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Carlos is Gone, But We are Here

Sara H. Goza, MD, FAAP and Kyle Yasuda, MD, FAAP
December 6, 2019

Yesterday, ProPublica released a video depicting 16-year-old Carlos Gregorio Hernández Vásquez’s last minutes alive. He fled Guatemala seeking safety in the United States. He died seven days later, on May 20, 2019 - just seven months ago – of the flu.  

The video is horrifying. It shows Carlos writhing in agony on the cold concrete floor in what is essentially a jail cell, where Customs and Border Protection (CBP) officials chose to put him despite him being extremely ill from influenza. There are several crumpled silver mylar blankets strewn about on the ground, including one draped over Carlos’s sleeping cellmate. No beds. No blankets. No pillows. No doctors to monitor his condition.

At one point, Carlos stands up and collapses, then staggers, disoriented, toward the toilet in the back of the cell where he slumps to the ground in a heap and stops moving altogether. His cellmate—just a teenager himself—wakes up four hours later to find Carlos unresponsive in the same position. You can see his desperation and anguish as he calls to CBP agents for help. He will likely live with this trauma for the rest of his life.

We both visited our southern border this past June, just a few weeks after Carlos died. While we were there, we visited a shelter run by the Department of Health and Human Services’ Office of Refugee Resettlement (ORR). What we were told by a staff member there has haunted us every day since: a shelter called Casa Padre had two beds available for Carlos and his cellmate, which had been communicated to CBP.

ORR shelters are nothing like the jail cell Carlos died in; they provide medical care and accommodations specifically designed for children. Some can even isolate children, like Carlos, who have an infectious illness. Why Carlos was not transferred to Casa Padre so that he could convalesce in a more appropriate environment is no doubt the subject of federal investigations looking into his tragic death.

It is our sincere hope that CBP will be transparent about the circumstances surrounding Carlos’s death, that appropriate steps are being taken to support his grieving family, and that the federal government is providing adequate trauma-informed care to the teenage boy in the video who found Carlos without a pulse.

As the holidays approach, our hearts goes out to Carlos’s family and all who knew him.

Newly released video shows 16-year-old Carlos Gregorio Hernández Vásquez, extremely ill with the flu and dying on the floor of a Customs and Border Patrol jail cell. In #AAPvoices, @AAPPres Drs. Kyle Yasuda and @SallyGoza call for better protections for immigrant children and basic humanitarian standards in CBP facilities.

CBP processing centers are no place for a child, and certainly not one with flu. At the CBP facility called Ursula our delegation visited in June, you were immediately confronted by overwhelming sensory responses upon arrival. The smell of urine, feces and sweat. The sight of what looked like a sea of silver, which was really just mylar blankets completely covering the concrete floors. You could hardly tell that children were underneath them. The only sound was crinkling mylar as they moved – no talking, no laughter. There were so many children with bloodshot, bulging eyes, expressionless and exhausted. There were no private exam rooms or appropriate spaces for ill children to rest and receive care.  

As horrifying as these conditions are, what’s now happening to immigrant children and their families is even worse due to the Trump Administration’s so-called “Migrant Protection Protocols,” or MPP. With no thought to the dangers children would face in Mexico and no mass-scale humanitarian response, the Department of Homeland Security is right now forcing all families seeking asylum in the U.S. to instead return to Mexico to await their hearings. Media reports indicate that the administration has sent more than 60,000 families back to Mexico.

Faced with abductions, gang rapes, kidnappings and murders in Mexico, parents are making the heart-wrenching decision to send their children across the border alone because MPP is not supposed to impact unaccompanied children. This policy must be ended right away.

“Carlos is gone, but we are all here together, and we must use our voices to urge our elected leaders to prevent what happened to Carlos from ever happening to another child ever again”

It is our hope that policymakers and the media will keep shining a light on what is happening to children in Mexico. The release of this video of Carlos should incite us all to speak out, not just for a transparent and fair investigation into his death, but also for an immediate end to MPP and immediate passage of H.R. 3239 and S.2135, legislation passed by the House in July and currently held up in the Senate which would require basic humanitarian standards in CBP facilities like the one where Carlos died.

Until these things happen, what can be done?

Carlos is gone, but we are here, with a pen and a platform, on behalf of 67,000 pediatricians who care for children every day, to share his story.

Carlos is gone, but you are here too, reading these words and watching his final moments, bearing witness to what happened to him and what is happening to other migrant children right now.

Carlos is gone, but we are here together, and we must use our voices to urge our elected leaders to prevent what happened to Carlos from ever happening to another child ever again.

It’s all we can do, and it’s what we must do.

* The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics.

About the Authors

Sara “Sally” H. Goza, MD, FAAP, is the 2019 President-Elect of the American Academy of Pediatrics. Dr Goza is a general pediatrician and has had the privilege of taking care of children in her hometown of Fayetteville, Ga., for over 30 years. She is a managing partner in First Georgia Physicians Group.

Kyle Yasuda, MD, FAAP, is the current resident of the American Academy of Pediatrics. Dr. Yasuda formerly worked in primary care pediatric practice for 18 years prior to joining the University of Washington School of Medicine where he served as clinical professor of pediatrics for 16 years and medical director of the associated pediatric clinics.