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Dr. Ben Hoffman visits with U.S.-Mexico border migrant children

AAP President Benjamin D. Hoffman, M.D., FAAP, and other AAP leaders traveled to the U.S.-Mexico border to better understand the conditions and treatment of migrant children. 

Child-centered care needed at U.S. border facilities, AAP leaders say

April 1, 2024

A recent visit to the U.S.-Mexico border with other AAP leaders provided many eye-opening experiences for AAP President Benjamin D. Hoffman, M.D., FAAP. He saw the tireless work being done by many to assist those seeking asylum in the U.S. as well as areas where improved care is needed.

“Getting to see the best of humanity in a circumstance where people were fleeing because of the worst of humanity was really affirming,” Dr. Hoffman said. “We still have a tremendous amount that we need to do to support kids and families in this process.”

Dr. Hoffman and AAP Executive Committee members visited several facilities in and around Tucson, Ariz., during the Jan. 29-31 trip. The region has seen a 190% increase in crossings compared to one year prior. The primary countries of origin among those arriving in Tucson include Mexico, Guatemala, Ecuador, Senegal, Guinea and India.

The group visited a U.S. Customs and Border Patrol facility inside a former Air Force base in Tucson, where many adults and families are taken for processing after crossing the border.

“There’s nothing child-centered or family-centered or kid-friendly about it,” Dr. Hoffman said of the intake process. “The kids have all experienced phenomenal amounts of trauma. How can this be done in a more trauma-informed way and a more humane way? The thing that repeatedly hit home is these are people. These are people who have been traveling for weeks and months, and it needs to be about acknowledging that they’ve already been through a lot and not exacerbating that.”

While children do receive care at the facility, Dr. Hoffman said exams typically are “cursory” and can miss significant health issues. A greater focus on the unique needs of kids would be beneficial.

“There are kids with special health needs there and kids who have been born on the way there who really haven’t had medical assessments,” he said.

Leaders later visited Casa Alitas, a respite center run by Catholic Community Services of Southern Arizona, where families are sent after processing at the border patrol facility. The center saw 230,000 people last year and can see up to 1,200 people each day.

During the visit, Dr. Hoffman and AAP Immediate Past President Sandy L. Chung, M.D., FAAP, met a woman from Venezuela, who had arrived at the facility with her 2-year-old son after six months of travel by foot.

“She showed us pictures of the journey through the jungle in Honduras and Costa Rica and pictures of people who didn’t make it who had died on the route,” Dr. Hoffman said. “She said there are cartels and they were constantly in fear of being kidnapped, but they persisted and survived. They were exhausted, but they were safe. She had a plane ticket and said she was flying to Florida to live with her sister. She was full of energy and life and joy just knowing she had made it.”

On the Mexico side of the border, AAP leaders visited the city of Nogales to see the Kino Border Initiative, a Roman Catholic organization that can provide short-term overnight shelter for families.

The group also visited a small Office of Refugee Resettlement (ORR) facility in Arizona that was caring for unaccompanied children. “They have child care expertise and pediatricians,” Dr. Hoffman said. “They have resources and access to vaccines.”

The care provided in the ORR facility was an example of how everything can be done right, especially when children are in smaller, more home-like settings, he added. “That was really child-centered and trauma-informed. All of the kids there go to school for the period of time they’re there. The ORR is vetting the person who will be entrusted with taking those children, and sometimes that takes a while.”

In total, roughly 8,000 children were in ORR custody at the time of the visit.

While resources are needed at the border, Dr. Hoffman said pediatricians can find organizations in their own communities that are looking for help.

“One of the recurring themes is they need pediatric expertise,” Dr. Hoffman said.

He encourages members to offer assistance to community organizations that are supporting newly arrived immigrants, unaccompanied children and doing refugee resettlement.

“Like everything else we do,” he said, “it’s about kids and families and communities.”

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