Court-Ordered Child Protection System at Southern Border Set to Expire #

A system designed to protect the health of children detained at the southern border is set to expire shortly after Donald J. Trump takes office with plans to intensify migrant deportations.

The system, established in July 2022, set detailed protocols for detaining minors at Customs and Border Protection facilities in the Rio Grande Valley and El Paso sectors. It required agents to provide access to emergency care and basic hygiene items, and forbade extended separation of children from their parents.

A key component of the reform was an independent pediatrician assigned to visit facilities and work with staff to improve conditions. This monitoring role is set to phase out even sooner than the overall agreement.

Despite improvements, reports showed that conditions still sometimes fell short. Medical experts worry that without the settlement and monitoring, conditions could worsen under an administration less friendly to immigrants.

The federal border apprehension system was originally designed for adult men entering the United States for work. The influx of families and unaccompanied children in the last decade revealed serious issues in a system built for another purpose.

The 2022 settlement, negotiated after three Guatemalan children died in custody, detailed what constituted safe and sanitary conditions for detained minors.

While improvements were made, sustaining them remained a challenge. Even with the monitor and settlement requirements, concerns about child safety persisted.

The monitor’s role provided a rare window into detention center conditions. Regular visits allowed for interviews with children and staff, tracking of various metrics, and reporting on the government’s struggle to meet agreement terms.

Children consistently reported being cold without adequate clothing or blankets. Border officials struggled to provide age-appropriate meals. Child separations continued in the Rio Grande Valley, a practice described as potentially traumatic with lasting harmful effects.

A particularly concerning event occurred in May 2023 when an 8-year-old girl died after being detained for eight days. An investigation found major lapses in medical support, with procedures and policies described as “catastrophically inadequate” and the death as “clearly preventable.”

The monitoring system proved effective not only in revealing shortcomings but also in helping to remedy them. Improvements were made in medical records systems, protocols for challenging medical cases, and addressing overcrowding issues.

Most pediatricians agree that a new system is needed for minors apprehended at the border—one that would outlive any administration and bring their care under a federal agency more oriented around child welfare. Until such a system is in place, the lack of accountability remains a significant concern.