Katherine R. Peeler and Vidya Kumar Ramanathan
Judge Dolly Gee’s recent order mandating the release of all detained immigrant children from the US Immigration and Customs Enforcement’s (ICE) Family Residential Centers (FRCs) was an incredible step forward for securing the health and safety of these children. But if our country’s three family detention centers are empty of children on July 17th–the mandated deadline for release–this will not be a victory. We will not be celebrating. Their emptiness will represent something far more sinister–a lack of inflow.
Let us be clear: we disagree with the use of detention for processing newly arrived immigrants. It is unnecessary, it is inhumane, and it violates the United Nations Convention on the Rights of the Child as well as the United Nations Declaration of Human Rights. Particularly for children, detention for any length of time is detrimental to their mental and physical health and their development. But even worse than detention is our government’s current refusal to allow almost anyone to enter this country to seek asylum, under the false pretence that closing the borders to this specific population will somehow decrease rates of COVID-19. Recognizing that this pandemic will (hopefully) be time-limited, the US government is now seeking to permanently alter our asylum regulations in such a way that virtually no one will be able to seek safe haven here ever again.
The current administration has masterfully and relentlessly worked to strip away nearly every single domestic and international right afforded to immigrant children and their families. It has been dizzying to keep up with these policy changes due to both their constant barrage and the insidious ways they have been rolled out. It would seem this administration is hoping we will either get too overwhelmed or too confused to continue fighting for immigrant rights. Members of this government and their anti-immigrant allies may be creative and relentless in their cruelty, but their strategies will not work. We refuse to allow such atrocities to go unnoticed. We–as pediatricians, human rights activists, and general citizens of the world who believe in equity, honesty, and kindness–have been paying attention every step of the way. We fought against changes in the public charge rules, and we work to ensure that our patients and their families understand the benefits owed to them. We called out the despicable family separation policies (past and present) and will continue to do so. We partner with attorneys to understand the new quarantine laws keeping asylum-seekers waiting in dangerous camps in Mexico. We publicize how the United States is in gross violation of its own bipartisan Trafficking Victims Protection Act pertaining to unaccompanied children and how the government deports children in the middle of the night in attempts to evade those same children’s legal counsel.
We research, we gather evidence, we testify, and we advocate. All of these actions are essential tools as a modern physician. Simply learning medicine without understanding the context within which it is practiced, and within which healthcare can be withheld, is no longer enough. As recently stated by Hardeman and colleagues, “all policy is health policy.”
This newest policy change, attempting to effectively wipe out our asylum system, should shake us all to our core. It is, by far, the most far-reaching attempt yet to disenfranchise entire groups of people for no reason other than naked xenophobia. Our country is just starting to grapple with the fact that structural racism, on all levels, is wrong, plain and simple. This sentiment must extend to immigrants–those already here and those traveling to seek safety within our borders. Young children have personally told us innumerable harrowing tales of living day after day in fear for their lives in their home countries. These traumas are compounded by experiences en route to the United States and in detention. The grim stories that we have heard from children, and the stark pictures that they have drawn for us–of themselves cowering in fear under their beds, or crying, holding onto a loved one, trying to avoid bodily harm–are the fuel for our advocacy. To imagine that we would then send these children back to the brutal conditions in their home countries after all they have suffered is not just a clear violation of their human rights; it is a moral travesty.
The public comment period for the proposed changes in asylum regulations ends on July 15th. To take action, you can real the full text of the proposed rule changes, and submit your comment here. A template to help you craft your comments can be downloaded here and here is another link to resources to both learn more and take action.
The time to raise our voices against systematic racism in immigration policy is now. If we allow these changes to go through, then we will not just be denying entry into the United States for these children and families; we will be blocking access to critical healthcare services and mental health provisions that would be life-saving for them. We would also be knowingly forcing these children into dangerous environments with poor access to education, poor nutrition, low immunization rates, unstable housing, and now in this time of the pandemic, much higher overall risk. We must use our place of privilege and knowledge as physicians of what is best for the health of the global community to speak out. Otherwise, July 17th will be more bitter than sweet. The recently released children will be safer and healthier out of detention, but only briefly. With the very asylum system they came for in jeopardy, they will almost assuredly be deported to lead lives of extreme poverty, food insecurity, violence, and early death. May we remember that health is a human right, and may we have the courage to stand up for it.
Katherine R. Peeler, MD is Instructor of Pediatrics and Global Health and Social Medicine at Harvard Medical School, Attending Physician in the Division of Medical Critical Care at Boston Children’s Hospital, and Medical Expert for Physicians for Human Rights, Boston, USA.
Vidya Kumar Ramanathan, MD, MPH is a pediatrician in Ann Arbor, Michigan, and the Medical Director of the University of Michigan Asylum Collaborative.