USA TODAY International Edition
NO SOAP. VOMIT ON CLOTHING. WARNING SIGNS
Centers’ poor conditions making detainees sick
PHOENIX – Children in Border Patrol holding facilities “would vomit on their clothing” and had no soap to clean up.
One child “had diarrhea, had dry lips, he had a fever,” but border agents declined to seek medical care and closed the cell door.
Children were told they could drink water from a sink, but “are not given any cups” nor soap to wash their hands.
Those allegations and many others, from families apprehended by Border Patrol agents, were included in a raft of legal filings in August.
Four months later, two Guatemalan children being held by the Border Patrol in New Mexico got sick, began vomiting and soon died.
The deaths of Jakelin Caal, 7, and Felipe Gómez Alonzo, 8, prompted widespread outcry. Last week, Homeland Security Secretary Kirstjen Nielsen announced “a series of extraordinary protective measures,” adding health screenings and more medical professionals for migrant children.
But concerns about migrant children becoming sick – and the lack of medical care for them in ill-equipped Border Patrol stations – were far from new.
They had already been documented, in the same court case that establishes standards for how federal officials hold and release immigrant children.
Federal officials did not comment on the filings directly, but in an interview with The Arizona Republic, defended their handling of migrants and said border agents were not expected to be medical professionals.
The risk of illness for migrant children in custody, though, has been obvious to many who observed the system.
“As pediatricians, we say these detention centers are bad,” said Dr. Colleen Kraft, the president of the American Academy of Pediatrics, which is now consulting with Homeland Security on providing better pediatric care. “They’re cold, the lights are on 24/7, there are open toilets, and as a child, if you’re not sick you can get sick.”
The legal filings
Of more than 200 documented cases of children in Border Patrol custody earlier this year, 1 of 6 reported children being sick, according to analysis of an Arizona Republic database of the legal filings.
As part of ongoing monitoring of the government’s compliance with a legal settlement that safeguards immigrant children in federal custody, volunteer monitors from the Center for Human Rights and Constitutional Law, who were typically lawyers or law students, interviewed parents and unaccompanied children in June and July. They documented the accounts of 218 families or individual children.
Those declarations, the majority taken in Spanish and translated into English by the interviewers, were entered into the record of the long-running case in federal court known as “Flores.”
They described children vomiting with little ability to clean up. Some alleged that border agents denied requests for medical aid or withheld medications from detainees.
Denia M., a 21-year-old Honduran mother, said she was held at a CBP facility in El Centro, California. “There is another baby about 3 years old who has not had a bowel movement for four days and his stomach is very hard,” she said. “The mother told the guards and they did nothing. This mom said she has been here for 5 days.”
Some described a general lack of sanitation, access to clean water or generally healthy settings.
Elsa F., a Guatemalan mother of a 2year old who was at a Tucson CBP facility said, “There is water available all day in our room but there is only one paper cup.”
Kraft said both the conditions and the lack of medical professionals were causes for concern. “If you’re sharing utensils and you’re sharing cups, you’re sharing germs,” Kraft said.
DHS responds to claims
The 1997 settlement in the Flores case set limits on how long the federal government can detain unaccompanied minors. A judge later ruled that its terms also apply to migrant children who arrive with families.
CBP policy says they’re to be held in these facilities no longer than 72 hours before being transferred to a more “residential” detention facility, though families’ stories show CBP frequently holds families for longer.
CBP officials were unable to speak to allegations from the Flores filings, saying the settlement is ongoing litigation but said clean water and medical care are required in the agency’s 2015 policy on transportation, escort, detention and search of immigrants, known as “TEDS.”
A Border Patrol official speaking on background to The Republic said facilities are required to maintain functioning drinking fountains and clean drinking cups. Across different facilities, these may be sinks, fountains, coolers or bottled water, and agents do hourly visual inspections when they would note availability of water and disposable cups.
The official said a person who needs medical care first gets assessed by an officer, who then would raise the concern to a medically trained professional such as an EMT, or a supervisor who can call 911.
“We do a quick assessment and if it’s undetermined, immediately we call 911. We’re not medical professionals, we’re not trained to go through a series of checks,” he said.
On Dec. 26, Nielsen announced that she had sought assistance from the Centers for Disease Control, the Coast Guard Medical Corps and the Department of Defense to provide medical expertise. She said, “all children in Border Patrol custody have been given a thorough medical screening.”
Officials, in part, have blamed the Border Patrol facilities themselves. Many CBP buildings were originally designed for holding single adult males. More recently, officials say, the rise in the number of families crossing has strained those facilities.
Nielsen reiterated this idea. “In just two months into this fiscal year we have seen 68,510 family units and 13,981 unaccompanied children,” she said in a statement. “This is a dramatic change from historical trends and has only become starker in December.”
“As a result of bad judicial rulings from activist judges and inaction by Congress, we are seeing a flood of family units and unaccompanied alien children,” she said.
Migrants and activists generally cite poverty and rising gang violence in Central America as the factor driving families toward the U.S. and say the Trump administration’s efforts to clamp down asylum claims have caused more people to cross the border illegally in hopes of being released into the country.
The 218 declarations filed in the Flores case also describe conditions in Immigration and Customs Enforcement family detention centers, where families can be held for 20 days. But many discuss Border Patrol facilities, where people of all ages may be held initially after being caught.
That’s the scenario encountered by Jakelin Caal and her father, Nery Caal, who were held in a garage at the remote Antelope Wells Port of Entry, and Felipe Gómez Alonzo and his father Agustín Gómez, who were held near El Paso, then sent to a Border Patrol station at Alamogordo, New Mexico.
Parents and children in such facilities report sleeping on cement floors or benches, sometimes with a metallic blanket and occasionally with a thin mat.
Dr. Marsha Griffin is a professor of pediatrics with the University of Texas Rio Grande Valley who has been visiting detention facilities for a decade. She has visited the 1,500-person capacity Ursula facility in McAllen but said that she hasn’t been granted a visit in 10 months.
“To my knowledge, there’s nobody walking around in the pods to check on people,” Griffin said about Ursula facility.
“They do have guards, but to date, no one that I know of has been trained in pediatric care, which is a problem because children are not little adults. They can get very sick and die.”
“As a child, if you’re not sick you can get sick.” Colleen Kraft, pediatrician