Dr. Paul H. Wise, a pediatrics professor at Stanford University, called the death of Anadith Tanay Reyes Alvarez of Panama “preventable” during an interview this week while he was in Texas’ Rio Grande Valley investigating the circumstances.
“Any child who is sick, but especially children with chronic problems, there should be some hesitation in referring them to local hospitals, preferably a children’s hospital or hospital with good pediatric capabilities,” Wise told the Associated Press.
US Customs and Border Protection has acknowledged that the girl was seen at least three times by medical personnel on the day she died – complaining of vomiting, abdominal pain and what appeared to be a seizure – before being taken to a hospital . CBP did not respond to a request for comment on Wise’s January report or his latest comments.
Wise authored a lengthy report in January on the Border Patrol’s custody of children in the Rio Grande Valley and El Paso, Texas, which gave favorable reviews on many counts but also highlighted serious concerns. Last year, a federal judge asked him to investigate custody conditions in the two busy regions as part of a 1997 settlement to ensure the safe treatment of child migrants.
Wise plans to file a report soon on the May 17 death of the girl, who died on her ninth day in custody after being transferred to a station in Harlingen, Texas, with her family after being diagnosed with the flu. The agency limits detention to 72 hours under its own policy.
While his findings are not yet known — he declined to discuss them — some of his earlier warnings may resurface.
Wise has previously expressed concern about overcrowding of children in medical isolation. His January report recounts how “a medical team” in El Paso was responsible for 125 sick patients, a number that “far exceeds” the team’s capabilities.
The Border Patrol also struggled to meet a requirement to conduct regular medical assessments of children when they arrived in families and at overcrowded stations, Wise said in January.
“The 5-day repeat medical assessment is most important when families are detained for extended periods in overcrowded conditions,” he wrote. “However, due to other important demands on available medical personnel, this medical protocol appears to have a relatively low priority under these circumstances.”
Wise raised further concerns about chronic conditions going undetected and “relevant medical information” being unknown or not shared among staff.
CBP’s relatively detailed public account of the girl’s detention does not directly address the requirement for an exam every five days or how crowded the station in Harlingen was when she was there.
The government’s responsibility for the medical care of children is clearly defined in the recently updated agreement for the El Paso and Rio Grande Valley sectors. “CBP shall immediately activate the 911 system or refer youth to the local health care system when appropriate for evaluation and treatment. In addition, CBP shall refer youth with acute or urgent medical problems to the local health care system,” the agreement states.
During his visit, Wise interviewed Anadith’s mother, Mabel Alvarez Benedicks, who told the AP that agents repeatedly ignored pleas to hospitalize her medically fragile daughter as she felt pain in her bones, struggled to breathe and was unable to go.
Agents said her daughter’s diagnosis of the flu did not require hospital treatment, Benedicks said. They knew the girl had a history of heart problems but were told to return if she passed out, the mother said.
Troy Miller, CBP’s acting commissioner, has since ordered a review of all medically fragile detainees to ensure limited custody. Wise said he spoke with U.S. officials, including medical personnel, to convey concerns from his recent visit.
“I have enough information at this point to make urgent recommendations to CBP, (the Department of Homeland Security) and to the court. And this will be focused around the steps that I believe should be taken to ensure that no preventable deaths of children in CBP custody,” he said.