What if Uncle Sam is responsible? Accountability for abused migrant children

As a child abuse pediatrician, my clinical work centers around medically evaluating children for possible physical abuse, sexual abuse, or neglect.  Mandated reporting laws are clear. 

As a physician, I am legally required to file a report with state child protective services if I have reasonable cause to believe a child has been abused or neglected. 

But what if the perpetrator of the maltreatment is the United States government?

A continuous stream of alarming news about the plight of migrant children includes a report finding that attorneys have been unsuccessful in locating the families of 545 migrant children who have been in U.S. custody, some since 2017.

Another lengthy report from Americans for Immigrant Justice outlines the pervasive maltreatment of children by U.S. Customs and Border Protection (CBP). 

The report draws upon interviews done with nearly 9,500 minors in 2019, equal to one in eight children detained by CBP that year. Over 40 percent of the children reported that they had inadequate food or water, including rotten or frozen food, during their detention. 

Reports of crowded, frigid conditions were common and align with the photographs of children covered by foil blankets, sleeping on concrete floors covered by thin mats.

Nearly 10 percent of the children reported being verbally abused by authorities, which has the potential to be particularly damaging given the trauma and loss already experienced by all of these children.

These children have been denied access to physical and mental health care. Since 2018 at least seven children have died either in custody or immediately after release.

The disposition of many of these vulnerable children is perhaps the final insult.  

A recently leaked email confirmed what had been rumored; U.S. border authorities have been expelling children into Mexico, regardless of their country of origin. This is in violation of a diplomatic agreement with Mexico and the U.S.’s own policy. 

These children are being placed with Mexican child welfare authorities, at least initially. Their ultimate fate, however, is unknown. With no accompanying adults or family to advocate for them, they are at high risk for trafficking or other exploitation. 

A recent report in Pediatrics characterized the treatment of children by U.S. CBP as torture. 

Without question, there is a different value placed on children born in the United States, and those seeking refuge in it. If the inadequate living conditions and maltreatment that have happened to migrant children in the custody of CBP happened to a child in a private residence or group home, the path would be clear. There would be investigations by state child protection officials, and likely law enforcement. If there was sufficient evidence of maltreatment, juvenile court proceedings would be initiated. If a sufficient burden of proof was reached, the criminal courts would be involved as well. 

Some will argue that migrant families forfeited their right to humane treatment when they entered the country “illegally.” Divisive terms are used to distract from the reality that it is both legal and reasonable for people to seek asylum in a country with the potential to offer safety and security that their countries of origin could not. 

Regardless of one’s views on immigration, these are children with the same needs of children everywhere. They need adequate food, shelter, safety and the opportunity to bond with and be cared for by at least one consistent adult caregiver. They need to be housed in a place that is good enough for our own children.

From the United States government, they need true change and accountability.  

Amanda Fingarson, DO, is a child abuse pediatrician at Ann and Robert H. Lurie Children’s Hospital of Chicago, Assistant Professor in the Department of Pediatrics at Northwestern Feinberg School of Medicine, and a Public Voices Fellow through The OpEd Project.