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Protecting children is up to us: Border policy illustrates need for advocacy

Pediatric resident Jennifer DeCoste-Lopez emphasizes the importance of nurturing caregivers and decries policies that separate children from parents.

Over the last few days I, along with my colleagues in pediatrics and millions of other outraged Americans, have watched in horror as more than 2,300 children were separated from their caregivers at the U.S. border.

When I originally sat down to write about this, I was at the playground at dusk, watching my daughter and a few of her neighbor friends playing on the swings when one of them, a 3-year-old little girl, fell from the swing and bumped her head.

Almost before she hit the ground, she was screaming, “Mommy! Daddy!” I hurried over and tried to comfort her, but it was useless. Her face a mess of tears, she just kept screaming, frantically and single-mindedly, for her parents. Finally, I convinced her to take my hand and I led her, still sobbing, to her home a few yards away. Her father met us at the back door, and when he took her into his arms the change was instantaneous. Her breathing slowed, her face relaxed, her whole body sunk into his chest, and the world was right again.

I was reminded of how the most common of human interactions — a loving adult guiding and comforting a child through the large and small trials of life — forms the foundation of how every child builds resilience. During the critical first years of life, highly stressful experiences can irreversibly harm children’s early brain development, putting them at risk of a lifetime of negative health effects. However, the negative effects are buffered when the child has a safe, stable, and nurturing relationship with her caregivers.

The need for that nurturing adult becomes especially paramount in the case of the traumas endured by children who have fled violence and traveled thousands of miles to seek refuge in a new country.

One school-aged child I cared for told me that gang violence was so bad in his home country that he and has family routinely passed “chopped-up bodies on the side of the road” on the way to doctor’s appointments. They stopped risking the trip altogether after a family member was murdered along that same road. Eventually, they managed to immigrate, and the boy received medical care here. We slowly witnessed him not only improve and thrive medically, but also lead a joyful life even in the midst of illness and trauma. This was possible because of the constant and fiercely loving presence of a mother who had left her entire life behind in order to save her son’s.

Seen through this lens, what has happened at the border is both a health crisis and an especially sinister kind of torture. These children have already endured violence, extreme poverty, and threats to their lives. Then at the end of their journey, they discovered that here in the United States we had made it intentional policy not only to put them in jail, but to commit the ultimate violence and deprivation by separating them from the only people in the world who would enable them to adapt, persevere, and thrive in this harrowing situation.

Children don't just need "things" beyond basic necessities: They need consistent, loving adults. The recent debate about the specific setting — Is it a cage? Is there food, water, and air conditioning? Is there a TV for children to watch the World Cup? — misses the point of the conversation. Even the most luxurious conditions in the world couldn't make up for the deep wounds to a child’s mind, body, and soul that we inflict when we forcibly remove her from her parents. Without the parent’s presence, even a fall from a playground swing would be an insurmountable obstacle. How much more will they suffer when coping alone with imprisonment in a strange land?

Earlier today President Trump signed an executive order that ends the separation of families at the border. But it’s not certain what will happen to these thousands of children who have already been taken from their families — or what will happen next. And this tragic event is a wake-up call for all of us: There’s a clear need for policies that truly protect children’s health in this country.

Jennifer DeCoste-Lopez, MD, is a third-year pediatrics resident at Lucile Packard Children’s Hospital Stanford. The opinions expressed in this piece are her own.

Photo by Trym Nilsen

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