By Dara Lind, Immigration Impact
An internal investigation into the death of a medically vulnerable eight-year-old girl after over a week in Border Patrol custody continues to reveal shocking negligence on the part of medical contractors and Border Patrol employees.
It’s becoming increasingly clear that the May 17 death of Anadith Danay Reyes Alvarez, an 8-year-old girl born in Panama to Honduran parents, could have been prevented if medical personnel had listened to her parents; consulted with on-call doctors, including a pediatrician; or even simply read existing medical documents and U.S. Customs and Border Protection (CBP) records about her history of heart surgery and sickle cell anemia.
The investigation, which is being conducted by CBP’s Office of Professional Responsibility (OPR)—the agency’s internal watchdog—is ongoing. Because the closed-circuit camera system at the Harlingen, Texas facility wasn’t working, the office hasn’t been able to verify what happened to Anadith. Its investigation also revealed that CBP records on her case are incomplete. For example, the written records OPR initially reviewed never mentioned that she had a 104.9-degree fever the day before her death.
OPR is reporting some of its findings as it goes, with one statement issued a few days after Anadith’s death and a second issued on June 1. Both statements say that the findings are “subject to verification,” but are based on a combination of CBP written records and camera footage (where available) and interviews with the medical personnel who treated Anadith and her family.
Information released in the two statements makes it clear just how many red flags medical personnel ignored, especially at the Harlingen Border Patrol Station where the family was sent—ironically, because Harlingen was “designated” for medical isolation for people like Anadith who had tested positive for contagious disease.
The most egregious findings include:
- When Anadith and her family were first screened by medical personnel at the Donna processing facility, closed-circuit recordings show that her mother handed “several papers” to the medical provider. According to CBP records, the family told the medical personnel at this time that Anadith suffered from sickle cell anemia and chronic heart disease. However, none of the medical personnel at the Harlingen station, where the family was transferred a few days before Anadith’s death, reported being aware of these conditions.
- The cameras at the Harlingen Border Patrol station were not working, making it impossible for the investigators to see exactly what happened while Anadith and her family were being held there. The cameras had been “flagged for repair/replacement” on April 13—over a month before Anadith and her family arrived. Congress requires Border Patrol to report such outages to OPR, but that never happened.
- According to interviews with medical personnel, Anadith was suffering from a fever for days before she died—peaking at 104.9 degrees. Personnel treated the fever “with a combination of ice packs, antipyretic (fever reducing) medications, and a cold shower,” but refused to take her to the hospital. None of this is recorded in the medical records.
- Doctors, including a pediatrician, were on call at Harlingen. But medical personnel “did not consult” with them about Anadith’s condition or treatment.
- A nurse practitioner saw Anadith on four occasions the day she died. Only some of these visits were reported in CBP records. The nurse practitioner told OPR that Anadith’s mother requested on “three or four” occasions that an ambulance be called for Anadith, or that she be taken to the hospital. The nurse practitioner refused every time.
- Another medical contractor told OPR that he got a “pile of documents” from the family’s personal possessions and brought it to the nurse practitioner, but the nurse practitioner “declined to review the papers.”
We’ve said, over and over again, that Border Patrol facilities are no place for anyone to be held for days on end—much less children or the medically vulnerable. Even in a best-case scenario where the staff are doing everything they can to care for migrants, these facilities may not have the resources to identify and treat medical crises or may be too remote to get someone to a hospital in time.
This was nowhere near the best-case scenario. The OPR investigation has already revealed several occasions on which people who are paid to keep migrants alive, and healthy, instead refused to take Anadith’s condition seriously—or even to look at the evidence they had about her medical history and condition. The starkness of this case reveals an uncomfortable truth: putting resources toward hiring more medical personnel, or other people responsible for caring for people in detention, doesn’t do anything if the people you hire refuse to listen to a mother’s pleas to call an ambulance for her feverish child.
The Biden administration’s retreat from its plans to reopen large-scale Immigration and Customs Enforcement (ICE) family detention facilities has been praised, and correctly so: families shouldn’t be in detention. But that’s true for Border Patrol detention, too. The federal government’s own guidelines set 72 hours as the recommended maximum time that anyone should be in CBP custody after being apprehended at the U.S.-Mexico border, before being transferred to ICE or processed and released. Anadith’s family was there for over twice that long before she died.
What the government finds truly intolerable is revealed by what it puts the most resources toward preventing. An executive branch that truly cared about minimizing the detention of families could dedicate more staff to processing them quickly, so they can be released with an appointment for a hearing before an immigration judge or an initial interview with an asylum officer.
That isn’t the choice this administration has made. It has chosen to maximize its use of expedited removal against asylum seekers, requiring them to pass a screening interview—which is now, thanks to the new asylum transit ban, a very high bar to clear—before it will give them a court date. And it has chosen to conduct some of those interviews (of single adults) while the asylum-seeker is still in Border Patrol custody – which limits the agency’s resources to deal with families at all.
A border policy that prioritizes processing asylum seekers—moving them through the legal process to determine whether they’ll ultimately be able to stay in the United States—is fully within the government’s power to build. (The Council’s recent report, Beyond A Border Solution, includes several recommendations that would bring the U.S. closer to that goal, including dozens of things the executive branch could do on its own.) But if the administration chooses to put its resources toward keeping families in CBP custody, it puts those families’ lives in the hands of people like the nurse practitioner in Harlingen, who may be careless or who simply may not care.