Texas pediatrician on border crisis: ‘Kids don’t go in cages’

Over a 13-year career as a pediatrician in Texas, Dr. Marsha Griffin has visited every government facility that could hold newly arrived migrant children in the Rio Grande Valley.

She visited U.S. Customs and Border Protection (CBP) facilities during the 2013 and 2014 surge in unaccompanied minors arriving from Central America, when the agency retrofitted a warehouse in McAllen, Texas, into its largest detention center for unauthorized immigrants. Over the past 12 months, she has been visiting the facilities again – including a new temporary CBP facility in Donna, Texas, amid another surge in unaccompanied minors and families from Central America.

Dr. Griffin sat down with the Monitor in early July to discuss what she has been seeing and how she thinks the government could be taking better care of the migrant children in its custody. The CBP and the Trump administration have been heavily criticized for the treatment of migrants along the southern border, with doctors, lawyers, and the Department of Homeland Security (DHS) inspector general reporting that children have been held for weeks in overcrowded facilities without adequate food, water, and sanitation. Six children have died in federal custody since September.

The CBP “leverages our limited resources to provide the best care possible to those in our custody, especially children,” an agency official said in a statement.

“Our short-term holding facilities were not designed to hold vulnerable populations,” the official added. “CBP works closely with our partners at the Department of Health and Human Services to transfer unaccompanied children to their custody as soon as placement is identified, and as quickly and expeditiously as possible to ensure proper care.”

Testifying before the House Oversight Committee, acting DHS Secretary Kevin McAleenan said the agency has been coping with “an unprecedented crisis at the border.” More than 530,000 migrants have been apprehended at the southern border since January, during which time he says the department has delivered more than 6 million meals, conducted more than 400,000 medical interviews, and conducted medical transport and held hospital watch for migrants for over 250,000 hours. More than 200 medical professionals are now embedded in facilities on the border, he said, a tenfold increase from January.

But what concerns Dr. Griffin is the quality of the meals and what is not being detected in the medical interviews, among other things. The interview has been edited for clarity and length.

What has been your general impression of how the government has been taking care of detained migrant children?

There’s a lot of different agencies that take care of them. I went into the Border Patrol facility in Donna in May, and then I was in two weeks ago again with officials from the American Academy of Pediatrics and the Texas Pediatric Society, because we feel that as the leading pediatric organized medical association we need to know how our government is treating children. We came down, and we’ve been down here almost every year for the last four or five years, going in to see what’s going on. And it has gotten increasingly worse.

The Donna temporary influx facility – we saw it before it opened. They were hoping it would be for unaccompanied children; it’s now for families. We went in there two weeks ago. We also went into the Ursula facility [in McAllen], which is all in the news. That one is overcrowded, and it’s where the cages are. Because they had so many coming in 2013 and 2014 they needed a pop-off valve. So Ursula was built in 2014, and it has the big cages in it. And it’s the one that everyone is up in arms about because of the sanitary conditions.

The Department of Health and Human Services (HHS) ones are completely separate.

What are the common medical issues you’ve been seeing?

Sixty-two percent of them are upper respiratory infection. Another 20% are vomiting and diarrhea. And then you’ll have 1 to 2% that are influenza ... or you have someone going into premature labor, or you’ve got some child that actually has an upper respiratory but also has a heart condition, and that heart condition was never recognized.

So the EMTs at the Border Patrol facility may have said, ‘This child has an upper respiratory infection,’ but when we see them and we actually examine them, we have to get them to the hospital and we find they actually are in congenital heart failure. It’s not an upper respiratory problem, or it’s an upper respiratory problem on top of something else. That’s not every day, but I think it contributes to why we had six kids die here. Because they’re screening, but they’re not screening the way we would screen, by actually examining them.

You mentioned earlier that HHS facilities are different from CBP facilities. How so?

HHS facilities are more child-friendly. ... They have licensed people in there, they get lots of training. They are not perfect, and there has been lots of news about how bad some of them are, but the vast majority of them are good.

But it used to be [the children] would be out within three to four weeks. Three to four weeks is OK, a kid can do that, but when it keeps dragging on is when it’s problematic. Because for the kids, it’s still detention to them. They can’t really leave, there’s locks on the doors, if they try to get out they’re going to be in trouble. But their medical care, although not perfect, is far superior to what’s at CBP.

What has happened is you’ve got a law enforcement organization, Customs and Border Protection, who have told us they don’t want to take care of kids. They want to be bringing in the bad guys. They don’t want to be babysitting, and we’ve charged them with setting up a facility that’s not going to traumatize kids. But the only thing they know how to do is set up jails. They’re law enforcement. They haven’t gone out and studied what’s a space for a child. They haven’t been trained in child development. They don’t know what’s going to traumatize them.

They don’t have that training to know how to design a building. Even though when CBP designed Ursula in 2014 they said they were designing it for unaccompanied children, what they did is put in cages. So, come on. Kids don’t go in cages.

Do you think all migrant children should be kept in HHS custody then?

Yes. You could send all the families to ORR [the Office of Refugee Resettlement], and you could have CBP have an office in there. They could design it so if the kids weren’t there long, it would be more friendly for a child, and be less traumatic, and you could have one tent where the Border Patrol came and the Border Patrol did all their processing there. ...

It seems easy, just give HHS most of that money. Give it to them and let them figure it out, and let Border Patrol go catch all the drug guys.

What is your estimation of CBP officers?

Lots of people want to make enemies of the Border Patrol. They want to demonize them just like [President Donald] Trump demonizes the immigrants. They are not demons.

They hire some of our best, best nieces and nephews in the Valley, because it’s a great job, great benefits. There are some great people in there. What they’re being asked to do goes against many of their morality and what they would consider right.

You said earlier that “it has gotten increasingly worse.” What do you mean by that?

First it’s the overcrowding. But the rhetoric around it in the last two years, the rhetoric about them being criminals, has made the atmosphere and the way that people talk about their time in the Border Patrol facilities more egregious than it was before.

When families come out, then what they talk about – about people kicking them, or about them abusing them – that has gotten worse. In the past migrants may have complained that it was cold, that they didn’t get good food and they kept the lights on all the time, but it wasn’t this constant, ‘Oh, and they abused us.’ You’d hear some, but not like this.

Maybe people are just frustrated because there’s so many. But this kind of behavior – we should be prepared for this. We don’t have to become animals.

What does that mean? That “we should be prepared for this”?

I think we can keep our core morality and our basic values in how to treat human beings when we’re faced with a humanitarian crisis. If we had just 10 arriving every day forever and ever and we treated them well, and then we suddenly got, for whatever reason, a hundred every day, we don’t have to start abusing them. You treat them like a human being, with dignity.

Sometimes I’ll fall down and cry. It’s like, this is not OK. It’s not what we would have our grandkids or kids be exposed to. And once you get to know them, once you see them and play with them, then it becomes a real atrocity. As long as it’s over there and you’re just seeing it in the news, it doesn’t hit you as much as if they’re running through here and you’ve got them in your arms. And then it’s, “Don’t you dare touch this kid.”