Immigrant crisis at the border has far-reaching effects

October 26, 2019
Rachael Zimlich, RN, BSN
Rachael Zimlich, RN, BSN

Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and Medical Economics.

Pediatricians across the country will be affected by the trauma inflicted on children who are separated from their families and detained at the border.

For immigrant children who cross the border alone or who are separated from their families, the time spent in detention facilities and the relocation process is traumatic. This is where the work of pediatricians begins, says Marsha Griffin, MD, FAAP, professor of pediatrics at the University of Texas Rio Grande Valley School of Medicine in Edinburg, near the border of Texas and Mexico. 

In a session titled, "Unaccompanied and Scared: Supporting Immigrant Children," presented on October 26, 2019  and repeated on October 27, 2019, at the 2019 American Academy of Pediatrics (AAP) Annual Conference and Exhibition in New Orleans, Louisiana, Griffin discussed what life is like for immigrant children crossing the border, whether alone or after separation from their families. She provides medical care to immigrant children and families on the southern border once they are released from detention centers. 

From late 2018 through July 2019, Griffin says almost 1000 immigrants were being released every day and brought by Customs and Border Protection to the Catholic Charities Rio Grande Valley Humanitarian Respite Center in McAllen, Texas, where she helps organize medical teams.

“These are all immigrant families, so over half of those dropped off are children. That is 500 children every day who were exposed to the harsh conditions within the detention centers,” Griffin says. “Almost all of these children were separated from their parents on arrival to those facilities. The trauma that comes from being separated from your family was experienced or witnessed by all of them. The stories are truly shocking."

There is a lot of uncertainty in the situation at the border, she says. The numbers being released dropped to a handful of families per day after the Migrant Protection Protocols were initiated.  “This policy requires border agents to send immigrants who attempt to cross the United States/Mexico border immediately back to Mexican border cities,” she says. “Families spend a lot of money trying to get their families to safety. When that effort has been for naught and there is no money left, the families are left in dangerous, unfamiliar cities trying to survive. The children are the most vulnerable. Legal advocates are fighting to overturn this dangerous policy.”

As pediatricians, Griffin says, the key is to put aside any political opinion and focus on how to help these children recover and move forward. "The stance of the AAP is that we stand for all children. It is possible to care for immigrant children, and at the same time, be protecting and caring for our own children. It is an issue of public health and wellbeing."

At the presentation, she discussed some of the specific abuses these children face as they make their way across the border and to their new homes.

“Many of these children are medically vulnerable and have been exposed to disease and trauma on their journey and in our detention centers,” Griffin says.

There is a lot of work to be done long after children cross the border, she adds.

"We have multiple reports from physicians across the country that children released from detention centers on the border arrive in destination communities and have to be taken immediately to emergency departments for admission,” says Griffin. She added that there have been accounts of hospitalizations for infections such as Shigella and invasive hemorrhagic Escherichia coli stemming from the crowded conditions in the detention centers, or pneumonias that were left undiagnosed and untreated in detention centers and end up requiring intensive care unit admissions.

“This is unacceptable,” Griffin says.

At the humanitarian respite center, the families are there for less than 24 hours before they leave on buses or planes to their destination communities. Some of the top cities receiving immigrant children from border detention facilities include Los Angeles, New York, Chicago, Houston, Atlanta, Miami, Philadelphia, and the Washington, DC area. They are also going to Cleveland, Indianapolis, Boston, Cincinnati, Kansas City, Charlotte, and smaller communities across the country.

Griffin says 1 year of grant funding has been secured to hire medical providers and case managers to provide care at the respite center for 365 days. They are seeking sustainable funds, as well. The next effort on the border is to use additional awarded grant funds to create a network of academic centers and clinics in top destinations across the country to serve as referral bases for immigrant children. These centers will provide the crucial medical and psychological care for these families in their new communities.

"I receive emails almost every day from physicians and well-meaning individuals who want to come down to the border to see kids in detention, and they want to help," Griffin says. “The children need you to stay in your hometown where you know the resources, where you know the connections or can create networks of care. This is where you can really, truly help them.”

Griffin says physicians who are looking for resources can find them on the AAP website.

“The AAP has been a leader when it comes to advocating for immigrant children,” she says.

Not only does the organization advocate for policy change, but it also offers recommendations on how to deal with problems in the present. Griffin discussed the new policy statement AAP published on providing care for immigrant children-a population that represents 1 out of 4 children in the United States today. 

 

For questions regarding the network of academic medical centers and clinics across the country providing care to recently immigrated families, you can email her at marsha.griffin@utrgv.edu.