We Must Step Forward on Behalf of the Children at our Border

“It is easier to build strong children than to repair broken men.”  — Frederick Douglass, abolitionist and statesman

“There can be no keener revelation of a society’s soul than the way in which it treats its children.”  — Nelson Mandela, Former President of South Africa

Everything I have learned in my almost three decades as a pediatrician and public health advocate caring for children and families tells me that what we are doing to migrant children at the border is morally and medically wrong. It goes against all that we know about how children should be treated. It is also not who we aspire to be as a nation. We are and must be better than this.  

Recent detailed reports of the appalling conditions in the detention centers our government operates along the border have provided chilling details on just how deeply we have abandoned our responsibility to care for and protect vulnerable children.  The shell game the government is playing with these already traumatized children, shuffling them out of and then back into the Clint, TX facility is further evidence that we are failing to show basic humanitarian concern for these kids.

Consider the love you dole out to your children, the concern we show for kids who are abused by their caregivers and are whisked off to protective services. And now consider these detained children. They are kept in isolated and overcrowded facilities, surrounded by cages, with only pallets on the concrete floor to sleep on and foil blankets to cover themselves. They lack adequate toilet facilities, diapers, or caring adults to change them.  Children as young as 7 or 8 years of age are left to care for even younger children they don’t know. Their meals are basic and leave many hungry. 

As if this wasn’t enough, they receive no assessment or intervention for the trauma they experienced getting to the border or the deep suffering our government imposed by separating them from their parents when they were taken into custody. A recent report from Physicians for Human Rights documents the mental and physical trauma, ranging from broken bones to dire infections to post-traumatic stress disorder (PTSD), that children seeking asylum have endured before they arrived at our border. We are casting these children into deeply traumatic experiences without any of the supports that we know would buoy them up and protect them from further emotional and physical harm. There is an extensive body of evidence that documents the damaging effects of this type of stress on the bodies and minds of children. Their inner flight or fight systems were already triggered by the trials of getting to the border and whatever they were fleeing from in their home countries. Through our draconian policies of separation, isolation, perpetual uncertainty, and the horrible conditions in the detention camps, we shifted those systems into overdrive, which literally changes their physiology and can alter their neural wiring.  

It goes without saying that isolating children from their families and keeping them in these desperate conditions is creating significant and totally preventable trauma and toxic stress that will have lasting impact on them. This is why organizations who know about children and their wellbeing, like the American Academy of Pediatricians, have argued against the government’s policy of forced separation and detention at the border. The economist James Heckman has argued persuasively that protecting and investing in young children is the most cost-effective way to avoid social costs later.

Yet, we are doing the opposite. Our government is knowingly creating the conditions that undermine the wellbeing of these children now and will result in predictable societal harm for them and the rest of us in the short and longer term. As a pediatrician who has cared for children who have experienced significant trauma, I know first-hand how much help these kids need and the critical difference timely and thoughtful intervention can make. However, I have never had to care for scores of children whose trauma was knowingly inflicted not by a troubled individual, but by our government, through intentional policy decisions and resultant practices that run contrary to sound medical evidence, basic humanitarian practices, and our values as a nation.   

Those of us who work in or with the social sector have a responsibility to use our knowledge and expertise to address situations like these. We must use all of our available platforms to call ourselves and each other to action. We are now at a point where, when confronted by the fact that children are living in these squalid conditions, surrounded by guards with guns and face masks to protect against the stench, our government’s lawyers have actually argued in court that we are not required to provide soap and water or other basic hygiene supplies to these children in our care. 

This is a manmade humanitarian crisis, which will be as devastating for these children as any hurricane or tornado. We know how to respond and mobilize in times of natural disasters—why not use those skills now during this manmade disaster? Influencers across all disciplines in the social sector can use their respective platforms to call for an immediate end to the warehousing of these separated children and reunification of families in settings that meet basic humanitarian standards.

  • Foundations have invested significant resources in generating and putting into practice the most up-to-date knowledge about preventing and healing childhood trauma.  Now is the time for the philanthropic sector to use its considerable influence at the state and federal level to immediately improve conditions for these children while the longer-term debates about immigration policy continue. We know that these children need access to basic facilities and most importantly to caring adults who can provide some degree of buffering to the toxic stress they are currently experiencing. Foundations could provide funding for community-based organizations to provide services and programming for these children while they await the outcome of their fraught judicial processes. This support could ensure that trauma-informed practitioners are deployed to the border communities that will likely inherit these victimized children.  Here is a list of organizations galvanizing to assist children separated and detained at the border. Perhaps there are foundations that could provide support to coordinate and amplify the work of these organizations and connect them with additional skilled staff as needed?  Recent reports indicate that Customs and Border Patrol are not accepting donations of goods and services, even as they argue they should not be required to provide soap. Why? Perhaps foundations can demand an answer to that question.
  • Businesses know that their consumers are paying attention to how they act in the world. Regardless of one’s stance on immigration policy, it is hard to imagine why deliberate cruelty to children would be defensible. If our government’s lawyers argue that the US does not have to provide simple things like soap and water for children to bathe, corporations can volunteer to provide basic hygiene supplies to these facilities.  Some businesses, like Wayfair, have discovered just how closely their employees are scrutinizing their decisions to sell goods and services to these detention centers.  What if these same companies used their considerable clout to offer to donate these goods and services with important stipulations about improvements in conditions? Perhaps they could stand with foundation CEOs to require a response for why these facilities are refusing donations. Businesses have cadres of employees who would undoubtedly be willing to volunteer their time providing some adult comfort to these vulnerable children, with the oversight of trauma-informed specialists. 

We must step forward, because our government has created a yawning moral vacuum that is harming vulnerable children. This must stop.

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