by Asma Fazal, MD, MRCPI, MHSc

Offering sanctuary to those fleeing conflicts is the most pressing human rights issue in the world today. Conflicts divide communities, deteriorate social relations, and undermine a family’s capacity to care for its most defenseless members, i.e., children. The most recent example is the crisis at the US-Mexico border.

American Civil Liberties Union (ACLU) reported that under the current US administration’s zero-tolerance immigration policy, almost 2,654 children were separated from their families at the US-Mexico border as an act to discourage border crossing. This practice continued until a federal judge ordered that the government reunite families who had been separated at the US-Mexico border. Within weeks, thousands of parents were united with their children. However, the parents of 545 children still cannot be found. As a pediatrician and mother, this situation is very heart-wrenching.

In the 21st century, armed conflicts have grown significantly. The disturbing fact that most modern-day conflicts are domestic, like in Mexico, makes children at particular risk. Combat takes place in homes and streets and involves acts of extreme ruthlessness and personal violence. As a result, many people, including children, are forced to migrate, impacting their health and wellbeing. The forced migration of children has a serious impact on their development. They suffer the most and face brutal violations of their human rights.  

The existence of a family unit is essential for child survival, especially during conflicts. In their “Detention of Immigrant Children policy,” the American Academy of Pediatrics (AAP) urged that children should not be separated from their parent or primary caregiver unless they are at risk of harm from the parent.

It is well known that persistent, highly stressful experiences during childhood, like displacement from one’s house and family separation, cause long-term injury to the developing brain and harm general health as the displaced household suffers a substantial reduction in food provision and worsened access to water and sanitation. Hunger and malnutrition, poor sanitary conditions affect the growth and wellbeing of children. Children residing in the conflict zones are susceptible to different communicable diseases. The situation does not get better after they flee from their country. In the host countries, governments usually treat arriving migrants as a problem. Children that are separated from their families at the border and are kept in the refugee camps and detention do not have access to adequate medical care. In the absence of their parents or caregivers, children become increasingly susceptible to abuse, exploitation, abduction, physical and mental health problems, and death. They feel a permanent loss and powerlessness. This feeling may manifest in developmental regression (bed-wetting, fear, loss of language). Conflicts can also profoundly impact a child’s cognition, including memory, problem-solving and moral reasoning, emotional expression, and social development (parent-child interaction, peer and sibling relations). Evidence suggests that childhood trauma does affect brain anatomy and function and hormonal and psychophysiological regulation, which permanently changes the developmental pathways. Childhood mistreatment is associated with psychiatric symptoms such as post-traumatic stress disorder (PTSD), depression, anxiety, sleep difficulties, somatization, and stress.

Fair and just societies protect children. It is our moral obligation to protect and welcome children from conflict zones. This obligation is grounded in our commitment to upholding basic human rights, as recognized in article 33 of the 1951 Refugee convention. Accepting more refugee children with their parents should be regarded as a distinct expression of the fundamental principles of freedom and equality. The human rights of children are both moral and legal. As moral rights, they are obligatory even if states choose to ignore them, while, as legal rights, they are established by international treaties. When a country is under conflict, neighboring countries have to step up and provide asylum to refugees, especially children, and provide necessary facilities to the refugees while ensuring their family unit is preserved. Other distant countries are responsible for providing economic and other forms of assistance to the neighboring countries and sharing the burden. In host countries, children should not be discriminated against based on status and should not be stigmatized. They should receive appropriate protection should be able to enjoy all international refugee and human rights without discrimination fully. 

Whether refugee children are at our doorstep or at a remote border, we should welcome them with open arms, nurture them, and invest in their future. If we allow them to flourish with their parents in a safe environment, they will contribute to the countries that host them. Our ability to make a difference in the lives of the refugee children is a test of our commitment to respect human dignity and equality.