The Health Imperative: Reunite Migrant Children with their Parents

By Gali Katznelson

Japanese family awaits evacuation 1942
A Japanese family awaits an evacuation bus to an internment camp in 1942. Children who spent time in the camps have high incidence of trauma and health problems, studies have shown. Photo via US National Archives.

Former first lady Laura Bush published an op-ed in the Washington Post where she reminded us that today’s mass detention centers for children whose parents are accused of illegally crossing the border is a public health crisis — one we have seen before.

Tara Neubrand, a pediatric emergency doctor in Colorado, wrote a Facebook post detailing her experience taking care of three toddlers in foster care who were taken from their parents at the Mexican border and brought to an emergency room by their foster parents. She explained that although their physical health needs were met, their behavior was far from that of a normal toddler.

Facebook post by Dr. Tara Neubrand.

“These children, in all cases, clung so tightly, and so completely, to their foster mothers, both in the ED [emergency department] and at home, that they were literally unable to be put down,” she wrote in a post that has since gone viral. “They didn’t explore the world; they were terrified that their world would be broken for a second time. Their trauma, and the direct effect it was having on their development, was obvious.”

One of the foster parents reportedly told the physician, “‘I’m just trying not to ruin his life. He screams every day for his pappa, and I don’t even know where his pappa is.’”

Department of Homeland Security Secretary Kirstjen Nielson claims that the 2,000 children separated from their parents and housed in detention facilities are not abused. “We give them meals and we give them education and we give them medical care. There are videos, there are TVs,” she said.

While the children may have basic access to food and medical care, it’s the infliction of trauma that can result in lifelong effects that is most alarming.

This trauma can result from a lack of parental touch. We know that children need to be held. Colleen Kraft, president of the American Academy of Pediatrics, witnessed a child wailing in a detention center who could not be held by an employee due to a policy. She explained that the stress response experienced by the child can become toxic. Without the stress relief of a comforting caregiver, the prolonged activation of stress response systems can disrupt emotional and physical development.

Early childhood trauma, such as a separation from a parent, is associated with reduced brain cortex size, an area that is responsible for executive function. Children age 0-2 who are exposed to trauma demonstrate poor verbal skills, exhibit memory problems, scream or cry excessively and have poor appetite. Children between ages 3 and 6 may have difficulties focusing or learning in school, develop learning disabilities, show poor skill development, act out in social situations, are verbally abusive, are unable to trust others, believe they are to blame for the traumatic event, lack self-confidence, and experience stomach or headaches.

These effects are well documented.

As Bush pointed out, the images of children in converted Walmarts are reminiscent of the World War II internment camps for people of Japanese descent. Years of research since those shameful days have revealed the mark left by the trauma of the internment camps, studies have shown. The long-term consequences of these camps included psychological anguish. The youngest of the detainees were affected most, reporting more Post Traumatic Stress Disorder symptoms, such as flashbacks, over their lives. The detainees also had a  greater risk of cardiovascular disease than a non-interned group and died earlier.

The events of this month are also reminiscent of Jewish children being separated from their parents during the Holocaust. Survivors, such as Yoka Verdoner who wrote the piece, “Nazis separated me from my parents as a child. The trauma lasts a lifetime“, attest to the long term effects of childhood trauma. And there is some evidence from Holocaust survivors to support the theory that trauma can cause epigenetic changes that can be passed down through generations.

And it’s reminiscent of another shameful mark on Canada and the US’ legacies—the separation of indigenous children from their parents. Beginning in 1879, the Canadian government separated Indigenous children from their parents and forced them to enroll in residential church-based schools, located away from the reserves, under the guise of formal education.

These children were separated from their families, with little communication, in schools that resembled prisons. The abuse, violence, and trauma suffered by children in residential schools may be one of many factors to explain why suicide rates in some Indigenous communities in Canada today are five times the national average.

We know, not just in our guts, but through health data, that childhood trauma can have long-standing psychological and physical health impacts. Events through history that we’ve vowed never to repeat have taught us this.

We need to design systems that outlaw the infliction of childhood trauma.

We need policies that do not separate migrant children from their parents.

Gali Katznelson

During her fellowship year, Gali Katznelson was an MBE candidate at the Center for Bioethics at Harvard Medical School. Before her master's degree, she completed a bachelor’s degree in Arts & Science at McMaster University in Canada. Her fellowship project focused on clinicians' perceptions of the uses and regulations of smartphone mental health apps.

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