In May 2017 pediatrician Marsha Griffin co-wrote a paper for the American Academy of Pediatrics on the detention of immigrant children, stating that “The Department of Homeland Security facilities do not meet the basic standards for the care of children in residential settings.” That was more than a year ago. We asked her to describe her more recent impressions when visiting Customs and Border Patrol.

Texas Monthly: Could tell me your involvement and what you’re seeing right now?

Marsha Griffin: I’m a general pediatrician, and I’ve been working on the border for over a decade. I’ve been down here for a long time, and I’m also co-chair of the American Academy of Pediatrics Special Interest Group on Immigrant Health. We started several years ago, probably back in 2012, because we were increasingly seeing children from Central America in clinics all over the country, and people wanted to know how best to care for them. We needed to know what their histories were; we needed to know, so that we could provide them with the best care. So I am co-chair with Julie Linton. It’s a group now with probably over 500 pediatricians who work very diligently to educate the rest of the 66,000 pediatricians in the country on how to care for immigrant children from wherever they come. And so I bring physicians to the border periodically to see the conditions on the ground. And I have done that for ten years, and during that time, sometimes I have taken them into the Customs and Border Patrol processing center here, which is the largest and receives the most immigrants coming through this area along the border. And so I’ve gone in there numerous times, and I’ve also been in the ORR [Office of Refugee Resettlement] facilities, which are very, very different. The [ORR] facilities try to create very child-friendly environments, they have medical care, they have education, they really try to care for these children in a more homelike setting, or at least child-friendly—unlike where the children are being separated from their parents at the Border Patrol processing center.

TM: Have you gone in there recently?

MG: Yes. I was there probably in February, but I would like to tell you what I saw in the processing center in December of 2017, six months ago. I was in there before this new forced separation of so many children from their parents. And at that time, in that facility, the children were separated from the adults by gender and age, depending on whether you’re an adult or a minor, and they were separated and placed in different chain-link enclosures while they were being processed. So boys would be in one big cage; the girls would be in another; adult men; adult women; and sometimes, if there’s little bitty children, they stay with the mother in their enclosures. So they do that really for their protection, to make sure that the adult the child may have come with is really indeed their mother or their father and not somebody else. And so they are doing that to make sure, first of all, that they are their mothers before they process their papers, and then they make decisions.

TM: One second. Can you explain why that’s important? An aunt can’t bring her niece?

MG: No. It’s not allowed because we don’t really know—they wouldn’t know if it really is an aunt. How can you prove that you’re the aunt and not just some woman who has been paid to traffic them into the United States and sell them into labor or sex trafficking? So it’s very hard to accept, but even if their grandmother brings them and that’s the person that’s raised them, they will separate the child from the grandmother. The same with tios (uncles), or a brother will be separated from his sister if he’s nineteen and she’s fourteen. They will be separated.

TM: Can you talk about food, punishment, contact with parents, sleeping arrangements, that kind of thing?

MG: Yeah. Well, let me say that in the processing center itself, they give them thin mats to sleep on the concrete floor and they give them a Mylar blanket to cover up. And they sleep in the chain-link enclosures that many call cages in there in groups, and they give them meals. They’re not warm meals, but they give them meals three times a day. They can take a shower. They have a change of clothes, and their clothes are washed and given back to them if they want them.

TM: But they’re not able to stay with siblings if they’re the opposite gender.

MG: Right. Not while they’re being processed within that facility. Children are not supposed to be in that facility for longer than 72 hours. And then they’re supposed to be moved to be released with their parent if that’s what they decide to do or taken to the [ORR] shelter, which will care for that child until they can make arrangements to find out who they should be placed with.

TM: I was under the impression that a lot of kids are staying in for longer than 72 hours, even if their parents are around. Is that because they’ve been released to ORR while ORR is trying to track down alternative family members as the parents are in detention?

MG: I don’t know all the rules, because it’s changing pretty rapidly now. Normally, any child cannot be in that processing center for more than 72 hours and then a decision needs to be made about where they’re going. Like, they’re going with their parents or they’re going to connect with their parents. But first they’re going to [ORR] until they can verify that it’s a safe place and it actually is their parent. So that’s how the process goes. I can’t give you all the details about all of that. I’m not an expert on that. Basically, my concern is the trauma that is being caused in that processing center when they are separated and when they’re separated from their families. And so I can describe in December of last year, I took several pediatricians in with me to view the processing center again. And when we were outside, and they were talking to us about the facility—what we would see, where we’re going, where we couldn’t go, that we could just go in a certain distance, which is where families and individuals were brought in when they’re first brought in by Border Patrol—we were standing outside, and there was a door going in there. You could hear the voices of children, but you couldn’t tell whether they were playing or running; you just hear a lot of children’s voices pretty loud.

And then, when they opened the door and we went in, what we saw were these enclosures, and the one right by us within six feet was an enclosure that was locked with around twenty or thirty 10-year-old boys who were crying and screaming and sobbing for their mothers. And some of them were reaching through the chain-link fence as if they were trying to reach out to their mothers, and screaming. One little boy had his back to the wall and was slumped to control his sobs. It appeared that their mothers—since the boys were screaming for them—were in identical cages about fifty feet away, unable to get to their sons or help them. In between them were the desks where the Border Patrol agents were sitting, working at their desk. At their computers. We suggested that they might consider having a child life specialist, which we pediatricians use in our children’s hospitals to help children when they’re going through hospital stays. When they might be going through procedures, child life specialists are wonderful individuals who can explain what’s going on to a child and keep them calm and let them know, from minute to minute, what’s going to happen. And it can help alleviate a child’s fears, whether they’re having a procedure in the hospital or, in this situation, they could help while the children are being processed. A specialist could talk to the children and help them get through that very scary thing of being separated from a parent and not being able to get to them. And we were told that we didn’t understand, that they were law enforcement. That’s not what they did. They’re not a childcare facility. They don’t do that. And they didn’t have time to do that.

TM: What effect does that have on a child?

MG: It can have really long-lasting effects on them, especially this level of stress and trauma. And when you [as a parent] can’t see them or you can’t be right next to them and [you can’t] comfort them and explain things to them, and they can see that you’re unable to protect them, that affects the attachment of a parent with a child because a child thinks they can trust their parent, that they can be protected, and if they can’t, then that takes a while to reestablish that attachment again, because they don’t know who is safe.  And when they’re that afraid for that long—even though 72 hours doesn’t seem like long, for a child that’s an eternity, and it will kick off the extreme toxic stress reaction in a child’s body. And it’s much worse in a child than in an adult, because a child’s brain is still developing. And so if you have that high level of stress hormones flooding the brain, it will change the brain structure. It will make that child more vulnerable for longstanding hypertension to cardiac disease, just because of the cascade of stress hormones and its reaction in the body for fight or flight. And it can cause some certain cancers and it can cause obesity, long-term problems for children. And that’s why you see so many pediatricians across the country speaking up—it’s because we know, when we see these things, when we see the way they are being treated, we know what effect that’s going to have eventually and that we need to help them. Now.

TM: What ages did you see?

MG: All ages. Babies, newborns.

TM: How are they being cared for?

MG: They’re all in cages. A mother would stay with her infant if she had a breastfeeding infant. They would be together in those enclosures. All ages in there.

TM: So a mother breastfeeding an infant would be in with the kids?

MG: Could be, if they’re very little kids.

TM: But the twenty to thirty boys you saw, they were . . .?

MG: Approximately ten years old. Probably some eleven-year-olds and nine-year-olds, maybe eight-year-olds, but they all looked around ten years old to me. It was terrible. Terribly disturbing. And not able to do anything. Those boys will be affected. Their health will be affected.

TM: Have you been in since then?

MG: I was in one other time, in February, and also just went in to the initial place where they go in—the same place where those little boys were. And at that time there were, probably in that same enclosure, there were probably maybe ten boys who looked like they were more [like] seventeen [years old]. Something like that. And they were just sitting there.

TM: And was this in what people are calling the Ursula?

MG: Yes, that’s a processing center.

TM: Have you been inside any of the other detention centers around McAllen?

MG: No. It’s the largest. I’ve been to the ORR centers, yes, but those are under the Department of Health and Human Services. It’s not at all the same as the Border Patrol processing centers. There are ORR shelters across the country. Some are better than others, but they are all licensed child residential centers. They are child-friendly. They’re usually painted brightly. It looks like a day care. It looks like a place you can take a child for day care. And so those are very, very different.

TM: You’re talking about December. Do you know if the Ursula situation is the same?

MG: I don’t know, because I haven’t been there, but if they are—which, the reports are all that they are intentionally separating the children and taking them away—it’s worse. Before, it was for several hours or a few days; maybe they could see them, maybe not. But the trauma that is going to be caused now is much worse.

This post has been updated to correct a reference to the American Association of Pediatrics; it is the American Academy of Pediatrics. We regret the error.