ARI SHAPIRO, HOST:
Department of Homeland Security Secretary Kirstjen Nielsen traveled to the southwest border today. She went to see conditions for herself after two migrant children died this month while in the custody of Customs and Border Protection. Nielsen has promised improvements. And as NPR's Joel Rose reports, local health care providers want to play a bigger role in caring for these children.
JOEL ROSE, BYLINE: Up and down the border, volunteer doctors and nurses are caring for the record number of migrant children and families arriving every day.
MARCELA WASH: We feel overwhelmed.
ROSE: Marcela Wash is a nurse in San Diego. She's coordinating medical screenings and care for migrants at local shelters. Wash told member station KPBS that some of these migrants are sick when they're released from federal custody.
WASH: They come over not having bathed for three or - days, however many days they've been in detention. Some of them arrive with upper respiratory problems, nausea or vomiting.
ROSE: Two migrant children have died this month. Eight-year-old Felipe Gomez Alonzo had the flu, according to an autopsy by the New Mexico medical examiner. Officials say 7-year-old Jakelin Caal Maquin was dehydrated and had similar symptoms. Both children came from Guatemala with their fathers and crossed the border illegally. Their deaths have raised new concerns about the quality of medical care at Border Patrol facilities.
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KEVIN MCALEENAN: This is just devastating for us.
ROSE: Customs and Border Protection Commissioner Kevin McAleenan and spoke to CBS earlier this week. He says he's concerned too.
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MCALEENAN: We've got over 1,500 emergency medical technicians that have been co-trained as law enforcement officers. They are - they work every day to protect people that come into our custody. We're doing dozens of hospital trips every single day with children that have fevers or manifest other medical conditions. And we've asked for help.
ROSE: Homeland Security Secretary Kirstjen Nielsen has also promised, quote, "extraordinary protective measures," unquote, for migrant children in custody. She's visiting the border today and tomorrow and meeting with Border Patrol agents and local health care providers. But pediatricians on the border say they've been raising these concerns for years. Marsha Griffin is in the Rio Grande Valley. She's a spokeswoman for the American Academy of Pediatrics.
MARSHA GRIFFIN: It's not a place for a well child, much less a sick child.
ROSE: Immigration authorities rarely allow visitors inside these facilities. But Griffin has gotten into some of them. She recalls touring one in south Texas in 2016.
GRIFFIN: We passed mounds of teddy bears and security blankets that were taken from the children because they might have scabies or lice. The lights are on 24 hours a day. The children sleep on thin mats on the floor with only a Mylar blanket.
ROSE: Griffin says the American Academy of Pediatrics has been trying to raise some of their concerns with the Border Patrol without success. But now, after the deaths of two migrant children, they are talking about how to work together. Pediatricians say early medical screenings are crucial for migrant children.
CARLOS GUTIERREZ: In a child, an infection or a medical condition can get worse within hours.
ROSE: Carlos Gutierrez is a pediatrician in El Paso. When the number of migrant children spiked before, back in 2014, he says local doctors and nurses were allowed to give these screenings at Border Patrol facilities. He is hoping to be able to do that again.
GUTIERREZ: It's a better chance of us preventing a catastrophe if we see them earlier. If we're allowed to get in there, things such as the death of the two children that we've heard about, they probably wouldn't have happened. Those are needless.
ROSE: Gutierrez is one of about two dozen local doctors and nurses who are giving free medical exams at local shelters. But that's only after migrant children and parents have been released from Border Patrol custody, sometimes nearly a week after they've crossed the border. Joel Rose, NPR News.