Whenever an illegal alien tragically dies along the U.S. border or while in detention, anti-border activists try to persuade gullible media outlets to promote their anti-law enforcement agenda. The predictable narrative is that the U.S. government treats foreign nationals poorly and the American people are responsible for any and all deaths, no matter the circumstances. The goal is to discredit immigration enforcement, the rule of law, and the nation’s sovereignty. Unfortunately, news outlets all too often go right along with the narrative, either not realizing they’re being used, or because they share the views of the anti-border groups.
Enter CBS News, which ran a number of headlines — both online and during television morning news and evening news segments — about the unfortunate death of an eight-year-old girl in May of this year. Words and phrases used in the CBS reporting to describe the situation included: “shocking lack of care”, “negligence”, “they killed my daughter”, “growing and damning evidence”, “neglect and discrimination”, a quote from an anti-border activist who claimed that the government saw the girl’s life as one that was not “worth saving”, and an unchallenged claim by the adults who brought her here that they were “discriminated the whole time” and their medical requests went ignored “because they are black”.
In her video report, CBS reporter Lilia Luciano says “If they had called the ambulance sooner, you know your daughter would be here.” She explained that the parents, “told me that despite feeling so helpless and humiliated then, they get the strength to keep fighting just thinking about any other parent having to go through what they have been going through”.
A doctor working as an independent monitor for a court overseeing treatment of children arriving at the U.S. border claimed that the death was “clearly preventable” in a new report. It is this significant claim that resulted in the flurry of reporting. And the message from the media has been clear. As one anti-border group interviewed by the Associated Press put it, “The only way to stop these preventable deaths is to stop jailing families. To stop jailing children.” In other words, just leave the border open and let everyone in. That’s the message that the media is spreading.
Here’s what really happened: Two foreign nationals decided to bring three children, one of whom was an 8-year-old girl with sickle cell disease and a history of surgery to repair a congenital heart defect, on a five-month journey from Central America through Mexico and across the Rio Grande. The 8-year-old was determined to have the flu and she and her family were transferred to a facility designated for cases requiring medical isolation for individuals exposed to communicable diseases. The U.S. government provided her medical treatment, she met with medical staff at least nine times, and an EMT was called when she had a seizure. She was brought to a nearby hospital, but unfortunately she did not survive. As the Associated Press put it, the young girl subjected to this dangerous journey was “medically fragile” but, curiously, CBS says the parents “did everything right”.
This entire conversation is about what could have or should have been done differently (though the media’s focus is only on what government employees could have done differently, even pointing out that Department of Homeland Security employees may face “criminal referrals”). Never once has the media asked why the parents didn’t seek asylum in the first country they traveled to instead of forcing a medically fragile child to “go through so much danger”, as CBS put it.
And, as expected, there has been no discussion of the fact that most illegal aliens arrive at U.S. borders having received limited or poor medical care most of their lives, many with a host of medical problems that U.S. taxpayers are expected to address with “free” medical care after a comprehensive health assessment.
There has been no discussion of the fact that many people arriving at U.S. borders have been harmed from their travels here and are not showing up in the best condition, or any discussion of the fact that many die on their way to the U.S. border.
There’s no discussion of the fact that the U.S. government spends hundreds of millions of dollars each year providing these foreign nationals medical care. In FY 2022 alone, at a time when ICE was detaining few illegal aliens on account of the Biden administration’s anti-enforcement policies, the ICE Health Service Corps had a budget of $324 million for providing health care to detained illegal aliens. (See the appendix at the bottom of this ICE report for all of the ailments treated in ICE detention facilities in FY 2020.) And that’s not including other health care expenditures of other DHS agencies. Often, the first time foreign nationals learn about medical problems they have (some of which have gone on for years) is after a health screening by DHS staff. I’m not aware of media ever writing a positive piece about this humanitarian aspect.
Media could have reported that DHS’s Office of the Inspector General reviewed deaths of aliens in CBP and ICE custody in 2022 and found that “no underlying systemic factors, policies, or processes played a role in the deaths” of 90 percent of cases.
But drama, unsupported claims, and lack of context wins out, because media reporting on detainee deaths is almost always driving an anti-enforcement, anti-border narrative.
Who Is the Monitor Responsible for the “Clearly Preventable” Claim? The report cited by the media on this death is from a Stanford University pediatrician, Dr. Paul H. Wise, who was appointed in 2019 to act as an independent monitor to review health conditions in U.S. Customs and Border Protection (CBP) facilities as part of a lawsuit against the U.S. government. Dr. Wise has an impressive medical background; his 22-page curriculum vitae is available here.
Dr. Wise may not be politically savvy enough to understand that his sweeping claim that the 8-year-old’s death was “clearly preventable” would be used for the purpose of delegitimizing law enforcement along the U.S. border. An absolute claim deserves absolute proof, especially when that claim is being presented to a court that will use it in a manner that has the potential to change national policy. The full quote from Dr. Wise is: “This report concludes that the death of this child in custody was clearly preventable.” The problem is that the report doesn’t provide any specific evidence that some treatment, care, or medication would have guaranteed the girl’s survival. As such, this statement’s lack of nuance makes it sound more political than medical.
In fact, nothing in Dr. Wise’s report shows that the government did anything wrong or violated any policies. The report contains a number of suggested changes to practices that could potentially improve the way the government provides free health care to foreign nationals arriving illegally at our borders.
While it’s entirely possible that some sort of treatment could have prevented the death of a child who was forced to travel on a five-month journey despite having sickle cell disease, a history of surgery to repair a congenital heart defect, and the flu, Dr. Wise doesn’t explain what that treatment with a 100 percent success rate would have been. And the media never asked. I pressed CBS reporter Camilo Montoya-Galvez on this a number of times, but he couldn’t point to anything in the report that explicitly lays out exactly what would have prevented this death.
It’s not surprising when media cuts-and-pastes language from a report — perhaps in an attempt to beat the news cycle or out of sheer laziness — but good reporters are supposed to question big claims and identify holes in a narrative. Most likely, media outlets found the claims in this report to be so supportive of the anti-border narrative that they didn’t want to risk undermining the narrative with basic questions. The claims were, as reporters often say, too good to check.
Is Dr. Wise Okay with His Report Being Politicized? Though he doesn’t have much of an internet presence, social media posts from Dr. Wise shows he opposed the so-called “zero tolerance” policy under the Trump administration, which was aimed at holding adults accountable for smuggling children to the U.S. border. He retweeted a number of posts from Human Rights Watch, including one that reads, “The US government shouldn’t be locking up kids.” He has written that “there is no excuse for separating children from their parents. None.”
Of course, there are plenty of instances where the U.S. government should lock up minors — Should all criminally convicted MS-13 gang members under age 18 go free, Dr. Wise? And there are plenty of instances where a child should be separated from their parents, such as in cases of abuse. When it comes to children being brought to the U.S. border, there’s no doubt that many of them have suffered because of the actions of their parents. Furthermore, it must be remembered that the word “parents” is being used very loosely here; many children are brought to the U.S. border by adults who are not their parents at all. Shouldn’t children dragged to the border by random, unrelated foreign nationals be separated from the unknown individuals?
Smugglers figured out that putting a child into the hands of an illegal alien is a method for getting the illegal alien into the United States; the children are then sent back to Mexico to serve as an entry ticket for the next illegal alien through a horrible process known as “child recycling”. Referring to these as “family units” results in bad policies and exploitation. Not surprisingly, the New York Times explains that there has been an “explosion” in migrant child labor at worksites across the nation that started in 2021 — when the Biden administration largely dissolved immigration enforcement and gutted worksite investigations. Dr. Wise hasn’t opined on this fallout from the Biden administration’s open-border policies.
The main opinion from Dr. Wise is that the girl could have received more physician consultations and that the lack of a physician consultation might indicate an “apparent lack of an appropriate protocol for assessing the custodial and medical requirements for children at elevated medical risk who are being held in CBP facilities”. He also wrote that her arrival to the border “should have triggered a close consultation with an on-call pediatrician or an evaluation at a local hospital with expertise in pediatric specialty care”. The report provides a number of recommendations about how children with elevated medical risks might be handled by the government, and some are probably good ideas.
But much of the report consists of proposals that aren’t necessarily needed, without more research. As an example, Dr. Wise writes, “There appeared to be no protocol to guide when consultation with an on-call physician was required.” Well, was there or wasn’t there a protocol? It seems like the doctor should have figured this out before reporting his findings to the court. As another example, the doctor writes, “Initial health intake interviews appear to be consistently performed on all individuals before entering the holding areas.” Again, were the interviews consistently performed or were they not? As another example, the doctor writes, “The quality assurance program appeared to be profoundly inadequate as it was not clear how the systems of care were being assessed.” If it was “not clear” to Dr. Wise, how can he assess the situation? It’s difficult to draw conclusions about policy changes from a statement like that. And yet he writes the phrase “appeared to be profoundly inadequate”, which is, itself, a conflicting mix of words; something might “appear to be inadequate” (which infers a need for greater investigation), but the phrase “profoundly inadequate” is so definite that it really shouldn’t be used after the word “appears.” Imagine the confused look on a patient’s face after Dr. Wise tells them, “It appears you have stage IV cancer that will kill you in weeks.”
The report also notes how overcrowding at the border facilities has an impact on processing aliens, generally. The doctor explains that in this particular case the time between apprehension and transportation of this family unit “was prolonged due the location of the apprehension ... and the relatively large number of families and [unaccompanied children] apprehended in this location and requiring transport.” In other words, the mass illegal immigration that has been encouraged by the Biden administration has overwhelmed border resources, and that slows down processing. Media wishing to dramatize this case (in favor of national borders) could suggest it’s possible that the child contracted the flu during this period, and argue that President Biden, Vice President Harris, and DHS Secretary Mayorkas are responsible for the girl getting sick in the first place. Media hasn’t made that argument, of course.
CBS reporters never raised a question of whether the Biden administration’s disastrous anti-border policies played a role here, they don’t question whether the parents in this case have any responsibility, they don’t push back on the unsupported racism claims, and they don’t even inquire about the asylum claims, effectively guaranteeing that more children will be smuggled and trafficked to our borders, many damaged along the way.
Death Not Clearly Preventable; CBP Concerned about Waste of Hospital Resources. The Los Angeles Times spoke with an emergency medicine physician and professor at USC’s Keck School of Medicine for her opinion, and she explained that the death was not clearly preventable. “It is hard to predict what might have happened, but certainly, she had a much higher chance of survival had she received this timely care,” said Dr. Parveen Parmar. Of course, after any death, it’s easy to say that putting a person in a hospital prior to the death might have helped — that doesn’t mean much. Any person who has died at home might have had a higher chance of survival had they been put in a hospital the week before. But we don’t put people in hospitals unless there’s a strong possibility of a medical event in the immediate future. And that’s what this particular case is largely about.
Government officials cannot send illegal aliens to hospitals simply because they request it. A decision was made about when to send this girl to the hospital based on information presented to officials and DHS policies. Dr. Wise wrote in his report that:
There appeared to be no protocol to guide when consultation with an on-call physician was required. There was also no standard practice for informing responsible BP personnel that a child at elevated medical risk had entered custody.
The monitor didn’t write that there wasn’t a protocol for consultations with on-call physicians, only that there “appeared” not to be one. So was there? That would be a central question media should be asking. Perhaps there should be an improved standard practice for dealing with aliens with elevated medical risk. That would require defining what fits into this category and creating an appropriate policy, if there truly isn’t one already.
Border Patrol reports serious concerns that detainees are being sent to hospitals without reason, which wastes taxpayer dollars and strains resources at hospitals. As the Los Angeles Times reported on a memorandum from May 22, 2023, that the newspaper obtained:
Border Patrol officials complained about the quality of medical care at the Donna facility. The staff at Donna had a “tendency to send migrants to the hospital for things that could easily be treated on location”, the investigators wrote. “For instance, persons with fevers are sent to the hospital instead of being given a fever-reducing medication at the facility,” they said. “The migrants typically return to Donna with ibuprofen from the hospital and no fever.”
The oversight office said that “it appears that the problems with medical care at Donna are costing CBP [U.S. Customs and Border Protection] and the main contractor ... valuable staff time. CBP reported to me that they have had as many as 12 agents at the hospital at once.”
A source familiar with the report on medical care at Donna who was not authorized to speak on the record said in an email that the oversight office’s description of the Border Patrol perspective on hospitalization was “an observation that more people should be treated on the spot with the appropriate level of care as intended in the contract, rather than burdening the hospital and [Border Patrol] transport staff who are needed for more emergent cases; such as those with pre-existing conditions.”
Inside federal agencies, government staff feel somewhat helpless to defend the government against the one-sided media narratives. The sense is that a statement will come across as a cold recitation of the facts surrounding the death — the government doesn’t really do warm and fuzzy — or a defensive-sounding statement about how much the government spends each year on detainee heath care. Additionally, the details of a death are often still coming in as the media goes to print, and the government doesn’t want to speak prematurely or incorrectly, out of concern for accuracy and potential legal consequences. Add to this some hesitance of the government to disclose an alien’s health history that may or may not have contributed to the death, and the result is a government agency that is often defenseless against dramatized, context-free media narratives.
No one knows what might have become of this girl had the Biden administration not encouraged her parents to bring her across multiple countries. Perhaps she would still be alive today, or perhaps her medical condition was worsening and she might have passed away around this time period anyhow. If she came down with the flu in Central America, can anyone say that medical facilities there would have been able to prevent her death? Can anyone say that sending her to a hospital in the United States would have prevented her death? There is simply no way to know that any change in CBP practice would have resulted in a different outcome.
Health Outcomes Are Never Guaranteed. A little less drama from the media over every migrant death would include some recognition that medical specialists cannot cure all ailments, and that some deaths cannot be prevented no matter how much taxpayer money the government spends on health care.
In some cases, too much health care might be to blame for a detainee’s death. In late May 2018, for example, a previously deported illegal alien arrived at the U.S. border and was promptly processed for an expedited removal. But the 62-year-old Mexican woman requested an immigration court review. Instead of being deported, she was detained and given a comprehensive medical screening; her vital signs were within normal limits except for an elevated pulse and a mildly elevated blood pressure. An x-ray indicated potential tuberculosis (TB), and a follow-up test revealed latent TB infection (which the CDC explains means the bacteria is present but isn’t causing symptoms and isn’t communicable).
She was sent to a hospital’s emergency room because the isolation rooms at the detention facility’s medical housing unit were full. A computer tomography (CT) scan of her chest was performed and it showed pneumonia. She received a medication regimen and also saw an infectious disease specialist to assist with the treatment. She remained stable and was discharged from the hospital and within days was returned to the detention center.
Upon return to the detention center, a doctor reviewed her hospital records which revealed a diagnosis of heart murmur and aortic stenosis (i.e., narrowing of the aortic valve, which the American Heart Association explains can be from a birth defect or, more commonly, a development of aging). The doctor submitted a referral for a cardiac surgeon consult for severe asymptomatic aortic stenosis. The off-site cardiac surgeon recommended aortic valve replacement surgery. Approximately two months after entering the United States, on July 25, 2018, the detainee was given heart valve replacement surgery.
At this point, most rational people would conclude that the United States acted very generously in providing this previously deported illegal alien open-heart surgery. But the day following the surgery, bleeding was observed, the patient was diagnosed with cardiogenic shock and was returned to surgery to replace the aortic valve prosthesis. During the operation, she went into a cardiac arrhythmia and died. After her unfortunate death, anti-border activists blamed the U.S. government for poor treatment of detainees and used it as an argument against ICE and immigration enforcement, generally.
This case represents a perfect storm of medical ethics, politics, and immigration policy, raising many questions about how the United States should respond in situations like this. Should the government err on the side of caution when allowing a detainee to get surgery? Should the government conduct a complicated risk analysis before any alien is sent to a hospital?
Specific to the medical situation in this case, there’s some debate in the medical field about when a person with severe asymptomatic aortic stenosis should undergo heart valve replacement surgery (e.g., “The optimal timing and modality of intervention in asymptomatic severe [aortic stenosis] (ASAS) remain controversial. Premature intervention may predispose individuals to unnecessary risks of [aortic valve replacement], while irreversible cardiac damage, with resultant heart failure (HF) or even death, may precede delayed intervention.”)
On the one hand, DHS doesn’t want to ignore a diagnosis and then face blame should a detainee die at some point in the near future from the condition. On the other hand, quickly signing off on a major surgery always comes with some risk; should the surgery fail, DHS risks being blamed for the death.
In theory, a government has options in cases like this: It could deny a court hearing for previously deported aliens; it could decide against offering medical procedures that carry a certain amount of risk; it could recommend detainees return to their homelands to undergo certain medical procedures; it could speed up hearings requested by detainees needing medical attention so that their presence can be resolved in advance of any surgery. There are bureaucratic, ethical, and legal reasons why these options may not be available or advisable, of course.
In this case, had a court ordered her released into the United States or ordered her removed, she might have sought medical treatment on her own either in the United States or Mexico depending on the ruling. Had she been quickly deported or released and died outside of ICE custody, her death wouldn’t necessarily have been on the hands of the U.S. government or the U.S. taxpayer, and therefore it wouldn’t have been used as a political weapon. But the truth is that no one can tell the future, and it’s entirely possible that this woman might still be alive had she never undergone the surgery. The right answer is never easy and the media should acknowledge some of these issues when reporting on a detainee death.
But if the United States is going to conduct health screening for every person who enters the country illegally and American taxpayers are going to provide these individuals medical treatment ranging from dental care to open heart surgery, as they do, the media should recognize that this generous policy is not always going to result in perfect outcomes.
Conclusion. It is easy to argue that the U.S. government can improve health care for foreign nationals crossing our border illegally — improvements can always be made. The question is how far the U.S. taxpayer should be expected to go in providing this expensive care.
If Americans want the government to build massive, cutting-edge medical facilities across the southern border to provide world-class, taxpayer-funded health care to anyone who shows up, Congress can fund that. If Americans want CBP and ICE detention facilities to provide the same amenities as a five-star resort, including highly advanced medical care, Congress can fund that, too. Congress has already spent billions of taxpayer dollars providing health services to foreigners with no connection to the United States who show up at our border. Professionals working at federal agencies are doing everything they can to provide quality service. Things can always be improved, but the media should stop embracing the talking points of anti-border activists who will never accept any level of enforcement of our nation’s laws, no matter how much health care is provided.
The media’s unquestioned and complete embrace of adults smuggling children to the United States will only result in more smuggling of children and more tragedies. If the media actually wanted to put an end to the largest child smuggling operation in world history, one would see many more articles about the harm caused by the Biden administration’s policies. Media would question why such policies continue and would force Biden administration officials to defend the chaos they’ve crated. Media would do deep dives into what’s become of the massive numbers of children that have been brought across our nation’s borders after being handed off to random sponsors. There are so many horrible things being unleashed by the Biden administration that are going ignored by media outlets that claim to be operating from a humanitarian perspective.
The chaotic conditions created by the Biden administration are not making things easier for career staff doing their best to manage the massive caseloads before them. Less drama from the media, and a greater willingness to question open-border policies would go far in getting our immigration system to a better place.