Resolution: S-20-23: INHUMANE TREATMENT OF ASYLUM SEEKERS AT U.S.-MEXICO BORDER

[Valerie Lile]

WHEREAS, current treatment of those forced to wait application decisions in overcrowded camps disregards the value of human life by willfully placing people in an environment of deliberate neglect and abuse, which has been classified as torture², and

WHEREAS, the individuals (asylum seekers) forced into these detention centers are not in violation of federal law, as U.S. federal law states that any migrant physically present in the United States, whether or not at a designated port of entry, may apply for asylum¹; and

WHEREAS, the policy and practice of indefinitely detaining asylum-seekers, based solely on their migration status, constitute arbitrary detention in violation of the UN Convention Against Torture, which the United States ratified and integrated into US law², and

WHEREAS, the UNHCR study interviewed Central American women seeking asylum in the United States, and found that 85% came from neighbourhoods controlled by criminal armed groups²⁵; and

WHEREAS, women also experienced or were at risk of rape, assault, extortion, and other threats, which 64% of the women cited as their main reason for migrating to the United States²⁵; and

WHEREAS, the United States Commission on Civil Rights (USCCR) reported that child detention facilities lack basic hygiene and sleeping arrangements; they sometimes lack soap, blankets, dental hygiene, potable water, clean clothing, and nutritious food⁹; and

WHEREAS, it has been reported in the New York Times and ProPublica that McKinsey & Company was contracted by the Trump administration to cut costs at detention facilities¹⁷; and

WHEREAS, the NYT and ProPublica report that McKinsey “proposed cuts in spending on food for migrants, as well as on medical care and supervision of detainees, according to interviews with people who worked on the project for both ICE and McKinsey and 1,500 pages of documents obtained from the agency after ProPublica filed a lawsuit under the Freedom of Information Act”¹⁷; and

WHEREAS, testimony and data indicate that federal agencies have not heeded the USCCR’s recommendations from its 2015 report. Agencies continue not to provide appropriate and critical legal and medical services to detainees, or transparency about the government’s policies in detaining individuals⁹; and

WHEREAS, agencies continue inequitable treatment of Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals, individuals with disabilities, and non-English speakers⁹; and

WHEREAS, the USCCR received evidence and testimony that child detention facilities lack appropriately trained medical personnel and medicine, medical staff are not routinely present at detention facilities, and wait times to see a doctor can be weeks long, regardless of how dire the situation⁹; and

WHEREAS, language barriers pose an immense hurdle to staff’s ability to offer adequate and appropriate medical and mental health treatment to children while detained⁹; and

WHEREAS, due to the negligence of detention staff, multiple children have passed away in detention from illnesses such as the flu, which with proper treatment would not be deadly¹²; and

WHEREAS, Customs and Border Patrol (CBP) has failed to provide vaccinations for detainees for the influenza virus in spite of the cost representing 0.002% of the overall budget of DHS, and 0.007% of the budget for CBP¹²; and

WHEREAS, at least six (6) children have died in border detention facilities during the Trump administration, and coverups of these deaths have been attempted by the administration¹⁰; and

WHEREAS, no migrant children had died in government custody in over a decade prior to the first child death of the Trump administration⁸; and

WHEREAS, at least 24 asylum seekers overall have died in border detention facilities during the Trump administration²¹; and

WHEREAS, the U.S. Department of Health and Human Services has published data suggesting that about one sexual assault per week has occured under CBP custody by staff on unaccompanied minors from FY 2015 through FY 2018¹⁵; and

WHEREAS, it has been reported that the number of clinicians on staff is insufficient and those who have been hired have not all be been required to pass the child abuse/neglect background check¹⁵; and

WHEREAS, according to a report by the Office of Inspector General, the Trump administration had waived FBI fingerprint background checks of staffers and had allowed “dangerously” few mental health counselors at a tent camp housing 2,800 migrant children in Tornillo, Texas¹⁵; and

WHEREAS, Dr. Lucia Servier, a Pediatrician with direct experience evaluating children held in detention centers, reported that “After assessing 39 children under the age of 18, she [Dr. Lucio Servier] described conditions for unaccompanied minors at the McAllen facility as including “extreme cold temperatures, lights on 24 hours a day, no adequate access to medical care, basic sanitation, water, or adequate food”¹⁹; and

WHEREAS, the American Academy of Pediatrics has recommended that immigration agencies should improve training in response to health-related emergencies and prioritize “the thoughtful release of children, more case management efforts and humane safe conditions”¹⁶; and

WHEREAS, the American Psychological Association attests that “Separating children from their families as they attempt to cross into the United States threatens the mental and physical health of both the children and their caregivers”⁶; and

WHEREAS, the longer that children and parents are separated, the greater the reported symptoms of anxiety and depression for the children. Negative outcomes for such children include psychological distress, academic difficulties and disruptions in their development⁶; and

WHEREAS, psychological research shows that immigrants experience unique stressors related to the conditions that led them to flee their home countries, the often traumatic journey to the United States, and the ongoing stress of starting a new life away from their family and culture⁶; and

WHEREAS, it has been studied that detained immigrant children demonstrate higher rates of clinical depression, post-traumatic stress disorder (PTSD), and anxiety disorders and would benefit from more comprehensive mental health screening and release into the community, as well as culturally-responsive and trauma-informed mental health care¹⁸; and

WHEREAS, it has been studied that perinatal outcomes including mental health, maternal mortality, preterm birth and congenital anomalies are predominantly worse among migrant women seeking asylum¹¹; and

WHEREAS, Project on Government Oversight found that from 2016 to May 2018, ICE regularly treated migrants and deportees with mental illness by placing them in solitary confinement for extended periods of more than 15 days and reported 40% of those placed in solitary confinement by ICE had mental illnesses²²; and

WHEREAS, in an open letter responding to criticism of comparisons between the US-Mexico border detention centers and concentration camps of the Holocaust, 150 holocaust scholars countered such criticisms, writing that “The very core of Holocaust education is to alert the public to dangerous developments that facilitate human rights violations and pain and suffering; pointing to similarities across time and space is essential for this task”²⁶; and

WHEREAS, those scholars further added that “to completely reject drawing any possible analogies to the Holocaust, or to the events leading up to it, is fundamentally ahistorical”²⁶; and

WHEREAS, US foreign policy has contributed to the dire conditions in Latin American countries, which is the foundation from which individuals are pushed to seek asylum in the United States; and

WHEREAS, The Nation relates that five years after the 2009 US-backed coup in Honduras that deposed the democratically elected leader of Honduras, the number of migrant children seeking asylum in the US increased by 1,272 percent⁷; and

WHEREAS, The Nation further relates that the US War on Drugs has contributed to the explosion of cartel violence in Latin American countries, pushing natives of those countries to seek asylum in the US⁷; and

WHEREAS, the Guardian relates that when the United States backed the Guatemalan military in a coup against Guatemala’s democratically elected leader, the resultant destabilization contributed to the current condition of Guatemala in which politicians are tightly associated with organized crime, and small-scale farmers are being violently driven off of their land to make way for multinational agricultural industries³; and

WHEREAS, experts working with the Office of the United Nations High Commissioner for Human Rights argue that the June 20, 2018 executive order to end child separation in fact fails to end child separation or alleviate the conditions present in the detention facilities²⁵; and

WHEREAS, the UN experts state that “Detention of children is punitive, severely hampers their development, and in some cases may amount to torture”²⁵; and

WHEREAS, the UN experts continue that “Children are being used as a deterrent to irregular migration, which is unacceptable”²⁵; and

WHEREAS, the Houston Chronicle, as recently as June 22, 2019, reports that child separations at the border have not ended, and hundreds of children are still being separated from their parents¹⁴; and

WHEREAS, numerous Trump administration officials (including Attorney General Jeff Sessions, HHS acting assistant secretary Steven Wagner, White House Chief of Staff John Kelly, DHS official John Lafferty, & DHS official Gene Hamilton) have stated that the intention behind the policies and conditions surrounding border detention facilities are explicitly to deter individuals from seeking asylum in the United States⁴; and

WHEREAS, border detention is demonstrably neither necessary nor the optimal policy, as research has shown that community-based alternatives to detention which have been employed in the past have extremely high appearance rates and cost less to administer¹³; and

WHEREAS, various community-based alternatives to detention have been shown to have between 93% and 99% appearance rates, and cost less than 20% of what it costs for detention¹³; and

WHEREAS, In 2015, prior to the zero tolerance, indefinite detention, and child separation policies of the current administration that result in the detainment of all individuals seeking asylum at the border, the Executive Office for Immigration Review reported that “For immigrant families who have legal counsel, 98 percent are in compliance with their obligations to appear for court hearings”¹³; and

WHEREAS, the USCCR received testimony that the legal process is very complex and difficult to navigate without legal assistance, especially considering that migrants have entered a legal system that is foreign to them, but many detainees must represent themselves⁹; and

WHEREAS, the limited resources available in detention center legal libraries are not readily available to detainees, making the process of learning their rights even more difficult⁹; and

WHEREAS, recent data also indicate fewer asylum applicants have an attorney compared to regular court cases. As of the end of June 2019, a total of 1,155 MPP cases had already been decided but asylum seekers were represented in only 14 of those cases—only 1.2 percent had legal representation⁹; and

WHEREAS, many organizations, including the American Bar Association, American Immigration Lawyers Association, Federal Bar Association, and the National Association of Immigration Judges have all urged Congress to create an immigration court system that is independent of the Department of Justice⁹; and

WHEREAS, previously mentioned organizations have pointed out that there is a conflict of interest when immigration courts are housed in the same department that is responsible for prosecuting immigrants in federal court, and this concern is exacerbated because immigration judges are Department of Justice employees, which leaves them vulnerable to political pressures and politicized interference into their duties⁹; and

WHEREAS, one of the most drastic policy shifts undertaken in regard to asylum is the practice of sending legal asylum seekers back to Mexico while their asylum cases are pending – this is also known as “Remain in Mexico” or more formally, the “Migration Protection Protocols” (MPP)⁹; and

WHEREAS, according to the Department of Homeland Security’s website, this policy is a “U.S. Government action whereby certain foreign individuals entering or seeking admission to the U.S. from Mexico – illegally or without proper documentation – may be returned to Mexico and wait outside of the U.S. for the duration of their immigration proceedings, where Mexico will provide them with all appropriate humanitarian protections for the duration of their stay”⁹; and

WHEREAS, according the Department of Homeland Security this policy, with certain exceptions, applies to noncitizens “arriving in the U.S. on land from Mexico (including those apprehended along the border) who are not clearly admissible and who are placed in removal proceedings under Immigration and Nationality Act § 240”⁹; and

WHEREAS, The policy includes non-citizens “who claim a fear of return to Mexico at any point during apprehension, processing, or such proceedings, but who have been assessed not to be more likely than not to face persecution or torture in Mexico⁹”; and

WHEREAS, some have criticized this new policy because when asylum seekers come to the border, instead of pleading their case in front of an asylum officer they are instead first put in front of a Border Patrol who are not sufficiently trained to assess the level of threat individuals may face in their country of origin⁹; and

WHEREAS, more than 11,000 migrants have been returned to Mexico to wait out their asylum cases pending in the U.S., burdening migrant shelters in Mexico and putting asylum seekers at increased risk of violence⁹; and

WHEREAS, Several asylum seekers who were turned away from U.S. ports-of-entry have been killed, women have been raped, and children have been kidnapped, calling into question the relative safety of Central Americans in Mexico; and

WHEREAS, The Flores agreement is a 1997 court-ordered consent decree that established standards detailing how children should be treated in the immigration detention system, and it has been upheld by federal courts as enforceable⁹; and

WHEREAS, The Flores agreement mandates all detention facilities that house immigrant children must be safe and sanitary, complete with suitable toilets, sinks, drinking water, food, medical assistance for emergencies, adequate temperature control and ventilation, adequate supervision to protect minors, and contact with all family members with whom the child was detained⁹; and

WHEREAS, the Trump Administration is not complying with the medical requirements of the Flores agreement, and is seeking to withdraw from the agreement⁹; therefore, be it

RESOLVED, that SOMA joins the organization Doctors 4 Camp Closure in calling for the closure of border detention centers and transitioning to a humane asylum evaluation system, and, therefore be it further,

RESOLVED, that the AOA joins the organization Doctors 4 Camp Closure in calling for the closure of border detention centers and transitioning to a humane asylum evaluation system.

Explanatory Statement

Doctors 4 Camp Closures is a non-partisan organization of over 2,200 physicians and healthcare professionals from all specialties who oppose the inhumane detention of migrants and refugees who are attempting to enter the United States of America. https://d4cc.squarespace.com/

References

1 8 U.S. Code § 1158 – Asylum. (2008, December 23). Retrieved February 22, 2020, from https://www.law.cornell.edu/uscode/text/8/1158

2 Amnesty International. (2018). USA: “You don’t have any rights here”. Retrieved from https://www.amnesty.org/en/latest/research/2018/10/usa-treatment-of-asylum-seekers-southern-border/

3 Borger, J. (2018, December 19). Fleeing a hell the US helped create: why Central Americans journey north. Retrieved February 22, 2020, from https://www.theguardian.com/us-news/2018/dec/19/central-america-migrants-us-foreign-policy

4 Bump, P. (2018, June 19). Analysis | Here are the administration officials who have said that family separation is meant as a deterrent. Retrieved February 22, 2020, from https://www.washingtonpost.com/news/politics/wp/2018/06/19/here-are-the-administration-officials-who-have-said-that-family-separation-is-meant-as-a-deterrent/?noredirect=on

5 Duetch, T. (2019, February 26). Deutch Releases Data Showing Sexual Assault of Unaccompanied Minors in HHS Custody. Retrieved from https://teddeutch.house.gov/news/email/show.aspx?ID=EUJ4FRX3MTYU7OLD6CI4OPKAYA

6 Evans, A. C. (2019, June 27). Immigration Letter from American Psychological Associations. Retrieved February 22, 2020, from https://www.apa.org/images/immigration-letter-trump_tcm7-258708.pdf

7 Faux, J. (2017, October 19). How US Foreign Policy Helped Create the Immigration Crisis. Retrieved February 22, 2020, from https://www.thenation.com/article/how-us-foreign-policy-helped-create-the-immigration-crisis/

8 Fichera, A. (2019, January 3). False Claim of Immigrant Children Deaths Under Obama. Retrieved February 22, 2020 from https://www.factcheck.org/2019/01/false-claim-of-immigrant-children-deaths-under-obama/

9 Goodson, P. T. (2019, October 24). TRAUMA AT THE BORDER THE HUMAN COST OF INHUMANE IMMIGRATION POLICIES. Retrieved February 22, 2020, from https://www.usccr.gov/pubs/2019/10-24-Trauma-at-the-Border.pdf

10 Herrera, J. ( 2019, May 28). Can We Be Sure Only Six Migrant Children Have Recently Died In Government Custody? Retrieved February 22, 2020 from https://psmag.com/news/can-we-be-sure-only-six-migrant-children-have-recently-died-in-government-custody

11 Heslehurst, N., Brown, H., Pemu, A., Coleman, H., & Rankin, J. (2018). Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Medicine, 16(1). doi: 10.1186/s12916-018-1064-0

12 Hudak, J., & Stenglein, C. (2019, November 26). The moral and policy failures of immigration detainee vaccination policy. Retrieved from https://www.brookings.edu/research/the-moral-and-policy-failures-of-immigration-detainee-vaccination-policy/

13 Human Rights First. (2015, July). Retrieved February 22, 2020, from https://www.humanrightsfirst.org/sites/default/files/MythvFact-Immigrant-Families.pdf

14 Kriel, L and Begley, D. (2019, June 22). Trump Administration Still Separating Hundreds of Migrant Children at the Border Through Often Questionable Claims of Danger. Retrieved February 22, 2020 from https://www.houstonchronicle.com/news/houston-texas/houston/article/Trump-administration-still-separating-hundreds-of-14029494.php

15 Levinson, D. R. (2018, November 27). The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff. Retrieved from https://oig.hhs.gov/oas/reports/region12/121920000.asp    

16 Linton, J. M., Griffin, M., & Shapiro, A. J. (2017). Detention of immigrant children. Pediatrics, 139(5),E20170483. Retrieved from https://pediatrics.aappublications.org/content/early/2017/03/09/peds.2017-0483

17 Macdougall, I. (2019, December 3). How McKinsey Helped the Trump Administration Carryout Its Immigration Policies. Retrieved February 22, 2020, from https://www.nytimes.com/2019/12/03/us/mckinsey-ICE-immigration.html

18 MacLean, S. A., Agyeman, P. O., Walther, J., Singer, E. K., Baranowski, K. A., & Katz, C. L.(2019). Mental health of children held at a United States immigration detention center. Social Science & Medicine, 230, 303-308.

19 Marshall, S., Zak, L., & Metz, J. (2019, June 23). Doctor compares conditions for unaccompanied children at immigrant holding centers to ‘torture facilities’. Retrieved February 22, 2020, from https://abcnews.go.com/Politics/doctor-compares-conditions-immigrant-holding-centers-torture-facilities/story?id=63879031

20 Morales, F. G. (n.d.). ACNUDH: UN experts to US: “Release migrant children from detention and stop using them to deter irregular migration”. Retrieved February 22, 2020, from https://www.ohchr.org/SP/NewsEvents/Pages/DisplayNews.aspx?NewsID=23245&LangID=E

21 Rappleye, H., and Riordan Seville, L. 24 Immigrants Have Died in ICE Custody During the Trump Administration. Retrieved from https://www.nbcnews.com/politics/immigration/24-immigrants-have-died-ice-custody-during-trump-administration-n1015291

22 Schwellenbach, N., Steinle, M., Hawkins, K., & Peterson, A. (2019, August 14). ISOLATED: ICE Confines Some Detainees with Mental Illness in Solitary for Months. Retrieved from https://www.pogo.org/investigation/2019/08/isolated-ice-confines-some-detainees-with-mental-illness-in-solitary-for-months/

23 Turrini, G., Purgato, M., Ballette, F., Nosè, M., Ostuzzi, G., & Barbui, C. (2017). Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies. International Journal of Mental Health Systems, 11(1). doi: 10.1186/s13033-017-0156-0

24 United Nations. (1984, December 10). Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. Retrieved from https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-9&chapter=4&clang=_en

25 United Nations. (2015, October). Women on the Run. Retrieved from https://www.unhcr.org/5630f24c6.html

26 Walke, A., Snyder, T., Orzoff, A., Bergen, D., & Bartov, O. (2019, July 1). An Open Letter to the Director of the US Holocaust Memorial Museum. Retrieved February 22, 2020, from https://www.nybooks.com/daily/2019/07/01/an-open-letter-to-the-director-of-the-holocaust-memorial-museum/?fbclid=IwAR1AoKWPKzbxZfxd8ia48BuBjDfbyerfRizy7SZziGGWqnCShfUQ8LFZjyY

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Submitted by:

Yara Khalifa, OMS II – Kiran C. Patel Nova Southeastern University College of Osteopathic Medicine
Phillip Ragusa, OMS I – Kiran C. Patel Nova Southeastern University College of Osteopathic Medicine
Chris Mamikkuttiyil, OMS I – Kiran C. Patel Nova Southeastern University College of Osteopathic Medicine

Action Taken:
Date:
Effective Time Period: Ongoing

[Marijo Botten<br>DMU]

Hello! I helped write a similar resolution that was passed by SOMA in spring 2019 and was shot down at the AOA in summer 2019. I don’t remember the resolution number, but since it was passed by SOMA, it should still be in the policy database.
Some critiques the AOA had were that it was too political (despite the focus being on health, etc.) and that it was out of their scope.
Marijo Botten, OMS III
Des Moines University

[Marijo Botten<br>DMU]

Addendum – not that we shouldn’t join Doctors 4 Camp Closures or recommend that the AOA do it, I just think it’s unlikely the AOA would consider it given they wouldn’t support a resolution voicing opposition to the maltreatment and negative health consequences of child detainees. To this end, I suggest at least reducing the amount of “inflammatory” language in any of the whereas statements or any specific mention of Trump/the Trump administration and just stating facts such as “Current medical requirements of the Flores agreement are not being met” instead of “the Trump administration is not complying…” I think some people might consider “humane” to be inflammatory as to suggest the current detention centers are inhumane, so if there was a way to word this with a more specific ask such as “replace the current asylum detention centers with a system that meets the basic health needs of asylum-seekers”.
Anyway, I support the idea of the resolution (and I would support the AOA supporting the resolution I helped write), but I would like to see the writing of both the whereas and resolved statements be as simple as possible, to the point of a specific ask, and without additional adjectives in as many places as possible, because I think especially AOA members reading this (though I’m not sure all of them read the whereas statements) will have some gut politically-related feelings to the wording which would undermine your ask. Then again, they might just not support the idea as a whole or think it’s “out of their scope”.
-Marijo Botten

[Philip Ragusa<br>NSU-KPCOM]

Marijo,

Given that the AOA did not agree to pass your resolution, it seems highly unlikely that the AOA will consider passing any resolutions regarding border detention facilities. If that is the case, then I believe we should still put forth such resolutions for SOMA to adopt. I understand the impulse to not want to propose anything the AOA may not approve, but we should not be afraid of taking a stance as an organization that may not be supported by the AOA. If there are any practical reasons why my analysis is wrong, I’d be interested to hear them.

Regarding the use of inflammatory language, we could remove all uses of the word “Trump” and use verbiage other than “inhumane.”

[Author]

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