After latest child's death, care at US border facilities under review
The Washington Post May 22, 2023
An 8-year-old migrant girl who died Wednesday after crossing the border in South Texas fell ill with the flu during a prolonged stay in U.S. custody, according to a timeline of the incident released by U.S. Customs and Border Protection, and authorities did not send her to a hospital when her symptoms worsened despite knowing her delicate medical history.
The girl, identified by Honduran officials as Anadith Tanay Reyes Álvarez, was the second minor to die in U.S. government custody within a week. A 17-year-old Honduran boy died May 10 while staying at a shelter in Florida for teens and children who cross the border without parents.
The deaths have refocused attention on U.S. medical care and treatment for migrant teens and children detained by the government, while underscoring the risks at border facilities where U.S. agents and staff are strained by record numbers of illegal crossings.
In a statement, CBP said acting commissioner Troy Miller has ordered a review of medical care practices at the agency's facilities and an assessment of all "medically fragile" individuals.
"We must ensure that medically fragile individuals receive the best possible care and spend the minimum amount of time possible in CBP custody," Miller said.
CBP said its internal affairs division is investigating the circumstances of Reyes' death. Under agency policy, detainees should not spend more than 72 hours in custody. But Reyes had been held with her family for eight days at the time of her death, according to the government timeline released Sunday.
While unaccompanied minors and families with children are prioritized for faster processing under CBP policy, backups can occur when the number of migrants crossing the border soars to unmanageable levels.
As her daughter battled the flu and her condition worsened, she "cried and begged for her life" but CBP staff "didn't do anything for her," Reyes' mother, Mabel Alvarez Benedicks, said in an interview with the Associated Press.
Rep. Raúl M. Grijalva (D-Ariz.) called in a statement for information to convey "the full context of the circumstances of the death of all the children."
"The Biden administration has a moral responsibility to act quickly to make certain this does not happen again and ensure that improvements are made to guarantee the safety and health of those seeking asylum," the lawmaker said.
Reyes crossed the border with her parents and two older siblings near Brownsville, Texas, on May 9, according to the CBP timeline, part of a larger group of 47 people. Her parents and older siblings are from Honduras, but the girl was a citizen of Panama, the agency said.
The family arrived in the United States during one of several days early this month when U.S. agents made more than 10,000 border arrests, the highest daily totals in CBP history. The influx occurred in the lead-up to the expiration of pandemic-era border restrictions on May 11, and it left U.S. border stations and processing facilities crowded beyond capacity.
The girl's parents provided agents with documents about their daughter's medical history, including sickle cell anemia and heart disease, during a standard intake and screening process on May 10 at CBP's processing facility in Donna, Texas.
The family was still at the processing facility four days later when Reyes came to the facility's medical unit with her mother, complaining of abdominal pain, nasal congestion and cough. She tested positive for influenza A, a type of flu; had a fever of 101.8 degrees and was given over-the-counter medications, according to the timeline.
The agency said medical personnel "documented a past medical history including cardiomyopathy (noting the girl had undergone heart surgery at the age of 5), about which the family reported that she has been stable since the operation, but still requires the continued care of a cardiologist."
Agents then transferred Reyes' entire family to the Border Patrol station in Harlingen, Texas, a facility for migrants designated for cases requiring medical isolation. The child was assessed by medical staff at the Harlingen facility when the family arrived on the evening of May 14.
Reyes continued to receive over-the-counter flu medications during the next three days, but on May 17, the girl's condition appeared to worsen. She and her mother went three times to the medical unit at the border station, complaining of vomiting, and later a stomachache.
CBP medical contractors listed her condition as stable, according to the agency's timeline, but at 1:55 p.m. the child's mother returned carrying her daughter "who appeared to be having a seizure" and then became unresponsive, CBP said.
Paramedics arrived 12 minutes later to rush Reyes to the hospital in Harlingen. She was pronounced dead less than an hour later, according to the timeline.
Preliminary autopsy results found a buildup of fluid in the girl's lungs, the agency said, adding that additional information about the cause and manner of death would be released from the Cameron County medical examiner.
CBP officials say they have significantly improved medical care and screening procedures in recent years, following the deaths of several children taken into U.S. custody along the border during a record influx of Central American families in 2018 and 2019.
The 17-year-old who died one week before Reyes was staying at a shelter in Safety Harbor, Fla., run by the nonprofit Gulf Coast Jewish Family and Community Services, according to the U.S. Department of Health and Human Services. That agency oversees the care of teens and children who show up at the southern border without parents, sometimes including those brought over by other adults. It oversees nearly 300 shelters in 27 states, and says minors in its care are given access to health care, legal services and counseling and are able to contact family at least twice a week.
Honduras Foreign Minister Enrique Reina identified the 17-year-old as Ángel Eduardo Maradiaga Espinoza. He urged U.S. authorities to conduct an exhaustive investigation into both his death and the death of Reyes.
HHS also has confirmed that a 4-year-old from Honduras in the agency's care since 2019 died on March 17 at Bronson Methodist Hospital in Kalamazoo, Mich., after going into cardiac arrest. The girl was also considered "medically fragile," the agency said.
Record numbers of children and teenagers traveling without their parents have been showing up at the southern border since President Biden took office and exempted them from the pandemic border restrictions imposed during the Trump administration. Those restrictions allowed authorities to expel recent border crossers to Mexico or their home countries quickly, without a chance to seek asylum.
More recently, in the days before the pandemic policy ended, illegal border crossings jumped again, as some migrants said they rushed to enter the country before new Biden restrictions took effect May 12 aimed at boosting deportations.
The Washington Post's Maria Sacchetti contributed to this report.