By Elliot Spagat - The Associated Press
The recent deaths of an 8-year-old Panamanian girl and a 17-year-old Honduran boy who were under U.S. government supervision have reignited questions aboutauthorities' preparedness for medicalemergencies for immigrants arriving in the United States, especially at a time when agencies are dealing with high numbers of immigrants at southern border holding centers.
Anadith Tanay Reyes Alvarez was knocked unconscious on what was at least her third visit to medical personnel Wednesday at the Border Patrol center in Harlingen, Texas, and later died at a hospital, according to U.S. Customs and Border Protection. The girl had suffered vomiting and stomach pain that day.
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He died on the ninth day his family was being held. Agency rules allow a maximum of 72 hours.
The family told agents the girl had a history of heart problems and sickle cell anemia, CBP acknowledged in its second statement about the death. He had been diagnosed with the flu on the sixth day the family was in custody, prompting them to be taken to another compound.
CBP released a detailed report Sunday confirming key elements mentioned by the girl's mother in an interview with The Associated Press two days earlier. The agency had initially issued only a brief statement.
Anadith Tanay Reyes Alvarez, 8, was a Panamanian national although her family comes from Honduras.
Mabel Alvarez Benedicks told the AP that agents ignored several requests to hospitalize her daughter, who was in frail health, because she had bone pain, struggled to breathe and could not walk. By the time her daughter was taken by ambulance, she was unconscious and bleeding from her mouth.
Agents said her daughter's flu diagnosis did not require hospital care, the mother said.
The girl died a week after Angel Eduardo Madariaga Espinoza, a 17-year-old Honduran boy, died in the custody of the Department of Health and Human Services. He was traveling alone.
Why are so many immigrants being held by the Border Patrol?
A flood of arrivals at the border before Title 42 expired — a public health, social welfare and civil rights measure that gave the federal government the authority to take emergency action to keep communicable diseases out of the country — put extraordinary pressure on the immigration system.
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The Border Patrol apprehended an average of 10,100 people a day the second week of May, compared with a daily average of 5,200 people in March.
The Border Patrol had 28,717 people in custody on May 10, one day before Title 42 was due to expire. The figure was double what it was two weeks earlier, according to a government document. By Sunday, that number had fallen 23%, to 22,259, still above normal.
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The capacity of detention centers is about 17,000 people, according to a government document last year, and authorities have been adding large temporary tents like one in San Diego opened in January with space for about 500 people.
Those who qualify for release and apply for asylum are processed to take their case to immigration courts, which takes between 90 minutes and two hours for an adult and longer for families. This process creates significant bottlenecks in the process.
A mother waits with her daughter to apply for asylum with US authorities on May 12. of 2023.AP
By contrast, releasing someone with instructions to report to an immigration office within 60 days, a common practice in 2021 and 2022, takes just 20 minutes. A federal judge in Florida who ordered an end to those rapid releases in March also blocked a government attempt to resume them last week, in what officials described as a necessary emergency measure given the overcrowding in their compounds.
Amid this month's surge of migrants, hundreds of migrants slept on the ground, many for days, on U.S. soil between two border walls in San Diego, while hundreds more camped out in a remote mountain area east of the city in huts made of branches.
The agency provided a diet scant for water and chips or oatmeal bars. Pedro Rios, director of the U.S.-Mexico border program for the American Friends Service Committee, said the Border Patrol told him to call 911 when volunteers found an eight-month-old baby "without power and vomiting" between the two walls.
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What happens when someone is detained?
Border Patrol detention centers are short-stay centers, where people sleep on mats on the floor with thermal blankets. Thick plastic curtains have replaced barbed wire to prevent the free movement of people.
Adults traveling alone are taken to U.S. Immigration and Customs Enforcement (ICE) for deportation, released into the U.S. with notices to appear in immigration court, or detained longer.
ICE had nearly 26,000 people in prolonged detention in April. Its facilities look like prisons and often are, run by local law enforcement agencies or correctional companies like CoreCivic and The Geo Group Inc.
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In general, a 2015 court order indicates that the government cannot hold families for more than 20 days. President Joe Biden broke the custom of his predecessors Donald Trump and Barack Obama by refusing to detain families beyond the initial 72 hours with the Border Patrol. His government had recently agreed to curfews and electronic surveillance measures for families released in four cities until they passed initial checks to apply for asylum.
Children traveling alone are referred to the Department of Health and Human Services, which usually sends them to parents or relatives after a few days in outsourced detention centers. In 2021, the department was not prepared to receive children within 72 hours, causing them to stay longer in Border Patrol custody. He eventually rented convention centers in California, military bases in Texas, and other temporary accommodation.
The Border Patrol is returning some migrants who do not qualify for release into the United States to Mexico.
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To deport non-Mexican nationals, ICE hires flights and sometimes uses commercial flights. The agency leased 117 flights in April: 33 to Guatemala, 21 to Colombia, 20 to Ecuador and 17 to Honduras, according to Witness at the Border, an advocacy group that uses flight data.
What medical care is available?
CBP, the Border Patrol's parent agency, created a medical director position in 2020, but services are limited. During a visit to a major detention center in McAllen this month, authorities said they had about 100 drugs available and that 23% of detainees had medical needs. The center has a one-stop shop and a more private consultation with two stethoscopes hanging on the wall.
Medical staff look for symptoms of infectious diseases, which is crucial during the COVID-19 pandemic. They also ensure that detainees have the medication they need, immigrants are cared for in case of childbirth and can be cared for so that a trip to the hospital can be avoided.
March 30, 2021 photo of the Rio Grande Valley detention center for unaccompanied minors, in Donna, Texas.
Its facilities added more than 1,000 "medical contractors" in the past two years, said Troy Miller, acting commissioner of CBP. Miller promised "immediate actions to review and, where necessary, reinforce practices to ensure that immediate and appropriate medical care is provided to all individuals, especially those at medical risk."
Are these challenges new?
No, and the growing presence of families and unaccompanied children at the border over the past decade has placed U.S. authorities with enormous responsibilities on the issue of health care.
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At least six children died between 2018 and 2019 during the Trump administration, while being held by the Border Patrol or the Department of Health and Human Services. In March, a 4-year-old Honduran girl with health problems who was in the custody of the Department of Health and Human Services died in a Michigan hospital three days after suffering cardiac arrest.
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In 2019, during a period when border crossings increased, the Department of Homeland Security documented that there were 750 adults crammed into a space for 125 people in El Paso, Texas, that forced people to stand on toilets to breathe.
Another 2019 monitoring report from the Rio Grande Valley noted that men were held for a week in standing-only rooms and children under 7 spent more than two weeks in overcrowded conditions.