As a medical provider, it has been challenging for me to watch the events that are occurring at our southern border. Putting aside the constant white noise of protestations vs affirmations on the correct way to address the situation of immigrants seeking asylum, I think all citizens can agree that mayhem is unfolding. Both adults and children are not being properly cared for, resulting in illness and the deaths of children.

I wonder: Why is this ongoing medical emergency not being treated with the same sense of urgency as medical disasters caused by events such as floods, tornadoes, and hurricanes, as well as other events in which America rallies its significant resources to respond with help?

Physician assistants (PAs) and nurse practitioners (NPs) have a long and proud history of participating in such responses, both on a national and international scale. So why not capitalize on such resources now? Where’s the Red Cross? Where’s the call for Medical Mission assistance? Where’s the call for PAs, NPs, and physicians with the skills needed to address this massive humanitarian and medical crisis? 

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Undoubtedly, the reason the US government is not asking for help is both political and defensive. For Homeland Security and other federal agencies to request assistance would be viewed as an acknowledgement of the difficulties that the incarcerated parents and children are facing at the border. While reporters, elected officials, and even government organizations describe the filth, the overcrowding, and the poor sanitary conditions, others dismiss those reports as being politically motivated lies and inaccuracies.

Our governmental agencies with the power make a change are lacking the will to address the problem. In January of this year, the American Academy of Pediatrics (AAP) published an article titled, “AAP pushes for appropriate medical care for immigrant children.” This piece was written in response to the news that 2 immigrant children had died under the care of Customs and Border Protection (CBP). The post reads, “The deaths of Jakelin and Felipe spurred a national dialogue about the medical care of immigrant children in CBP custody. Pediatricians reiterated that children have unique vulnerabilities that may be easily overlooked by medical professionals without pediatric expertise.”   

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“When it comes to the medical care of children, if you’re not trained in pediatric care, you don’t know what you don’t know,” stated AAP Immediate Past President Colleen A. Kraft, MD, MBA, FAAP, in an interview with PBS Newshour.2

The Academy is urging CBP to ensure all children receive the medical care they need from professionals trained in pediatric care. In the days following Felipe’s death, Dr Kraft spoke to CBP Commissioner Kevin McAleenan, sharing this message, asking questions, and offering the AAP’s expertise.

Since then, I haven’t seen any evidence that CBP has taken the AAP up on their offer. As fellow humans continue to suffer incarceration at the border, the unwillingness or inability of federal authorities to marshal help from a broad array of highly trained volunteer medical personnel such as PAs and NPs remains troubling. 


1. Miller D. AAP pushes for appropriate medical care for immigrant children. American Academy of Pediatrics. Published January 31, 2019. Accessed August 2, 2019.

2. Why children in U.S. custody need specific pediatric expertise. website. December 27, 2018.  Accessed October 2, 2019.