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 The families of the children "indicated that they had albuterol in
their possession that was confiscated and replacements were not
supplied," said Dr. Noy Halevy-Mizrahi of Stony Brook University,
coauthor of the report in Pediatrics. "We wanted to bring awareness
to this topic. Our main message is one of advocacy. We wanted to
make sure to alert other physicians who might be caring for these
patients."
The first patient was a school-aged-girl with a history of mild
intermittent asthma who had immigrated from Central America two
months before she showed up in a Long Island emergency room with
severe breathing problems due to unremitting asthma attacks. When
examined, the girl was also found to have viral pneumonia,
Halevy-Mizrahi said.
The second child, a 7-year-old boy, showed up in the ER also with
severe unrelenting asthma attacks. The boy, who had a history of
moderate persistent asthma, also had the flu. He, too, had his
albuterol inhaler confiscated by the border patrol and was not given
a replacement.
Because they were so sick, the two children were admitted to the
intensive care unit.
While the blame for the children's illnesses can't be placed
entirely on their lack of inhalers, "we do think this is an
important factor contributing to the severity of their
presentations," Halevy-Mizrahi said. "The confiscation of albuterol,
which is vital to the health maintenance of asthmatic patients,
placed these children in vulnerable conditions."
Not having an inhaler "contributed to the severity of their clinical
presentation when they did ultimately seek treatment,"
Halevy-Mizrahi said.
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Halevy-Mizrahi and coauthor Ilana Harwayne-Gidansky suggest that
when pediatricians are confronted with similar cases of migrants
sickened because their medications were confiscated and not
replaced, they should report these cases to U.S. Customs and Border
Protection Information Center, the Department of Homeland Security
(DHS) Office of Civil Rights and Civil Liberties, or the DHS Office
of the Inspector General.
In addition, the authors write, "pediatricians should feel empowered
to work with representatives in congress and their local districts."
News reports have described border patrol agents confiscating other
life-saving medications from migrant children, including insulin and
epilepsy drugs, the authors note.
The new report is "depressing," said Dr. Albert Wu, an internist and
professor of health policy and management at the Johns Hopkins
Bloomberg School of Public Health in Baltimore, Maryland. "The
confiscating of an asthma inhaler or other essential medication from
a child seems cruel, misguided and possibly criminal," Wu said. "I
think this represents a direct assault on the health of people - and
they are people - crossing the border."
"This kind of behavior should be condemned and the workers
punished," Wu added. "This is not who we are."
SOURCE: http://bit.ly/2DFBcYf Pediatrics, online December 3, 2019.
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