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How conditions in U.S. detention centers can affect children’s health

The plight of migrant children held in U.S. detention centers continues to generate controversy. As Congress battles over emergency funding for care and resources at the border, medical professionals warn that even brief exposure to the current conditions could be damaging to children’s health. William Brangham reports and talks to pediatrician Julie Linton, who has visited some of the facilities.

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  • Judy Woodruff:

    The United States Congress is under growing pressure tonight to send much-needed money to the southern border. The task took on new urgency today, as the fate of children at the border raised new fears, and as lawmakers planned a week-long recess.

    William Brangham begins our coverage.

  • William Brangham:

    As the situation along the southern border continues to worsen, the Senate voted to increase funding for critical aid for migrants crossing into the country.

  • Sen. Richard Shelby, R-Ala.:

    I believe, overall, this is a solid bill. It provides the resources needed to address the crisis that we face at the border. So I say to my colleagues in the House, do not derail the one bipartisan vehicle with a real chance of becoming law soon.

  • William Brangham:

    The bipartisan bill passed 84-8. Meanwhile, the House of Representatives passed their own $4.5 billion border funding bill last night, but the Senate rejected that today.

    There are key differences between the House and Senate bills. One of the biggest is over the issue of border security. The House bill doesn't increase funds for that. It does include $1 billion for shelter and food for migrants and $3 billion for the Department of Health and Human Services to care for unaccompanied minors. It also sets improved standards of care in HHS shelters that hold the children who are waiting to be placed with sponsors.

    The Senate bill provides nearly $3 billion to HHS and $1.3 billion for the Department of Homeland Security to provide food, shelter and medical care for adult migrants. It also allocates $65 million for more immigration judges. It doesn't set standard for care.

    House Speaker Nancy Pelosi and President Trump spoke today by phone to hash out their differences on the two bills.

  • President Donald Trump:

    I have been saying you have to change the loopholes, you have to change asylum. You wouldn't have this problem.

  • William Brangham:

    The president today also responded to the harrowing widely circulated photo of father Oscar Alberto Martinez Ramirez and his daughter, Valeria. The two drowned attempting the cross the Rio Grande River into Texas.

    Mr. Trump seemed to blame their deaths on Democratic inaction.

  • President Donald Trump:

    I hate it. And I know it could stop immediately if the Democrats change the law. They have to change the laws. And then that father, who probably was this wonderful guy, with his daughter, things like that wouldn't happen.

  • William Brangham:

    The president's claim is not entirely accurate. Many experts say the president's own policies, like changing asylum laws, have made border crossings more dangerous and made migrants more desperate.

    The Associated Press photographer who captured that image, Julia Le Duc, noted that same desperation.

  • Julia Le Duc (through translator):

    It's not an area people choose to cross because they know they are easily caught. But the understanding that Oscar and his family had arrived recently and didn't know this, that is why they attempted the crossing in desperation.

  • William Brangham:

    Today's legislation also comes as recent reports have revealed alleged inhumane conditions at a Customs and Border Protection facility in Clint, Texas.

    Children inside were reportedly kept in overcrowded, unsanitary conditions, with teenagers left to care for toddlers and other young children; 300 were transferred out of the shelter on Monday, but Customs officials say 100 have been moved back.

  • Sen. Amy Klobuchar, D-Minn.:

    This president has put us into this situation.

  • William Brangham:

    This issue made it to campaign trail today near Miami today, where Democratic presidential candidates pushed back on the president's policies.

  • Sen. Elizabeth Warren, D-Mass.:

    These children pose no threat to people here in the United States.

  • William Brangham:

    Massachusetts Senator Elizabeth Warren and Minnesota Senator Amy Klobuchar visited the Homestead shelter, a large for-profit detention center for unaccompanied migrant children.

    And several other Democratic candidates say they too will visit this week. While Congress is wrapping up business in Washington, backlash to conditions along the border continues. Employees from the Boston-based home decor company Wayfair today protested their company's contract with the government to sell bedroom furniture for its detention facilities.

    Even as these battles play out over money, security and policy, advocates are also especially concerned about the impact this is having on detained children.

    Dr. Julie Linton is with the American Academy of Pediatrics. She's leading an initiative there focused on the health and well-being of child migrants and immigrant families. And she has visited some of these facilities herself.

    Dr. Linton, thank you very much for being here.

    As I said, amidst all of this jockeying and the blame game, there are some very real tragedies that are unfolding along the border. But we really wanted to talk to you about the impact this is having on kids.

    And so what are the immediate potential impacts of separation and detention on children?

  • Dr. Julie Linton:

    I think what's really important to remember is that, after fleeing country of origin and an incredibly harrowing journey to seek safety here in the United States, children and families are exposed to conditions that are unsafe and unhealthy.

    In the short term, exposure to these conditions may lead to physical symptoms, increased stress responses that make children susceptible to infection, responses that lead them to have changes in their behavior, changes in their memory, and changes in their ability to sleep, as well as to eat and to be able to be potty-trained.

    In the long term, this causes some very serious health risks.

  • William Brangham:

    For the — on these more immediate impacts, how much of it does the facilities themselves play?

    I understand, from what I have seen of video and reporting from inside them, that they're very bright, the food is not great, they can be sort of loud and noisy.

    Does that contribute to these negative impacts?

  • Dr. Julie Linton:


    I have been inside these facilities myself. I have taken care of children who have been in these facilities, and I'm in touch with pediatricians across the country who are seeing these effects firsthand.

    Being exposed to lights 24/7 disrupts the sleep-wake cycles of a child, which makes it very unlikely that they will be able to fight off infection, and it makes them more likely to be exposed to illnesses that they would otherwise be able to fight off without these conditions.

    Being put on mats on the floor, listening to crinkling sounds from an aluminum blanket as the only protection that a child has, these are the type of conditions that I would never send somebody home from my office to recover from an illness if they were exposed to something.

  • William Brangham:

    You touched on this issue of some of the longer-term impacts from these events. What would those look like?

  • Dr. Julie Linton:

    In the long term, when children are exposed to prolonged activation of their stress responses or this fight-or-flight response, the response that our bodies are designed to do when we're fleeing a tiger, in the long term, those type of responses, the constant flow of adrenaline and cortisol and other hormones going through the body, impair the immune system, impair the metabolism of children, and disrupt their developing brains.

    And, in the long term, what we see is an increased risk for things like heart disease, diabetes, depression, post-traumatic stress disorder and substance use.

  • William Brangham:

    Those seem like awfully severe ramifications.

    Are these — are these permanent impacts, or is it — let's just say these children do get out and reassume some level of normalcy, wherever that is and with whomever that is. Can some of these negative impacts be reversed?

  • Dr. Julie Linton:

    I think the children and families that are fleeing these conditions have an incredible amount of strength and resilience.

    And the resilience and protective factor it takes to be able to flee these conditions and to make it through the harrowing journey show me that there's a lot of opportunity for healing to begin.

    But that is not an excuse to prolong the horrible conditions that are exposing them to threats to their health and well-being. And it behooves all of us in our communities across the country to begin to help children and families to heal as they await their immigration proceedings.

  • William Brangham:

    As you said, you have been inside some of these facilities.

    I wonder, right now, starting today, are there things within these environments that could be done to make this situation better for the kids?

  • Dr. Julie Linton:

    There's no amount that any amount of time in detention is safe for children.

    And, certainly, any conditions that expose children to lights 24/7, conditions that do not allow access to medical care when parents or when they themselves are seeking it, conditions that don't allow consistent access to sufficient food and hydration, these are not safe for children.

    And those things need to be urgently addressed, and we need urgent pediatric medical expertise on our border.

  • William Brangham:

    Now, Customs officials, ICE officials, the president have all said, we just need more money, and if we were granted more money, we could do a better job for these children.

    Do you think that that is the fix here?

  • Dr. Julie Linton:

    I think the fix needs to come from a combination of emergency funding that can mitigate some of these problems urgently, as well as long-term legislation that prevents this problem in the future, such as the bill being suggested by Representative Ruiz to ensure that all children have access to medical attention and all people have access to medical attention, sanitary conditions, and safe conditions, as they're being held prior to being released into our communities as their cases proceed.

  • William Brangham:

    All right, Dr. Julie Linton from the American Academy of Pediatrics, thank you very much.

  • Dr. Julie Linton:

    Thank you for having me.

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