Jurisprudence

Let the Doctors In

I was one of the lawyers who visited the Clint detention facility. I want to know why the government won’t let independent physicians assess the sickest children.

A temporary facility set up to hold migrants at a United States Border Patrol Station in Clint, Texas.
A temporary facility set up to hold migrants at a United States Border Patrol station in Clint, Texas.
Paul Ratje/Getty Images

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.

How do I know it’s so important for independent doctors to evaluate these children? The previous week, during interviews with teenage moms at a Border Patrol facility in McAllen, Texas, lawyers and a pediatrician on our team had identified five detained babies who needed immediate hospitalization and were admitted to the neonatal intensive care unit of a local hospital. 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.

The law is clear. Children in federal immigration custody must be provided with “safe and sanitary” conditions. This requirement is set forth in the Flores settlement agreement from 1997. Earlier this month, a draft report by inspectors from the U.S. Department of Homeland Security recommended immediate action to remedy the hunger, overcrowding, and prolonged detention of children and adults in CBP custody. This isn’t about comfort: Unless unsafe and unsanitary conditions at Border Patrol facilities are addressed immediately, the spread of illness will continue, endangering even more children’s lives.

Because CBP blocked our access to the quarantine at Clint, we are left with the children’s reports of what it is like there. A 14-year-old girl explained:

I was in the first cell for seven days, sleeping with no mattress. … It is hard to sleep when you don’t have a mattress. I then came down with the flu. I then went into the flu cell for seven days.

When you are in the flu cell, you also sleep on the floor, but you have a mattress. There were 21 other kids in that space with the flu. I had a fever in there and I was shaking. Some of the other kids were vomiting. They all had fevers. No one was taking care of the kids with the flu …

We were not allowed to leave the flu cell, ever. It was very boring. I did nothing to entertain myself, nor was anything offered. It was sad, very sad. I felt locked up and closed in. In the other cells, we can go out of the cell to get water one time a day …

An 11-year-old held in CBP custody for 13 days, despite having parents in New Jersey, shared:

About three days ago I got a fever. They moved me alone to a flu cell. There is no one to take care of you there. They just give you pills twice a day. I also am having an allergic reaction all over my skin. My skin is itchy and red and my nose is stuffed up. Two times they gave me a pill for it but not anymore.

On Wednesday, the Center for Human Rights & Constitutional Law and co-counsel filed a motion to enforce the 1997 settlement agreement on behalf of class members, i.e., the kids currently in custody, submitting hundreds of pages of evidence documenting the inhumane conditions they are experiencing. Their demands are simple. Among them: Independent doctors should be allowed immediate access to assess and triage children’s medical needs. A public health expert should inspect facilities and determine how to make them safe and sanitary.

On Thursday, the government opposed these requests, calling them “coercive remedies.” The government wants more time, “an opportunity to fully review and respond.” The government says that the children’s demands go “beyond simply ordering that [the government] comply with the plain terms of the Flores Settlement Agreement”—an argument strikingly similar to the administration’s argument before the 9th U.S. Circuit Court of Appeals that “safe and sanitary” conditions do not require the government to provide detained children with toothbrushes, soap, and beds.

But the government fails to address the central question: Why should the government ban independent doctors from assessing children in custody? If there’s nothing to hide, why not let the doctors in?

Apparently, blocking access is CBP’s default position. But the outcry by the American public in recent days has forced the agency to make changes. During the week of June 17, more than 2,600 children were detained in Border Patrol facilities. Because of the public attention, that number has dropped to fewer than 1,000. At Clint, the changes have been dizzying. Two hundred forty-nine children were transferred on Monday. The facility was cleaned up. Then, 100 children were brought in so that CBP could stage a highly restricted media tour, during which reporters were barred from speaking with any children, taking any photographs, or going into cells. But toothbrushes and even a soccer ball were on site. That’s a baby step in the right direction.

It should not take a national outcry for children in custody to have toothbrushes. It should not take a national outcry to ensure that babies, toddlers, and children held in carceral settings are safe with adequate food, beds, and showers. It should not take a national outcry to ensure that there are no more babies dying in custody. But that outcry—the outcry of the American public—must continue. Because for now, independent doctors are still banned from border detention facilities where vulnerable children languish. Let’s not sanction another child’s death in our country and in our name.