Dr. Clif CleavelandPeople around the world thrilled to the rescue of 12 boys and their soccer coach on July 10. The group had entered a cave following a soccer match on June 23. Premature, monsoon rains flooded the cave, trapping the group in a complex of multiple passageways and dead-ends. Desperate searches involving an international team of divers finally located the team on July 2. A complex rescue was planned on-site. Large pumps reduced water levels, and a dam prevented additional water entering the cave from outside. A support team of hundreds worked at the entrance.
Until they were found, the group had survived in darkness with no food or blankets. Against improbable odds, the boys and their coach were taken to safety along a 2-mile, largely submerged course. Some passageways were barely wide enough to accommodate an adult. A single transit required four hours. One diver perished during the preliminary rescue effort. A doctor and seven divers who treated the boys and taught them how to wear diving masks and oxygen tanks stayed with the team and coach until all were rescued. An international search-and-rescue effort brought universal acclaim and thanksgiving.
In stark contrast, the well-being of thousands of immigrant children in U.S. custody remains uncertain. Accounts of their detention present grim pictures that can only be categorized as child abuse.
A "zero tolerance" policy toward families entering the U.S. illegally began in May, resulting in separation of 2,300 children from their parents. Justice Department officials, who defended the policy, stated that there were no facilities for caring for children of detained families who were being processed through the legal system. The policy was rescinded on June 20 after widespread condemnation.
An additional 8,000 unaccompanied minors are in U.S. custody, some for almost a year. The Department of Health and Human Services is responsible for the care of both groups of children.
Detained children were shipped to 100 shelters in 17 states. An estimated 1,100 resided in a converted warehouse in McAllen, Texas where lights were kept on constantly. Continuous exposure to light disrupts the metabolism of children and can have long-term, adverse effects on physical and psychological health. (See New England Journal of Medicine article, DOI:10.1056/NEJMp1808450).
An abandoned Walmart store in Brownsville, Texas, housed 1,500 boys, ages 10 to 17. Children slept under plastic foil on foam mats placed on concrete floors. Pictures from detention centers showed children sitting on metal benches behind chain-link fences. A tent city in El Paso provided additional housing. Some teenage detainees have disappeared, presumably walking away from their confinement sites.
By law, school-age detainees must have access to free, age-appropriate education every day. One teacher described the difficulty of conducting classes amid constant turnover of students.
HHS assigned younger children and babies to "tender age shelters" in South Texas. Independent inspectors describe these shelters as clean and well-run but described children in tears because of uncertainty over their parents' whereabouts. Infants younger than 15 months are susceptible to separation anxiety when abruptly taken from parents. They may become agitated, suffer insomnia and digestive upset. Longer-term problems include anxiety, depression and cognitive impairment.
Federal courts have issued July deadlines for reuniting the 2,300 children with their parents. In several instances, parents of children cannot be located. No clearly defined procedure for reunification of children with their parents seems to exist.
Separating children from their parents is morally repugnant. Families who cross into the U.S. illegally should be detained but as family units. Officials who approved the rescinded policies should be identified and fired from their positions.
Unaccompanied children who enter the country are owed humane care until immigration courts can deal with the particulars of each case.
This black chapter in our nation's history must end.
Clif Cleaveland, M.D., is a retired internist and former president of the American College of Physicians. Email him at ccleaveland@timesfreepress.com.