[...] Ms. Cooper, 23, who had promised to show her boyfriend another side of her country on this visit — meaning Las Vegas and the Grand Canyon — eventually learned that he had been sent in shackles to a rural Virginia jail. And there he remained for more than 10 days, locked up without charges or legal recourse while Ms. Cooper, her parents and their well-connected neighbors tried everything to get him out.

Mr. Salerno’s case may be extreme, but it underscores the real but little-known dangers that many travelers from Europe and other first-world nations face when they arrive in the United States — problems that can startle Americans as much as their foreign visitors.

“We have a lot of government people here and lobbyists and lawyers and very educated, very savvy Washingtonians,” said Jim Cooper, Ms. Cooper’s father, a businessman, describing the reaction in his neighborhood, the Wessynton subdivision of Alexandria. “They were pretty shocked that the government could do this sort of thing, because it doesn’t happen that often, except to people you never hear about, like Haitians and Guatemalans.”

[...]

One recent case involved an Icelandic woman who was refused entry at Kennedy Airport because, a dozen years earlier, she had overstayed her visa by three weeks. The woman, Erla Osk Arnardottir Lillendahl, was deported Dec. 10 after what she described as 24 hours of interrogation and humiliating treatment — locked in a cell and barred from making phone calls.

[...]

Ms. Cooper said that at the airport, when she begged to know what was happening to Mr. Salerno, an agent told her, “You know, he should try spending a little more time in his own country.”

Another agent eventually told her to go home because Mr. Salerno was being detained as an asylum-seeker.

“The border patrol officer said to my face that Domenico said he would be killed if he went back to Italy,” she recalled, voicing incredulity that, in his halting English, he could express such a thought. “Also, who on earth would ever seek asylum from Italy?”

[...]

Ten days after he landed in Washington, Mr. Salerno was still incarcerated, despite efforts by Senator John W. Warner, Republican of Virginia, and two former immigration prosecutors hired by the Coopers.

The 1996 Anti-terrorism and Effective Death Penalty Act (AEDPA) and the 1996 Illegal Immigration Reform and Immigrant Responsibility Act (IIRAIRA) have had the combined effect of dramatically increasing the number of immigrants in Immigration and Naturalization Services (INS) detention from 8,500 in 1996 to nearly 16,000 in 1998.

[...]

Indefinite detention is a feature we expect of repressive regimes, not of our own. The INS's authority to detain a non-citizen ordered removed derives from one purpose: effectuating removal. Once it becomes clear that removal is not possible, the rationale for continued detention evaporates and the non-citizen's liberty rights demand that he or she be released under supervision. It is grossly unfair to detain a person forever, after they have served their time in prison, just because the INS has been unable to remove them.

The courts are beginning to agree. Several federal district courts have recently ruled that indefinite detention with no realistic prospect of removal is unconstitutional. In July of 1999 a panel of five district court judges in Seattle reached the same conclusion in five cases that should have nation-wide implications. The Ninth Circuit Court of Appeals upheld that decision on April 10, 2000.

It is time for Congress to agree as well.

[...] Currently, no government body is charged with accounting for deaths in ICE detention, a patchwork of county jails, privately run prisons and federal facilities. Getting details about those who die in custody is a difficult undertaking left to family members, advocacy groups and the media. Since 2003, at least 83 people have died in immigration custody.

More than 300,000 men, women and children are detained by ICE each year. They include asylum seekers, long-time green card holders with minor immigration violations and families with small children.

FLORENCE, Ariz. -- Underneath her baggy jail-issue pants, Yong Sun Harvill feels the soft lump just below her left knee. Sometimes it tingles. Sometimes it is numb. Like her cancer felt when it arrived behind the knee a few years ago.

She noticed the lump under the thin, blue cotton in August, five months after federal immigration officers, to her amazement, took her into custody to try to deport her for buying stolen jewelry more than a decade ago. The lump grows slowly. It is now three inches across. And though she keeps asking, no one has done a test to see whether her sarcoma has come back.

Her leg is painful and swollen from hip to foot, damaged by past surgeries and radiation treatments. Some nights, liquid seeps through cracks in her distended skin. Her left ankle is three times as big as her right. For years, she relied on a leg pump to boost her circulation and keep the swelling in check. But as an immigration detainee in this desert prison town, Harvill, 52, has been unable to persuade anyone to get her a pump, or to let her family back in Florida send hers from home.

Nor has she gotten the biopsy that a doctor has told her she needs to determine whether the spots on her liver might be tumors. And it remains uncertain whether her frequent crying spells are part of bipolar disorder, as some records suggest, or a flare-up of old anxieties -- heightened now by chronic pain, bewildering medical problems, and the fact that, three decades after she arrived from South Korea as a teenage Army bride, she is in a jail far from home with the government trying to eject her from the United States.

Harvill is one of 33,000 immigration detainees in the custody of the Department of Homeland Security's Immigration and Customs Enforcement agency, known as ICE, on any given day. They are locked up in a patchwork of out-of-the-way federal detention compounds, private prisons and local jails. This unnoticed prison system was built for a quick revolving door of detainees -- into custody, out of the country. But often, people linger in detention for months or years.

These detainees, like other prisoners, are by law and regulation entitled to medical services if they are sick. But Harvill's journey through immigration detention provides a glimpse into a medical system that often fails those who need it most. It is an upside-down world where patients have no say, doctors and nurses on site have little power to administer timely treatment, and a managed-care system in Washington operates from a rulebook that emphasizes what is not covered rather than what is.

The U.S. government has injected hundreds of foreigners it has deported with dangerous psychotropic drugs against their will to keep them sedated during the trip back to their home country, according to medical records, internal documents and interviews with people who have been drugged.

The government's forced use of antipsychotic drugs, in people who have no history of mental illness, includes dozens of cases in which the "pre-flight cocktail," as a document calls it, had such a potent effect that federal guards needed a wheelchair to move the slumped deportee onto an airplane.

"Unsteady gait. Fell onto tarmac," says a medical note on the deportation of a 38-year-old woman to Costa Rica in late spring 2005. Another detainee was "dragged down the aisle in handcuffs, semi-comatose," according to an airline crew member's written account. Repeatedly, documents describe immigration guards "taking down" a reluctant deportee to be tranquilized before heading to an airport.

In a Chicago holding cell early one evening in February 2006, five guards piled on top of a 49-year-old man who was angry he was going back to Ecuador, according to a nurse's account in his deportation file. As they pinned him down so the nurse could punch a needle through his coveralls into his right buttock, one officer stood over him menacingly and taunted, "Nighty-night."

Such episodes are among more than 250 cases The Washington Post has identified in which the government has, without medical reason, given drugs meant to treat serious psychiatric disorders to people it has shipped out of the United States since 2003 -- the year the Bush administration handed the job of deportation to the Department of Homeland Security's new Immigration and Customs Enforcement agency, known as ICE.

Involuntary chemical restraint of detainees, unless there is a medical justification, is a violation of some international human rights codes. The practice is banned by several countries where, confidential documents make clear, U.S. escorts have been unable to inject deportees with extra doses of drugs during layovers en route to faraway places.

Federal officials have seldom acknowledged publicly that they sedate people for deportation. The few times officials have spoken of the practice, they have understated it, portraying sedation as rare and "an act of last resort." Neither is true, records and interviews indicate.

Records show that the government has routinely ignored its own rules, which allow deportees to be sedated only if they have a mental illness requiring the drugs, or if they are so aggressive that they imperil themselves or people around them.

[...] An analysis by The Post of the known sedations during fiscal 2007, ending last October, found that 67 people who got medical escorts had no documented psychiatric reason. Of the 67, psychiatric drugs were given to 53, 48 of whom had no documented history of violence, though some had managed to thwart an earlier attempt to deport them. These figures do not include two detainees who immigration officials said were given sedatives for behavioral rather than psychiatric reasons before being deported on group charter flights, which are often used to return people to Mexico and Central America.

[...]

But many of those injected with psychotropic drugs, records show, are neither violent nor mentally ill. They simply do not want to go home.