We Must Step Forward on Behalf of the Children at our Border [fsg.org]


By Lauren Smith, FSG, June 26, 2019.

Everything I have learned in my almost three decades as a pediatrician and public health advocate caring for children and families tells me that what we are doing to migrant children at the border is morally and medically wrong. It goes against all that we know about how children should be treated. It is also not who we aspire to be as a nation. We are and must be better than this.  

Recent detailed reports of the appalling conditions in the detention centers our government operates along the border have provided chilling details on just how deeply we have abandoned our responsibility to care for and protect vulnerable children.  The shell game the government is playing with these already traumatized children, shuffling them out of and then back into the Clint, TX facility is further evidence that we are failing to show basic humanitarian concern for these kids.

Consider the love you dole out to your children, the concern we show for kids who are abused by their caregivers and are whisked off to protective services. And now consider these detained children. They are kept in isolated and overcrowded facilities, surrounded by cages, with only pallets on the concrete floor to sleep on and foil blankets to cover themselves. They lack adequate toilet facilities, diapers, or caring adults to change them.  Children as young as 7 or 8 years of age are left to care for even younger children they don’t know. Their meals are basic and leave many hungry. 

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This is a really nice piece. There is some policy and legislative info I would like to share in response, and also, although the list it refers to is much more thorough than most, it still does not include some of the organizations most involved with the kids, though it is a great list. The article presents important questions about how we should respond to the soap and welfare issue, for instance, but those issues are actually being addressed by a major human rights group. I am also concerned in general that the public is not aware of the difference between ORR and ICE facilities and policies (though most professionals here probably are) as well as the importance of not protesting on or near facilities where children are housed.

Regarding litigation, a court case has already been filed regarding the conditions at the shelter, including the soap/toothbrush issue, sanitation, malnutrition and other conditions, etc. There was a federal inspection in early June that clearly depicts that federal agencies were well aware of the gravity of conditions prior to the recent inspections. Inspections have not been uploaded to the ICE site since April of 2019, which is also a bit disturbing. This inspection was conducted by the Inspector General http://bit.ly/2XBNahd. While the ORR is typically underfunded, ICE is a multi-million dollar industry. ICE is choosing to maintain these miserable conditions and even arguing that they should get to keep doing so, as most have heard. They don't need donations. They have plenty of funding. They need to be held accountable. 

Most ORR facilities could never get by with that level of neglect and abuse, as I choose to call it. ICE has however routinely gotten by with blatantly ignoring certain policies and regulations. That is one reason children were not usually kept in ICE facilities longer than 48 hours, 72 hours tops. Babies and toddlers in the past would not usually be kept there.

The Center for Human Rights and Constitutional Law is the group who conducted the recent inspections you have seen in the news, and one of the main groups who is taking this administration to court. It is a large volunteer group of attorneys, medical professionals, case workers at times, and interpreters. They are the attorneys who supplied the media with all of the most recent data from the detention centers over the past few weeks that was so harrowing - Attorney Binford Warren, Attorney Peter Schey, etc. 

They filed a TRO (temporary restraining order) on behalf of the children http://bit.ly/2J0UkDI, then the Trump administration responded, then on Thursday of last week, the federal judge responded that ICE has had 22 years to come up with an acceptable method of handling this type of situation and mandated that the defendant (U.S. government) engage in expedited mediation with the children's attorneys (Center for Human Rights and Constitutional Law) - immediately - and report back to her by 12 July. 

Meanwhile, this administration is trying to change Flores to extend the amount of time allowed for children to remain in ICE and ORR facilities (they are aiming for 3 months). Nearly all of the children in custody have families who can care for them here in the U.S. These children have come to the U.S. legally to seek asylum. Seeking asylum is legal immigration. If they cross a border, they turn themselves in. They are not sneaking across, but most of these children were apprehended at the border, not within. Also, there is sufficient space (currently empty beds) in ORR facilities which are much more child friendly in the meantime.

This administration had hoped to stop the sponsorship process altogether, and they still seek ways to degrade the experience at ORR facilities (taking away education, recreation, funding, etc.). It has been reported that ICE facilities (not ORR facilities) profit on average around $750 per detainee per day. Not all facilities are equal, but this a for-profit business. This administration is seeking to hold kids longer than necessary in both ICE and ORR facilities, but ICE facilities are the main concern. 

In ORR facilities, children are provided with medical care, an assigned case worker and an assigned mental health professional who work in collaboration with the children's families, along with other services, including education and recreational services. Not all ORR contractors are the same or of the same quality, but they have a clean bed to sleep in, a clean environment, toiletries, and services and routines designed for children. Audits of ORR facilities are thorough, though there is one ORR contractor I don't prefer who I don't think likely performs as well as others on audits. I have been in both types of facilities, but every facility is different. However, there is no comparison between ICE and ORR facilities in most cases. 

The court usually rules in favor of the children, but conditions in ICE facilities have been a concern for decades. However, children are usually only kept in ICE facilities for no more than 48-72 hours. Now many have been stuck in those facilities for weeks and months. And although they ruled against family separation, it is also still the norm. But this judge's comments were pretty adamant. Whether that will result in swift change or not, I don't know, but I wanted to be sure, in response to this article and the important questions it raises, to include that info. Some of it has been shared with the media, so some members might have come across it already. If anyone needs additional inspection or case info, feel free to reach out. 


"While the Court is aware that the influx of migrants presents special challenges and that the facilities' conditions are not static, the Flores Agreement, executed in 1997, contemplated such circumstances and charged Defendants with the task of preparing a 'written plan that describes the reasonable efforts that it will take to place all minors as expeditiously as possible.' If 22 years has not been sufficient time for Defendants to refine that plan in a manner consistent with their 'concern for the particular vulnerability of minors' and their obligation to maintain facilities that are consistently 'safe and sanitary,' it is imperative that they develop such a comprehensive plan FORTHWITH... By July 12, 2019, the parties shall file a joint status report regarding their mediation efforts and what has been done to address post haste the conditions described in the Ex Parte Application. The parties shall participate in the mediation process in good faith. Pending the parties' mediation, the Court holds the Ex Parte Application in abeyance. IT IS SO ORDERED."

Here is the link to the judge's full response. http://bit.ly/31ZZCqy  

A proactive, responsible organization is addressing this matter, and inspections will continue, in case that reassures anyone, but she is correct that we need to be supporting the legal aid agencies most engaged with these facilities, which are actually spread across the USA and not just on the border. We are seeing rushed procedures, many unable to find representation in time, and bond fees they could never pay - they are trying to price asylum seekers out by making bond fees unaffordable, and due process less possible.

Al Otro Lado https://alotrolado.org/ and ALDEA https://aldeapjc.org/ have large case loads and I rarely see them listed. I also rarely see the NWIRP - NW Immigrant Rights Program https://www.nwirp.org/, so there are 3 important groups that can be added to the list. Al Otro Lado might have been on there. I didn't have my glasses on and might have missed it. Here is a direct link to one of their bond funds http://bit.ly/2ZZDOth. There are several others who are involved and are not appearing on popular media lists, which saddens me because it is so critical right now to be thorough. However, supporting any who are actually representing these families and children is still a great way to help.

I have seen some popular organizations running ads as if they are involved and they are not. I have seen some of the involved attorneys respond in dismay upon seeing that as well. I am sure those groups aim to do something to help with any funds raised, but we must be aware that is happening.   

You might have seen in the news where one mom raised more than $2 million in 48 hours https://on.today.com/2YoUha4. She raised those funds with remarkable creativity, and working directly with an attorney from this same volunteer group. You can read more about that attorney here. She is amazing. https://law.ucdavis.edu/faculty/cooper/. That is a highly effective way to funnel donations directly where they are most needed, whether they are small or large. Every dollar counts. The more direct we can be, the better. Money should not be what is keeping these children from surviving. 

On the community note, we need to keep up the calls and visits to representatives, and any organizing for protests or demonstrations needs to be at capitol and office buildings, not ICE and ORR facilities. 
Here are some reasons to consider why it is best not to show up where children are being housed. Please, if at all possible, do not organize protests at facilities where children are being housed. 

There have been protests that have turned out okay at facilities for older children, but even those serve to raise the level of hostility inside of the facility. If you can imagine protesting outside of the home of an abusive parent (who knows you can not get inside) what would happen to the kids inside? It would possibly cause more abuse, or resentment and hostility, jokes between agents, and worsen attitudes. It can also be frightening to the children. As social workers, we would likely never do that. Every change and disruption, anything that rattles the staff, can have a negative impact on the kids. In this case, it might lead to someone not being fed, ugly comments, increased neglect, or worse, but it is not going to make things better. 

There are good agents in every facility, I am not saying all ICE agents are bad people or hostile, but this situation is tense for everyone, including them. And on that note, drawing attention to the facilities can attract some person on a rampage to those locations to seek public attention by some heinous act and/or harm the children. We are not living in a peaceful nation.

Also, it puts the entire group of children inside of the facility at risk of being moved. If they are relocated somewhere else, it will be even more difficult for attorneys and case workers and medical professionals to find, inspect, and serve the children, and cause delays. One of the worst facilities inspected recently was Clint, and it was not originally on the list. It was discovered by chance when attorneys were inspecting and looking for a different facility. 

Additionally, the children inside are many times the only people looking after the younger ones. We are talking about more than 100, sometimes more than 200 children of all ages being shoved together in one area, not getting to bathe, older children trying to care for infants, little to no spare clothing or diapers, no adults usually except guards. (Not all facilities are that grave, but many follow similar trends.) There were babies without diapers covered in their own urine and fecal matter whom other kids were trying to take care of, in very cold temperatures. There were many who didn't feel well. They have been sitting on concrete floors for an extended period of time and they're not being well-nourished or given proper time outdoors.

This is not due to a lack of funding. It is a choice ICE has made to maintain these conditions. We are talking about a highly abusive system that has been abusive for decades but has reached a worse-than-ever state of abuse. They even often try to move the kids right before attorneys, case workers, and doctors are scheduled to arrive. A reactionary move is yet another frightening change for the children and can cause them to be separated from one another, and sometimes, the only connection they have made within a facility is another peer. And in recent inspections, we have noted that upper elementary and teenage children are caring for the toddlers and infants more often than the ICE staff. If they are separated from one another abruptly, they might lose that one person who knows their needs and their story, and with whom they have built some level of trust.  

Lastly, recent protests have caused some arrests, and whether those arrests were justified or not, protesters are now needing help paying for their legal fees when they had originally hoped to garner support for the kids. I know they feel badly about that. They should still be commended for standing up, but any organizing needs to be legal so that donations can be directed toward the children and families, as much as possible. Community tensions will be less turbulent away from the children.

This article is excellent, so I am not criticizing it in any way, but many of the articles that are circulating on a viral level are spreading bits of misinformation which are being written and published by well-meaning people who are gathering information from random media sources instead of original sources -people and groups who are directly involved - and all of that potentially works against these children in some way. People care deeply about the situation, but they are still putting it out there, because they want so much to be able to help and to be proactive, but they are often inadvertently making things worse, or running the risk of doing so.

So both with community organizing and blogging or publishing, we need to handle these kids with as much care as we would our own, and even more, since they have so much stacked against them. If wanting to organize community action, doing so on capitol steps, all across this country, visiting legislators in groups, calling in groups and waves, and keeping up the pressure is going to be a safer bet for the children.

These attorneys are not getting paid, and neither are the doctors or interpreters or case managers, and they do not all belong to a group everyone has heard of, but they are investigating these facilities, taking this administration to court, and providing all related data to the media. This week and next will be mediation/deliberation, and additional inspections by this group are forthcoming. To read personal testimony from children interviewed, follow that first link (the TRO link http://bit.ly/2J0UkDI,). Some of their comments have appeared in the news and on social media.


An additional frightening concern among the many is children who were/are in "quarantine," and who were for whatever reason not allowed to be seen, even by doctors. We are gravely concerned about those kids. Here is an excerpt from one of the attorneys on the team and a related article. 

LET THE DOCTORS IN | "I was one of the lawyers permitted to interview children detained at the Border Patrol facility in Clint, Texas. As you’ve no doubt read by now, my colleagues and I met with dirty and distressed children held for days without access to soap, showers, toothbrushes, clean clothing, adequate nutrition, or adequate sleep. We were not, however, allowed to visit with the sickest children. The government refuses to allow independent doctors in to help them.

At the Clint facility, my colleagues and I learned about a flu epidemic that left young children quarantined. We had a doctor on our team and wanted to ensure that these children were receiving appropriate care. I pleaded with Customs and Border Protection officials for permission to visit the children in the quarantine. But CBP blocked us from doing so. Eventually we were able to negotiate phone calls to the quarantine. This meant we could talk with sick teenagers but had no way to evaluate tender-age children. You just can’t gather any meaningful information from a very sick baby, toddler, or preschooler by phone...

Over the past year, at least seven children are known to have died in federal immigration custody or shortly after being released. These tragedies occurred after nearly a decade of no reported child deaths. As this public health crisis unfolds, doctors across the nation are volunteering to care for these vulnerable children, just as lawyers rushed to airports at the start of Trump’s Muslim ban. But the government won’t let them in. This is indefensible." http://bit.ly/2XMcfq4

And another concern is the children who are disappearing http://bit.ly/2KIN3uf on the other side of the border, and the fact that many of the "shelters" asylum seekers are being sent to in order to indefinitely wait out their cases are actually full, so they are then homeless in Juarez and surrounding areas. Some of the attorneys in this group and others are still serving them from afar and as they can in person, but they are deeply concerned that they are not in safe conditions. To be trapped in those conditions, and then later in an ICE facility, is often more trauma than the migration journey itself. 

Sorry to ramble on. Thanks for this community and for all of the ways you help us connect with one another and seek and provide professional growth opportunities.

Here are 3 pieces I appreciated reading that can help with advocacy:

"A Sudden and Lasting Separation from a Parent Can Permanently Alter Brain Development" http://bit.ly/2IUHNld from colleague Jacek Debiec, Assistant Professor in the Department of Psychiatry, Assistant Research Professor in the Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor. 

The same article in Spanish - "Separar a un niΓ±o de sus padres puede modificarle el cerebro" http://bit.ly/2RH951l

And one I always love to refer back to - "Vulnerable But Not Broken: Psychosocial Challenges and Resilience Pathways Among Unaccompanied Children from Central America" http://bit.ly/31WZIzc from the Immigration Working Psychology Group

With love and respect, Stacy

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