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June 27, 2019


The Honorable Alex Azar
Secretary of Health
U.S. Department of Health & Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201


The Honorable Kevin McAleenan
Acting Secretary of Homeland Security
U.S. Department of Homeland Security
Washington, D.C. 20528


The Honorable Greg Abbott
Office of the Governor
P.O. Box 12428
Austin, Texas 78711-2428


Dear Secretary Azar, Acting Secretary McAleenan, and Governor Abbott:


No child, and especially no child on American soil, should ever be put in a position in which they are scared, hungry, sick, cold, feel unsafe, or experience life-altering trauma. Yet many of us across the political spectrum have watched with increasing horror as conditions continue to deteriorate at our border for children of all ages seeking refuge and asylum in the United States. 


In the words of former First Lady Laura Bush: “Americans pride ourselves on being a moral nation, on being the nation that sends humanitarian relief to places devastated by natural disasters or famine or war.” There is a public health emergency unfolding at our own border, impacting hundreds of children, and our nation’s leaders must respond swiftly and effectively.


Congress has passed a humanitarian aid bill, but it will take time to organize and implement the funds to make a difference in the lives of these children. The Department of Health and Human Services and the Department of Homeland Security must work together in the short-term to resolve the immediate crisis.


1. We call on Secretary Azar to deploy the Public Health Service Commissioned Corps and on Governor Abbott to deploy the Texas Medical Reserve Corps of volunteers to provide immediate medical care and services to the children in federal custody, in response to this public health and humanitarian crisis. While the legislation provides funding for health services, this will take months to process and procure. Reports indicate that the basic healthcare needs of these children are not being met, including adequate treatment for influenza, which can be life-threatening for vulnerable children, and lice infestations. The Commissioned Corps and volunteer Medical Reserve Corps can provide this care and facilitate appropriate transfers of extremely sick children to local hospitals to avoid future loss of life, pending further support from Congress. 

2. We call on Secretary Azar and Acting Secretary McAleenan to coordinate agency efforts to ensure: 

    a. Humane and safe living conditions for those detained while seeking asylum in the United States. This must include: medical care and basic hygiene, licensed and trained caregivers who have completed appropriate background checks, access to legal and translation services, and resources to ensure that children can be timely reunited with a parent, legal guardian, or adult relative, or transferred to a licensed facility for unaccompanied minors within three to five days, consistent with the Flores Settlement. 

     Humane treatment must include, but not be limited to: access to clean water for drinking and washing; soap; toothbrushes and toothpaste; beds with mattresses, pillows, and blankets; toilets; menstrual pads and tampons; breastfeeding/nursing pads; clothing; diapers and wipes; and bottles with formula.

     b. Rapid development of an inter-agency system to expedite reunification of children and their parents or other potential sponsors. Family reunification is in the best interest of the child and will reduce the need for further federal spending to shelter and care for them. 


As our political leaders work towards a sustainable immigration solution, we must not lose sight of who we are as Americans. No child in crisis should have to wait to have their basic health and safety needs met.



Maya Uppaluru

Former Policy Advisor, White House Office of Science and Technology Policy

Amira Choueiki Boland


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