A guard at the Otay Mesa detention center watches a protest in 2018. Photo by Chris Stone

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In America, we believe everyone deserves a basic standard of care, including the asylum seekers and migrants who come looking for help but end up in detention centers.

As a resident physician, I see the inhumane conditions experienced by our immigrant and asylum-seeking populations creating a public health time bomb. The four walls of the detention centers hold overcrowded quarters, cruelly surpassing capacity and forcing these families to live without necessary medications and basic hygienic items in facilities that spread infection.

The existence in these detention centers does not reflect our American values, and each day that we continue to turn a blind eye to those asking for our help we sacrifice our conscience. As the daughter of a Cuban asylum seeker, my passion for providing quality care to immigrant patients and families guided me to a residency program in Miami, which was long a sanctuary city.

The state of detention centers today and callous treatment of asylum seekers and immigrants are very personal to me, both as a doctor and a sister. You see, I have two foster brothers, both asylum seekers from Honduras. Their journeys to this country, though 10 years apart, were strikingly different.

The elder foster brother, Luis, told me how the day he came to this country was the happiest of his life. Luis, at age 12, traveled alone, without his mother who was already in the United States saving to provide for him in this country. He explained that after telling the officers he had asthma, he received an inhaler that day. He stayed in a community-based foster program with other children his age. He attended school, received clothes to wear and food to eat, had access to a bathroom and shower, and a bed to sleep in.

Although the efforts were simple, he was shown the best of what this country is about: the human spirit. Becoming part of a community, he was given the opportunity to flourish. Now a proud U.S. citizen, Luis is thriving, attending university and interning with NASA.

Luis’s cousin, Wilson, arrived in this country three months ago. At 10 years old, he made the journey from Honduras with his mother. Upon arrival, Wilson was separated from her and placed in the equivalent of a prison cell — bars and all — with 11 boys of different ages. He was fed once a day at irregular times, and was expected to sleep on a cement floor with a “thermal foil” in place of a bed with blankets. He was not given access to a shower.

Dr. Linda Alvarez

Today Wilson is out of the detention center and safe with his mother, but he exhibits symptoms of anxiety daily. He shows signs of food insecurity, hiding food just “in case” he will not have access to it in the future. He is anxious when in school, afraid his mother will be arrested or deported while he’s away. The psychological damage to the children and adults in these detention centers will affect them for months, if not years.

Wilson’s experience is not our America. We must create logistical and financial access to comprehensive, safe and timely care for immigrants and asylum seekers across the country by:

  • Replacing the use of detention centers with community support systems and release on recognizance

  • Ending the separation of families

  • Implementing independent medical oversight

  • Allowing use of medications (such as inhalers and insulin) that patients bring with them across the border, or supplying patients with the American equivalents of medications at time of confiscation

  • Ensuring the availability and administration of routine childhood vaccinations and influenza vaccines for all detainees.

We stand at the precipice of this public health and humanitarian crisis in America. Something can — indeed, it must — be done. As a resident physician and the national secretary-treasurer of the Committee of Interns and Residents SEIU, I am using my voice to advocate for immigrant rights, including healthcare access.

The committee represents over 6,000 resident physicians, interns and fellows across 18 California hospitals. Recognizing the failings in our immigration system, Residents have devoted countless hours over the last two years providing clinical care and forensic exams for individuals locked in detention centers and asylum camps through programs like the Los Angeles Human Rights Initiative, Physicians for Human Rights, and the Refugee Health Alliance.

Together, speaking as a union with one voice, our resident physicians can shed light on these atrocities within our communities, and demand our elected officials do better. But there is something we all can do to bring an end to the public health crisis on our border and within the detention centers. One vote at a time we can get back to the safe and accepting America we once were; the America that welcomed my brother Luis and empowered him to thrive. Let’s do our part.

Dr. Linda Alvarez is the national secretary-treasurer of the Committee of Interns and Residents SEIU and a board-certified family medicine physician in hospice-palliative medicine.

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