In Costa Rica, a man named Randal Alberto Gamboa-Esquivel, who had been detained by U.S. Immigration and Customs Enforcement (ICE), died after being airlifted back to his home country due to a critical illness. Gamboa-Esquivel had been hospitalized at Valley Baptist Hospital since June 12, 2025, during a scheduled immigration hearing, where he suffered from severe health issues including unspecified psychosis and severe undernourishment. His wife, Cordero, reported that they lost contact with him until his attorney discovered him in August, unresponsive and only able to blink. Concerns were raised about the medical care he received while in custody and the circumstances surrounding his transportation back to Costa Rica without proper medical documentation.

ICE detention facilities have come under scrutiny regarding their health care protocols, particularly as they relate to the treatment of individuals in their custody. Numerous reports and studies have highlighted the need for improved health care standards and practices within these centers. The U.S. Immigration and Customs Enforcement (ICE) is responsible for overseeing the health care of detainees, ensuring both access and quality of care. In recent years, there has been increasing attention from advocacy groups, legal entities, and lawmakers who are concerned about the potential impacts of substandard medical care on the global human rights landscape and the lives of individuals detained by ICE. Health care protocols for individuals in ICE detention centers should encompass a robust system that includes not only screening and treatment for existing conditions but also preventative care. This is especially vital in the context of infectious diseases, such as COVID-19, where overcrowding can facilitate the spread of illness. Protocol adherence is crucial, with a particular emphasis on timely medical examinations, access to mental health services, and the management of chronic illness. The integration of mental health care with physical health services also reflects a more comprehensive approach to the well-being of detainees, which has been both a point of advocacy and necessity in recent discussions. In terms of implementation, ICE has established certain guidelines aimed at ensuring detainees receive appropriate medical attention. However, these protocols have been criticized for being inconsistently applied and for not meeting the standard of care expected in the broader health care system. Reports have documented instances where detainees faced delays in receiving care, which has had severe consequences in some cases. Additionally, concerns over transparency and accountability within the health care provision model utilized by ICE remain significant obstacles to improvement. As ICE reform efforts are underway, it is imperative to examine these health care protocols critically. Stakeholders must advocate for more stringent oversight and accountability measures to ensure that health care services rendered to detainees are not only sufficient but also equitable. The future of ICE detention health care protocols thus rests on the dual imperative of humane treatment and upholding the health rights of individuals, regardless of their immigration status. Ensuring that these protocols are grounded in best practices and compassion will ultimately lead to a more ethical system that respects human dignity.