Undocumented immigrant children: Am I my brother’s keeper?
FernandoStein, M.D., FAAP, President, American Academy of Pediatrics
Letter from the President
Since January, executive orders issued by the government and discussions in the media
regarding immigrants seeking refuge or living in the United States have challenged
us to look deep into our own value systems and ask, “Am I my brother’s keeper?”
As pediatricians, the national discussion about immigration policy is not an abstract
political issue but a reality in the lives of our patients and their families. I have
witnessed and you have told me that the impacts of the immigration debate are evident
every day in pediatric practice for our patients and families. As caregivers and citizens,
we are challenged to reevaluate our value system and resolve the competing interests
of values, laws, morality, ethics and politics.
I have had the privilege of joining AAP leaders visiting the southwest border of the
U.S. and the detention facilities there along with community efforts to help immigrant
families and children who have been released after being legally processed. In these
places, one truly sees it all. There are moments of compassion and warmth where the
best of what society and human beings can offer is present for the scared children
and adults. There you also can see and touch “the wall” that separates nations and
people. And most importantly, there are the families and children who are entering
the country looking for refuge. They are fleeing abject poverty, violence and hunger.
Let me describe what we saw.
Capture and processing
Motorized vehicles of various sizes come to the detention center. A tall warehouse
building with 25- to 40-feet-high thick and hard chicken wire-like metal separations
for each area. Women with children, unaccompanied minors, occasional adult males with
children and rarely an entire family constitute the deliveries that come all day and
all night. Clothes are removed, standard issued clothing replaces their own and possessions
are confiscated and placed in individual plastic bags. (This includes shoes, security
blankets and other simple possessions.) A mountain of these bags forms quickly near
Adult males are separated from young males and young males from male children. Same
for women, although young children can stay with their mothers. About 1,000 individuals
per day are processed at the Ursula (Texas) detention center alone, according to the
Customs and Border Protection officials we spoke to during our visit. The place is
clean but cold, and the lights are on 24 hours a day for security reasons. Simple
food and drink are provided. The guards are kind and polite but stern. Many are immigrants
Separation and reunion
There are cries of desperation when brothers and sisters are separated because of
age or gender — fear exacerbating existing trauma — but they will be reunited usually
in less than 48 hours. After being photographed, cursory biometrics, an even more
cursory health check (inspection with no vitals unless appearing ill or complaining
of illness) and an interview, the detainees are released. There is no capacity to
hold them because there will be 1,000 more arrivals the next day. Ankle monitors are
placed on all adults. Possessions are returned.
Community to the rescue
The communities of Harlingen, Del Rio and McAllen are not exactly wealthy, and yet
they send buses to pick up the children and families at the release site and bring
them to churches and other community facilities.
At Sacred Heart Church, volunteers line up in two rows. As the children and families
walk in, they are received with applause to make them feel welcome. They were served
a warm, hearty meal, and each child is given a bag or backpack that includes a set
of clean, age-appropriate clothes and personal hygiene items for the journey across
the country to their sponsors.
I personally spent time with several beautiful, loving families. They cried as they
told me stories that support the concept of “credible fear”: family members killed,
boys threatened with death if they don’t join drug gangs, threats of sexual abuse
and kidnapping. These families made heart-wrenching decisions to leave their homes,
often having to leave some of their loved ones behind.
I believe we have a moral duty to help these families and children. It has been said
that not everything that is legal is moral and not everything that is moral is legal.
I hope you stand with me and the AAP leadership when we say, “Yes, I am my brother’s
I would like to acknowledge AAP Immediate Past President Benard Dreyer, M.D., FAAP,
for his help in writing this letter.