A CBP agent at San Ysidro crossing from Tijuana, Mexico, in April at the U.S.-Mexico border.
Photo: guillermo arias/Agence France-Presse/Getty ImagesWASHINGTON—U.S. Customs and Border Protection doesn’t consistently follow its own guidelines governing medical care of migrant children in its custody and chose to ignore a recommendation from the Centers for Disease Control and Prevention to give the flu vaccine to children, a new report by the Government Accountability Office found.
The report, commissioned by Pennsylvania Democratic Sen. Bob Casey, reviewed CBP’s attempts to improve the medical care it provides migrant children—along with the training it gives border agents—following the high-profile deaths of at least five children in its custody beginning in December of 2018.
Though CBP policy states migrants shouldn’t remain in their custody longer than about three days, the surge at the border last year backed up the entire immigration system, resulting in overcrowding in cramped border detention centers and stays that frequently lasted longer than three days. Infectious diseases, including the flu and the measles, were widespread.
The Congressional watchdog found CBP did make progress: It hired more medical personnel at the border, enlisted help from the CDC to improve its procedures and developed more complete health guidelines.
A CBP officer instructing migrants seeking asylum in the U.S. as they depart Nuevo Laredo, Mexico, in September 2019.
Photo: Fernando Llano/Associated PressStill, the report found CBP applied those guidelines inconsistently. For example, in one survey last November across South Texas, GAO found three of 10 border stations it visited didn’t have medical staff present to perform medical assessments.
In a different survey conducted in February of border-patrol stations without medical personnel present, 143 of 373 children taken into custody over one week didn’t receive basic health checks by border agents. Among those who did, some who indicated to border agents that they had symptoms including a cough weren’t then referred for a full medical assessment.
The report also found that CBP chose not to follow the CDC’s recommendation that migrant children be vaccinated against the flu. CBP officials told GAO that vaccinating children would pose logistical, medical and legal hurdles, and as of April still opposed the idea.
The agency faced intense public pressure to vaccinate children in its custody from health-care groups and other immigrant advocates after several children with the flu died in detention. In December 2019, a group of doctors hoping to give children flu vaccines staged a protest outside a border detention center near San Diego. In response, a spokeswoman for the Department of Homeland Security, CBP’s parent agency, tweeted: “Of course Border Patrol isn’t going to let a random group of radical political activists show up and start injecting people with drugs.”
The report also found that GAO has inconsistently reported deaths in its custody to Congress and lacks a consistent way to track other serious illnesses or injuries in border facilities, according to the report. The agency promised to overhaul its record-keeping by September and report the information to Congress more consistently.
In response to the Congressional watchdog’s findings, CBP said that it wasn’t aware of the extent to which its guidelines were being inconsistently applied and that it was already working to address the issue.
Central American migrants waiting for food in a pen erected by CBP to process a surge of migrant families and unaccompanied minors in El Paso, Texas, in March 2019.
Photo: Cedar Attanasio/Associated Press“CBP takes its role in providing care and ensuring the health, safety, security, and welfare of each adult and child in its custody very seriously,” a CBP spokeswoman said. “CBP is committed to improving its care and custody of adults and children.”
A White House spokesperson referred questions for comment to the CBP.
“Children who are seeking refuge in our country should not be dying in our care,” Sen. Casey said in a statement. “The Trump Administration should do their job and ensure the Department of Homeland Security is consistently implementing the CDC’s recommendations so that we ensure the safety of migrant children and youth.”
The deaths of a 7-year-old and an 8-year-old child in CBP custody last year prompted a public outcry and Congressional investigations, as well as Sen. Casey’s request for the GAO report.
The poor conditions at the border led the Trump administration to request emergency funding from Congress to help pay for food, shelter and medical care for the surge of asylum seekers in the spring of 2019. Congress approved a $4.6 billion package, but GAO found last month that the agency put some of the money meant for medical care toward unrelated expenses for its canine program and new vehicles including dirt bikes.
The report no longer reflects the reality at the border. Under new rules issued by the Trump administration set to last for the duration of the coronavirus pandemic, children and nearly all other migrants are immediately turned back to Mexico or deported after crossing the border. They aren’t given a chance to ask for humanitarian protection, a process that often takes months to adjudicate and aren’t taken into custody at all.
Write to Michelle Hackman at Michelle.Hackman@wsj.com
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