For Dr. Theresa Cheng called the scene “apocalyptic.”
She had come to Valley of the Moon, an open-air camp in San Diego’s rural Mountain Empire, to volunteer to provide medical care to asylum seekers who had breached the U.S.-Mexico border wall and were waiting to be apprehended by American authorities .
Among the crowds at this and other locations, she found children with deep cuts, broken bones, fever, diarrhea, vomiting and even seizures. Some hid in dumpsters and overflowing portable toilets. An asthmatic boy without an inhaler gasped in the acrid smoke of bush and rubbish fires lit for warmth.
With capacity at immigration processing centers strained, migrants, including unaccompanied children, wait for hours, sometimes even days, in outdoor detention centers, where the lack of shelter, food and sanitation infrastructure raises a range of public concerns for most people Health has led to vulnerable.
“From a public health perspective, there are communicable diseases and outdoor exposure that would affect anyone, let alone this medically vulnerable population,” Dr. Cheng, an emergency physician at Zuckerberg San Francisco General Hospital and Trauma Center.
A federal district court judge in California could decide as early as Friday whether the government has a legal obligation to house and feed the waiting children.
In a court filing, Justice Department lawyers argue that the children are not required to provide such a service because they have not yet been formally taken into custody by U.S. Customs and Border Protection.
“Minors in these areas – near the California-Mexico border – have not been arrested or detained by CBP and are not in CBP’s legal custody,” the attorneys wrote.
“CBP immediately apprehended minors and transported them to U.S. Border Patrol safe and sanitary facilities. But until that happens, plaintiffs are not in DHS custody,” they wrote, citing the Department of Homeland Security.
When asylum seekers enter the United States between official ports of entry, they often present themselves to border patrol agents near the wall with the intent of being arrested. They are taken to a processing facility where they receive a medical exam, background check and basic care before beginning the process of filing their claims.
But unlike these immigration centers, there are no shelters, meals or government medical staff at the open-air sites. According to Erika Pinheiro, executive director of the legal and humanitarian nonprofit Al Otro Lado, which has been providing assistance in the camps, some sites have no toilets, leading people to defecate in the open air. Due to the limited number of diapers, wipes and creams provided by volunteers, babies were kept in dirty diapers for extended periods of time, resulting in severe diaper rash, according to court documents.
A senior Customs and Border Protection official acknowledged in an interview that people had at times waited days for processing, but said that vulnerable groups such as children were always given priority and that wait times had become significantly shorter in recent months. He said the agency has more than tripled the capacity of processing centers in San Diego and increased the number of transport buses and staff to speed arrests.
Still, he said, the system was not designed to handle migrant encounters on the current scale, and moving border crossings to more remote regions has made the process all the more resource-intensive, requiring vehicles and personnel to travel further between camps and border patrol stations. He said a significant increase in federal funding is needed to fully address the problem.
At least seven migrant holding areas have been created at various points along the California border. One is a large piece of land in the desert next to a highway; another is a plateau in mountainous wilderness; Another reason is the narrow gap between two parallel border walls built just meters from the Mexican city of Tijuana.
None of the holding areas have been officially set up by immigration officials, but they have become a pillar of their operations – makeshift camps where they instruct asylum seekers to line up to be counted, remove their shoelaces, strip down to a layer of clothing and wait.
Adriana Jasso, who runs a volunteer aid station against the steel slats of the border wall in San Ysidro, California, on behalf of the nonprofit American Friends Service Committee, said increasing shortages of government-provided food, water and baby formula were particularly concerning. “There is no logic when the most powerful country in human history, the country with the highest concentration of wealth, is unable to meet the basic needs of children,” she said.
Migrant advocacy groups have filed several complaints with the Department of Homeland Security’s Office of Civil Rights and Civil Liberties, and a group of lawyers representing children in immigration custody have done so under a 1997 federal court agreement known as the Flores agreement decided the courts on the conditions.
The Flores settlement agreement established the standards of treatment for immigrant children detained by the government. It essentially requires that children in immigration detention have similar rights and protections as children in the country’s welfare system, and that they be released from detention “without unnecessary delay” to an appropriate sponsor, such as a parent or relative.
Lawyers in the settlement, including the Oakland-based nonprofit National Center for Youth Law, have filed a new motion to enforce Flores’ conditions for young migrants still awaiting trial in the open. They argue that the children waiting at the border wall deserve the same safe and sanitary accommodation as those already in official custody because they are banned from moving from the camps and have no option to return.
The burden of medical problems among children in detention areas is difficult to measure because volunteers are admitted to sites only at the discretion of border officials and a hodgepodge of aid groups do not keep collective records of wounds treated or electrolytes dispensed.
In a December 2023 email to federal officials, an attorney wrote that infants in the holding areas began vomiting due to severe dehydration and that some children were given one granola bar per day as food. Pedro Rios, director of the American Friends Service Committee’s U.S.-Mexico border program, said he encountered migrants who ate leaves because they had been there without food for five days, as well as mothers who stopped producing breast milk because of it traumatic stress and infants without replacement foods.
Hundreds of children have been collected at the sites every month since last summer, and Dr. Cheng, who is also a professor of emergency medicine at the University of California, San Francisco, estimates that she examined or treated 100 children in one week alone. She encountered a 5-year-old and a 12-year-old who had spent three nights outdoors; an 8- or 9-year-old whose face she stabbed outdoors; a 13-year-old boy with a traumatic injury that left blood flowing from his ears and nose.
Children are not the only migrants with serious health problems. In remote parts of eastern San Diego County, those who surrender to border authorities often endure arduous journeys through steep mountain terrain and desert terrain and arrive in detention areas in deteriorating health. Doctors said they encountered a man with a kidney transplant who ran out of immunosuppressants, a woman with a traumatic stroke who couldn’t reach her own shoelaces and a migrant who had traveled on an oxygen concentrator and became hypoxic. He finally died.
Doctors are particularly concerned about cases of hypothermia in children because many of them have less body fat than adults and may be malnourished due to their travels. Migrants were drenched in waiting areas overnight by heavy rains, which can cause body temperatures to plummet. Two minors were hospitalized last month for hypothermia.
Karen Parker, a retired social worker in Boulevard, Calif., who does volunteer medical triage in the eastern camps, said that in addition to broken feet and twisted ankles, she regularly encounters unaccompanied minors suffering from panic attacks. “The stress, the exhaustion, the trauma makes them physically ill,” she said. “I look at them and think they’re finally here, but their eyes are so empty.”
The number of people and the length of waiting times have fluctuated since last summer. In recent weeks, Mexican military activity has pushed migrants west, to a more urban region between Tijuana and San Ysidro, California, where asylum seekers who breach the primary border wall must wait for federal agents in the 280-foot-wide space behind a second wall. Fewer gaps in the primary border wall mean more children are being dragged over it or smuggled under it, despite concertina wire. Responders have documented an increase in deep lacerations to the head and local neurosurgeons have reported an increase in traumatic injuries.
In recent weeks, a three-year-old and a one-year-old fell from the border wall in their parents’ arms.
“When you hear the babies screaming and screaming right on the other side of that wall, that’s the worst thing,” said Clint Carney, government affairs representative for the nonprofit Survivors of Torture, International, which provides aid across the border wall.
Local emergency services were inundated with calls from the sites, and responders said federal agents often rejected their requests to call 911, suggesting migrants were feigning injuries. Those who had serious injuries often called volunteer medical personnel to provide them with telephone advice.
As Dr. When Cheng received such a call one morning and found a 13-year-old boy at the scene with a weak pulse and blood coming from his ears and nose, two border officials stood nearby but had not yet taken any steps to assist, she said in court documents.
Dr. Cheng performed cardiopulmonary resuscitation, but it took an hour for emergency medical services to arrive, she said. The boy died.
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2024-03-28 20:24:29
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