Serious medical and mental health emergencies have been routine at the nation’s largest U.S. Immigration and Customs Enforcement detention facility since its opening in August. Data from more than a hundred 911 calls at Camp East Montana in El Paso, Texas, along with interviews and court filings, offer a disturbing portrait of overcrowding, medical neglect, malnutrition and emotional distress. Current and former detainees say they struggle to obtain health care as disease spreads, lose weight because of a lack of food, and fear security guards known to use force to put down disturbances. A Department of Homeland Security spokesperson rejected claims of subprime conditions, saying Camp East Montana detainees receive food, water and medical treatment in a facility that is regularly cleaned.