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PACEs in Medical Schools

What a Pediatrician Can Do for a Child Seeking Asylum-And What She Can't [newyorker.com]

 

By Rachel Pearson, The New Yorker, October 8, 2019

On a cool spring afternoon, in a clinic that serves refugee and immigrant families, I sit across from a teen-age girl. She is otherwise known as an unaccompanied alien child, or U.A.C. She left her home in Central America, crossed the southern border, and was detained for a week—in Texas, she thinks—in a facility where breakfast was a cold bean burrito, lunch was a cup of microwavable noodle soup, and dinner was a cold bean burrito. She says that the detention facility was fine—no, nothing bad happened. Yes, it was only girls. Her main complaint is that she was not allowed to brush her teeth.

From the detention center, she was taken to a shelter in the Pacific Northwest for such children. She remains in the custody of the Office of Refugee Resettlement (O.R.R.), waiting to hear that she has been cleared to travel on to her family members in this country. I meet her during her first seventy-two hours at the shelter, when she is brought to my clinic for an initial refugee-health screening. The shelter is fine, she says. The people are very nice.

Today, I will order a chest X-ray and a series of blood tests. I will ask her a long list of intrusive questions, and I’ll send the answers to O.R.R. I’ll tell O.R.R., for example, when her last period was. I will tell them whether she has been physically or sexually abused, and, if so, in what country. I will tell them if she has frequent headaches and whether she wishes to commit suicide, homicide, both, or neither. I will send them the results of testing for H.I.V, tuberculosis, and pregnancy.

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