Undocumented immigrant children: Am I my brother’s keeper?

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 the door.

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 themselves.

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 keeper!”

I would like to acknowledge AAP Immediate Past President Benard Dreyer, M.D., FAAP, for his help in writing this letter.