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The repeated and avoidable deaths of migrant children in detention is unconscionable. We at Migrant Clinicians Network demand immediate implementation of greater safeguards and better conditions to reduce the likelihood of yet more deaths. As clinicians, we recognize the impact of pre- and peri-migration stress and trauma on the health of migrants, who are then further stressed and traumatized in detention. Poor and overcrowded detention conditions and lack of sanitation only elevate the risk of serious health issues and death. Children are more susceptible to illness, with fewer immunological defenses than adults. Additionally, they are more prone to concerns like dehydration, hypothermia, and heat illness as a result of their larger surface area in relation to their weight.
“Because of the poor conditions, in which children are sleeping outside on cement under a mylar blanket, common illnesses like the flu can quickly progress to become life-threatening,” said Laszlo Madaras, MD, MPH, Chief Medical Officer of Migrant Clinicians Network. “Large numbers of people kept together in close quarters is a recipe for disease outbreak where there was none before. Those detained then get blamed for causing the outbreak which was created by the environment over which they had no control. Even with a caring medical staff who, I am sure, do not want to see a single death under their watch, the care they can provide under current overwhelming circumstances is insufficient and does not meet the national standards of care that we require from our country’s health professionals.”
As of May 24th, six minors have been reported dead, after accounts surfaced of a 10-year-old who died in custody last year. Earlier this week, a 16-year-old died of the flu after being held in the facility for three days longer than the federally mandated 3-day limit. Last week, a two-year-old died in the hospital, and on April 30th, another 16-year-old died after being hospitalized. Two additional children, ages 7 and 8, died in custody in December.
MCN continues to assert that detention is never an appropriate place for children. Contrary to a recent assertion [3] by the administration, an increase in duration of detention greatly threatens the health and well-being of children. In order to avoid further trauma, families awaiting their hearings must be provided community-based care. Children, even those with their families, should be quickly released to avoid significant and lasting health effects including trauma and toxic stress. Detention centers should be managed and operated as community-based resettlement centers: a place of short-term residency during which families are processed, provided basic trauma-informed care, and released to a community where they can await their asylum hearing. Through this process, we can respect the basic human rights of those crossing the border and follow internationally recognized processes for asylum seekers while beginning to address the compounding layers of trauma that migrant children have brought with them. It will also reduce deaths.
“No one should die in detention, ever,” said Karen Mountain, RN, MBA, MSN, Chief Executive Officer of MCN. “MCN will continue to push for health justice for the mobile poor, including for humane conditions at the border and adequate and timely medical care.”
Read more of MCN’s statements and resources on children in detention:
From the Border: [4] Refugees and Their Health Needs
Detention for Families: [5] Why It's Dangerous for Children, and How Clinicians Can Help
Children at the Border: [6] Layers of Trauma Compounded By Detention
Out of the Detention Center, and Into the Exam Room: What Clinicians Need to Know [7]
Post-Migration Trauma and Evaluating Children in Texas Immigration Facilities: [8] Q&A with Dr. Luis Zayas
Access resources to better serve refugees:
CDC: Guidelines for Pre-Departure and Post-Arrival Medical Screening and Treatment of US-Bound Refugees [9]
The National Child Traumatic Stress Network: Refugee Trauma [10]
American Academy of Pediatrics: Immigrant Child Health Toolkit [11]
MCN’s 2018 webinar, Treating Global Health At Your Doorstep Starts with a Good Patient History [12]
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