identified by first name and initial because she is undocumented, waited three months for a mammogram to rule out breast cancer and a chest ultrasound. After seeing images of ICE vehicles entering the hospital parking lot on Facebook, she cancelled both. Her husband has been held in an immigration detention centre since March. “My fear is stronger than what's actually happening with my health,” she said. The mammogram has been rescheduled for January, and she says she will judge the risk again before deciding whether to attend. Another patient, Liseth M. of Oakland, whose husband was deported to Honduras in July, told El Tímpano she is taking only half of her prescribed depression medication because she is too afraid to go to the hospital pharmacy for a refill, and that without the full dose she is more restless and has difficulty concentrating.

What the law and county policy say

Alameda County has an ICE-free zones policy that bans the use of county property as staging areas, processing locations or operational bases for immigration enforcement — but officers accompanying a person already in their custody can still enter county property, which is how the agents lawfully remained on the campus in a physical sense while the warrant dispute played out. California law separately requires health facilities that receive public funds to maintain policies directing staff on what to do when federal agents appear, including designating non-public areas to protect patient privacy. At Highland, providers carry a badge card instructing them to refer legal questions to an on-call administrator, ask agents to leave the room during evaluations, and inform patients of their rights. Staff say the preparation is not enough: registered nurse Marina Stankov-Hodge told El Tímpano that staff have pushed administrators for months for ongoing training and clearer guidance on what counts as public and private space. “We don't have ongoing training,” she said. “I don't feel safe.”

Why this hospital matters beyond Oakland: Highland, at 1411 East 31st Street, is Alameda County's primary acute-care facility and its busiest emergency department, an adult Level I trauma centre, and one of the largest providers of care in the county for Medi-Cal and uninsured patients — care it provides regardless of immigration status. It is, in other words, exactly the kind of safety-net institution that immigrant families across the East Bay, including the region's large Punjabi diaspora households in the wider Bay Area, cannot simply replace with a private clinic when fear sets in. When patients skip cancer screening, fracture follow-up or psychiatric medication at a hospital like this, the medical cost does not disappear; it returns later, sicker and more expensive, through the same emergency doors.

What happens next

AHS says it is reviewing its protocols and training, and its October 23 statement stressed that no patient was then in immigration custody at Highland and no ICE personnel were on campus. The county's political argument is not finished: supervisors have already confronted hospital executives once in a joint meeting, the ICE-free zones policy is under pressure from advocates who say it has no answer for agents escorting detainees, and volunteer ICE-watch groups that formed outside the hospital on October 23 remain active. For patients like Maricela and Rosa G., the next test is personal and dated — specialist and screening appointments in January that they must each decide, on their own, whether it is safe to keep.