We Visited the Southern Border. The Children We Saw There Need Access to Pediatricians. Now | Opinion

We are two pediatricians who have recently visited the southern border. What we saw there compelled us to speak out.

We had seen the news headlines. We had read the revealing reports from the Department of Homeland Security's (DHS) Office of the Inspector General describing concerning conditions for immigrant children and families arriving at our southern border. As two pediatricians, one a sitting member of Congress and one the incoming president of the American Academy of Pediatrics, we were well-versed in the policies being implemented by DHS and we understood the ins and outs of our immigration system.

And still, we were surprised by what we saw.

After touring two Customs and Border Protection (CBP) facilities on separate trips to Texas this summer, we are united in our assessment that they are no place for children. These facilities were crowded with people and many reported not having regular access to showers and handwashing facilities, increasing the risk of spreading disease. The lights were kept on 24 hours a day, and floor-to-ceiling metal fencing separated the space into cages. Children, pregnant women and others slept inside the cages on cold cement floors with mylar blankets, only some able to find mats to sleep on. One Border Patrol manager recently called these conditions "a ticking time bomb." And this unsafe and unkind treatment of fellow human beings is wholly inconsistent with American values.

Although children and families are only supposed to be in CBP custody for less than 72 hours, we heard directly from children who had been held longer. While CBP agents report that given current circumstances, they are trying to do their best, they are law enforcement personnel, not medical professionals. These children need to be seen by medical experts with pediatric training. Children are not just little adults, and they show illness in different ways. It takes a medical expert trained in evaluating and treating children to recognize symptoms of a mildly ill child versus a seriously ill child.

There are clear, definable steps that can happen right now to alleviate this suffering and ensure better care and treatment of children.

As children spend more time in CBP custody in the conditions we describe, we are calling for medical experts with pediatric training to evaluate children promptly in every facility where children are being held.

While we know that detention is no place for a child, the political reality is that children will be held in CBP facilities for hours or a few days for at least the near future. We must make sure that basic humanitarian standards are met to ensure their access to medical care, nutrition, and hygienic supplies. As physicians we believe that proximity to timely care, access to medications, and appropriate infection control practices such as handwashing stations and isolation – accompanied by their parents -- of those with easily communicable diseases are critically important to children's health.

The good news is that the U.S. House of Representatives passed a bill last week, H.R. 3239, that will help address these issues by requiring reasonable minimum standards for children in CBP custody for things like access to medical screening, clean water, adequate food, clean toilets and soap, and appropriate lighting. It is now up to the Senate to act and pass the bill without delay.

We have serious concerns about reports of children being separated from parents or adult family members who they have been traveling with. The separation of children from parents, or other family members they have been traveling with, is causing severe distress and affecting children's mental health. As pediatricians we know all too well the long-lasting impact of this cumulative trauma on children, but having the loving embrace and reassurance of a family member ameliorates this harm. A safe, quick way to verify family relationships to prevent separation and to allow children and their families to be released together in the 72-hour window would help.

The children we met at the border are not so different from those we've treated in our pediatric clinics. However, these children, unlike the patients we've cared for who recover from illness under the care of a parent in the comfort of their own homes, have been through so much, from their harrowing journeys to our border fleeing violence and adversity, to being forcibly separated from their parents, to enduring inhumane conditions in federal custody. U.S. policy is compounding danger and trauma.

The children seeking safe haven in the U.S. deserve our compassion and they deserve our immediate attention. They are children. We don't have a moment to lose.

Sally Goza, MD, FAAP, is President-Elect of the American Academy of Pediatrics d Congresswoman Kim Schrier represents the 8th Congressional District of Washington State.

The views expressed in this article are the author's own.​​​​​