The first emergency call about a detainee trying to harm himself came about a month after Camp East Montana — an immigration detention center in El Paso, Texas — started to house immigrants. It was 2:50 p.m. on Friday, Sept. 12.

“We have a patient currently in holding who is saying he’s got suicidal ideations, swallowed some foreign object, has refused our basic medical care here,” a nurse told the operator. In the audio, you can hear that someone is moaning and yelling in the background.

“At this point he is unable to speak and rolling on the floor in agonizing pain, holding his stomach,” the nurse continued. “A preliminary X-ray was done and a foreign object was found. We just need to take him to the hospital that’s closest so that they can verify if the object is currently in his system and possibly to excavate the object.”