‘My Dream Job Wasn’t Supposed to Be This’: Public Health Workers Resign Over Trump’s Guantánamo Immigration Detention Mission

Last April, Rebekah Stewart, a 10-year veteran nurse with the U.S. Public Health Service (PHS), got a deployment notice that left her in tears. She had been selected to serve at the Trump administration’s new immigration detention operation at Guantánamo Bay, Cuba. This posting fulfilled two longstanding Trump promises: his years-long push to use the offshore military base to move “some bad dudes” out of the United States, and his pledge made shortly after inauguration to detain thousands of noncitizens there. The base has been globally infamous for the torture and cruel inhumane treatment of post-9/11 terrorism suspects held there for decades.

“Deployments are typically not something you can say no to,” Stewart said. She pleaded with the coordinating office, which eventually agreed to replace her with another nurse.

Other PHS officers who served at Guantánamo over the past year have described shocking conditions for detainees, including that some immigrants only learned they were being held in Cuba after the medical staff sent to treat them told them. Speaking on condition of anonymity over fears of professional retaliation for speaking publicly, the officers said they provided care to immigrants locked in Camp 6, a maximum-security prison so dark no natural sunlight ever filters into its cells. Camp 6 was originally built to hold detainees suspected of ties to al-Qaeda. The officers also confirmed they received no advance briefing on the specific details of their roles and duties before being deployed to the base.

Though PHS is not an official branch of the U.S. military, its roughly 5,000 uniformed health workers — doctors, nurses, and other clinicians — function as frontline “stethoscope soldiers” activated for national emergencies. The government deploys them to respond to hurricanes, wildfires, mass shootings, and measles outbreaks, and they fill critical staffing gaps across dozens of federal agencies between crises.

The Trump administration’s mass immigration enforcement crackdown has created an unprecedented, manmade public health crisis as the national immigrant detention population hits all-time record highs. Current data from U.S. Immigration and Customs Enforcement (ICE) puts the number of detained immigrants at roughly 71,000, and most have no criminal record.

Homeland Security Secretary Kristi Noem has said: “President Donald Trump has been very clear: Guantánamo Bay will hold the worst of the worst.” However, multiple independent news investigations have found that most immigrants transferred to the base have no criminal convictions at all. A May progress report from a chaplain who monitors detainee conditions classified as many as 90% of the Guantánamo immigrant detainees as “low-risk.”

Per The New York Times, the Trump administration has transferred roughly 780 noncitizens to Guantánamo Bay in fits and starts since launching the operation, with the population fluctuating regularly as new detainees arrive and others are transferred back to the U.S. or deported.

While PHS officers have provided care to detained immigrants in the past, this marks the first time in U.S. history that Guantánamo has been used to house noncitizens who were already residing in the United States. Officers also noted that ICE deployments for PHS staff have become increasingly common. After dodging the Guantánamo posting, Stewart was ordered to report to an ICE detention center in Texas.

“Public health officers are being asked to facilitate a man-made humanitarian crisis,” she said.

With no formal process to refuse deployments she considered morally unconscionable, Stewart resigned after a decade of service, walking away from a full pension she would have earned after 20 years with the agency.

“It was one of the hardest decisions I ever had to make,” she said. “It was my dream job.”

Another PHS nurse, Dena Bushman, faced the same ethical crisis just weeks after the August shooting at the Centers for Disease Control and Prevention (CDC), when she received her own Guantánamo deployment notice. Bushman, who was assigned to work at the CDC at the time, initially got a medical waiver to delay her deployment due to acute stress and grief from the attack. But after weighing her options, she ultimately chose to resign too.

“This may sound extreme,” Bushman said. “But when I was making this decision, I couldn’t help but think about how the people who fed those imprisoned in concentration camps were still part of the Nazi regime.”

While several other PHS officers have resigned over the deployments, many have stayed on the job. Multiple officers who remain told KFF Health News that even though they are deeply alarmed by the Trump administration’s detention tactics, detained people still need life-saving medical care that only they can provide.

“We do the best we can to provide care to people in this shit show,” said a PHS nurse who worked in immigration detention facilities last year.

“I respect people and treat them like humans,” she said. “I try to be a light in the darkness, the one person that makes someone smile in this horrible mess.”

The officers acknowledged that their ability to protect detainees is severely limited by a detention system plagued by systemic overcrowding, disorganization, and widespread psychological trauma from constant uncertainty, forced family separation, and sleep deprivation.

“Ensuring the safety, security, and well-being of individuals in our custody is a top priority at ICE,” said Tricia McLaughlin, chief spokesperson for the Department of Homeland Security, in an emailed statement to KFF Health News.

Admiral Brian Christine, assistant secretary for Health at the Department of Health and Human Services (HHS), which oversees the Public Health Service, said in an email: “Our duty is clear: say ‘Yes Sir!’, salute smartly, and execute the mission: show up, provide humane care, and protect health.” As WIRED and other outlets have previously reported, Christine is a recent Trump appointee who, until taking his current role, worked as a urologist specializing in testosterone therapy and male fertility.

“In pursuit of subjective morality or public displays of virtue,” he added, “we risk abandoning the very individuals we pledged to serve.”

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Going Into the Unknown

In the months leading up to her resignation, Stewart reflected on her earlier deployment during Trump’s first term to Customs and Border Protection-run immigration processing centers. She recalled one Texas facility where 50 women were crammed into a single concrete holding cell.

“The most impactful thing I could do was to convince the guards to allow the women, who had been in there for a week, to shower,” she said. “I witnessed suffering without having much ability to address it.”

Stewart worked alongside Bushman and other PHS officers embedded at the CDC last year, where they supported the agency’s measles outbreak response, sexually transmitted infection research, and other core work. Their roles became especially critical last year after the Trump administration carried out mass layoffs of long-time CDC career staff.

Stewart, Bushman, and a small group of other PHS officers at the CDC met with mid-level managers to press for clear answers about Guantánamo and ICE deployments. They wanted to know: If they served at these facilities, how much autonomy would they have to provide the care they deemed medically necessary? If they witnessed unethical treatment, what reporting channels would be available to them? Would complaints be investigated? Would they be protected from retaliation?

Stewart and Bushman said the only answer they received was a PHS office phone number to call if they had a complaint while on assignment. All their other questions went unanswered. They resigned before reporting to Guantánamo, and deployed PHS officers who did go to the base confirmed that they also received no advance details about their duties or medical care standard operating procedures before arriving.

Stephen Xenakis, a retired Army general and psychiatrist who has advised on Guantánamo medical care for two decades, said that lack of advance transparency is deeply troubling. Before health workers deploy, he said, they should understand what they will be expected to do.

The consequences of deploying without clear guidance can be severe. In 2014, the Navy threatened to court-martial a Guantánamo-based nurse who refused to participate in force-feeding of hunger-striking detainees, who were protesting inhumane conditions and indefinite detention. The protocol was notoriously brutal: detainees were shackled to a five-point restraint chair while nurses shoved a liquid feeding tube into their stomach through their nostrils.

“He wasn’t given clear guidance in advance on how these procedures would be conducted at Guantánamo,” Xenakis said of the 2014 nurse. “Until he saw it, he didn’t understand how painful it was for detainees.”

The American Nurses Association and Physicians for Human Rights sided with the nurse, calling the procedure a violation of the ethical standards of medical professionals. After a year, the military dropped the charges.

Xenakis explained that a clinician’s ability to push back against unethical practices at Guantánamo depends heavily on their rank, their supervisor, and the chain of command. More than a decade ago, he helped end some inhumane interrogation tactics at the base when he and other retired senior military leaders publicly objected to a practice called “walling,” where interrogators slammed terrorism suspects’ heads into a wall to induce minor concussions. Xenakis argued that there was no scientific evidence walling produced reliable intelligence, and that it was unethical, amounting to torture.

While torture has not been confirmed in Guantánamo’s immigration operation, ICE shift logs obtained via a Freedom of Information Act request by government watchdog American Oversight document growing concerns about hunger strikes and self-harm among detainees.

“Welfare checks with potential hunger strike IA’s,” short for illegal aliens, says an April 30 note from an ICE contractor. “In case of a hunger strike or other emergencies,” the report adds, PHS and ICE are “coordinating policies and procedures.”

“De-escalation of potential pod wide hunger strike/potential riot,” says an entry from last July. “Speak with alien on suicide watch regarding well being.”

Detainee accounts and independent investigations have repeatedly documented delayed medical care and dangerous conditions, including overcrowding and a lack of sanitation, at U.S. immigration detention facilities. Thirty-two people died in ICE custody in 2025, making it the deadliest year for immigrant detention in two decades.

“They are arresting and detaining more people than their facilities can support,” said one PHS officer. The most prevalent problem the officer saw among imprisoned immigrants was psychological. They worried about never seeing their families again or being sent back to a country where they feared they would be killed. “People are scared out of their minds,” the officer said.

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No Sunlight

PHS officers who served at Guantánamo said immigrant detainees are held in one of two settings: low-security barracks with a handful of people per room, or Camp 6, the dark, high-security facility with no access to natural light. ICE shift logs refer to the two sites by their location on the island: Leeward for the barracks and Windward for Camp 6. About 50 Cuban men transferred to Guantánamo in December and January have languished in Camp 6 for months, according to The New York Times.

A Navy hospital on the base mainly serves active-duty military and other non-detained residents, and its medical capabilities are limited even for that population, officers said. To reduce the high cost of emergency medical evacuations back to the U.S. mainland for specialist care, immigrants are medically screened before being shipped to Guantánamo. People over age 60 or who needed daily medication to manage chronic conditions like diabetes and high blood pressure, for example, have generally been excluded. Even with that pre-screening, some detainees have still required emergency evacuation back to Florida, officers said.

PHS nurses and doctors screen immigrants again when they arrive, provide ongoing care, and treat common complaints including gastrointestinal distress and depression. One observer’s report notes, “The USPHS psychologist started an exercise group” for detainees.

Doctors’ requests for lab work were often turned down because of logistical hurdles, partly due to overlapping bureaucracy from the multiple agencies operating on the base, officers said. Even a routine complete blood cell count took weeks to process at Guantánamo, versus just hours in the U.S.

DHS and the Department of Defense, which have coordinated on the Guantánamo immigration operation, did not respond to multiple requests for comment about conditions at the base.

One PHS officer who helped medically screen new arrivals said detainees were often surprised to learn they were at Guantánamo.

“I’d tell them, I’m sorry you are here,” the officer said. “No one freaked out. It was like the 10-millionth time they had been transferred.” Some of the men had been moved through multiple different facilities over five or six months and said they only wanted to return to their home countries, according to the officer. Health workers had neither an answer nor a fix to give them.

Unlike ICE detention facilities on the U.S. mainland, Guantánamo has not faced overcrowding. “I have never been so not busy at work,” one officer said. For non-detained staff, the tropical military base offers amenities like snorkeling, paddleboard yoga, and kickboxing. Even so, the officer said they would rather be home than carrying out this assignment at taxpayer expense.

Transporting staff and supplies to the island and maintaining operations at the base is enormously expensive. A 2025 Washington Post analysis of DOD data found the government paid an estimated $16,540 per day per detainee at Guantánamo to hold those accused of terrorism, compared to an average of $157 per day to detain immigrants in mainland U.S. ICE facilities.

Even with the staggering cost, funding for immigration detention has skyrocketed: Congress granted ICE a record $78 billion for fiscal year 2026, a staggering increase from $9.9 billion in 2024 and $6.5 billion nearly a decade ago. Last year, the Trump administration also diverted more than $2 billion from the national defense budget to expand immigration detention, according to a report from congressional Democrats. About $60 million of that diverted funding went to Guantánamo.

“Detaining noncitizens at Guantánamo is far more costly and logistically burdensome than holding them in ICE detention facilities within the United States,” wrote Deborah Fleischaker, a former assistant director at ICE, in a declaration submitted as part of a lawsuit brought by the American Civil Liberties Union early last year. In December, a federal judge rejected the Trump administration’s request to dismiss a separate ACLU case, questioning the legality of detaining immigrants outside of the country.

Anne Schuchat, who served with the PHS for 30 years before retiring in 2018, said PHS deployments to detention centers may cost the nation in terms of public health security too. “A key concern has always been to have enough of these officers available for public health emergencies,” she said. (Andrew Nixon, an HHS spokesperson, said the immigration deployments do not affect the Public Health Service’s potential response to other emergencies.)

In the past, PHS officers have set up medical shelters during hurricanes in Louisiana and Texas, rolled out COVID testing in the earliest months of the pandemic, and provided crisis support after the deadly shooting at Sandy Hook Elementary School and the Boston Marathon bombing.

“It’s important for the public to be aware of how many government resources are being used so that the current administration can carry out this one agenda,” said Stewart, one of the nurses who resigned. “This one thing that’s probably turning us into the types of countries we have fought wars against.”

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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—the independent source for health policy research, polling, and journalism.

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