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Friday Sep 06, 2019

Our Treatment of Immigrants Should Reflect Our Values

The Department of Homeland Security recently published a final rule(www.govinfo.gov) that would allow the government to detain migrant children at our southern border indefinitely. The new rule would put an end to more than 20 years of protections for migrant children granted in a settlement agreement(www.aclu.org) and related court orders and other documents, including limits on how long these children can be detained.

U.S. Border Patrol agents lead people into the Central Processing Center in McAllen, Texas.

The AAFP and four other health care organizations -- the American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, and American Psychiatric Association -- representing more than 452,100 physicians and medical students are voicing strong opposition to this rule, which should be rescinded by DHS or rejected by the courts. As physicians, we protect the health and well-being of our patients, and we are compelled to speak out about policies that will harm patients and families.

As we noted in our statement,(www.groupof6.org) federal detention facilities too often fail to ensure access to health care that meets guideline-based standards, treatment that mitigates harm or traumatization, and services that support immigrants' health and well-being.

Although immigration has proven to be a contentious, partisan issue, the humane treatment of immigrants is not. A recent Quinnipiac poll(poll.qu.edu) revealed that nearly 70 percent of Americans consider the conditions in immigration detention centers to be a "serious problem," and more than 60 percent of respondents said "the federal government is not doing enough to ensure humane conditions" in these facilities.

The same poll asked participants if it would be better to keep all undocumented immigrants in detention centers, regardless of overcrowding and poor conditions, or whether some undocumented immigrants should be released under supervision. Less than one-third of respondents voiced support for detention in overcrowded facilities.

Like the majority of Americans, I am disturbed by reports of the appalling conditions in these detention centers.(www.oig.dhs.gov) These reports signal a stain on our national honor that will be difficult to erase. Our grandchildren and great-grandchildren will read about this crisis in their history books and wonder why more was not done.

Part of the problem is that we cannot comprehend how government officials could lose sight of either common decency or the values our country holds dear. Tearing families apart; putting children in overcrowded cages; and depriving them of basics such as soap, toothpaste, blankets and vaccinations should not happen in our country or anywhere.

In my community, I am legally mandated to report the kinds of conditions that credible sources are reporting in border detention centers. To whom do I report if this is happening at a government-run facility?

We need to be cognizant that child trafficking is real, and U.S. border policy must take this into account and protect children who are brought across our borders. But my fear is that children and families are being used as pawns in a political contest in which some of the players have no compunction about infringing on human rights, violating international law,(time.com) or using this population to achieve a win on a campaign promise.

Meanwhile, children are suffering emotional trauma(www.npr.org) that likely will have long-lasting consequences on their health. Presumably, many will gain entry to this country and will be our patients for years to come. When we hear their stories, we will remember the sick feeling we have now.

There must be more resources and fewer roadblocks to reduce the backlog of immigration and asylum cases that is the limiting factor in processing this population. In the short term, the conditions of detention centers must be improved. Detainees should have access to medical care and vaccines to prevent influenza, mumps and measles.

Most of all, we need a frank discussion among members of Congress. Collaboration and negotiation are not signs of weakness; rather, they have been the source of strength for our democracy and the reason for our success as a nation. As family physicians, we have an obligation to inform our legislators about the impact of adverse childhood events and lack of access to health care services.

What is not negotiable is the humane treatment of the detainees at our border. Conditions must ensure access to health care that meets guideline-based standards, treatment that mitigates harm or traumatization, and services that support their health and well-being. This includes timely processing.

Through the act of detention, these people have become our country's responsibility, and their treatment must reflect our values as a country. As family physicians, we can demand nothing less.

John Cullen, M.D., is president of the AAFP.

Posted at 12:45PM Sep 06, 2019 by John Cullen, M.D.

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