Why Migrant Children Keep Dying In Custody, According To A Doctor Who Treats Them

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On Monday, 16 year-old Carlos Gregorio Hernandez Vasquez from Guatemala died while in U.S. custody, making him the fifth migrant child to die after being apprehended at or near the U.S.-Mexico border since December, according to BuzzFeed News. A doctor who works with detained children in El Paso tells Bustle that identifying early illness symptoms is key to preventing deaths like his.

"It's absolutely tragic and avoidable and preventable, but I'm also not surprised," Dr. Lisa Ayoub-Rodriguez says of the recent string of deaths among migrant children who were apprehended by U.S. Customs and Border Protection (CBP). "Just given the circumstances that they're coming from and the circumstances that they're in. It's not surprising that these these children with common illnesses die."

Ayoub-Rodriguez is a member of the American Academy of Pediatrics Immigrant Health Special Interest Group. A working pediatrician in El Paso, she tells Bustle that she treats children who are in CBP custody, and also sees some patients after they are released.

According to Ayoub-Rodriguez, many of these migrant children probably leave home undernourished, and their health likely only gets worse after they make the long journey north to the United States. Being placed in a crowded detention facility, where illnesses can easily spread, makes it even easier to both get sick and have those symptoms go unnoticed, she says.

CBP released a statement on Monday expressing condolences to Hernandez's family. “The men and women of U.S. Customs and Border Protection are saddened by the tragic loss of this young man and our condolences are with his family,” acting CPB Commissioner John Sanders said in the statement provided to NBC News. “CBP is committed to the health, safety and humane treatment of those in our custody.” Bustle has reached out to the Department of Homeland Security (DHS) for comment.

The cause of the teen's death is currently unknown, according to NBC News. However, his death is the latest in a string of similar incidents in recent months. The exact circumstances surrounding these cases vary, but what connects them is that the migrant children all had been apprehended at or near the U.S. border before their deaths. Just last week, a 2-year-old boy named Wilmer Josué Ramírez Vásquez died weeks after being released from U.S. custody. BuzzFeed News reports that he spent several weeks in the hospital following his initial release. Al Jazeera reports that all five children who died were from Guatemala.

Before the 2-year-old was Juan de León Gutiérrez, a 16-year-old boy who was hospitalized after officials at a youth detention facility noticed that he was ill. He was released from the hospital, then returned a day later, AP reported. Gutiérrez died on April 30 of a brain infection that could have been caused by head trauma or an untreated sinus infection, according to Time; the exact cause of the infection remains unknown.

In December, 7-year-old Jakelin Caal Maquin died of dehydration and shock, per The Washington Post. She was in CPB custody at the time. Her family has said that she had no previous illnesses before she was apprehended at the border with her father.

Another child, 8-year-old Felipe Alonzo Gomez, died of the flu on Christmas Day, per CNN. Like Maquin, he was in CBP custody at the time of his death. After Gomez died, CBP said that it would make changes to the way that it handles migrant children in its custody.

Specifically, the agency said that it would conduct “secondary medical checks” on detained children, putting a special emphasis on those 10 years or younger, according to NBC News. But, as the news outlet noted, CBP did not provide specifics about how or when those checks would take place. The agency also said that it would notify Congress and the media of all deaths in its custody within 24 hours.

The series of deaths of migrant children comes after a turbulent year or so for DHS, which has faced hefty criticism for over the treatment of migrants at the U.S.-Mexico border. Last April, then-Attorney General Jeff Sessions issued what was termed a "zero-tolerance" policy, instructing all U.S. attorneys working in border states to prosecute every case referred to them. Although that zero-tolerance policy was peeled back, USA Today reports the government is still working to identify all of the children that were separated from their families as a result of it. About 47,000 children were apprehended by immigration officials between July 1, 2017 and June 25, 2018, according to the news outlet.

In a joint statement provided to Bustle, Kids In Need of Defense (KIND), Women's Refugee Commission, and the Young Center for Immigrant Children's Rights said that CBP should take special care when detaining and handling child migrants. Among their recommendations for CBP are speaking to a child in his or her first primary language, tracking any time a child migrant claims to be related to another migrant, and keeping state-licensed child welfare professionals on hand.

The groups note in their statement that "all children in CBP custody should receive prompt medical screenings by qualified medical professionals who have expertise and experience working with children." That, in combination with on-hand welfare officials, would help ensure "access to adequate food, hydration, and hygiene, dry clothing, regular showers, and other appropriate care," these groups say.

Ayoub-Rodriguez says that another key step toward preventing child deaths is making sure that they see medical providers trained in detecting problematic health symptoms in children, which she says often manifest differently than in adults.

"I think one of the most important things is getting them out of detention custody as soon as possible," she says. "The conditions they are in during the time that they spend in detention are not optimal for emotional well-being, physical well-being, or access to health care."