Children at southern border are facing a public health crisis

The public health crisis facing migrant children at the southern U.S. border is at a boiling point. Detained kids are sleeping on concrete benches because the government is running out of room, and out of money. Thousands have been sexually abused. And six have died in U.S. custody over the past eight months alone.

A decades-old legal agreement was established to prevent this very situation from happening. But no one appears to be enforcing it; and the Trump administration is now trying to kill it.

More kids are in U.S. custody than ever before. As of May 31st, over 1,400 unaccompanied minors had been detained by Border Patrol for more than 72 hours, the maximum allotted timeframe for a migrant of any age, according to NBC News. Some are under 12 years old.

When these children are finally transferred to a government shelter, their stay can be open-ended. Amy Cohen, a psychiatrist who works closely with these children, has seen them detained anywhere from 50 to 75 days at a time. “I have interviewed children held for more than a year,” she recently told the New York Times.

The living conditions they endure while in U.S. custody are horrific. Overcrowding at Border Patrol stations has resulted in a bed shortage as children wait to be processed. Health and Human Services (HHS), which oversees shelters for migrant children, is operating at near maximum capacity, and has appealed to Congress for emergency funding to address “critical” child needs. Meanwhile, HHS has announced the planned elimination of basic welfare programs essential for child development, such as education and athletics, because the agency simply doesn’t have the funds to support them.

Observers say this violates the Flores settlement, which establishes standards for the proper treatment and expeditious release of detained children. Specifically, it mandates a child must receive basic necessities, and that unaccompanied minors must be released to a parent, relative, or guardian willing to assume responsibility for their care. The Flores settlement also includes a general standard for children who accompany their parents across the border; they can’t be held for more than 20 days.

The settlement is named after Jenny Lisette Flores, who left El Salvador when she was 15 to reach her aunt in the United States. She was detained, repeatedly strip-searched, forced to share living spaces with adult men and women, and denied release despite the fact her aunt was willing to take care of her. The American Civil Liberties Union sued the government on Jenny’s behalf in 1985, and a consent decree was reached more than 10 years later to prevent a similar situation from happening again.

“I have to tell you, Judge Flores, whoever you may be, that decision is a disaster for our country,” President Trump mistakenly told Border Patrol authorities in April. There is no “Judge Flores,” of course. But President Trump’s failure to understand the settlement’s historical context would be laughable if his underlying position, gaffe notwithstanding, didn’t risk the wellbeing of thousands of detained migrant children currently in U.S. custody.

The Flores settlement limits the amount of time the U.S. can detain children, which is why the Trump administration wants to end it. After last year’s backlash when migrant children were separated from their parents, the Trump administration needs to modify or replace the agreement in order to keep families together.

But ending Flores would remove established standards that assure children will be treated with some degree of dignity during their detainment. And removing it would open the door for the Trump administration to hold children and their parents indefinitely, and extinguish baseline thresholds for the way children are handled while under the care of U.S. authorities.

We are already seeing the ramifications of the Flores settlement’s slow erosion. Children are being held far beyond what the standards currently stipulate. And the deplorable living conditions they’re forced to endure today defy the very reason why it was established in the first place. What these children are experiencing now will haunt them for the rest of their lives. Removing Flores altogether will simply pave the way for more cruel and inhumane treatment.

Congress must fight to keep the Flores settlement intact — and take action to enforce its provisions. Doing so will help prevent children from being abused, mistreated, malnourished, or sleep-deprived. It will enforce humanitarian guidelines that establish minimum quality-of-care standards for defenseless kids. And it will reduce the frightening time they spend in U.S. custody.

Even in today’s deeply divided times, can’t we agree on that?

Lyndon Haviland DrPh, MPH, is a distinguished scholar at the CUNY Graduate School of Public Health and Health Policy.