Opinion: ICE policy change keeping sick people from badly needed care

Empty waiting rooms. Missed appointments. A palpable sense that something is wrong.

Earlier this year, the Department of Homeland Security quietly rolled back protections for sensitive locations, allowing Immigration and Customs Enforcement (ICE) to resume enforcement actions near hospitals and clinics — with immediate and devastating consequences.

ICE raids have sent shockwaves through Southern California neighborhoods, leaving many community members afraid to seek the care they desperately need. Health care must be a source of healing, not surveillance.

Safe care is a human right — and realizing that right means ensuring our clinics and hospitals serve as sanctuary spaces.

As a medical student, I have seen the consequences of fear in our exam rooms. At a free clinic in Pomona, I met a woman with symptoms of a urinary tract infection. She had spent two years in a border detention center, where clean drinking water was scarce and she had no control over what or how much she could drink.

Her vitals revealed dangerously elevated blood sugar. She was in acute hyperglycemia, worsened by dehydration — likely minutes from organ failure — but she hesitated. I didn’t ask about her immigration status — it wasn’t relevant. What mattered was her safety, and the terror in her eyes was undeniable.

No one should have to choose between seeking care and staying safe.

Health is collective. From preschool to medical school in Riverside County, I lived and learned alongside immigrant — documented and otherwise — classmates and neighbors, less than 150 miles from the U.S.-Mexico border.

We are bound not only by the land beneath us, but by our shared vulnerability — to communicable diseases, to policy decisions, to fears — and by the people beside us, whose labor and lives shape our communities.

In California, over one-third of physicians and nurses are immigrants. My own parents are immigrant health care workers. But our well-being also depends on those who harvest our food, prepare our meals, and build our homes — the people who support the infrastructure of public health itself. To protect our neighbors’ health is to protect our own.

Unchecked law enforcement in health care settings puts all of us at risk, regardless of immigration status, according to the Journal of Racial and Ethnic Health Disparities. Physical health is at risk, with growing reports of excessive force. Mental health suffers, with heightened distress and diminished senses of safety. Social trust deteriorates, contributing to more provider bias and patient silence. Policing in places meant for healing turns hospitals into sites of surveillance and becomes a negative determinant of health for all.

Patients should feel safe to share their stories. California mandates reporting of abuse, neglect, violence and communicable disease to protect public safety — not to target undocumented individuals. Immigrants are not threats to our communities. They are our communities. As future physicians, we must not forget our duty to serve them.

That begins with clearly telling patients that immigration status will not be documented in medical records. It means welcoming stories about immigrant struggles, carrying important clinical weight. Even visual cues displaying support — buttons and brochures — can spark life-saving conversations. Providers should also prepare patients facing detention-related fears with basic emergency planning support, connecting them to legal and community resources. Needing care is not a crime.

My fellow medical students and I are doing our part. At free clinics, we hand out “know your rights” cards. On June 14, we marched together in scrubs across Southern California, holding signs in support of sanctuary spaces and democracy.

But we need more.

We must push for approaches such as sanctuary doctoring to be integrated into training at every level, from undergraduate to continued medical education. Within clinics, staff should be trained on confidentiality and clear ICE protocols, including requesting judicial warrants and notifying legal teams. States should follow California’s lead. Under the California Values Act (Senate Bill 54), public health facilities must adopt policies that limit cooperation with immigration agents. These protections must be enforced and expanded: Immigration enforcement has no place in our exam rooms.

When I entered medical school, I committed to advocating for my community, including patients as the woman from the Pomona clinic.

Now is the time for us — as health care providers, policy makers and neighbors — to stand up to make health care safe for each other.

Dhama is a student at UC Riverside School of Medicine and lives in Riverside County.