Strangers in the Field

Isaac* looked up at me curiously with big brown eyes, his tight curls a similar shade of chocolate brown, prominent against his slightly lighter skin. He was a new patient in our clinic and had come for his 3-year-old well child visit. A foreign-looking vaccine record was tucked into his chart, signalling to me that he had recently moved from another country. As I spoke to his father, a thin man of short stature with a warm smile, their story slowly unraveled.

Isaac’s father had fled from Ethiopia to South Africa as a political refugee before Isaac was born. When Isaac was 2 years old, his mother left them, and he and his father left South Africa to seek asylum from political violence in the United States. Over a 4 month period, they traveled through Colombia, Ecuador, Panama, Costa Rica, and Mexico. At times, they were able to stay with friends, but they also spent time on the streets and in the jungles. They were able to cross the border from Mexico into Texas, and shortly thereafter had their first deportation hearing. 

When I met them, they were living with a friend and her family. Isaac’s father was unemployed and was concerned about getting Issac into school, finding employment for himself, and having enough money for food, insurance, and housing. He was working with a free legal services agency on their asylee status. Our social worker had to explain to him that because they were undocumented immigrants, they were not eligible for the Supplemental Nutrition Assistance Program (SNAP), cash assistance, or shelter placement.  We were, however, able to enroll Isaac in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) as well as to refer them to the food pantry co-located in the hospital.

While Isaac and his father suffered many abuses during their journey to and upon arrival in the United States as they navigated the asylum application process, they were fortunate in that they were not separated at the border. In 2019, more than 851,000 individuals were apprehended at the US southern border, 473,682 of whom were traveling as families and 76,020 of whom were unaccompanied minors [1]. Between July 2017 and July 2019, 5,512 children were separated from their parents at the border [2].

The separation of families at the southern US border is a growing crisis, so extreme that it has been equated with torture [1,2]. This degree of trauma imposes toxic stress on children, which has been shown to alter children’s brain architecture, disrupt immune function, and shorten telomeres, leading to developmental disabilities, chronic disease, mental illness, and lower life expectancy [3,4,5,6]. In short, the experience at the border strips asylum seekers of their humanity, leaving them perhaps even more vulnerable than prior to entering the US.

The Book of Ruth, read during the Jewish festival of Shavuot, carries great relevance as we consider Isaac and his father’s plight. Naomi, her husband Elimelech and their two children are economic refugees who flee Bethlehem to the land of Moab. Elimelech soon dies, and his sons, who have married Moabite women, die as well. Naomi and her two daughters-in-law set out to return to Israel, and along the way Naomi convinces Orpah to return to her family of origin in Moab, because Naomi cannot guarantee her the familial and economic security she deserves. Ruth decides to carry on with Naomi, despite the many hardships that lie ahead, and concretizes her place as one of the most famous immigrants in Biblical history. 

The rest of the book constitutes a struggle between those who see Ruth as a righteous woman who has sacrificed much for the sake of her family and adopted people, and those who see her as a foreigner who is worthy of nothing but suspicion and scorn. The story ultimately focuses on the businessman Boaz, who negotiates a deal to take over Elimelech’s old familial lands, support Noami, and marry Ruth. Together, Boaz and Ruth have a son who becomes the grandfather of King David. 

Ruth (the book and the woman) holds great significance for Jews and all who study the Bible and seek to learn its lessons. In thinking about our place in 21st Century America, we - Jews and non-Jews alike can look back on our own experiences as immigrants, many of whom came to this country as refugees. Like Ruth, there were those who treated us with racism, suspicion and hostility. And like Ruth, there were those who chose to embrace us, to acknowledge the sacrifices we made in coming here, and to celebrate and honor the diversity we brought to this country. The fact that Ruth became the ancestor of King David is a loud and clear acknowledgement of the potential for the all to be included, and a call to each of us to do what we can to welcome those who are vulnerable and in need of our embrace. 

Let us all consider the plight of the countless refugees - individuals, families and children. Let us feel their pain, appreciate their humanity, and work together as a society to provide for them the opportunities to survive and thrive in their new land not as strangers but as full members of our society.  

Rachel Stein Berman, MD, MPH, is a pediatrician at Children’s Hospital at Montefiore (CHAM) and an Assistant Professor of Pediatrics at the Albert Einstein College of Medicine. An observant Jew and active member of her Modern Orthodox community, she resides in Bronx, NY with her husband, Rabbi Yonah Berman, and their three sons. Dr. Berman serves as a member of IPHN's Community Council.

Rabbi Yonah Berman serves as Mashgiach, Director of Alumni Engagement and Chair of Professional Rabbinics at Yeshivat Chovovei Torah in Riverdale, Bronx, NY.  A Teaneck, New Jersey, native, Rabbi Berman is passionate about Israel, the Jewish community, and Jewish learning. 

*Name changed to protect privacy.

Photo Credit: ProtoplasmaKid via WikiMedia Commons

References:

[1] Oberg C, Kivlahan C, Mishori R, Martinez W, Gutierrez JR, Noor Z, Goldhagen J. Treatment of Migrant Children on the US Southern Border Is Consistent With Torture. Pediatrics. 2021;147(1):e2020012930.

[2] Habbach H, Hampton K, Mishori R. “You Will Never See Your Child Again”: The Persistent Psychological Effects of Family Separation. Physicians for Human Rights. 2020. https://phr.org/our-work/resources/you-will-never-see-your-child-again-the-persistent-psychological-effects-of-family-separation/. Accessed 14 May 2021.

[3] Jednoróg K, Altarelli I, Monzalvo K, Fluss J, Dubois J, Billard C, Dehaene-Lambertz G, Ramus F. The Influence of Socioeconomic Status on Children's Brain Structure. PLoS One. 2012;7(8):e42486.

[4] Franco Suglia S, Duarte CS, Sandel MT, Wright RJ. Social and Environmental Stressors in the Home and Childhood Asthma. Journal of Epidemiology & Community Health. 2010;64:636-642.

[5] Needham BL, Fernandez JR, Lin J, Epel ES, Blackburn EH. Socioeconomic status and cell aging in children. Soc Sci Med. 2012 Jun;74(12):1948-51.

[6] Bochenek MG. US: Family Separation Harming Children, Families: 5-Year-Olds Held Without Adult Caregivers. Human Rights Watch. 2019. https://www.hrw.org/news/2019/07/11/us-family-separation-harming-children-families#. Accessed 14 May 2021.