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“Detaining Families Is Not Necessary”

8.1.19

From left: Ashish Jha (at podium), Theresa Betancourt, Sural Shah, Jodi Berger Cardoso, and Sarah Sherman-Stokes

Photograph courtesy of the Harvard Global Health Institute


From left: Ashish Jha (at podium), Theresa Betancourt, Sural Shah, Jodi Berger Cardoso, and Sarah Sherman-Stokes

Photograph courtesy of the Harvard Global Health Institute

Óscar and Valeria Martínez, the migrant father and two-year-old daughter who were found drowned in the Rio Grande in June, had been waiting to make their asylum claim. Under the Trump administration’s “metering” system, immigrants who arrive at the U.S.-Mexico border must wait on the Mexican side for their turn to cross and present their case, explained Sarah Sherman-Stokes, an immigration law professor at Boston University, at an event on the border crisis hosted by the Harvard Global Health Institute (HGHI) Tuesday. “They get a tiny piece of paper, the size of your fingernail, that has a number on it. The number is in the thousands. Every morning they pack their bags, they come from the tent they’re staying in with their whole family, they come to the port of entry at 7 a.m., and they wait to see if their number will be called. Some days 10 families are called. Some days no families are called.” So few people are called, she explained, that ports of entry are effectively closed to asylum seekers. Óscar and Valeria, who had come from El Salvador, tried to cross the river “because they couldn’t wait any longer.”

Dozens of public-health professionals, lawyers, social workers, and other guests gathered at the three-hour event to hear from Sherman-Stokes and other practitioners on the front lines of the crisis at the border. They heard the panelists report that children in the custody of Customs and Border Protection (CBP) are being abused, needlessly detained, and illegally separated from their families for long stretches of time. One of the speakers, Columbia Law School professor Elora Mukherjee, is part of the team tasked with monitoring the 1997 Flores settlement, resulting from a federal lawsuit over the treatment of migrant children in government custody. The court-supervised settlement requires the government to release children from detention to their families without unnecessary delay. As part of her work, Mukherjee interviewed children at the Border Patrol facility in Clint, Texas earlier this summer. What she saw horrified her so much that she and her colleagues decided to go public. 

“By now, evidence of child abuse of children in the custody of U.S. Customs and Border Protection has become indisputable,” said Mukherjee, who Skyped into Tuesday’s event. What she saw in the Clint facility—filthy conditions, overcrowding, epidemics of flu and other illnesses, children who were unable to bathe or brush their teeth or change clothes for days, and prolonged separation of children from their parents for weeks or months—have been corroborated by government watchdog agencies and CBP officers, she explained. “I was and I remain shaken to my core by what I witnessed at Clint,” she said in her July 12 testimony before Congress, which was played at the beginning of the event. “I have three children of my own. They are three, six, and nine. I do not have the words to explain to them what is happening to children their age in America right now.”

Institutions “can’t be a parent” 

Li professor of global health and professor of medicine Ashish Jha, HGHI’s faculty director, opened the panel with comments on understanding the border crisis in a global-health context, and how Americans should think about their obligations to refugees and displaced people. Displacement “is not voluntarily leaving to go to a new place; it is often about physically, forcibly being pushed,” he said. “There are about 70 million people who are displaced in the world today, the highest number we’ve seen since the end of World War II. These are very important times....Maintaining the health of a displaced population is a difficult business,” he continued. “We have obligations to do it, but it is not just like taking care of any other population. They have very specific needs, challenges. It is our obligation to figure out how to do it.”  

Theresa Betancourt, Sc.D. ’03, of the Boston College School of Social Work, formerly a professor at the Harvard School of Public Health, drew from her decades of work on adversity in children, families, and mental health. She stressed the crucial role of attachment relationships in child development: in situations of toxic stress and family separation, she said, children’s “bodily stress response is activated, but they don’t have their caregivers with them to soothe them and help them make it through those very traumatizing events. The science on this is clear. We don’t have to debate it any longer...family and attachment relationships are so critical in shaping how young people fare over time.” Even in cases where institutions are well designed to care for children, she added, they cannot be a substitute for attachment relationships. “That’s what institutions can’t do. They can’t be a parent....They can’t give you the individualized attention that children need.  

“There are consequences of those early deprivations across the life course,” she added, and critical periods after which the deficits can’t be made up. The refugees at the border are “fragile families looking to advance themselves, and what we’re adding to [their trauma] is immense.” 

One number that the speakers returned to throughout the afternoon: seven children have died in CBP custody in the last year. Before that, there had been no deaths for about a decade. “It seems like something has changed,” Mukherjee said, “and we need to figure out what it is and how to make sure that another child doesn’t die in federal immigration custody.” Sural Shah, M.P.H. ’15, a pediatrician who conducts forensic evaluations for children and families seeking asylum, explained that “children are not just little adults. They get sick faster. They go from looking like they’re fine to decompensating rapidly, and it’s really important that we have people that are very familiar with how to identify those signs.” That point is crucial for both the physical and the psychological health of children, she added—including how they cope with trauma. “They seem like they’re fine until they’re not, and when they’re not the consequences can be grave, they can be life-threatening, and they can last for a very long time.” 

Jodi Berger Cardoso, a professor of social work at the University of Houston, recalled her experiences meeting with migrants at respite centers. “Particularly difficult to me [were] the significant signs of distress and continued emotional and physical exhaustion that I observed in children, infants, toddlers,” she remembered. “I asked many families what the age cutoff was for when CBP separated the parents from children. It seemed to be 10 years and older...that has no developmental research to support it.” 

“A cruel policy choice”

“Detaining asylum-seeking families is not necessary” in the first place, Mukherjee said. “It is a cruel policy choice. Almost all children and families who are seeking asylum and have access to appropriate supports show up for their immigration court proceedings. The U.S. government’s own data show that for asylum-seeking families who are paired with a lawyer, they show up for their immigrant court proceedings 99 percent of the time.” Despite this, the Trump administration “abruptly terminated” the program that allowed families to be released while waiting for their court date, Mukherjee said. (“If you want to talk about taxpayer dollars,” she added, releasing families is also vastly less expensive than detaining them—even in the inadequate facilities and conditions she and other speakers documented.)  

Sherman-Stokes’s main focus in the discussion, she said, was to stress the “intentionality” with which the border crisis has been created. “This administration has intentionally and relentlessly created and manufactured the human-rights crisis and the public-health crisis on the border, and then, as is Trump’s playbook, has purported to rescue us from this crisis at various intervals.” She talked about a recent news report that documented an unnamed member of the National Security Council writing in an email, "My mantra has persistently been presenting aliens with multiple unsolvable dilemmas to impact their calculus for choosing to make the arduous journey to begin with." Metering is one of those “unsolvable dilemmas,” Sherman-Stokes said; requiring migrants to cross the border at a port of entry, even though the law “unambiguously” says asylum-seekers can arrive through any point, and detention itself, are others. 

“Our clients, our patients do not take this journey lightly,” Sherman-Stokes said. “They take this journey because they have no other choice. They have to protect their lives and the lives of their children and families. It is not a choice. And the ‘unsolvable dilemmas’ that this administration is presenting…they are countless and they are unrelenting and they are literally endangering the lives of our clients and patients. They are killing our clients and patients.”   

Toward the end of the panel, Sherman-Stokes stressed the historical context of today’s refugee crisis. “Our history of discrimination against Central Americans in particular is many decades old,” she said. “There were lawsuits in the ’80s because asylum-grant rates for Central Americans were abysmally low, whereas people fleeing communist countries had grant rates that were very high....There has been unbelievable racism and animus directed specifically at migrants from the Northern Triangle” of Guatemala, Honduras, and El Salvador. Until then, the racial dimension of the crisis had not been so explicitly discussed—but Jha, the panelists, and audience seemed to agree, it was enough to fill another three-hour afternoon. 

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