The secretary of homeland security is traveling to the Texas border town where an 8-year-old migrant from Guatemala was detained before dying in U.S. custody the day before Christmas.

Kirstjen Nielsen already vowed improvements in medical care after two migrant children died in the custody of U.S. Customs and Border Protection this month. Nielsen is visiting El Paso, Texas, and Yuma, Ariz., on Friday and Saturday, according to a DHS official, and meeting with Border Patrol agents and local health care providers.

Eight-year-old Felipe Gomez-Alonzo had the flu when he died on Monday, according to an autopsy by the New Mexico medical investigator. Officials say 7-year-old Jakelin Caal Maquin, who died three weeks ago, was dehydrated and had similar symptoms.

Both children came from Guatemala with their fathers and crossed the border illegally. Their deaths have raised new questions about the quality of medical care at Border Patrol processing centers.

But pediatricians on the border say they have been raising similar concerns for years.

"It's not a place for a well child, much less a sick child," said Marsha Griffin, a pediatrician in Brownsville, Texas, and spokeswoman for the American Academy of Pediatrics.

Immigration authorities rarely allow visitors inside processing centers near the border. But Griffin did get access to some of them while conducting research for the AAP, and she recalls touring one facility in South Texas in 2016.

"We passed mounds of teddy bears and security blankets that were taken from the children because they might have scabies or lice," Griffin said. "The lights are on 24 hours a day. The children sleep on thin mats on the floor with only a Mylar blanket."

Record numbers of migrant families

Federal officials say they are scrambling to care for a record number of migrant children and families, many of them fleeing from Central America and seeking asylum in the U.S.

"This is just devastating for us," said Kevin McAleenan, the commissioner of U.S. Customs and Border Protection, in an interview earlier this week with CBS This Morning.

"We've got over 1,500 emergency medical technicians that have been co-trained as law enforcement officers. They work every day to protect the people that come into our custody," McAleenan said. "We're doing dozens of hospital trips every single day with children that have fevers or manifest other medical conditions."

Up and down the border, volunteer doctors and nurses are also struggling to care for migrant parents and children after they've been released from federal custody.

"We feel overwhelmed," said Marcela Wash, a nurse in San Diego who is coordinating medical screenings and care for migrants at local shelters. Wash told member station KPBS that some of these migrants are already sick when they're released from CBP custody.

"They come over not having bathed for three or four days, however many days they have been in detention," Wash said. "Some of them arrive with upper respiratory problems, nausea, vomiting."

Pediatricians say migrant children would benefit from earlier medical screenings.

"In a child, an infection or a medical condition can get worse within hours," said Carlos Gutierrez, a pediatrician in El Paso.

Gutierrez is one of about two dozen local doctors and nurses who are giving free medical exams at local shelters. But that is only after migrant children and parents have been released from Border Patrol custody, as many as five or six days after they've crossed the border.

When the number of migrant children spiked back in 2014, local doctors and nurses were allowed to give these screenings as soon as they arrived at Border Patrol facilities, Gutierrez said. He hopes to be able to do that again.

"It's a better chance of us preventing the catastrophe if we see them earlier," Gutierrez said. "If we're allowed to get in there, things such as the death of the two children that we've heard about ... they probably wouldn't have happened. Those are needless."

Copyright 2018 NPR. To see more, visit https://www.npr.org.

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