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Caring Beyond Borders

Posted By Julie M. Linton, Monday, August 1, 2016
Dr. Julie M. Linton is an Assistant Professor of Pediatrics at the Wake Forest School of Medicine, the Advocacy Director for the Wake Forest Pediatric Residency Program, and the Chair of the Immigrant Health Special Interest Group for the American Academy of Pediatrics.


A young child and her pregnant mother are detained for days at our country’s southern border after fleeing gang violence in the Northern Triangle; alone and pregnant, a teenage girl has traveled from Mexico to escape chronic sexual abuse and abject poverty; and an entire family, having lived for nearly two decades in a refugee camp in Tanzania after fleeing their homeland due to armed conflict, have finally been able to cross the Atlantic and enter the United States of America.  

I have heard the stories of so many families from so many places across our globe. Their stories are set amidst circumstances that comprise my own worst nightmares. I make every effort to avoid casting judgment on why a family chooses to make the journey across our borders.  Caring for immigrant children and families is a continuing education beyond traditional medical textbooks.  It is an education in history, political science, anthropology, and religion.   I have heard my first words of beautiful languages like Tigrinya and Kinyarwanda. I have cried while listening to stories of trauma that threaten innocence, and palpate bravery and resilience.  I have seen the impact of a lifetime of lacking access to primary care - stunted growth and malnutrition. I have seen the results of exposure to egregious conditions.   

As I approach the shy child hiding behind her mother in the exam room, I seek to understand her journey.  Did she suffer from trauma in her country of origin, or as she traveled to the United States, or even upon crossing our border?  Has she felt welcomed by our community?  Does she feel safe?   Through the eyes of these children and families, I have seen the scars of trauma overcome by the beauty of new hope. Caring for immigrant children who have fled their homelands is humbling, exhausting, and inspiring.  

The United Nations High Commission on Refugees (UNHCR), per the 1951 Convention, defines a refugee as “a person who is outside his or her country of nationality or habitual residence; has a well-founded fear of being persecuted because of his or her race, religion, nationality, membership of a particular social group, or political opinion; and is unable or unwilling to avail him—or herself of the protection of that country, or to return there, for fear of persecution” (unhcr.org).  

For me, refugees are children seeking safe haven from fear, violence, and persecution, children who are yearning for a future within our borders.  This includes diverse populations, such as refugee children who enter the U.S. through the Office of Refugee Resettlement (ORR), unaccompanied children, and children in family units who have been in detention at our border.    

The CDC has extensive guidelines for the care of refugees.  The AAP Immigrant Health Toolkit offers an adaptation of these guidelines to help pediatricians care for all immigrant children from under-resourced settings. 

Get involved.  Join the AAP Immigrant Health Special Interest Group (SIG) via the AAP Council on Community Pediatrics. As the chair of the AAP Immigrant Health Special Interest Group, I feel incredibly grateful to be surrounded by inspiring colleagues committed to social justice, human rights, and a child's right to thrive.  It’s continuing education. 

For assistance with joining the Immigrant Health SIG, please contact cocp@aap.org 

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