For the past year and a half, Dr. Eric Russell has been traveling from Houston to McAllen, Texas, every three months or so to volunteer at the Catholic Charities Humanitarian Respite Center, a first stop for many asylum-seeking migrants who’ve been released by U.S. Customs and Border Protection in the Rio Grande Valley.
During his most recent visit to the clinic in April, when he saw more than 150 migrants, he noted a troubling new trend: a number of people reported that their medication had been taken from them by U.S. border officials.
“I had a few adults that came who had high blood pressure, who had their blood pressure medications taken from them and, not surprisingly, their blood pressure was elevated,” Russell told Yahoo News. “There was a couple of adults that had diabetes that had their diabetes medicines taken from them, and wanted to come in because they were worried about their blood sugar. And, not surprisingly, their blood sugar was elevated.”
For Russell, a pediatric emergency medicine physician, the patient who stood out the most during that visit was a boy of 8 or 9 with a history of seizures. According to his mother, the child had been on a long-term seizure medicine in their home country, but the medication had been taken from him upon entering the Border Patrol custody in McAllen and never returned.
“The mom came to the clinic because she was concerned that he was going to have a seizure,” said Russell. He wasn’t sure exactly how long they’d been in custody — “usually it's a matter of days,” he said, “but with seizure medicines, that’s enough.”
Fortunately, by the time they made contact with Russell, the boy had not yet had a seizure. But like most asylum-seeking families who pass through the respite center and other shelters like it along the border, McAllen was not their final destination but a stop along the journey — usually by bus — to join relatives or other sponsors elsewhere in the country.
“My concern is, what’s going to happen if you put a 9-year-old child who has a history of seizures, without any seizure medicine on a bus for 3 days ... is that he’s going to have a seizure,” Russell said.
Russell added that he can understand the need for a policy regarding the use of outside medication by detainees. However, he said, “At the end of the day, as a medical provider, as a physician, we take an oath to first do no harm. And taking somebody’s medications seems like it’s causing harm.”
“Somebody’s going to get hurt, if they haven’t already,” he added. “Or frankly, someone could die.”
When Russell returned to Houston, he relayed his concerns to Dr. Marsha Griffin, who helps coordinate medical volunteers for the McAllen Respite Center.
Griffin, who also serves as co-chair of the American Academy of Pediatrics Immigrant Health Special Interest Group, said that Russell’s experience reflected what she and other volunteer physicians had also been hearing from parents and children seeking medical care at the respite center in recent months.
“I don't know if it's gotten increasingly worse or if it's just something we're seeing more often because there's just so many families coming across,” said Griffin.
Yahoo News spoke to five doctors, including Russell and Griffin, who volunteer at shelters and clinics on the border and each confirmed that they regularly see migrants with chronic conditions like diabetes, asthma, seizures and high blood pressure, for which they claim to have had medication that was confiscated while they were in custody of U.S. Customs and Border Protection and neither returned nor replaced. It happens more frequently to adults, who are more likely to be on such medications in the first place, but doctors said they’ve been hearing similar reports from increasing numbers of children or their parents.
For these doctors, all of whom are pediatricians, the seizing of medications heightens concerns about the medical care provided to the record numbers of children held at processing centers and short-term holding facilities along the southwest border.
According to CBP standards, any detainee who enters Border Patrol custody with medication prescribed outside the United States “should have the medication validated by a medical professional, or should be taken in a timely manner to a medical practitioner to obtain an equivalent U.S. prescription.”
A U.S. Border Patrol official told Yahoo News that, “detainees are not typically allowed to keep medications on their persons while in our care and custody.”
A CBP official with knowledge of the agency’s medical operations on the border explained this policy is for the safety of the detainees themselves.
“You can imagine a migrant or an alien comes across and maybe they have a bag or just a pocket full of pills and they say 'Oh, this is for my high blood pressure,'” the CBP official told Yahoo News. “There's no way of knowing what that is. It could be an illicit substance. It could be something that some unlicensed provider gave them on the other side of the border. It could be dangerous, it could be harmful.”
“So unless it is very clear that it is from a legitimate provider and that it's a legitimate medication,” he continued, “generally speaking, Border Patrol will confiscate that, but only in the context of making sure that alien or migrant is evaluated onsite or at a local hospital to identify what medication they need.” Once the migrant receives a diagnosis and a U.S. prescription, the official said, Border Patrol agents will then fill the prescription and dispense medication accordingly. “We do not have the migrants self-medicating while they're in holding.”
Claims that Border Patrol agents confiscate medications arbitrarily and deny access to necessary treatment are “clearly not true,” he insisted. “It's actually going above and beyond in terms of ensuring the safety and the security and also the medical appropriateness of the prescriptions and the dosing of the medicine. No one pays more attention and interest and is more dedicated to the health and well-being and the safety and security of the migrants in our custody than Border Patrol.”
Asked whether this process is always followed for every migrant who enters custody with medication, the CBP official said, “Yes, that is the standard practice.
“That’s bulls***,” said Dr. Carlos Gutierrez in response to the CBP official’s comments. “He’s lying to you.”
Gutierrez is an El Paso, Texas-based pediatrician who provides regular volunteer medical care to asylum seekers at various shelters throughout the Texas border city.
“You can ask providers who care for them day in and day out,” he continued. “We know that the medicines are taken away.”
A few weeks ago, for example, Gutierrez said that he treated a girl, approximately age 10, who had congenital adrenal hyperplasia, a genetic disorder that interferes with the body’s ability to naturally produce steroid hormones necessary “to be able to deal with stressful situations, like infections or stressful activities.”
Patients with this diagnosis “have to be put on steroids every day for the rest of life,” Gutierrez said. When this girl entered Border Patrol custody, he was told, her steroids were taken away as well as a couple of other medications she needed.
“This was a little walking time bomb,” said Gutierrez, estimating that the girl had been in custody for about a week before he saw her. He was able to provide her with enough of her steroid medication to last a week.
“That could've been a potentially deadly situation, taking away stuff like that from a child,” he said. “They can get by OK,” as long as they’re healthy. “But any infection or cold, it’ll kill them.”
“Fortunately, she was well, but if she had picked up strep or pneumonia without meds, she probably would’ve died en route,” he said — not an improbable scenario given how common such illnesses are among those Gutierrez sees after they’re released from custody.
“It’s strange they’re saying it’s not true,” said Taylor Levy, a lawyer for Annunciation House, an El Paso-based nonprofit that’s been providing shelter and other assistance to migrants for 40 years. [As of April 1, the Washington Post reported that federal immigration authorities had released 50,000 migrants to Annunciation House since October alone.]
While Levy said she has seen some people arrive at the shelters with U.S. prescriptions they got from a doctor while in Border Patrol custody, “it’s definitely more frequent that meds are taken away without giving them replacement prescriptions.”
“It’s just so commonplace that people arrive at the shelter saying, ‘I took X drug and it was taken away,” said Levy, noting that high blood pressure and diabetes are the most common conditions mentioned by adult migrants.
“I've heard countless people tell me their insulin was taken away,” said Levy. She said often migrants often say their medication was in their bag or backpack, which along with other personal property was confiscated when they were taken into custody.
Dr. Lisa Ayoub-Rodriguez, a member of the American Academy of Pediatrics Immigrant Health Special Interest Group who helps coordinate doctors around El Paso to provide volunteer care to migrants through Annunciation House, said she’s heard similar stories from various doctors.
“Recently a lot of pregnant women have had their prenatal vitamins taken away,” she said.
Just last week, Ayoub-Rodriguez said an 11-year-old girl in Border Patrol custody with respiratory issues was brought to an El Paso hospital, where she received prescription medications along with a backpack and some coloring books that had been donated by members of the community. When she was returned to the Border Patrol processing center, however, the backpack had been confiscated and later that day the girl was readmitted to the hospital.
“The nurse who discharged her said her prescriptions were in the backpack, and then we were told the backpack was taken away,” said Ayoub-Rodriguez.
“To be fair, I haven't been in a CBP station and seen them take [medication] away,” said Dr. Bert Johansson, another El Paso-based pediatrician who provides volunteer medical care at shelters run by Annunciation House. “This is being reported to me by the migrants.”
Nonetheless, Johansson said he hears about it from both adults and children almost every time he visits one of the shelters.
”You have to realize, I’ll often see 30 to 60 people in a night,” he said. Of that, he estimates usually two or three report they had medication taken away for diabetes, asthma, seizures or other chronic illnesses. “I've also had some tell me that ‘I ran out and they wouldn't give me any more.’”
“Whether they were taken or they ran out and couldn't replace them, in either case, we sometimes see children who are in reasonable extremis and I need to take them to the emergency room or treat them right away,” Johansson said.
He recalled the case of a 15-year-old Guatemalan girl who arrived at one of the shelters in mild diabetic ketoacidosis, which can be fatal. “If left on its own, it would have gotten worse,” he said.
The girl told Johansson that she’d been given medication for her diabetes in Guatemala but that when she was in custody in the U.S., that medicine was taken from her.
“I don’t know if it's really true or not, but there needs to be a mechanism where these medicines can still be supplied,” he said. “The bottom line is, these kids aren’t getting the meds they need.”
For Johansson and the other physicians, the questions concerning access to medication for children with chronic conditions are part of a larger conversation about the type of care provided to children in CBP custody — which became the subject of heightened scrutiny amid a string of deaths among migrant children over the last six months, as well as recent reports revealing overcrowding and prolonged detention in temporary holding centers at the border.
In light of these deaths, the American Academy of Pediatrics, along with other child health and welfare experts, have offered a number of recommendations for how CBP can improve the care of migrant children in its custody, which include ensuring access to screenings and treatment by medical professionals who know how to recognize and respond to the subtle yet often rapidly worsening signs of illness in children.
“The AAP has been in discussions for months with [CBP] about increasing the number of pediatric-trained providers that are at these large processing centers,” said Griffin. However, information provided by CBP officials suggests the agency has yet to heed the AAP’s advice as it expands contracted medical services across the southwest border.
A Border Patrol official told Yahoo News that, as of May 30, over 200 medical professionals were contracted at Border Patrol facilities along the southwest border, including both support staff (EMT, registered nurses, and certified nursing assistants) as well as practitioners (nurse practitioners, physician assistants, and physicians) who are “trained and experienced in family practice medicine to appropriately assess and care for the broad age range of children and adults in CBP custody.”
Asked whether the agency was seeking to hire additional contractors with specific pediatric training, the CBP official with current medical operations said, “Obviously pediatricians can only treat children, but we have pregnant women and adults in our custody.”
“We do consult with pediatricians … and if we identify requirements for more specific specialities, then we will pursue that,” he continued. “But as of right now, this is what we have.”
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