The Southern Border and the Power of Pediatricians

Steven J. Goldstein, MD, FAAP

Steven J. Goldstein, MD, FAAP

(Dr. Steven J. Goldstein, MD, FAAP is a pediatrician in Brooklyn and Queens. He is immediate past president of the NYS AAP Chapter 2 and serves as co-chair of its Pediatric Council and Committee on Environmental Health.

The list of priorities of the current administration that have the potential to harm the children we care for and future generations is startling.  Undoing climate change protections, reversing water and air pollution caps, opening pristine lands to mining, protecting pesticide use and manufacturers, shrinking National Parks, restricting health care initiatives designed to protect children, and even back-pedaling on what constitutes a healthy school lunch are just a few of these initiatives.  Pediatricians need to be familiar with these issues so that they can raise their voices in protest and do so in an authoritative way that will influence public opinion, and ideally change the conversation.  Pediatricians can help parents and grandparents understand these important issues that will affect their children and grandchildren.  Do not underestimate the power of 67,000 pediatricians to influence public policy.

The mistreatment of children and families at the US Southern Border is ongoing and pediatricians, parents, and citizens are becoming inured to the constant news drone about the wall and the immigration issue.  The demonization of those seeking asylum at the border with subsequent pushback from the public resulted in what was supposed to be a change in policy regarding the separation of children and families.  But that has not happened at all.  Indeed, recent news reports have shed light on new issues, many kept hidden by those in charge at the border, that are putting children at risk of illness, toxic stress, and death.

As the number of those seeking asylum has risen, the ability of the government to accept and care for new applicants has been overwhelmed.  Children have been kept in facilities meant for very short stays for much longer periods of time without adequate clothing, food, or access to healthcare. Some of these facilities, meant for housing single men, can’t meet the needs of children. Many children are still sleeping in cold caged-in spaces that are never darkened, with little or no access to healthcare.  And if that wasn’t bad enough, funding for schooling and other activities for these children has been cut.  Mothers entering the US and delivering babies have been separated in the postpartum period, with nursing babies sent to other states for foster care while the mother awaits an immigration court appearance.  These babies and mothers are not criminals.

The new “Remain in Mexico” policy, with refugees forced to apply for asylum in the countries along their route before entering the US, subjects children to further food insecurity, violence, and poor living conditions as the burden of caring for them falls upon unprepared governments.

While we have been dealing with measles nationwide, mumps is now epidemic in some detention facilities with 236 cases reported as of March 2019.  One trope of the administration is that immigrants spread disease but this is untrue. Central Americans often have better immunization histories than at least some American communities.  Pediatricians know that mumps vaccine is the least effective of our vaccine arsenal, as we have seen multiple institutional epidemics in previously immunized populations.  This epidemic may be related to the close, unsanitary quarters where these children are   housed.

As this story unfolds and children and families at the border continue to suffer under intolerable conditions, many of us wonder if somehow America has lost its moral bearings and forgotten that all human beings deserve compassion and respect no matter their origin or citizenship.

In the late 1800s, Emma Lazarus, moved by the plight of immigrants coming to seek refuge in our great land, composed the following poem that is on display now at the base of the Statue of Liberty. It is no less relevant today:

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
“Keep, ancient lands, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!”

Pediatricians have more power than most of us know.  Speak to your patients when the opportunities arise.  Change the conversation and promote kindness, acceptance, and tolerance for all who seek refuge in our great land.  This is not over.  We can influence the future of this country and the life trajectory of countless children.