Close to 60,000 children have crossed illegally into the U.S. since last October. They're sparked a crisis. But is it a humanitarian crisis or a public health one?
The children carry "swine flu, dengue fever, Ebola virus, and tuberculosis" and can spread the disease to the U.S., wrote Rep. Phil Gringrey (R-Ga.), a retired obstetrician-gynecologist, in a July 7 letter to the Centers of Disease Control and Prevention.
Gingrey's concerns have been widely circulated as part of a public campaign by folks who share his view that the kids should be sent back. And some of the points he's raised have been widely rebuffed. The current Ebola outbreak has been confined to Africa, as have past outbreaks. And neither dengue nor the "kissing bug" disease known as Chagas, which was brought up by others, spread from human to human. Transmission involves bugs and dogs.
But some health issues in this contentious debate require closer examination. There have, for example, been a handful of reported cases of TB among the children. And concerns that the children may not have been vaccinated - or may harbor scabies and lice - aren't as absurd as the Ebola claims.
A TB epidemic is perhaps one of the biggest concerns, since the U.S. doesn't vaccinate against the disease. The fear of a fatal respiratory disease that attacks the lungs and can spread through the air is understandable.
But the facts on the ground do not back up such worries. All children who arrive at a border station are screened for TB with skin tests and chest x-rays; those infected are immediately isolated and treated. So far this year, only three TB cases among unaccompanied children have been reported by federal officials to the Texas Department of State Health Services, says spokeswoman Carrie Williams. And only one case in Arizona, according to a report by Pima County Health Director, Francisco Garcia.
Such low numbers are not cause for alarm, given that Arizona already sees about 200 cases of TB a year, and Texas sees nearly 1,300.
What about the possibility that the children could spread measles and mumps? Gingrey wrote that many children come from countries that lack basic vaccinations, which would pose a risk to unvaccinated Americans.
The general public may well believe that vaccines are hard to come by in low- and middle-income countries, but that's not always the case.
"The primary care system in developing countries is more effective than in the U.S. — better than people think," says Irwin Redlener, a pediatrician at Columbia University and cofounder of the Children's Health Fund, which provides health care to the disadvantaged.
To be on the safe side, all children are vaccinated during their short stay at processing facilities in Texas and Arizona. That happens at least three days before they're sent to different shelters around the country, says Kenneth Wolfe, a spokesman for the Department of Health and Human Services, in an email.
"Like any shelter system, when you have a group of people or children living [together], there's always theoretical risk of spreading diseases," says pediatrician Alan Shapiro, who cofounded an immigrant youth clinic in New York, called Terra Firma. But those risks, he adds, usually remains within the shelter and won't spread to the community as long as good primary care is provided.
Since October, Shapiro's clinic has provided physical and mental health care to nearly 50 unaccompanied children now living with a family or sponsor. He says there's no need to worry about a spread of contagious diseases. "The children that I see for the most part have a good experience in the shelter," he says. "The facilities have been more than adequate and they are seen by medical personnel and getting vaccines."
Some kids have even brought immunization records from their home countries, he says. At the processing centers, vaccinations are updated: everything from measles, mumps and rubella to tetanus, whooping cough and polio.
As a cautionary measure, all detainees are evaluated right at the border to stop any potential disease from spreading as early as possible.
They're screened at least once - first by a border patrol and then by physicians, if necessary — for signs of any disease. This includes rash, fever, persistent coughing, vomiting and diarrhea, says Jessica Maxwell, a spokeswoman for the Department of Homeland Security, which works with border patrols.
The incidence of infectious diseases is very low, she says. The more common issues are related to traveling: dehydration, heat exhaustion, foot and ankle injuries, lice and scabies, which are treatable. Children who have medical problems may be transferred to a hospital for treatment.
Aside from the TB cases, there have been there have been three flu cases and a few gastrointestinal and respiratory issues at the McAllen Processing Center in Texas, says Williams. Of the 4,000 unaccompanied minors processed in Nogales Processing Center in Arizona, there were two flu cases and two chicken pox cases, reports Garcia, who noted that the risk of spread beyond the shelters is low.
That's not to say there are no health issues among the kids; it's just that none pose a threat to the public.
The centers haven't been perfect. Texas health officials who visited the McAllen facility two months ago reported overcrowding as well as a lack of full medical scans and hand-washing stations. But Williams says better care is now being provided, partly because fewer immigrants are arriving.
Meanwhile, the "fear mongering," as Shapiro calls it, takes attention away from the bigger issue at hand: mental health.
"These are children who are coming over to escape the violence that absolutely pervades the community [back home]," he says. During their journey they are at risk for abuse by Mexican gangs. In the U.S., they must adjust to a new environment and unfamiliar faces.
"There's such incredible amount of change that these children have to go through during a relatively short period of time," he says. "The amount of trauma or stress cannot be understated."
Detroit moved one step closer toward bankruptcy after crossing a major hurdle on Monday.
With a large margin, retired police and firefighters approved modest cuts in their pensions that are part of the city's bankruptcy plans.
"About 82 percent of retired and active Detroit police and firefighters who voted overwhelmingly approved the city's plan to reduce their inflationary increases but preserve their base pensions, according to balloting results filed late Monday night in U.S. Bankruptcy Court.
"Members of the General Retirement System approved the city's plan on a margin of approximately 73 percent yes, 27 percent no during a historic 60-day vote that ended July 11, the results show. Detroit's plan calls for base pension cuts for GRS members of 4.5 percent.
"Detroit also got 88 percent of retirees owed lifetime health insurance benefits to accept $450 million for a $4.3 billion liability — one of the biggest debts the city could shed if the reorganization plan is approved by U.S. Bankruptcy Judge Steven Rhodes."
The Detroit Free Press reports that city retirees also endorsed the city's plan to allow the Detroit Institute of Art "to spin off as an independent institution."
The support of city pensioners was seen as a major hurdle toward a successful bankruptcy. As the News puts it, a year ago, this kind of support was seen as "inconceivable."
The Free Press quotes University of Michigan bankruptcy law professor John Pottow as saying that the city's emergency manager Kevyn Orr must be very happy.
"Orr's got to be having a little celebration tonight," Pottow told the paper. "It's not over yet. They've got to go to court and have another fight. But the big pieces are falling into place. This is exactly what Judge Rhodes is going to want to see."
Good morning, here are our early stories:
And here are more early headlines:
Rain Could Help Ease Threat Of Western Wildfires. (AccuWeather)
Deadlock Ends In Cambodian Political Crisis. (Bangkok Post)
Police Find Body Of Capsized South Korean Ferry Owner. (Bloomberg)
Current, Retired Detroit Workers Approve Cuts To Pensions. (Detroit News)
Georgia Republicans Hold Senate Runoff Election Today. (ABC)
Senate Panel To Open Confirmation Hearings For VA Nominee. (The Hill)
Montana Judge Faces Reprimand Over Rape Remarks About Victim. (AP)
Chicago Cubs Suing 2 Imposter Mascots Who Misbehaved. (Chicago Tribune)
As Israel's offensive against Hamas entered its 15th day, Secretary of State John Kerry was in Cairo pressing for a truce modeled after the 2012 cease-fire.
Still, the violence continued unabated with the death toll on both sides rising: More than 500 Palestinians and 25 Israeli soldiers and two Israeli civilians have been killed.
With that here's what you need to know:
— Later today, Israeli Prime Minister Benjamin Netanyahu was scheduled to meet with U.N. Secretary-General Ban Ki-moon.
"Ban was traveling to the region to discuss [an] effort to reach a cease-fire between Israel and Hamas in the Gaza Strip," the Jerusalem Post reports.
— Reuters quotes Justice Minister Tzipi Livni, the prime minister's most dovish cabinet member, saying "a ceasefire is not near."
"I see no light at the end of the tunnel," the wire service quotes her saying.
— In Gaza City, USA Today reports that this Israeli offensive has "led many Palestinians to express their support for Hamas." The paper reports:
"'We faced two Israeli wars before but this one is the most bloodiest and most cruel,' said Abu Awni, 38, of Gaza City. 'Civilians are attacked in their homes. I'm against Hamas, but when Israel is killing my family, then I will join Hamas.'
"'The world must wake up and stop consuming Israeli propaganda,' he added. 'More than half of the population in Gaza is not affiliated with Hamas. But we have been collectively punished.'"
— The Washington Post reports Israel says one of its soldiers is missing, but it is not known if he is dead or alive.
"The development," the paper reports, "could complicate diplomatic efforts underway to stop the conflict between Israel and Hamas as it enters its third week."
— NPR's Emily Harris visited Al-Aksa hospital in the middle of the Gaza strip that was shelled yesterday.
"Four people were killed, according to hospital officials," Emily tells our Newscast unit. "Israel says it's 'initial investigation suggests' anti tank missiles were stored nearby."
"It's clear that more than one rocket or shell hit the hospital. Judging by the pattern of shrapnel gouges in the concrete and charr marks on the ceiling, it looked like at least two rooms on the fourth floor were directly hit. At least one missile travelled through three rooms, making a series of holes in a walls. Other rooms had broken windows, broken beds. Supplies were on the floor, the ceiling lights were twisted. There had been shelling in the area - I could see a building close by was also hit. And it smelled different that the rest of the hospital," Emily reported. "On the ground floor, when we came in, someone was mopping and its smelled sort of soapy clean. Upstairs, as soon as we entered the hospital units that were damaged, it was dusty, chalky kind of smell."
— Correspondent Daniel Estrin tells our Newscast unit that the Israel's military says it has killed 10 militants today "who had infiltrated Israel through tunnels." Israel also said that militants fired at least a dozen rockets into Israel today. For the first time, one of those rockets landed in the Tel Aviv area.
"Dammit, why is this happening to me? I mean, this shouldn't happen to people like me."
This desperate question from a beloved character (Rose) on a beloved show (The Golden Girls) is the defining moment in yet another landmark episode in the critically-acclaimed series. The show known as much for its hilarious comedy as for fearlessly venturing into taboo TV territory was tackling its next sensitive topic: AIDS.
In "72 Hours," Rose receives a letter alerting her that she may have contracted HIV from a blood transfusion during gallbladder surgery six years earlier, and she is advised to get a test. As she waits for the results, worry and a deep-rooted panic take hold, and a pivotal scene takes place between the delightfully dimwitted Rose and saucy Southern belle Blanche.
Rose's dialogue embodies several misconceptions about HIV infection, pervasive at the time: that "people like her" — an older, middle-class, heterosexual, "innocent" woman — shouldn't get such a disease, that none of her friends will want to associate with her now, and that she is being punished for some kind of bad behavior.
To which Blanche thoughtfully replies, "AIDS is not a bad person's disease, Rose. It is not God punishing people for their sins."
In 1990 when the episode first aired, AIDS testing was still relatively new; just five years prior the FDA licensed the first commercial blood test. Since 1981, over 100,000 deaths from AIDS had been reported to the CDC by that year — almost one-third of them during 1990. It was a scary time, and despite efforts to educate the public, myths and misinformation ran rampant.
Cue the ever-tactless Sophia, who reacts by using Dorothy's bathroom so she won't have to share one with Rose and prominently marking her coffee cups with an "R." The kind of groan-worthy moments of TV that make you want to crawl under the couch. After a verbal slap from Dorothy, Sophia admits, "I know intellectually there's no way I can catch it, but now that it's so close to home, it's scary."
But this is what The Golden Girls was so good at: bringing home those topics that often made people uncomfortable — racism, homosexuality, older female sexuality, sexual harassment, the homeless, addiction, marriage equality and more — and showing us how interconnected and utterly human we all are at any age. Served, of course, with that delicious trademark humor that infused the show throughout its groundbreaking, taboo-busting seven-season run.
In true kick-ass Golden Girls fashion, the storyline reinforces the importance of friendship — in this case, staring into the face of a terrifying disease. Because, of course, Blanche, Dorothy and Sophia showed up at the hospital while Rose took the HIV test and supported her during the nail-biting, three-day wait for the results.
Then the happy ending: Rose gets the all-clear and we've all had a hearty laugh. But in 21 minutes we've also learned something: AIDS is not just a "gay disease" and it can happen to anyone. Understanding is vital. A pretty good lesson from a show about four older women living together in Miami, Fla., don't you think?
Watch the full episode here.