Firsthand Accounts of Medical Negligence in Customs and Border Protection Facilities

This administrative complaint with government oversight agencies highlights a systematic failure to provide adequate medical care to children in Customs and Border Protection (CBP) custody—in violation of CBP’s own internal guidance and extensive medical guidelines.

The complaint is based on 200 survey responses and numerous statements from mothers who spent time in CBP custody with their children prior to being detained at the South Texas Family Residential Center (STFRC) in Dilley, Texas.

The American Immigration Council and the American Immigration Lawyers Association filed this administrative complaint with the Department of Homeland Security (DHS) Office for Civil Rights and Civil Liberties, DHS Office of the Inspector General, and the Federal Bureau of Investigation (FBI).

Government Response

On August 17, 2021, the DHS Office for Civil Rights and Civil Liberties notified the Council and AILA that it conducted and completed its investigation. The agency identified concerns related to conditions of detention and medical care, and made numerous recommendations to CBP to address issues related to:

• time in custody for unaccompanied minors,
• protections for vulnerable children,
• adherence to guidance for the management of COVID-19,
• medical screening of migrants,
• provision and monitoring of medical care to individuals in CBP custody, and
• assurance of privacy to those undergoing medical care.

A copy of the government's notice is available here. 

Nine firsthand accounts of poor medical care children experience in CBP custody.

1. Account of Beatriz

Beatriz fled Honduras this summer with her nine-year-old daughter, who was diagnosed prenatally with cysts that prevented one of her kidneys from working. The child’s doctor had instructed Beatriz to change her daughter’s underwear and bathe her carefully every day due to her high risk for urinary tract infections. In July 2019, the family was detained and transferred to a CBP facility. When her child vomited twice, an immigration official told Beatriz that “they only took children to a medical provider if they had fever or had vomited three times.” Despite multiple requests to officials and a medical provider, Beatriz’s daughter went five days without a shower or a change of underwear. The child complained of genital itching and burning during urination. Beatriz states:

“I told another official about my daughter’s medical problem and need to shower. She said that we had to wait for her assigned bathing day. I asked if we could at least have another pair of underwear. She said she could not help. I saw girls’ clothing nearby and asked if we could have one of those but she said she could not help. I put a sanitary napkin in my daughter’s underwear to try to keep her clean.”

2. Account of Yuri

Yuri, an asylum-seeking Honduran mother arrived in the United States in July 2019 with her three-year-old daughter. They were taken into CBP custody and held for eight days. Yuri reported that her daughter is only accustomed to drinking from a bottle, which officials refused to provide. Her daughter then stopped drinking liquids almost completely. Two days after Yuri’s arrival, the CBP facility was put under quarantine. According to Yuri, immigration officials told Yuri and the other people detained with her to stay away from them because they were afraid of getting infected. The officials stopped taking roll and handing out food individually. Yuri’s daughter became very ill during their detention in the CBP facility. Yuri made frequent visits to a dirty bathroom with her daughter, who had diarrhea. At one point, her daughter vomited about ten times in an hour, but officials told Yuri she could not receive medical care because of the quarantine. Yuri recalls:

“The majority of children were sick. One Guatemalan mother had a boy who was three or four years old. He had a cough, diarrhea, fever, and vomiting for several days. An official told her to stand [in line] waiting to see a doctor. She waited from one in the morning until about eleven at night and still was waiting in the same place without being seen. Her son started to convulse, and they finally took them away.”

Yuri says that both fathers and mothers became so angry about the lack of medical care for their sick children that everyone began to yell at the same time. After that, CBP gave all of the adults a pill and all of the children one dose of liquid medicine but that was the only time they received medicine in eight days. Yuri saw a woman leave to give birth and return to the facility, which was under a quarantine, with her newborn baby. The mother had to lay her newborn on the cement floor with only a Mylar sheet between the baby and the floor.

3. Account of Marisela

Marisela, a 21-year-old mother of a two-year-old son, fled Honduras and entered the United States in July 2019. A few days after their detention in CBP custody began, immigration officials stopped bringing in or releasing anyone, in what seems to have been a quarantine. Officials told Marisela and others detained with her that they were “on alert.” Officials gave the adults a pill related to the quarantine, but told her that her son would not receive one because they had run out. Her son developed a fever, cough, and diarrhea. Marisela recounts:

“My son was losing weight and I would sometimes have to change his diaper every 10 or 15 minutes because of the diarrhea.  An official told me that they were not giving medication to children and he could only give me a little electrolytes. That was the only time my son received electrolytes during the week we were in the perrera*.”

Marisela reports that most of the children in the CBP facility were sick with vomiting or diarrhea, and that she thinks the portable toilets, which were frequently overflowing, could have contributed to spreading infection. Marisela and her son waited in the medical area to see the nurse for over five hours one day, but the nurse never arrived. When they finally saw the nurse the next day, she was told that there was nothing that could be done for her son.

*"Perrera” is the Spanish word for “dog pound.” 

4. Account of Sofia

Sofia fled El Salvador with her nine-year-old daughter, entering the United States in June 2019. In CBP custody, her daughter had stomach pain and nausea which she believed was from the ham sandwiches and burritos provided. Sofia reports that her daughter barely ate anything while in custody. Her daughter vomited and had diarrhea so many times Sofia says she lost track. Sofia says that her daughter vomited into her hands because she could not reach the bathroom in time. Sofia was very worried because her daughter’s lack of appetite was very uncharacteristic of her daughter. Sofia states:

“My daughter’s health kept getting worse so on Monday June 24 I asked an official for my daughter to see a doctor. She was going to the bathroom with diarrhea and vomiting very frequently. The official put her hands on her hips and asked if she had a fever. I said no. The official said that if she didn’t have a fever she couldn’t take her anywhere and told us to go back to our cell.”

Sofia and her daughter never saw a medical professional in the four days that they were detained by CBP.

5. Account of Carla

Carla fled Honduras with her six-year-old son, entering the United States in June 2019. She reports that immediately after crossing the border, she looked for an official so that she and her son could turn themselves in and request asylum. However, they were caught in a rainstorm and walked for an hour before finding an immigration official. Carla describes conditions in the CBP holding cell:

“My son was wet and very cold from the air conditioning and only had a Mylar blanket. We had to sleep on the cold cement floor. He was naked and trembling, crying, and couldn’t sleep from the cold. I asked for diapers so he could have something to wear but the officials said he was too old to wear them.”

Carla’s son woke up with congestion, fatigue, and a fever. Carla reports that she requested medical attention for him, but the official told her that her son was just tired and needed to sleep. Yet officials woke Carla and her son up at four in the morning while he was sick to process the belongings that were being confiscated from them.

6. Account of Vidalina

Vidalina fled Guatemala with her four-year-old daughter to seek asylum in the United States. She entered the country, was detained in July 2019, and spent six days in CBP custody. Despite her daughter having wet clothing, she was denied dry pants and socks for her daughter and was told not to take their shoes off because their feet would smell. They were given a meal and then told that if they wanted to shower, they would need to do so right away. As a result, they did not finish their food because they had had to leave it right next to the portable bathrooms and there were flies circling. They were afraid the flies would settle on their food. Vidalina’s daughter came down with a fever, diarrhea, and a headache. A CBP official told her that no medical care was available. Vidalina says:

“My daughter got sick with a fever, diarrhea, and a headache. I tried giving her more water but the next day she woke up even more sick. Her lips were chapped from the fever. I asked the official in charge of our area for medical attention. I told her my daughter had a fever and headache. The official responded, “Listen, I don’t have medicine for you and much less for her. Hold her in your arm and put her to sleep.”

7. Account of Diana

Diana and her 11-year-old daughter, both from Honduras, arrived in the United States in July 2019. After crossing the U.S.-Mexico border, they were transferred to CBP custody and held for at least a week, where they were separated from one another in different fenced areas. She recounts:

“On Friday, July 12th at 6:00 in the evening, we noticed that no new people were arriving and that the officials were no longer calling people for interviews. The officials told us that this was because there was an epidemic of fever, diarrhea, and vomiting. They gave all of us women a pill and told us that we had to stay detained for 48 hours after taking the pill to be sure we weren’t contagious. ... From our cell, we could see two women in other areas with babies who looked just a couple days old. The mothers had to sleep on a mattress on the floor with the newborns, wrapping them up to try to keep them warm.” 

Diana states that she heard many mothers request medical care, but none of the children were taken to a doctor, even though some of them seemed seriously ill. After she was reunited with her daughter, she learned that her daughter had not received a pill like the one she had been given.

8. Account of Isabel

Isabel, a mother from Honduras, arrived in the United States in June 2019 with her three-year-old daughter. Isabel asked officials in CBP custody for dry clothes for her soaking wet daughter, but was told she could not have any. Isabel wrung the clothes out as best she could in their cell. They were each given a single Mylar blanket, so Isabel wrapped both blankets around her daughter, who was still wearing wet clothes, and slept without one herself. They did not receive dry clothing for two days. Isabel states:

“The next day, [my daughter] woke up with a fever and congestion. I asked several officials for medicine but the officials said they didn’t have any. One told me to wait but she never came back.

9. Account of Fatima

Fatima, a 21-year-old Salvadoran mother, arrived in the United States in June 2019 with her four-year-old daughter. She and her daughter were very cold in CBP custody and only received one Mylar blanket each. Fatima requested dry socks and an additional blanket for her daughter but was denied. The child started sneezing and becoming congested. Fatima reports that every time her daughter tried to eat the ham sandwiches or burritos that were provided for every meal, she gagged as if she were going to vomit. Fatima requested medical attention from two different officials, both of whom denied her requests. She says:

“It seemed to me like the officials would only provide medical care in a very extreme situation like if someone had a seizure, but not for most sick children. I did not see anyone receive medical care in the days that I was there even though most children there looked sick.”

After three days in CBP custody, Fatima and her daughter were transferred to the STFRC. Upon arrival at the STFRC Fatima’s daughter was still congested and had a fever. She was barely eating and had stomach pain. Fatima believes that the conditions in the facility caused her daughter to get sick.