The sight of a beggar, paralyzed from the waist down by polio, dragging himself through the muddy streets of India is a memory not easily forgotten. Yet, there is a world of difference between an impoverished society and a fractured nation. I have conducted medical missions in the remote Himalayas and in Bihar state, the poorest region of India, where, despite rampant disease and low life expectancy, people remain meaningfully connected through an ancient cultural fabric.
In contrast, Kathmandu, after the assassination of the beloved royal family in 2001 and the government takeover by Maoist rebels, became a place of fear, confusion and chaos. Guatemala, El Salvador and especially Honduras suffer the worst of both. Conditions are so dire that en masse children now risk their lives to knock at the golden doors of the United States.
Instability in Central America has been percolating for years. I remember hitchhiking through Guatemala in the early ’80s while on a pilgrimage to ancient Mayan ruins. The country was in the midst of a civil war. It was obvious that most bridges had been blown up multiple times with only makeshift repairs made in anticipation of the next assault.
In Honduras, stability was eroded when the Central Intelligence Agency installed bases to support the Contras in their fight against the leftist Sandinistas in neighboring Nicaragua during the 1980s. This effort was part of the Cold War strategy to stem the entrenchment of communist or socialist regimes that would be hostile to American interests.
Many believe that the 2009 military coup in Honduras was born of the same sentiment. Honduran President Manuel Zelaya, a rancher who had grass-roots support from labor unions and the poor, was ousted by the wealthy business community that feared he would bring on a Hugo Chavez brand of socialist populism. Some have alleged that Hilary Clinton, then secretary of state, gave tacit support.
The U.S. has a long-standing history of supporting despots in an effort to protect American interests. Other examples include the Shah of Iran and Hosni Mubarak of Egypt. While doing so, some would argue, is better than the alternative, the long-term social costs have been gripping.
The principal beneficiaries of the coup in Honduras are a dark underworld comprising corrupt government officials, military and police and above all the cartels that use Honduras as a staging ground for transport of cocaine from Colombia and Bolivia. The government is weak, but justice and education bear the brunt of the fallout. There are few jobs to be had. For many young men, the only choice is to join a gang or be executed for refusing. For children and their mothers, the only choice is to flee.
President Barack Obama asked Congress for $3.7 billion on July 8 to stem the tide of young, illegal immigrants and to manage in a humane manner those who successfully pierce the porous border with Mexico. Almost half of these funds are to house and care for children and parents caught traveling with them. The remainder is to improve border security, add judges and to repatriate them to their countries of origin.
Those resisting the bill in Congress argue that this is simply too much money. They demand changes to the bill that would repatriate these children more quickly and minimize the cost of health care, schooling and legal services.
The majority of Americans think that the dramatic escalation in the number of children crossing the border is the belief that the U.S. does or will soon grant them amnesty. Only one-quarter of Americans believe that violence in the countries of origin is the main reason, according to YouGov.
While Obama’s request for $3.7 billion includes $5 million for communications to dissuade illegal immigrants from coming to the United States, "coyotes" who cash in on human trafficking speak far louder, promising desperate parents a better life for their children, including health care, housing, education and jobs.
The problem of countless children now seeking a new life in the United States has been a long time in the making and will not be solved easily. The difference from intractable problems in the Middle East and North Africa is that this one is on our doorstep.
It is unconscionable to callously turn these children away and equally unimaginable to simply absorb them. The solution will not be quick or easy and, regardless of the course taken, will require immense resources and tough choices. As we make them, we should remember the early days of our nation.
When my own ancestors came through Ellis Island as refugees just over a hundred years ago, they took solace in the inscription on the Statue of Liberty:
"Give me your tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your teeming shore. Send these, the homeless, tempest-tossed to me. I lift my lamp beside the golden door!"
Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions info@manakaiomalama.com.
