POLITICS
05/22/2019 05:45 EDT | Updated 05/22/2019 13:45 EDT

This Is Why So Many Children Are Dying In Border Patrol Custody

Five kids have died in U.S. custody since December, and experts warn it will keep happening.

A 16-year-old migrant boy was found dead Monday after being taken into Border Patrol custody, making him the fifth minor since December to die shortly after being detained in a government processing facility. Given the arduous journey many children take to get to the U.S. and the unsanitary conditions in Border Patrol centers, medical experts and immigrant rights advocates warn these deaths are likely to continue.

“There’s no reason to think we’re not going to see more of this,” said Neha Desai, the director of immigration at the National Center for Youth Law. “Until the government starts complying with its basic legal obligations, they are jeopardizing the health and lives of children in their custody.”

The teenager, named Carlos Gregorio Hernandez Vasquez, was originally diagnosed with the flu and given medicine. But instead of being taken to a hospital, he was transferred to a nearby border station where he could be segregated from other detained migrants. He was found dead the next day.

His death follows a similar pattern to those of the other four children: Vasquez’s initial symptoms quickly worsened after an initial diagnosis, and he did not have adequate access to medical care or a safe environment for recovery.

Customs and Border Protection says it’s providing migrants care to the best of its ability, given the influx of families that are crossing the border. So why are children continuing to die after being put in Border Patrol holding cells?

Perilous Journeys

Most immigrants do not arrive at the border in good health. Many families and children come from poor countries in Central America, where children might not be receiving all the nutrients or medical care they need, said Dr. Lisa Ayoub-Rodriguez, a member of the American Academy of Pediatrics immigrant health special interest group. They often make dangerous journeys that involve trekking through the U.S. desert in extreme temperatures with limited access to water or doctors.

Immigrants rights advocates say the U.S. government is leading migrants to cross the border in remote locations because a “metering” policy in place at major ports of entry limits how many people can request asylum or other help each day. People are forced to wait in Mexico for weeks or months before they can get into the U.S. 

The number of families making remote journeys through the El Paso sector, which encompasses west Texas through New Mexico and includes part of the Chihuahuan Desert, has increased from 3,000 to 53,000 this fiscal year, and the number of migrants who die while trying to reach the border is also on the rise.

The Canadian Press
An autopsy report confirmed that an 8-year-old Guatemalan boy who died while in custody of the U.S. Border Patrol on Christmas Eve succumbed to a flu infection.

Jakelin Caal, a 7-year-old girl who died less than 48 hours after being detained by Border Patrol in December, traveled more than 2,000 miles from Guatemala with her dad, including through the New Mexico desert. She died of dehydration and septic shock after getting a fever, having seizures and being flown to a hospital in El Paso.

By the time children show up at Border Patrol processing centers, they might already be dehydrated and have compromised immune systems, Ayoub-Rodriguez said, which means their bodies cannot fight off illnesses and they’re at risk of developing more serious conditions

Inadequate Medical Care

Medical experts are concerned that children aren’t receiving adequate medical screening before being placed in Border Patrol facilities. After two children died in CBP custody in December, the Department of Homeland Security issued a memo saying every immigrant under 18 had to receive a medical assessment. Minors were previously “provided medical attention on an as needed basis,” a CBP official wrote in an email to HuffPost.   

Migrants being held by CBP in outdoor detention pens in Texas’ Rio Grande Valley said they did not receive medical examinations or treatment, even though their children had headaches, coughs, fevers, body aches and other flu-like symptoms, according to a complaint filed by the ACLU of Texas

The CBP official said the agency is currently prioritizing medical screening in the busiest areas but that it aims to provide the service “for the entire Southwest border.” 

“Throughout this emergency DHS will never lose sight of our humanitarian obligations and is doing everything we can to fulfill our mission while caring for those in our custody,” the official told HuffPost, noting that families are showing up to the border in record-high numbers.

Children are screened by “physician assistants, nurse practitioners practitioners and EMTs,” the official said. 

But experts say it’s important for children to be examined by pediatricians who know exactly what to look for.

Symptoms can spiral into more serious illnesses if health care providers miss them, said Dr. Julie Linton, co-chair of the American Academy of Pediatrics immigrant health special interest group. For example, signs of sepsis ― the body’s potentially life-threatening response to an infection ― are different in adults than in kids and can involve subtle changes such as increased heart rate or fast breathing, she said.

“Kids get sick quickly,” Linton said. “Each hour of delay for treatment can increase mortality.”

Ayoub-Rodriguez said it’s also important that children are monitored after an initial screening to make sure symptoms don’t worsen.

Felipe Gomez Alonso, 8, died less than 24 hours after being detained by Border Patrol in December. He initially had glossy eyes and a cough, and he was diagnosed with a common cold and given Tylenol. Then he developed a fever, began vomiting and died from the flu.  

In my opinion, CBP facilities aren’t suitable for anyone. They are absolutely, positively, not in any capacity appropriate for children.Neha Desai, the director of immigration at the National Center for Youth Law.

CBP facilities are not typically set up for long-term care. Only “basic, low acuity care is provided” on site after a child is examined, the agency official said. 

Border Patrol facilities in McAllen, Texas, the most heavily trafficked stations in the U.S., are “among the few in the country that have a small number of midlevel health professionals — nurse practitioners or physician assistants — on site,” The New York Times reported in March. 

CBP stations have become so overcrowded that Ayoub-Rodriguez worries it would be difficult for staff to give sick migrant children the attention they need, even in stations that do have medical professionals available.

“I imagine [the signs] are very easy to miss,” she said. “One minute they are just taking a nap, and the next they’re not responsive when you’re trying to wake them up.”

Conditions Not Suitable For Children

Sick children need to recover in a safe environment, but border facilities could exacerbate their illnesses. Migrants refer to these holding cells as “hieleras” ― Spanish for “iceboxes” ― or “perreras” ― Spanish for “dog kennels” ― to describe their cold temperatures and chain-link fences. Children often sleep on the floor covered only by foil-like Mylar blankets.

“In my opinion, CBP facilities aren’t suitable for anyone,” Desai said. “They are absolutely, positively, not in any capacity appropriate for children.”

According to the Flores Settlement, a 1997 government agreement that outlines immigrant children’s rights, minors should only be kept in these facilities for up to 72 hours. But activists told HuffPost that the government regularly violates this settlement because of overcrowding in Office of Refugee Resettlement shelters, where children are detained while they await sponsors.

Vasquez, the teen who died this week, was held in a CBP facility for six days ― twice as long as the Flores Settlement permits. Desai said a minor was recently recently kept in a temporary holding cell for 11 days.

Children with illnesses need access to food, water and nutritious liquids such as Pedialyte or Gatorade, which they can’t easily get in border facilities.

Jakelin’s father said his daughter was not given water while they were detained, a claim that Border Patrol denied, and immigrants report being fed frozen ham sandwiches in these facilities.

Linton said kids are often returned to CBP stations after going to the hospital, which violates basic medical guidance. Both Felipe and Juan de León Gutiérre, a 16-year-old who died in April after being taken into Border Patrol custody, were returned to government-run facilities after they were examined by medical professionals.

No child can recover while “lying on a concrete floor on a mat, with cages that extend from floor to ceiling, and lights kept on 24/7 disrupting their sleep,” Linton said.

“These are not conditions that promote healing,” she said. “They further place children at risk for serious repercussions from illnesses.”