[Editor’s Note: It’s Giving Tuesday! You have an unprecedented opportunity to support Migrant Clinicians Network’s many critical programs like SCAN through a triple match, today only. MCN’s match campaign for Giving Tuesday is moving to Global Giving, who will match every monthly donation up to $2500. So, your $10 will become $30, thanks to MCN donors and Global Giving! Don’t want to donate monthly? All one-time donations made today will be doubled as well, up to $9500, thanks to our generous match donors. In this blog post, we hear from Luis Retta, Health Network Associate, about one asylum-seeking child that he helped. But what does case management cost? For $250, you can support an asylum-seeking child’s case management, from the child’s enrollment with MCN, until they are linked with their specialty care in their new home community. Donate $250 today as a monthly donor, and your donation will become $750 – enough to provide case management for three children through SCAN. Donate at Global Giving today.]

Most of the children who arrive in the US to seek asylum with their families are healthy, which is pretty miraculous, considering the grueling and long journeys the families often take, sometimes with long stretches on foot.  But sometimes, a child arrives who really needs immediate care. 

A few months ago, Juan,* a two-year-old boy, arrived at the US-Mexico border with his family from Central America. The family was seeking asylum. They were taken into detention for a short time, but Juan got very sick in detention.

He was transferred to a children’s hospital in Texas. A cardiologist there determined that he had a serious heart condition that requires surgery. Without it, he could die. 

The family was released from detention, and was ready to move to the East Coast, where they have some family, and where they would wait for their asylum case to be heard in court. Juan was released from the hospital with instructions to get more care and a list of providers, but case management for specialty care isn’t generally provided after families are released from detention. One of the clinicians at the hospital, however, knew about Migrant Clinicians Network’s participation in Specialty Care Access Network (SCAN), a collaboration of Migrant Clinicians Network, Texas Children’s Hospital, Stanford Medical School and UT Rio Grande Valley School of Medicine. 

So, I got a call from Juan’s clinician at the Children’s Hospital and I started work right away. SCAN has a two-part process. First, we use MCN’s Health Network, which helps people who are migrating, like Juan’s family, to find primary care in their next location. Second, we connect the patient with a network of volunteer SCAN Champions, pediatric specialists all over the country who can step up to help children like Juan who need urgent specialty care. 

I began the work through Health Network in finding a health center who can help Juan stay up to date with vaccinations and serve his overall health. I also called a SCAN Champion in the state where Juan’s family was moving to see if they could help find a cardiologist who would take him. 

Specialty care can be very difficult to get. It can be a long process, even for people who aren’t migrating, who speak English, who have health insurance. Now, imagine the process if you’ve just arrived in the country, you don’t know how the health system works, you don’t speak the language well, you don’t have much money, you don’t yet have a job – and you find out your child requires major heart surgery. 

Juan’s mom is 18 years old, and she was overwhelmed by it all. But we really helped her a lot, not just with appointment scheduling but with helping her feel welcome and giving her support to navigate the system. Within just one week, I had scheduled Juan for a well-child visit at a health center close to their new home, and our SCAN Champion found a cardiologist who would take Juan as a charity case just a few days later. One of the doctors volunteered to meet with the mom at the emergency room because that’s easier to find, and then walk her and Juan to the cardiology department. 

Unfortunately, as we got closer to scheduling surgery, Juan’s family had to move again. They moved to a Midwest state, and I had to once again find a SCAN Champion, sign Juan up with primary care, and transfer over records from the previous doctors and cardiologist who he had already seen. I also have to ensure that the new practitioners Juan will be seeing understand the gravity and urgency of his heart health needs. We're still working to make sure his care isn’t further delayed, impossible to find, or prohibitively expensive, so he can grow up to be a healthy and happy kid. His family is still waiting for their asylum hearing, but at least they have the support they need to make sure his urgent health needs will be met. 

Refugee children like Juan deserve better. They need case management, they need to access a network of specialists who care. That’s why SCAN exists. You can support SCAN, to directly support children who need specialty care, by donating to Migrant Clinicians Network.

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