This is a call for congressional hearings concerning the health and safety of recent illegal border-crossers, especially children, the persons who care for them, and the people of the communities to which they are sent. Citizens and local officials are not receiving adequate information from federal agencies, and Border Patrol officers and medical personnel have reportedly been threatened with firing or even arrest if they speak out.
Whistleblowers must be protected.
Public health questions that require urgent answers include but are not limited to the following:
1. Where are the migrants from? Public health officials need to know because of outbreaks of Ebola in West Africa, chikungunya virus in the Caribbean, dengue fever in much of Latin America, and multiple-drug-resistant tuberculosis. Leprosy is endemic in Mexico.
2. What health screening is done? What are the results? Do public health officials of the communities receiving migrants think it is adequate? Is the quarantine period long enough? (For example, it may take 21 days for a person infected with Ebola to feel sick.)
3. Are proper sanitary and isolation practices observed? For instance, are public transportation vehicles inspected for lice and mites and adequately treated? Are they effectively sanitized to prevent transmission of bacteria and viruses that survive on surfaces? Are proper precautions in place at reception centers and shelters to prevent outbreaks of infectious diseases such as viral gastroenteritis, influenza, Streptococcal disease, hepatitis, measles, etc.?
4. How will contact tracing be done for diseases discovered after a migrant enters the community? For diseases such as tuberculosis or measles, public health authorities try to track or warn all persons who might have been exposed on an airplane, in a medical facility, in a public place, etc. How are migrants identified, and how is their location known?
5. If persons who are in custody become ill and require emergency treatment, such as intravenous rehydration, what facilities are available, and who pays?
6. Are law enforcement officers or medical personnel restrained from communicating about problems? If so, who gave this order and why?
7. Are public health authorities and local physicians briefed on any problems? Note that most non-dermatologists do not know how to recognize early leprosy, and most American physicians are unfamiliar with dengue, chikungunya, Ebola, malaria, Chagas, and other diseases common in tropical, poor countries.
8. Who has custody of minors here without their parents? Who is responsible for safety, medical decisions, and communication with families, as well as nutrition, education, and shelter? If private contractors are involved, who are they, and to whom are they accountable?
For questions, please contact:
Jane M. Orient, M.D.
Executive Director, AAPS
1601 N Tucson Blvd Suite 9
Tucson, AZ 75716