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Review: The Public Health Crisis on the U.S. Border: An Urgent Conversation

This article provides a review of the talk at Harvard Global Health Institute titled, “The Public Health Crisis on the U.S. Border: An Urgent Conversation.”

" one leaves home until home

is a damp voice in your ear saying

leave, run now,

i don't know what i've become."

- Home, by Warsan Shire (British-Somali poet)

On a sweltering hot New England summer day, I walked up the street and across Harvard’s campus to attend an important event. The event caught my eye in my inbox in mid-July, about two weeks before the “urgent” event took place. Despite its urgency, it took me nearly a week to organize my thoughts enough to share a review. The pace of progress for meaningful seeds of action to take root frustrates me. Yet I know that weeks are a relatively short timeframe when public health issues on the border have been building for decades to the point that we’ve declared it a crisis.

The event organized by the Harvard Global Health Institute featured a dream team of guests: first, a talk discussion led by Elora Mukherjee, the Director of the Immigrants’ Right Clinic at Columbia University; and next, a panel discussion with Theresa Betancourt, Director of the Program on Children & Adversity at Boston University (and my former qualitative methods professor at Harvard T. H. Chan School of Public Health), Jodi Berger Cardoso, Associate Professor at the Graduate College of Social Work at University of Houston, Sural K. Shah, Assistant Professor of Medicine & Pediatrics at UCLA, and Sarah Sherman-Stokes, Associate Professor of the Immigrants’ Rights Clinic at Boston University.

Throughout the interactive discussions, the speakers shared their first-hand experiences working with children and families who had experienced traumatic events on the U.S. border and in war-torn areas throughout the world. The speakers threw out a few data points and legal facts to put the magnitude of the crisis into context. For example, 40% of all women immigrants who cross the border are sexually assaulted. Moreover, one speaker stated that it took her less than 60 seconds to cross the border, whereas undocumented children can be legally separated from their families for up to 72 hours. In reality, however, many children seem to be held in private detention centers (that earn money each day the children are held) for 5 to 6 days or more without contact with their families.

The cutoff for the age of separation from families seemed to be arbitrary – at some checkpoints, children of 10-years-old or younger were kept with their families, whereas others seemed to house entire camps of young children without guardians. Although these children are legally required to undergo medical screenings when they cross the border, there is no evidence to show that screenings or medical care at all for that matter are available when migrants are detained. In fact, in this year alone, 7 children have died while detained on the border, which is a sharp spike from the track record of zero reported deaths in previous years.

As telling as these numbers may be, what was truly impactful was not the data points but the stories. Elora, for example, described in great detail the undignified sights, sounds, and smells she experienced when working with detained children on the border. The stench of urine, vomit, feces, and sweat was so concentrated on some children that had been unable to bathe for several days that Elora said she could barely stomach to be close to them. After being born to lands in which they could not live in safety, after long and arduous attempts to flee their homes, and after days of mistreatment and abuse while being detained without their mothers to comfort them, many of these children were inconsolable. They were crying, kicking, screaming, and soiling themselves. Others, on the other hand, were silent – unable to utter their names let alone the extent of traumatic events to which they had borne witness.

Of course, these stories tugged at the hearts of the audience. And of course, we were the audience who wanted to hear them. Many of the questions to the speakers related to measured steps to ignite change.

In response, Elora told us to rally, march, and contact our political representatives – a tall order for an audience of academics, not activists.

“So… as public health experts, what should we do?” an audience member asked, expectantly.

Staring blankly, Elora repeated, “Rally, march, contact your political representatives.”

Later, Jodi stated that in her line of work, sometimes the most impactful action means speaking directly with migrant families and showing them maps of the country rather than sitting at her desk and sifting through documents. Another speaker offered that as long as you can make peanut butter and jelly and share your humanity, you can be of use in aiding volunteer agencies that help newly-migrated families.

For big thinkers with high-price-tag degrees, it can be difficult to hear that our most helpful actions may remove us from the comfort of our desks, our laptops, and our abstract thoughts. Yet the cost of inaction can weigh even graver on our souls – to know that we have the potential within the limitations of our individual reach to spark collective momentum for change.

But what does that mean in practical terms? The audience wanted concrete steps, an action plan, an outline of pre-determined efforts to show that despite our privileged positions, we truly do care. Should our existential crises be the subject of our next urgent conversation?

“Thank you for taking the time to walk across the quad to fit this urgent conversation into your busy agendas, and we hope our ice water was chilled enough for you,” the moderator concluded, and the audience paused in the uncomfortable silence that proceeded our next thoughts.

Find the recording of the event HERE:

And find more resources HERE:


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