MILWAUKEE—On July 18, Milwaukee County Sheriff David Clarke Jr. strode onto the stage of the Republican National Convention. In a fiery speech, he called Black Lives Matter protests “anarchy,” praised Donald Trump’s “belief in our American system of justice,” and declared, “I would like to make something very clear: blue lives matter.”

Four days earlier, Shadé Swayzer was giving birth in the jail that Clarke runs. She went into labor in a solitary confinement cell, and when she cried for help, according to a recently filed lawsuit, a guard laughed at her and left her alone. By the time medical staff checked on her the next morning, the lawsuit reads, her newborn baby was dead.

Swayzer’s baby wasn’t the only person to die in the Milwaukee County Jail. Since April, as Clarke has campaigned around the country for Trump, three other inmates have died in his custody. One was a 38-year-old with mental health issues who died of “profound dehydration”—thirst—after guards apparently turned off the water in his cell.

Now Clarke, a darling of the Tea Party and Fox News and known for his inflammatory statements, is reportedly in the running to be Trump’s Secretary of Homeland Security. He met with the President-elect at Trump Tower on Monday afternoon, decked out in his trademark cowboy hat.

Kristina Fiebrink, 38, was found unresponsive in her cell on August 28. Inmates who talked to the Milwaukee Journal-Sentinel said they heard her screaming for help overnight but no guards came to check on her.

Fiebrink’s brother Leon Limon said it was hard to imagine Clarke running detention centers around the country.

“We can’t even get any answers here,” Limon told the Daily Beast. “He’s not doing anything for the four families. It seems like he only cares about trying to help himself.” He said sheriff’s deputies investigating his sister’s death had only called him twice in the last three months: One time to ask a few questions and another time when they accidentally dialed his number.

“It’s so haunting to me because I wonder, ‘Did she suffer all night long?’” he said.

If he gets the Homeland Security job, Clarke would be in charge of the federal government’s 111 immigration detention centers and the more than 42,000 detainees held in them. The families of the inmates who died in the Milwaukee jail say his disregard for their loved ones’ safety should raise alarm bells about that prospect.

“Sheriff Clarke needs to take responsibility for the people dying in his jail,” said Erik Heipt, a lawyer for the family of Terrill Thomas, the inmate who died of thirst.

Fellow inmates told the Milwaukee Journal-Sentinel that guards shut off the water in Thomas’ solitary confinement cell and ignored him as he begged for water for days. “The family doesn’t understand how something like this could happen in an American jail,” Heipt said. “They want answers and they want accountability.”

Clarke’s office issued a statement saying the sheriff would not comment (PDF) until “the completion of all investigative and review processes, and any resultant civil litigation.” Thomas was the first inmate to die this year, on April 24, and Swayzer’s newborn baby died on July 14.

“There appears to be an unfortunate and deadly pattern (in the jail),” said Jason Jankowski, the lawyer representing Swayzer, who he said was depressed and distraught. “It has basically compromised the health and safety of those unfortunate people who enter and receive inhumanely substandard care.”

Michael Madden, 29, died after having a seizure on October 28. A fellow inmate told a local Fox News channel that a guard had picked him up and then let him fall, hitting his head. The same day Madden died, Clarke tweeted “Mrs Bill Clinton is an empty pantsuit.”

Why have there been so many deaths over a short time period? In each of the cases, investigations are ongoing and there are more questions than answers. But some observers point to its substandard healthcare.

Since 2002, Dr. Ronald Shansky has been visiting the jail twice a year as part of a consent decree. When he visited earlier this month, 37 percent of the health care positions in the jail’s staff were vacant, up from 30 percent this spring, he wrote in a report.

“There’s been no improvement,” Shansky told The Daily Beast. “Questions certainly can be raised about the occurrence of these four recent deaths and the relationship to officer shortages,” he wrote in the report.

The increasing vacancies “suggests a snowball effect,” said Pete Koneazny, a lawyer with the Legal Aid Society of Milwaukee who has been involved in litigation over the prison for decades. He said the jail should improve training for staff about handling inmates with mental health issues. “We see no signs that [Clarke] has taken any particular responsibility for these deaths,” he said.

The prison’s healthcare is run by Armor Correctional Health Medical Services, a private company in Miami. The New York State Attorney General sued the company earlier this year, alleging that its neglect of inmates in a jail on Long Island had led to five inmate deaths.

Since April, Sheriff Clarke has refused to publicly address the four deaths, leaving the inmates’ family members in the dark. Meanwhile, he’s been traveling around the country to give speeches to conservative groups and at Trump campaign events. In 2015, he reported receiving more than $150,000 in free travel, speaking fees and gifts.

“If the criteria is someone who can face terrorists who want to appear on cable TV talk shows, then he’s the guy,” Milwaukee Mayor Tom Barrett told the Daily Beast. “I’ve been mayor for 12 and a half years and in my 12 and a half years I’ve never once seen him at the scene of a crime.”

Barrett said he was especially concerned that Clarke hadn’t made public statements about the jail deaths, and suggested that state authorities should step in to investigate the facility.

“The fact that you would be stonewalling after four deaths at an institution under your command is extremely troubling,” Barrett said.

Christine Neumann-Ortiz, the executive director of Milwaukee immigrant rights group Voces de la Frontera, said his leadership of the jail suggests that he wouldn’t care about what happens to immigrants in detention centers.

“He’s too busy promoting himself to really care about what are the conditions and the treatment for the people within the jail,” Neumann-Ortiz said.

Her group is suing Clarke over his department’s refusal to release information about which immigrants he refers to federal authorities.

The sheriff’s office referred a request for comment about the deaths to Milwaukee County’s counsel due to the pending lawsuits. The counsel did not respond to a request for comment. Armor Correctional Health also did not respond to a request for comment.

Clarke isn’t a shoe-in for Homeland Security—his fellow hard-line Sheriff Joe Arpaio of Maricopa County, Ariz. is also seen as a contender. Some locals doubt that even a Republican-controlled Senate would confirm Clarke after hearing the long list of his more controversial statements.

He’s called for American citizens to be treated as “enemy combatants.” He’s suggested sending up to 1 million people who use”Jihadi rhetoric” online to the Guantanamo Bay prison. During the presidential campaign, he repeatedly referred to Hillary Clinton as “Mrs. Bill Clinton” and accused her of being a “straight-up cop hater” who is “in bed with criminals.” Last month, he tweeted “pitchforks and torches time” with a picture of an angry mob.

But there are reasons to think Clarke could be high on Trump’s shortlist. He was a vocal supporter of Trump’s campaign, even while other elected officials were jumping ship. As an African-American and a registered Democrat, Clarke would also bring some diversity to a cabinet that is so far mostly white.

And Clarke’s worldview and demeanor seem to fit Trump’s cabinet like a puzzle piece.

“He’s someone who is dangerous, divisive, has no regard for civil or constitutional rights and he’s really driven by his ego,” Neumann-Ortiz said. “His temperament is a carbon copy of Trump himself.”