Health officials in Bogotá, Columbia, are investigating the death of a Black trans woman following reports of questionable actions from paramedics after they were informed the woman was HIV-positive. 

According to BuzzFeed News, Alejandra Monocuco alerted her housemate Leidy Tatiana Daza Alarcón late on May 29 with noises similar to someone gasping for air. After realizing Monocuco might be in real danger, Alarcón called emergency medical services to aid her housemate. She described Monocuco’s symptoms, and the operator advised that she may have COVID-19. 

The women waited nearly an hour for the paramedics to arrive and waited even longer for them to finally treat her. Monocuco died later that evening after a second paramedic unit was called. 

Alarcón said Monocuco didn’t receive the care she needed because she was a Black, trans sex worker living with HIV. Juli Salamanca of the Red Comunitaria Trans (RTC), an organization that works to build trans rights awareness and advocates for sex worker rights in Columbia, said the state “left her to die.”

“They killed Alejandra. Alejandra was killed by a negligent State that never cared for her throughout her life, and that in her last moments left her to die,” Salamanca told BuzzFeed via Whatsapp. “Because of the stigma that her body carried, for being trans, for being Black, for being poor, for living with HIV, for being a sex worker.”

When the EMS workers first arrived, Alarcón said she noticed that their focus seemed to shift once they saw the community that stood by to support Monocuco.

“When the ambulance arrived and [saw] we have many maricas here, they already started to relax,” Alarcón said, describing Monocuco's supporters with a term that is used as a slur toward the LGBTQ+ community.

It took the paramedics an additional 20 minutes to adorn themselves in PPE gear before they began to administer care to Monocuco, per Alarcón. As they were drawing Monocuco’s blood, Alarcón told them that she was living with HIV, which made the paramedics reevaluate their care of her. 

“He was terrified and by now he had told me, ‘This could be symptoms of overdose. Don’t give her water, don’t give her food, don’t give her absolutely anything, because she seems to be in respiratory arrest. She could choke and that would kill her,” Alarcón said.

Monocuco’s housemate pleaded with the paramedics to take her ill friend with them, but she said she was told to relax because they believed Monocuco was experiencing an overdose, not symptoms of COVID-19. 

“That was when he said, ‘No, take it easy … It's no longer a symptom of COVID, it could be a suspected overdose. Leave her be, relax, nothing is going to happen to her,’ and look at what happened!” Alarcón said.

Alarcón said it took more than 15 hours for city officials to collect Monocuco’s body from the apartment. She died in bed around 3 a.m. when the second ambulance finally showed up. Her body wasn’t retrieved until about 5:30 p.m. 

The next morning, the RCT released a statement on Twitter admonishing the EMS workers who, the organization said, refused to provide medical attention to Monocuco. 

“At 3 in the morning, Alejandra, a trans sex worker from the Santa Fe neighborhood, died after an ambulance refused to provide her medical service, telling her that she was living with HIV,” the translated tweet read. “At this moment [her] body is still in the room. She died drowned and without medical attention.”

On May 29, the Bogotá health secretary’s office said in a statement that a companion of Monocuco signed a waiver which kept paramedics from transferring her. 

District Health Secretary Alejandro Gómez apologized and said the waiver doesn't exist, but his office said in another statement Monocuco herself asked not to be transferred, a claim heavily refuted by Alarcón and other friends. 

City officials said the process to remove Monocuco’s body was slow because there was no relative to register her death and that the city needed additional paperwork to circumvent the usual procedure. 

Although the city says it followed proper COVID-19-related death protocol, which included cremating Monocuco's body, attorney Jorge Perdomo said her death certificate mentioned nothing about her having the disease. According to Perdomo, the city’s decision to cremate Monocuco is an indication of “irregularities” within the city’s accountability system. 

Without a body to study, health officials are doubtful that clearer answers will present themselves in Monocuco’s case. Her family said they never imagined she would lose her life due to discrimination.

“What happened to [her] was terrible,” Monocuco’s sister Isbelia Cardona Ruidiaz said. “I never thought my [sister] would die in that sad way for being trans and because [she] had HIV.” 

According to Ruidiaz, the family hadn’t received any news until the city called about picking up Monocuco’s ashes.  

On June 26, the city's health secretary's office launched three investigations into Monocuco’s death evaluation. 

Columbia’s inspector general also opened an investigation into the case that could result in disciplinary actions, like removal from roles or criminal charges. If charges are brought against those who contributed to Monocuco’s death, lawyer Daniela Diaz told BuzzFeed it would be the first time a Columbian public official was criminally charged for discrimination on the basis of gender identity.

In New York, members of two law enforcement agencies were held responsible for their involvement in cases of discrimination against trans people.

As Blavity previously reported, a total of 17 corrections officers are being disciplined for the death of Layleen Xtravaganza Cubilette-Polanco, a transgender woman who died from a seizure in solitary confinement on Rikers Island on June 7, 2019.

After Polanco was removed from a housing unit for trans women and sentenced to 20 days in solitary confinement, she began showing signs of mental distress. During this time, stationed officers said she attacked one of their colleagues, and Polanco was subsequently sent to Elmhurst Hospital. After nine days, she returned to Rikers Island, where she died in solitary confinement after suffering an epileptic seizure.

Three officers and one captain have been suspended without pay, while the punishments for the other 13 officers being held responsible have yet to be released, NBC News reports.

After he said he was violated by members of the New York Police Department last year, a Black trans man is suing the department for $5 million in damages. Jamel Young, an Army veteran, was pulled over on March 29, 2019, by police for not having a license plate sticker. While he was being arrested for having a gun registered in Georgia, Young said was ridiculed by officers once he informed them that he was transgender. The suit states that an officer aggressively groped his chest and genital area during searches as his peers watched and laughed. 

“I felt worthless. I felt like all those triggers that trans people try so hard to manage throughout the transition, all of it just exploded," Young told BuzzFeed.