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Physicians to Trump: Immigration detention centers must close

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On Saturday, Oct. 19, thousands of doctors and medical students will gather on the National Mall in Washington, D.C. Donning our white coats, we will stand together to deliver a simple and firm message: Immigration detention centers must close.

As physicians who have worked with detained migrants and asylum seekers, we have seen firsthand the harm that detention can have on the physical and mental health and wellbeing of all migrants, especially children and pregnant women.

We believe that U.S. values and traditions conflict profoundly with the inhumane imprisonment and treatment of those seeking safety in our country. Those who would rather risk everything than remain in countries where violence and gangs reign. Where their lives and their children’s lives are under constant threat. Under U.S. and international law, they are allowed to seek protection and apply for asylum.

Instead, because of new government policies, thousands have been turned away and returned to Mexico, where they remain in danger.  Thousands of others have been sent to immigration detention centers to await decisions on their fate. That includes children and women, even those who are pregnantwho should not be held in detention at all.  

 Asylum seekers should not be forced to stay in detention centers or camps while awaiting adjudication of their claims. News reports and other testimonies have documented substandard and even terrible conditions: no running water, no soap, no beds, inedible food. Medications have been taken away from those who need them; outbreaks have occurred and the government has decided not to provide vaccines. This is unacceptable.

Many advocates have rightfully been fighting to change these conditions.  But we are here to say that it is not enough to ask to improve the conditions in the detention centers. We must demand that they be closed altogether, because they are inherently immoral and should not be there in the first place.

 Individuals who await decisions while in detention risk worsening of chronic medical conditions, development of new illnesses and pregnancy complications, and even death.  Those dying in immigration custody include at least seven children, among them Felipe Gomez Alonzo, Carlos Gregorio Hernandez and Jakelin Call Maquin.

A child’s death is the ultimate atrocity. But children are vulnerable to short and long-term consequences in general. The evidence tells us that there is no acceptable amount of time for a child to be place in detention. All of us — physicians from all specialties and disciplines, including our professional medical organizations such as the American Academy of Pediatrics, The American Academy of Family Physicians, American College of Obstetrics and Gynecology and the American Medical Association — agree on this point.  We have outlined the myriad ways that children suffer when detained, especially if they are separated from their parents. A number of children have died in federal custody, some have become ill and it is clear that all are at risk for developing lifelong psychological harm. Many of the children have experienced trauma before coming the U.S., as well as during their journey to this country, and their trauma is compounded by being kept in cages, separated from family and familiar adults, and without the basic conditions needed to their physical and emotional development. 

 Some in the government have commented that the tough conditions, risk of separation, and complicated and unpredictable process should deter people from attempting to cross the border, from seeking asylum in the U.S. But the fact is there is no evidence that detaining asylum seekers will deter them from seeking safety in the U.S. Many are fleeing severe persecution and death threats; that is the reason for risking further danger to come to the U.S. The bleak setting of detention will not dissuade them from fleeing even greater danger in their home countries. 

 Migration opponents have voiced concern that individuals crossing the border in the U.S., seeking legal recourse for human rights violations, will just disappear into our communities and will not return to immigration court to have their claims adjudicated. But immigrants who are not in detention and have legal representation comply with court appearances at high rates, in fact, data shows that nearly 98 percent of families and unaccompanied children comply with their legal obligations. This fact that argues strongly against the rationale for keeping them confined while awaiting adjudication.

So next Saturday we, along with other physicians, health professionals and medical students from around the country, will gather and speak on behalf of all those who care about the welfare of children and the inhumane treatment of those legally seeking refuge in the U.S. We will demand that the administrations’ shameful and devastating policies be changed and that detention camps be closed permanently. Nothing short of that is enough.

Katherine McKenzie, M.D., is a physician and the director of Yale Center for Asylum Medicine. Kate Sugarman, M.D., is a family physician at Unity Health Care in Washington and evaluates asylum seekers at the Georgetown Law Center for Applied Legal Studies. Ranit Mishori is a family physician, director of Georgetown University’s Asylum Program and senior medical Advisor to Physicians for Human Rights.


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