Disrupting Immigrant and Pediatric Care

Routine surgeries performed as preventive care, such as putting in ear tubes or taking out tonsils and adenoids, are not normally associated with dire consequences, but the conditions they are designed to prevent can be extremely dire. Ear tubes, for example, are recommended because the child is having too many ear infections—not treating this can spread infection and/ or lead to permanent hearing loss. When you don’t treat conditions early on, they can give rise to bigger problems— possibly sleep apnea, hearing loss, speech delays, head and neck tumors, and thyroid disease, as examples.

There is also the important issue of vaccinations, a key aspect of preventive care. As a family medicine physician, Dr. Madaras emphasized that despite recent changes in vaccination recommendations, many essential vaccines are still advised. He highlights one vaccine that is particularly critical in the ENT field. “Since the 1990s, we’ve not had cases of Haemophilus influenzae B because we had the HiB vaccine that is given at well child checkups,” he said. “I was a student in the late 1980s, and we used to see epiglottitis due to this strain of the H. flu bacteria, which necessitated antibiotics and steroids, and sometimes we needed to open a patient’s airways. Now, due to this vaccine, I haven’t done a cricothyrotomy in almost 20 years.” Dr. Madaras expressed concerns about parents now balancing their desire to have their child vaccinated with the risk of an ICE encounter. “Preventable diseases may become problematic and more common, causing unnecessary suffering,” he said.

Circumstances within detention centers pose additional risks. “If you round up a bunch of folks—whoever they are, immigrants or non-immigrants— and put them together in detention centers in close circumstances with locked doors and windows, you risk their health. For example, if one person has active tuberculosis, many of them will soon have TB as well,” Dr. Madaras said. “We are already seeing this with an even more rapidly contagious infection: measles.”

Anne Messner, MD, professor at Baylor College of Medicine and chief of pediatric otolaryngology at Texas Children’s Hospital in Houston, shared experiences of seeing patients held at ICE detention centers. “Several kids have been brought to us for hearing loss. Some of these kids would greatly benefit from hearing aids, and we do our best to obtain aids for them, but we are not always successful,” she said. “This is especially the case because often, by the time we get the appropriate aids, the children are no longer in the area.”