A 16-year-old boy died in a Border Patrol station in Texas on Monday. He was the fifth child to die after spending time in United States government custody since December.
Customs and Border Protection agents found the Guatemalan teenager unresponsive that morning and announced his death soon after. The boy, identified as Carlos Hernandez Vasquez, had told CBP agents the night before that he wasn't feeling well, and was prescribed medication for what a nurse diagnosed as a flu.*
CBP broke its own regulation by keeping Hernandez Vasquez in detention for over a week: Border Patrol agents apprehended him on the Texas–Mexico border on May 13th, and federal law limits the amount time people can be held in rudimentary Border Patrol stations to 72 hours. The child, an unaccompanied minor, should have been transferred to the Department of Health and Human Services (HHS) by May 16th (for placement in a shelter, foster care, or with a stateside sponsor). Instead, he was found dead in the Weslaco field station on May 20th. (In a statement, CBP said the boy was "due for placement" with HHS.)
In addition to the teenager who died on Monday, two other children (ages seven and eight) died in CBP custody in December, a 16-year-old died in HHS custody in April, and a two-year-old who fell ill while in CBP custody died in a hospital in May. All five of the children were Guatemalan.
Why are migrant children dying in government custody? Here's some key context.
Border Patrol Stations Are Not Made for Children and Families
Border Patrol stations, especially in rural stretches along the border, exist as bare-bones accommodations meant only for short-term holding. Among many Spanish-speaking migrants, the stations are known as hieleras (ice boxes) for their frigid cold and perreras (dog kennels) for their cramped conditions.
These stations were not designed to hold children and families. Historically, the vast majority of border crossers have been single adults, most of them men. But in recent years (following a wave of intense violence in Central America) the number of families and unaccompanied minors arriving at the border has skyrocketed. Since last fall, the majority of people apprehended by Border Patrol have been people traveling as families. Though the total number of border apprehensions remains well below historic highs, this major increase in family arrivals has completely overwhelmed an infrastructure designed for single men, and CBP officials have warned that the system is at "a breaking point."
That's part of why the government is keeping children in rudimentary detention conditions for extended periods of time. Multiple internal investigations have found that CBP, overstretched and underprepared, has frequently held people for longer than the 72-hour maximum—as was the case with the teenager who died on Monday.
The Journey Through Mexico Is Dangerous
In December, when seven-year-old Jakelin Amei Rosmery Caal Maquin became the first child to die in government custody under the Trump administration, some government officials blamed her death on the "dangerous journey" through Mexico. Caal Maquin and her father had traveled through remote desert before crossing the border with a group of other migrants, and her symptoms were related to dehydration and exposure.
The perils Central Americans face traveling through Mexico are well known, and Doctors Without Borders has noted that northbound migrants "often find themselves extremely vulnerable, subject to robbery, exploitation, and numerous health issues, but with little or no access to medical care." But it's unclear what role the journey has played in the deaths of these five children over the last six months.
Caal Maquin, for instance, was held in a Border Patrol station for hours without medical attention after she and her father turned themselves in. (It was only later, after the girl lost consciousness on a bus to another detention center, that CBP began medical care.) The 16-year-old who died at the end of April had already been transferred out of CBP custody to HHS custody before he was first sent to the hospital. And, according to early reports on the two-year-old who died last week, the child developed pneumonia after spending three days in CBP custody.
Though few details have been released about the most recent death, CBP noted that Hernandez Vasquez was apprehended near the Texan city of Hidalgo, a heavily populated area across the border from the Mexican city of Reynosa—not a remote desert crossing.
Agents Might Not Be Able to Tell When Children Are Sick
According to experts, one of the reasons that migrant children are dying in government custody might be that Border Patrol agents can't tell when children are sick.
Kids are robust: They hang on to the last minute. And then ... they just fall off a cliff. They can look pretty OK, and then suddenly they're not. So you need to have clinical expertise and experience to be able to recognize when someone is in impending danger. But there's no way that a CBP agent, who has not had that training, is going to be able to do that—and not really through any fault of their own. It's just not actually part of their job right now.
Pediatricians like Peeler explain that, without specific medical training, a government agent can't be expected to perform triage, and notice the critical signs that a young child is in danger.
Experts Argue That Detention Is Never Safe for Children
Experts in children's health say that, at the end of the day, a detention center is never a safe place for children.
In 2017, the American Academy of Pediatrics released a policy statement recommending that no child be placed in detention, warning that "even short periods of detention can cause psychological trauma and long-term mental health risks."
Last year, two medical experts hired by the Department of Homeland Security sent a whistleblower letter to Congress warning that, no matter how caring or well-trained detention staff might be, children face immediate danger in detention centers. "No amount of programming can ameliorate the harms created by the very act of confining children to detention centers," they concluded.
*Update—May 20th, 2019: This post has been updated to include Carlos Hernandez Vasquez's name and diagnosis.