The real border crisis: medical neglect of migrants in detention centers

In his Oval Office address on Tuesday, President Trump called the situation at the border a “growing humanitarian and security crisis.” His declaration failed to acknowledge the real crisis at hand — the medical neglect at border facilities and the more than 200 immigration jails across the country that has led to more than 20 deaths since 2010.

Among them were three children. Eight-year-old Felipe Alonso-Gomez and 7-year-old Jakelin Caal Maquin died in Customs and Border Protection custody this past December. In May of 2018, 19-month-old Mariee Juarez died after being released from an Immigration and Customs Enforcement facility where she had been detained with her mother for three weeks. Their deaths could have been prevented with timely access to appropriate care.

As a physician who has evaluated adults held in immigration jails, I have witnessed conditions in detention facilities that are unsafe for adults and deadly for children. Advocates have called attention to overcrowding, insufficient food and water, and abusive conditions at border processing facilities. Across the country, immigration jails are plagued by human and civil rights abuses and dangerously subpar access to medical care.

More children — almost 15,000 of them — are now in immigration detention facilities than ever before. Sadly, there is money to be made from jailing migrants, including children. Southwest Key, whose facilities include a converted Walmart Supercenter, has collected $1.7 billion in federal grants for warehousing migrant children. While making record profits, these facilities have been cited by the Office of Inspector General for providing inadequate medical care.

Contractors have failed to protect the vulnerable children under their charge. Reports have surfaced of their failure to complete adequate background checks of employees. There have also been widespread reports of child abuse occurring in detention facilities, including forced medication and sexual assault.

Even as pediatricians strongly oppose the detention of children, which causes long-term psychological trauma and health harms, Trump has asked Congress to terminate the Flores settlement agreement, which gives children the right to reasonably prompt release, potentially allowing for their indefinite detention. Children whose parents are seeking asylum could instead be released to sponsors and spared from this psychological damage. Yet the Trump administration has slowed this process almost to a halt, while Immigration and Customs Enforcement has targeted more than 170 potential sponsors for deportation.

The preventable deaths of adults in immigration detention facilities are no less a crime than the deaths of children. According to an NBC analysis, there have been 22 deaths in ICE detention since Trump took office (not including Felipe, Jakelin, and Mariee). Roxsana Rodriguez, a transgender woman and asylum seeker from Honduras, died in ICE custody in May. An autopsy showed that she had been physically abused before her death.

Jose Azurdia, a refugee from Guatemala, died in a California detention facility after falling ill and vomiting. According to Human Rights Watch, a nurse did not want to treat him because “she did not want to get sick.” It turned out that Azurdia was having a heart attack.

All Americans should be outraged by the preventable deaths of children and adults who were needlessly detained. A $5.7 billion border wall will not address the root cause of migration and displacement.

It is time to end the inhumane detention of children and families seeking asylum. Justice for these families will entail increased oversight of detention facilities, better access to quality medical care, and an independent investigation into all of the deaths at detention facilities.

The agencies responsible for jailing children, lobbing tear gas canisters at migrant mothers and their toddlers, and separating families need to be reined in before more people are harmed.

Chanelle Diaz, M.D., is a resident physician in Bronx, N.Y.; a National Physicians Alliance Copello Health Advocacy Fellow; and a volunteer for the New York Lawyers for the Public Interest Medical Provider Network.