Rebekah Stewart, a nurse in the US Public Health Service, received a call last April that made her cry. He was selected for the deployment of the Trump administration’s new immigration control operation in Guantánamo Bay, Cuba. This posting combined Donald Trump’s longtime love of using the beach base to operate “some bad guys” from the United States with a promise made shortly after his inauguration to keep thousands of non-citizens there. The sea base known for torture and not human treatment of male terrorism suspects after 9/11.

“Deployments are usually not something you can say no to,” Stewart said. She pleaded with the coordination office, finding another nurse to take her place.

Other public health officials, who worked at Guantánamo last year, described the conditions there for the detainees, some of whom first learned they were in Cuba from the nurses and doctors sent to care for them. They treat immigrants held in a dark prison called Camp 6, where there is no daylight, the officials said on condition of anonymity because they fear reprisals for speaking out publicly. It used to hold people suspected of having ties to Al Qaeda. The officials said they were not informed in advance of the details of their potential duties at the base.

Although the Public Health Service is not a branch of the US military, its uniformed officers – roughly 5,000 doctors, nurses, and other health workers – act like stethoscope-wearing soldiers in emergencies. The government deploys them during typhoons, forest fires, shootings, and measles attacks. In the interim, they will fill in the gaps in an alphabet soup of government agencies.

The Trump administration mass arrests to curb immigration has created a new kind of health emergency as the number of people detained reaches record high. About 71,000 immigrants are currently in jail, according to data from Immigration and Customs Enforcement, which shows that most do not have a criminal record.

Homeland Security Secretary Kristi Noem said: “President Donald Trump has been very clear: Guantánamo Bay will hold the worst of the worst.” However, several news organizations have reported that most of the men sent to the base do not have criminal convictions. About 90 percent of them are described as “low-risk” by a May progress report from a chaplain observing the prisoners.

In fits and starts, the Trump administration has sent about 780 non-citizens to Guantánamo Bay, according to The New York Times. The numbers fluctuate as new detainees arrive and some are returned to the US or deported.

While some Public Health Service officials have provided medical care to detained immigrants in the past, this is the first time in American history that Guantánamo has been used to house immigrants living in the US. Officials say ICE postings are on the rise. After escaping Guantánamo, Stewart was ordered to report to an ICE detention center in Texas.

“Public health officials are being asked to expedite a man-made humanitarian crisis,” he said.

Seeing no choice but to turn down deployments he found objectionable, Stewart resigned after a decade of service. He left out the possibility of a pension being offered after 20 years.

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

One of her colleagues at PHS, nurse Dena Bushman, wrestled with the same moral dilemma when she received a notice to report to Guantánamo a few weeks after the shooting at the Centers for Disease Control and Prevention in August. Bushman, who was posted with the CDC, obtained a medical waiver that delayed his deployment due to stress and grief. He considered resigning, then did.