By Colleen Kraft
As a pediatrician, before I begin an exam, I talk with the parents and children about what’s going on in their lives. The 16-year-old patients I care for in my practice in Southern California are starting to drive, starting to date, to talk about colleges. Their eyes are on the horizon, brimming with life and expectation of the future.
Carlos Gregorio Hernandez Vasquez was also a 16-year-old boy, but that is where the similarities end. Carlos did not get to dream of any of the rosy milestones my patients share with me. He simply dreamed of living in a land where he might be safe, free from the threat of violence, and with the possibility of a brighter future.
Instead, he died alone, without family, from an illness that is usually treatable in the U.S. He died in the custody of the Department of Homeland Security (DHS), the sixth child to die in nine months in the custody of the federal government. More children will continue to die if we do not make immediate, permanent changes to the way we treat them when they come here.
Carlos and countless children like him are put in DHS-run facilities in which they are forced to sleep on concrete floors, where the lights are on 24-7 and the temperatures are frigid. Staff confiscate and destroy medications to treat chronic conditions such as type 1 diabetes, asthma and seizure disorders, and most of the children have no access to pediatricians.
No child should be subjected to these facilities. The American Academy of Pediatrics has made repeated offers to assist in providing medical care, to review screening and treatment protocols, and to make processing of children more child-friendly. Our pleas have gone unheeded.
In direct opposition to AAP recommendations, DHS leadership and a panel they appointed to look at children and families in custody have argued as recently as May 22 — the week Carlos died — that they should be allowed to detain children with their parents for weeks, months or years, through a legislative change to alter the Flores Settlement Agreement. During his testimony before the Senate Homeland Security committee, Acting Secretary McAleenan said that while the agency wants to move children as quickly as possible out of border-patrol custody, “detention for a child is for the safety of the child.”
That’s false. A review of the evidence shows that no amount of time in detention is safe for a child. Even short amounts of time in detention are harmful. When children are detained, they experience physical and emotional stress, placing them at risk for serious short- and long-term health problems. Congress must immediately reject the proposal to extend the time children and families spend in detention.
For children under 18, conditions in DHS custody are not only unsafe but potentially deadly. This agency has proven repeatedly that it cannot care for children. Security personnel are not medical professionals. They play an important role in cyber security and preventing illegal drugs and weapons from entering our country; they should not be charged with meeting the basic needs of children.
Children are not just small adults, and their signs of illness are subtle. They need providers who can recognize the differences between a mildly ill child and a seriously ill child.
America needs to stop detaining and separating children from their parents and stop threatening the community of family members, caregivers and sponsors by putting their housing, financial security, and immigration status in jeopardy. Most of all, our country needs to ensure that no child ever again dies on our watch.
When I send a 16-year-old patient with influenza home from my California practice, he has a parent to care for him, a bed to sleep in, a home in which to recover, and medication to ease the symptoms. He has a pediatrician his parent can call if things get worse.
Carlos did not have any of those comforts. I think about him every day.
Until I see this inequity between immigrant children like Carlos and my patients resolve, until I see our government pursuing policies based on science and designed with compassion, I will continue speaking out. I do so for Carlos, Jakelin, Felipe, and all the other immigrant children who have died in our country, striving for a better life.
Kraft, MD, MBA, FAAP, is the immediate past president of the American Academy of Pediatrics.