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Federal immigration officials are force-feeding six immigrants through plastic nasal tubes during a hunger strike that's gone on for a month inside a Texas detention facility, the Associated Press has learned.

U.S. Immigration and Customs Enforcement says 11 detainees at the El Paso Processing Center have been refusing food, some for more than 30 days. Detainees who reached the AP, along with a relative and an attorney representing hunger strikers, said nearly 30 detainees from India and Cuba have been refusing to eat, and some are now so weak they cannot stand up or talk.

Another four detainees are on hunger strikes in the agency's Miami, Phoenix, San Diego and San Francisco areas of responsibility, ICE spokeswoman Leticia Zamarripa said Wednesday.

The men say they stopped eating to protest verbal abuse and threats of deportation from guards. They are also upset about lengthy lock ups while awaiting legal proceedings.

In mid-January, two weeks after they stopped eating, a federal judge authorized force-feeding of some El Paso detainees, Zamarripa said. She did not immediately address the detainees' allegations of abuse but did say the El Paso Processing Center would follow the federal standards for care.

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ICE officials say they closely monitor the food and water intake of detainees identified as being on a hunger strike to protect their health and safety.

The men with nasal tubes are having persistent nose bleeds, and are vomiting several times a day, said Amrit Singh, whose two nephews from the Indian state of Punjab have been on hunger strike for about a month.

"They are not well. Their bodies are really weak, they can't talk and they have been hospitalized, back and forth," said Singh.

Singh's nephews are both seeking asylum. Court records show they pleaded guilty to a misdemeanor charge in September after illegally walking across the border near El Paso.

There have been high-profile hunger strikes around the country at immigration detention centers in the past, and non-consensual feeding and hydration has been authorized by judges in court orders. Media reports and government statements don't indicate immigration detainees actually underwent involuntary feeding in recent years, opting to end their hunger strikes when faced with nasal intubation. ICE did not immediately respond to queries about how often they are force-feeding detainees.

To force-feed someone, medical experts typically wind a tube tightly around their finger to make it bend easily, and put lubricant on the tip, before shoving it into a patient's nose. The patient has to swallow sips of water while the tube is pushed down their throat. It can be very painful.

The El Paso detention facility, located on a busy street near the airport, is highly guarded and surrounded by chain-link fence.

ICE classifies a detainee as a hunger striker after they refuse nine consecutive meals. Federal courts have not conclusively decided whether a judge must issue an order before ICE force-feeds an immigration detainee, so rules vary by district and type of court, and sometimes orders are filed secretly.

In Tacoma, Washington, where immigration detainees have held high-profile hunger strikes in recent years, courts have ordered force-feeding at least six times, according to court records. In July 2017, a federal judge refused to allow ICE to restrain and force-feed a hunger striking Iraqi detainee who wanted to be housed with fellow Iraqi Chaldean Christians detained Arizona facility.

Since May 2015, volunteers for the nonprofit Freedom for Immigrants have documented 1,396 people on hunger strike in 18 immigration detention facilities.

The force-feeding of detainees through nasal tubes at Guantanamo Bay garnered international blowback. Hunger strikes began shortly after the military prison opened in 2002, with force-feeding starting in early 2006 following mass refusals to eat.

After four weeks without eating, the body's metabolic systems start to break down, and hunger strikers can risk permanent damage, including cognitive impairment, said Dr. Marc Stern, a correctional physician at the University of Washington in Seattle who has previously consulted with the Department of Homeland Security.