U.s. border enforcement a detriment to

migrant safety and health

At the border, search and rescue personnel need to operate separately from enforcement practice so that medical personnel no longer place border enforcement above medical care. And, what should already be guaranteed, those offering medical or humanitarian services to migrants must be free from persecution, while violations of enforcement guidelines serve to be sanctioned. Migrants require ease of access to safe healthcare, civil society groups at the border deserve aid in reducing fatality and health risks and most importantly CBP enforcement guidelines need to be held accountable under law.

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UN guidelines for state obligations as they apply to border governance demand to be followed. U.S Customs and Border Protection (CBP) continues to violate their own established guidelines at the U.S border, including the large scale ignorance of the Use of Force Policy, Guidelines and Procedures Handbook. And, the abrupt prevention through deterrence platform, established in the 1990s and utilized to delegate patterns of migration to unsafe terrain, flourishes today.

Furthermore, the agency’s record with healthcare is truly appalling. Migrants have their direct access to basic human necessities blocked (example: water bottles slashed), their access to medical services denied, access to medical aid may also be limited based upon documentation, or possible deportation without medical approval. Policies like the 100 mile rule continue to revoke constitutional protections from individuals within a given range of the U.S border, and the rate of fatality and health issues among migrants skyrockets. These occurrences are in direct disregard of regulations such as the Sensitive Locations Policy, which prohibits enforcement actions in and around hospitals.

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It is time the U.S Congress to take action. The Sensitive Locations Policy needs to be codified into law under the Immigration and Nationality Act, ensuring individuals can access healthcare without fear. And, The 100 Mile Rule needs to be reviewed to allow constitutional protections to be preserved in and around medical facilities. Compliance with enforcement guidelines is no longer an option, sign on now to guarantee Congress demands it.


USA border enforcement activities include numerous human rights violations, including:

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  • Despite the existence of the U.S. Customs and Border Protection (CBP) Use of Force Policy, Guidelines and Procedures Handbook, migrants are still being injured and killed

  • CBP officials impede and criminalize volunteer first responders who are providing lifesaving assistance to migrants in the field by arresting them and filing federal charges against them;

  • CBP officials have been documented destroying humanitarian assistance;

  • CBP officials have used medical personnel to conduct body searches without warrants or consent;

  • In violation of U.S. asylum law, CBP is preventing asylum seekers from crossing legally at ports of entry, and deporting individuals with medical conditions through official ports of entry without having secured safe medical release; and

  • CBP’s law enforcement arm, the U.S. Border Patrol (USBP), conducts enforcement actions in and around hospitals, in violation of the Sensitive Locations policy, and violates U.S. and international law by using hospitals as de facto detention centers where patients are denied access to legal counsel and contact with family members.

Congress should:

  • Ensure non-discriminatory access to emergency medical services through adoption of legislation that codifies the Sensitive Locations policy into the Immigration and Nationality Act;

  • Ensure that access to lifesaving medical and other humanitarian assistance is safeguarded by explicitly protecting from prosecution those who offer medical or humanitarian services to migrants;

  • Separate search and rescue from law enforcement by clarifying the respective mandates of Border Patrol and local search and rescue efforts, to ensure that medical personnel and activities are protected from pressures to prioritize immigration policy enforcement over medical care, and to ensure that those who are rescued have access to medical care;

  • Review U.S. Customs and Border Protection authority under the “100-mile rule” to determine how constitutional protections can be preserved in and around medical facilities while implementing border enforcement activities.


The Department of Homeland Security and U.S. Customs and Border Protection (CBP) should:

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  • Rigorously evaluate border enforcement practices for negative impact on the right to life, including through ongoing consultations with independent medical professionals to evaluate health consequences of existing policies and practices and during development of new policies and guidelines;

  • Publicly clarify CBP’s existing Sensitive Locations policy, which prohibits enforcement actions that impede first responders from delivering lifesaving treatment;

  • Train agents to effectively avoid any excessive use of force and to respect medical ethics and medical professional opinions regarding the medical needs of patients impacted by enforcement actions at all times, including updating the CBP Use of Force Policy, Guidelines and Procedures Handbook and improving training for agents;

  • Fully investigate allegations of harm perpetrated by agents, sanction agents who violate guidelines, and make the results of those investigations public;

  • Abide by the standards in the CBP National Standards on Transport, Escort, Detention, and Search handbook that strip-searches, X-ray searches, body cavity searches, and monitored bowel movements must be recorded in an electronic system of record, including the reason for the search and who authorized the search;

  • Enforce the standards in the CBP National Standards on Transport, Escort, Detention, and Search handbook that body cavity searches are conducted “only under the most exceptional circumstances,” by medical practitioners in a medical facility, with either the individual’s consent or a search warrant from a judge;

  • Foster closer collaboration with community groups, including those providing medical assistance to migrants.