None of This Damage Is Collateral

Many of the children and families who crossed the border illegally need treatment for communicable diseases, including tuberculosis, chicken pox and scabies, according to the inspector general's report, released Thursday. Homeland Security workers said they had been exposed to such diseases while on duty and, in two cases, transmitted chicken pox to their children. Another issue is sanitation. Some immigrants didn't know how to use the bathrooms, the report said, resulting "in unsanitary conditions and exposure to human waste." Inspectors made 87 unannounced visits to 63 sites from July 1 to 15, in part because of an American Civil Liberties Union complaint that the Homeland Security Department was violating the civil rights and liberties of 116 unaccompanied children.

Contrary to allegations, the report said, "We did not observe misconduct or inappropriate conduct by DHS employees during our unannounced site visits." Some violations were found, however, including children held more than the 72-hour legal maximum because no permanent shelters were available. After 72 hours, children are supposed to be transferred to the Health and Human Services Department, which tries to place them with sponsors while they await an immigration hearing on whether they qualify to stay in the U.S. Under a 2008 law, children from all countries but Canada and Mexico are entitled to a hearing.

Fear spread that while disease was rooted in the polluted living conditions of New York’s poorer communities, disease could easily spread to the more well off citizens too. Public health officials realized that the city’s soiled streets and polluted sewers were a health risk to all New Yorkers. ¹⁹ In the mid-nineteenth century, New York possessed a primitive sewage system. Poorly planned sewers spanned the city, but most citizens’ homes did not connect to these pipes. Instead, most New Yorkers relied on outdoor outhouses and privies. These outhouses were usually poorly maintained and covered in filth. Poorer families did not even have the luxury of an outhouse. They simply dug a small trench into the ground outside of their homes. Trenches and outhouses were both unsavory solutions as waste was rarely removed from them and frequently flowed into the streets of the city.

“Unaccompanied children have often faced trauma prior to, during and/or after arriving to the United States,” said Julie Linton MD, chairperson of the Immigrant Health Special Interest Group of the American Academy of Pediatrics. “Trauma-informed care is essential as they access health services.” Border crossings by unaccompanied minors, most of them from Central America, reached a peak in 2014, when 68,500 were apprehended at the border. The Centers for Disease Control and Prevention reported clusters of pneumonia and influenza at the time in temporary shelters in the Southwest.

The AMA House of Delegates has characterized unaccompanied minor immigration as “a humanitarian issue” and resolved that the organization would work to identify obstacles to mental and physical care in cooperation with other organizations. “Partnership with community-based organizations is essential when caring for unaccompanied children,” Dr. Linton said. To be effective, health care must work in tandem with the trauma, legal and institutional trust issues that child immigrants experience, she said.

Eight of the children were treated at North Central Bronx Hospital and four received care at Bellevue in Manhattan, Katz said. Dr. Daran Kaufman, director of pediatric emergency services at North Central Bronx, said the doctors treated the patients for conditions including asthma, constipation and depression. "Although we've been able to treat their medical diagnoses, they are sad and despondent and we are unable to treat the emotional scars they're presenting with," she said. Katz said those were only the children that the health system has identified to date as being separated from their parents. "There are undoubtedly more because our commitment is to serving them, not interrogating the circumstances that brings them to our facilities," Katz said.

Dinosaurs couldn't stick out their tongues like lizards. Instead, their tongues were probably rooted to the bottoms of their mouths in a manner akin to alligators. Researchers from The University of Texas at Austin and the Chinese Academy of Sciences made the discovery by comparing the hyoid bones -- the bones that support and ground the tongue -- of modern birds and crocodiles with those of their extinct dinosaur relatives. In addition to challenging depictions of dino tongues, the research proposes a connection on the origin of flight and an increase in tongue diversity and mobility.