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The Misery At The Border Never Stopped. This Is Biden's Chance To End Family Separation

A migrant girl from Central America waits with her mother for a bus after they are dropped off by the US Customs and Border Protection at a bus station near the Gateway International Bridge, between the cities of Brownsville, Texas, and Matamoros, Mexico, on March 15, 2021 in Brownsville, Texas. (Chandian Khanna/AFP via Getty Images)
A migrant girl from Central America waits with her mother for a bus after they are dropped off by the US Customs and Border Protection at a bus station near the Gateway International Bridge, between the cities of Brownsville, Texas, and Matamoros, Mexico, on March 15, 2021 in Brownsville, Texas. (Chandian Khanna/AFP via Getty Images)

The words of the Customs and Border Protection (CBP) agent, rising above a chorus of children’s sobs, seared themselves into the conscience of a nation: Bueno, aquí tenemos una orquesta. Faltaba el maestro. Translated it means,Well, what we have here is an orchestra. All that’s missing is a conductor.”

Though spoken in unfeeling jest at the expense of traumatized children who had been abruptly separated from their parents under 2018’s “zero tolerance” policy, the agent’s words proved an apt metaphor for the broader chaos unfolding at the border. The Trump administration abdicated responsibility for addressing the underlying violence and poverty — much of it rooted in decades of failed U.S. foreign policy — driving desperate families to risk the perilous journey north in search of safety. Instead, Trump opted to implement a sweeping and undiscerning strategy of punishment and deterrence of asylum seekers.

Unsurprisingly, the number of migrant children apprehended at the border since President Biden’s inauguration has rapidly increased. The tripling of migrant children detained at the border in the past several weeks does not reflect a new “surge,” but rather the long deferred exhale of an already displaced population finally glimpsing hope after years of encountering protections denied at every turn.

The consequences of the Trump administration’s policies on young migrants in particular were dire: More than 5,400 children were separated from their parents, some 500 of whom have yet to be reunited three years later. CBP agents lobbed tear gas across the border at toddlers. In just the first nine months of the ensuing “Remain in Mexico” policy, more than 16,000 children, including 500 infants, were sent to languish in squalid tent encampments targeted by bandits, where more than 200 child kidnapping cases have been reported to date. At least 700 children subjected to the cynically named Migrant Protection Protocols with their families crossed alone into the U.S. after their parents determined it was too dangerous for them to wait any longer in Mexico, or after their caregivers fell victim to cartel violence and disappeared.

Twenty children died in 2019 after attempting desperate border crossings, including 10 who drowned and five who succumbed to dehydration or exposure. Another 13,000 unaccompanied children were summarily turned away under the specious Title 42 public health order purporting to limit the spread of COVID-19, even as otherwise careless immigration detention practices fomented the spread of the epidemic across the country and the globe. The institutionalized maltreatment of migrant children at the border ultimately sank so low as to meet international definitions of torture.

The tripling of migrant children detained at the border in the past several weeks does not reflect a new “surge,” but rather the long deferred exhale of an already displaced population ...

Such policies cynically endangered migrant children in a politically expedient effort to push them out of sight and out of mind, but did nothing to alleviate the factors that drove them to seek safe haven in the U.S. in the first place.

Recent reports of children detained in overcrowded CBP facilities longer than the 72 hours permitted under law echo the disturbing circumstances under which an unprecedented six children died in immigration custody over an eight month stretch of the Trump administration’s tenure. Five of those six died from inadequately treated infectious diseases, amplifying the stakes of repeating past errors in the context of the COVID-19 pandemic, particularly given the challenges of identifying subtle but potentially life-threatening manifestations of Multisystem Inflammatory Syndrome in Children (MIS-C).

Last year I testified before Congress about the deaths in CBP custody of two of the children, 8-year-old Felipe Gomez-Alonzo and 7-year-old Jakelin Caal Maquin. To review the hundreds of pages of CBP investigative documents surrounding their deaths is to be haunted by the multiple missed opportunities to save them. The string of deaths of migrant children in custody was tragic illustration of a simple fact reiterated by physicians and child welfare professionals ever since unaccompanied children began arriving at the border in significant numbers during the Obama administration seven years ago: Detaining children in prison-like settings is not only deeply traumatizing, but fundamentally unsafe.

The orchestra of chaos and misery at the border never dissipated; we are just finally being permitted to hear it again.

The Biden administration now faces a familiar challenge, and an opportunity.

While failing as yet to heed public health experts’ appeals to fully rescind Title 42, the administration has exempted unaccompanied migrant children and at least some families from the policy, and is working on steps to expedite transfer of migrant children from CBP facilities to safer Office of Refugee Resettlement shelters and ultimately to the care of appropriately screened sponsors. But this is the bare minimum of what a just immigration policy demands, and only a small step toward undoing the myriad harms inflicted upon migrant children over the past four years.

Too many children like the young girl I helped evaluate in the MGH Asylum Clinic — who fled domestic and community violence, only to be cruelly separated from her mother and detained alone in U.S. immigration facilities — have arrived at our borders seeking safety, but instead been further traumatized. The former president of the American Academy of Pediatrics rightly described this treatment as "government-sanctioned child abuse." The resulting emotional and developmental scars may take a lifetime to heal.

The orchestra of chaos and misery at the border never dissipated; we are just finally being permitted to hear it again.

The Biden administration has inherited a long overdue imperative to demonstrate true leadership, to re-envision an immigration system that does not promote separation of families, that never resorts to detaining children in prison-like facilities, and that recognizes fostering the wellbeing of all children as crucial to the future of our nation and the stability of the region.

It is long past time to build an immigration system that protects children, in place of one from which children require protection.

The opinions expressed are those of the author and do not necessarily reflect those of the Mass General Hospital.

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Fiona Danaher Cognoscenti contributor
Fiona Danaher, MD, MPH is a pediatrician at the MassGeneral Hospital for Children and director of the Massachusetts General Hospital Center for Immigrant Health. She has testified before Congress about the deaths of migrant children in CBP custody.

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