Multiple sclerosis research in the Northwest could lead to new treatments

The mystery of why the Pacific Northwest has one of the highest rates of multiple sclerosis in the world is as enduring as the mystery of the D.B. Cooper hijacking. And has proven about as difficult to crack.

Recently, however, scientists have been closing in on some likely triggers that may be causing the body to hijack its own immune system and turn on itself. Those new findings could lead to new treatment strategies in the future.

MS is a sneaky, unpredictable autoimmune disease that damages nerves and can impair vision and mobility as well as thinking and memory. The prevalence of MS here is about triple the level in the lower part of the United States, and many more times higher than elsewhere in the world. In King County, there are 9,000 known patients, and a growing number of them are children.

The prevalence is so high here that the Northwest chapter of the National Multiple Sclerosis Society has posted giant billboards around the city for the past several years asking questions like these:  Is it the trees? Is it the rain?

The questions may have been rhetorical, but the billboards were a reminder of the need to keep digging for answers about what causes MS.

On a macro scale, scientists actually do know why the rate appears elevated here.

Pediatric MS cases rise in the Northwest

The Pacific Northwest has one of the highest rates of multiple sclerosis in the world, yet the reasons why remain elusive. It’s an old mystery, but one that now has a new face. Today, doctors are seeing a growing number of cases in kids. They hope these young patients will yield more clues to what causes the disease.

MS is an autoimmune disease that causes nerve damage over time. It’s more common at higher latitudes, and tends to affect more women than men. Eventually, it can impair someone’s mobility, their vision – even their thinking and memory. It’s always been known as a “prime-of-life” disease, one that typically strikes in young adulthood.

For Allexis, now a senior at Central Kitsap High School in Silverdale, that wasn’t the case. She was diagnosed when she was 14 years old.

It started one Friday during the summer two years ago.

“I couldn’t sleep because I had the worst headache,” she said. “Out of a scale of one to 10, it was a 15.” She tried to go for her regular morning run the next day, and things got worse.

Detention center houses few serious criminals

Most illegal immigrants who end up behind the Northwest Detention Center’s razor wire are, at worst, petty criminals. Their stays at the lockup are but brief stops on the way out of the country.

On a walk-through last year of the low-slung complex on Tacoma’s Tideflats, federal immigration officials and a privately-employed warden explained how the hundreds of men and women dressed in color-coded uniforms wound up here.

About 1,000 of the roughly 1,300 adult detainees within its walls wear blue, they said, a classification that means they have little or no criminal history. Those in blue who do have rap sheets mostly committed minor offenses – traffic offenses and other misdemeanors that likely sent them to one of the hundreds of local jails in Washington, Oregon or Alaska where immigration officials later encountered them.

Another 200 immigrants, wearing orange, have committed more serious, “mid-level” crimes, such as drug-related offenses.

The rest of the population – a mostly unseen group of about 100 segregated detainees dressed in red – are criminals with serious convictions for sex offenses, assault, even homicide.

About 75 female detainees — all of whom don yellow uniforms, but wear colored wrist-bands that correspond with security classifications — are separately housed in living pods away from the men.

Detainees come from more than 70 nations, with Mexico by far the most common country of citizenship. Most wind up in Tacoma from three Northwest states served by the facility, but at least 165 detainees held at the Northwest Detention Center as of July were transferred from other “areas of responsibility.” They included 100 detainees from the San Antonio area, 33 from three different areas in California, 30 from the Phoenix area and one each from the Salt Lake City and New Orleans areas.

‘I can’t even talk about it’

Leticia Jimenez-Diaz, 41, has two children who are U.S. citizens. But she herself is not. That fact divides her family in a way that could soon rip it apart.

Slumped at a table in a bare-walled meeting room at the Northwest Detention Center, she started to cry when a visitor asked about her children, then ages 9 and 16. She hadn’t seen them in a month and a half, ever since she was taken to the detention center for being in violation of a long-ago deportation order.

Fearful of being deported and possibly leaving her U.S.-born children behind with relatives, Leticia Jimenez-Diaz, breaks down in tears during a interview at the Northwest Detention Center. Dean J. Koepfler/The News Tribune

It’s an order she says she did not even know about.

In 1993, immigration officers swept through the plant nursery where she was working at the time. As a result, she was supposed to appear before an immigration judge.

But she says she never got the notice to appear.

“I think that they sent the notice to the wrong place,” she said. “I never received it.”

Her attorney, Carol Edward of Carol L. Edward & Associates, confirmed records show Jimenez-Diaz missed the date of that hearing, and in her absence, an immigration judge ordered her deported to Mexico in 1994.

Unaware of that development, however, Jimenez-Diaz continued raising her young sons in Mt. Vernon. She volunteered at their schools. Helped them play soccer. She worked in the flower bulb business and took classes at Skagit Valley College to learn English.

Is There a Right to Counsel? Class Action Suit Represents Detainees with Mental Disabilities

Detainees pass the time in one of the pods of the Northwest Detention Center's 1575-bed facility as they wait for a decision on their cases.
Dean J. Koepfler/The News Tribune

The legal decisions facing detained immigrants trying to represent themselves in immigration court are intimidating enough. For those with mental disabilities, they can be incomprehensible.

But a recent federal court decision could lead to a legal precedent that would give immigrants with mental impairments the right to a court-appointed attorney.

Currently, immigrants have no right to court-appointed legal representation for immigration proceedings.

“People with severe mental disabilities who are locked up in immigration detention are ground through this system without even understanding what is happening to them,” said Matt Adams, legal director of Northwest Immigrant Rights Project. NWIRP has taken up the cause on behalf of a severely schizophrenic man from the Ukraine, who was held at the Northwest Detention Center on Tacoma’s Tideflats for more than two years – from April 15, 2010, until June 22, 2012.

This is in stark contrast to the American criminal justice system, which gives defendants the right to court-appointed counsel, and also has a formal system for determining whether a defendant is mentally competent to understand charges and stand trial.

The High Cost of Technicalities

Children dressed up for a visit with family members detained in the Northwest Detention Center pass by immigration activists at a recent protest in front of the facility.
Dean J. Koepfler/The News Tribune

Young love, and a near-fatal car accident brought Ana Maria Gutierrez to the United States nearly half her life time ago. 

Now she faces a collision of another kind – between immigration policies and her hopes for the future of her family, which includes six children, all American citizens.

Ana Maria, was only 15 when she first noticed the young man visiting at church in Tamastian, a tiny village in Jalisco, Mexico.

“He had really long eyelashes,” she said through a translator. She blushes. “I noticed that right away.”

The young man was Alvaro Gutierrez, a U.S. resident who had been visiting family in the village. Alvaro had been a lawful permanent resident of the United States since the age of four.

The two fell in love. A few years later, he proposed to her in the plaza of the same town. She was 19. They married in a civil ceremony, and 10 months later held a church wedding. After each, though, she stayed behind in Mexico while he returned to the United States.

In 1997, just after the civil wedding, she did make one attempt to unite with her husband. But her timing was bad. That was also the year provisions of the 1996 Illegal Immigration Act had gone into effect – new rules that included stepped up enforcement at the borders.

She got caught at the border and ordered deported. Prior to that, more relaxed security had allowed many immigrants to come and go across the border with fewer stops. Even those who were caught, were often turned back without an actual deportation order.

How We Reported on the Northwest Detention Center

"Center of Detention" reflects reporting conducted in parts of 2010, 2011 and 2012 during a first-of-its kind reporting partnership for The News Tribune with an independent journalism nonprofit.

TNT reporter Lewis Kamb teamed with reporter Carol Smith of Seattle-based InvestigateWest, to interview more than 75 people, attend various hearings and review more than 20,000 pages of records. TNT photographer Dean Koepfler chronicled some of the interviews and other events to capture the special report's visual elements.

Sources for the stories included various undocumented immigrants and their family members; private and government attorneys; city and county police officials; city fire officials; county jail officials; municipal bond experts; various city, county, state and federal government officials; academics and activists.

The reporters conducted interviews of some immigrants while they were in local or federal custody. When needed, reporters used the services of a volunteer Spanish-language interpreter.

Records obtained and reviewed include paper documents, audio files and video records. Such records, if not otherwise publicly available, were obtained directly from private individuals or in response to state and federal public records requests.

Fifteen Minutes in Immigration Court

Portraits of President Barack Obama and Attorney General Eric Holder hang in a waiting room where families of illegal immigrants wait as their loved ones attend hearings in two immigration courtrooms.
Dean J. Koepfler/The News Tribune

A narrow passageway separates the interior of the sprawling Northwest Detention Center in Tacoma from a trio of small federal courtrooms where the fate of the majority of men and women in the center will be decided. It is a courtroom of first appearances and, for many, last hopes.

The hallway, just off the one they call the “gray mile,” is short by design. It expedites getting people from detention into the court system that, while sagging under sheer numbers of cases, is still set up to speed them out of the country.

Speed matters from a cost-saving standpoint: Immigrants are detained at taxpayer expense.

The Tacoma court, operated by the U.S. Dept. of Justice’s Executive Office of Immigration Review, is one of 59 immigration courts nationwide that are handling record numbers of deportation cases. It has two full-time judges and last year handled a total of 11,249 hearings. Many detainees have multiple hearings before they are ordered deported, released on bond, or their cases dismissed.

On a typical morning, the docket is already packed with 40 cases. In Judge Theresa Scala’s courtroom, men – most appearing to be in their 20s and 30s – fill the half-dozen pew-like benches. Each man wears a uniform that signifies his criminal history or threat: Blue if no criminal history, or only minor charges or convictions; orange for mid-level offenses, such as drug-related crimes; red for those with assault charges or convictions. Women, who make up only about 10 percent of the detention center population, wear yellow. On this day, the courtroom is a sea of mostly navy blue.