Medical school students: Detained migrants still have a right to proper medical care

As medical students who will all take an oath to uphold the highest standard of patient care, we are profoundly disturbed by the detrimental treatment of detained migrants.

As future public servants, we dedicate our careers to the health of all human beings, regardless of race, sex, gender identity, ethnicity, ability, religion or country of origin. Current practices by Immigration and Customs Enforcement (ICE) blatantly disregard and endanger detainees' health and well-being, and directly oppose our values and beliefs.

Detained migrants are dying, in large part from inadequate care. This neglect begins with the initial detainment, during which migrants do not receive proper health screenings, and continues under the adverse conditions of the detention centers. These dire conditions, under which the detainees are deprived of adequate nutrition and sanitation, particularly affect children, pregnant women and individuals with chronic medical conditions.

Demanding change for migrants

As future physicians, we need to speak out against the abuse of migrants and families. As a collective of medical students based nationwide, we wrote a petition outlining the changes that must take place to ensure the humane treatment of detained migrants. We've since collected more than 1,000 signatures from future physicians.

We call for the humane treatment of detained migrants through:

►Proper health screening of detained migrants.

►Clear orientation on the process of detainment for migrants.

►Access to appropriate nutrition and water.

►Access to suitable housing and sanitation.

►Access to proper medical care.

►Robust precautions to stop sexual assault toward minors.

►Children, pregnant women and severely ill migrants should not be detained.

There is a lack of thorough medical care for detained migrants. According to a May 2017 report from the American Academy of Pediatrics, some border processing facilities provide limited initial medical screening (e.g. screening for scabies, lice or chicken pox) to migrants. Individuals with chronic conditions such as heart failure and cardiovascular concerns require regular monitoring from medical professionals, which is not available at the detention centers.

According to a report by Human Rights Watch, in eight of 15 cases reviewed by experts, they concluded that poor medical care contributed to or resulted in deaths from December 2015 to April 2017. Some of the cases involved heart failure, heart attacks and seizures. In none of these cases did the migrants receive adequate care.

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Some detention centers have severely substandard care, with reports that detained migrants have sparse bathing and cleaning supplies, inadequate sleeping conditions, and insufficient food and water. Medical professionals at the front lines of the border have been reporting these human rights violations.

Women, children worth more than this

Detained children are a particularly high-risk health population. Physicians for Human Rights reported that many children migrants have experienced violence in their home countries and show serious signs of trauma. At times, children and families are separated at detention, causing profound psychiatric harm.

Many of these unaccompanied migrant children have been detained longer than the 72 hours established by federal laws, according to The Washington Post. Children are then placed in unsafe detention centers. From October 2014 to July 2018, there were 4,556 allegations of sexual harassment or sexual assault toward unaccompanied minors. The harm is compounded by the lack of nutrition and sanitation at the detention centers. Since September, at least six migrant children have died in federal custody.

It is dangerous for pregnant women to be detained. Pregnant detainees have inadequate access to prenatal vitamins and have been ignored by on-site doctors, denying them standard, thorough prenatal checkups. This substandard care means that pregnant women in detention are not adequately screened for preeclampsia and other high-risk pregnancy concerns, putting both mother and fetus at risk. Yet from October 2017 to the end of last August, 1,655 pregnant women were booked into ICE custody.

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In addition, there is a lack of transparency about the detainment process. Detainees are not fully oriented to the process of detention or the amount of time they will continue to be held in detention facilities. Migrants also have limited access to appropriate legal counsel and interpreters. This process has a profound impact on the mental health of migrants, who report high levels of anxiety, depression and post-traumatic stress disorder both during and following detention.

Future of medical profession at risk

Being new to medicine, we worry about the culture that may shape the guiding principles for our future careers. We worry that the word “migrant” will become synonymous with the word “inhuman.” We worry that migrants will lose their right to proper health care. We worry that legality, which is so arbitrarily defined, will dictate our humanity.

Medicine is the study of humanity, and those who study medicine must study human values. In fact, an accreditation committee requires medical school curricula to cover “medical ethics and human values” extensively. When human life is devalued, the very basis of our education and the guiding principles of our future careers are threatened.

We are impacted by the stories of the detained migrants both viscerally and intellectually. Medical students include Deferred Action for Childhood Arrivals program recipients, whose families are refugees and immigrants and whose friends are being deported.

We will one day serve as the caretakers of this country — a country that currently refuses to treat migrants with humanity, a country that refuses to protect human life. As future doctors, we will be impacted by the lasting consequences of the dreadful treatment of detained migrants and the precedent it sets. We are compelled to lay a foundation for a healthier nation, and it starts by tackling this institutional atrocity.

Thomas Pak is a medical student at the University of Iowa. Neha Siddiqui is a medical student at the Carle Illinois College of Medicine. The views in this column do not represent the views of the authors' and contributors' institutions.

Medical students Courtney Harris, Anna Tran, Cindy Tsui, Eric Hirsch, Camille De Jesus, Samira Ali, Abhishek Jay Dharan, Sally Midani, Baillie Bronner, Miriam Rienstra Bareman, Laura Barrera and Harrison Khong contributed to this column.

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This article originally appeared on USA TODAY: Health care in immigration detention: Migrants deserve humane care