Case Study: Jakelin Caal's Death and CBP Accountability

This case study examines the tragic death of Jakelin Caal, a 7-year-old Guatemalan girl who died in the custody of U.S. Border Patrol. The analysis delves into the circumstances surrounding her death, including her journey with her father, the apprehension by CBP, and the subsequent medical complications. The study identifies key actors such as CBP agents, the girl's father, and medical officials, and highlights central problems including accountability, medical care, and policy failures. It applies course knowledge to analyze the case, proposing alternative actions, and recommending the implementation of standardized medical checks at the border to prevent similar incidents. The analysis emphasizes the need for improved accountability structures within the CBP and better reporting of custodial deaths. The study concludes with an implementation plan, potential obstacles, and an evaluation plan to assess the effectiveness of the recommended alternative. This case study highlights crucial public health and human rights issues related to migrant detention and border security.

Jakelin Caal’s Death in Border Patrol Custod
1| P a g e

Table of Contents
Narrative Summary of the Case.................................................................................................2
Case Summary.......................................................................................................................2
Key Actors and Their Roles...................................................................................................2
Central Problems....................................................................................................................3
Identification of Case Problems and Issues and Application of Core Course Knowledge to the
Related Case Problems and Issues.............................................................................................3
Case Analysis.........................................................................................................................3
Alternatives for Action...............................................................................................................4
Alternative 1...........................................................................................................................4
Alternative 2...........................................................................................................................5
Alternative 3...........................................................................................................................5
Selection of Recommended Alternative.....................................................................................5
Method...................................................................................................................................6
Criteria....................................................................................................................................6
Recommendation....................................................................................................................6
Implementation of Recommended Alternative..........................................................................6
Implementation Plan..............................................................................................................6
Obstacles................................................................................................................................7
Evaluation Plan......................................................................................................................7
Reference List............................................................................................................................8
2| P a g e

Narrative Summary of the Case
Case Summary
The case study involves around the death of a 7-year-old Guatemalan girl who had died in the
custody of US border patrol. The girl named Jackeline Caal was travelling with her father
from a rural indigenous community in Guatemala’s impoverished region of Alta Verapaz. A
group of 163 illegal migrants consisting of the girl and her father and other 50
unaccompanied minors were travelling for the last three days after which they were
apprehended in a remote area of New Mexico desert on December 6, around 10:00 pm.
According to the reports and statements provided by CBP, the girl started experiencing
seizures around 6:25 am in the next morning with a fever of 105.7 degrees and was sent to
the Providence Children’s Hospital in El Paso through helicopter, where she went into
cardiac arrest and died within the next 2 hours. The congress has asked for a thorough
investigation of the case for ensuring appropriate following of policies (Ray Sanchez, 2019).
According to the ACLU, the lack of accountability and culture of cruelty within the CBP
might be the major reason for the cause of death of the child (Theguardian, 2019). However,
in response to these accusations, the CBP stated the girl was travelling without food and
water for the last three days and despite every possible measure were taken by CBP for her
well-being, they were unable to avoid this tragic situation.
Key Actors and Their Roles
The key actors that are involved with the chosen case study is the border patrol agents of
CBP, the father of the child and the medical officials of the Providence Children’s Hospital in
El Paso (Vera, 2019). Based on the report of the case study provided by the CBP, each of
these key actors had specific roles in this situation (Vera, 2019). The role of father of
Jackeline CaalMaquin was to report the CBP patrol guards about the sudden deuteriation of
the child’s heath as she went into cardiac arrest multiple times. As the people in charge at the
detention centre, it is the duty of the CBP officials to get the girl necessary medical treatment
as soon as possible immediately after their informed by the father of the child. The medical
officials should have provided medical care to the child as soon as possible to avoid such
incidents (Sant, 2019). Also, there are concerns about the right measures taken by CBP after
addressing of the situation and whether they could’ve managed better treatment facilities
sooner than it actually happened.
3| P a g e

Central Problems
Although there are some key areas of concern about the accountability of the CBP officials
and their policies in such scenarios, multiple problems are also involved with the case study
including the responsibility of the father who accompanied the child in an illegal attempt to
enter the US through a remote region which might be responsible for the delay in treatment.
Also, the medical treatment provided by the medical officials at the Providence Children’s
Hospital in El Paso is also a major area of concern (Sant, 2019). However, as the child died in
the custody of the CBP, the central problem is the accountability and measures of the CBP
border patrol agents for treating the child (Nast, 2019). As the CBP has reputation of cruel
treating of migrants after arrest, the congress has asked for a thorough investigation on the
involvement and role of CBP is this tragic incident.
Identification of Case Problems and Issues and Application of Core Course Knowledge
to the Related Case Problems and Issues
Case Analysis
For the sake of keeping the case study brief, despite the multiple issues that might have led to
the death of the 7-year-old girl, the central problem that should be the focus of the assignment
is the responsibility of the CBP officials and investigating whether they took all the right
measures to get appropriate medical treatment for the girl. As per the official statement for
the CBP, the girl has been travelling through the desert for the last three days without any
access to food and water which had already deteriorated her condition prior to their arrest on
December 6 (Lind, 2019). However, according to the child’s father, after their arrest, the CBP
sent the 50 unaccompanied minors in the migrant group to a station 95 miles away in
Lordsburg, New Mexico while the others were held inside the sally port of Antelope Wells
Port of Entry. The father also stated that her daughter was in good health condition until that
point and later in the morning of the following day got sick and started vomiting (Lind,
2019). The CBP agents were notified about the emergency medical treatment required by the
child and the situation got worse when she stopped breathing. To their defence, the CBP
stated that they are generally outnumber in night patrols and due to the location of arrest
being in a remote region of the desert, proper medical treatment couldn’t be arranged on
time(Gov, 2019). However, the border patrol EMT revived the chid twice before transporting
her to the Texas trauma centre by air ambulance. Again, after reaching the medical centre, the
child went into cardiac arrest where she was again revived. A CT scan revealed swelling in
the brain and she was put into machine-aided breathing and diagnosed with liver failure.
4| P a g e

According to the CBP, their emergency medical technicians did everything in their power to
provide emergency medical assistance for the girl and it was the long travelling through the
desert that was responsible for the child’s death (Sant, 2019).
As a response to this event, ACLU border rights advocacy manager, Cynthia Pompa stated
that the lack of accountability and a culture of cruelty within the CBP have exacerbated
policies which are the reason for the migrant deaths. Additionally, she also stated that such an
incident came into the limelight after a week and this alone proves the need of transparency
for CBP (Aclusandiego, 2019). She also claimed for a rigorous investigation on how this
tragic incident happened and serious reforms are required to prevent future deaths.
After the investigation, if it is found that, the death has happened due to the lack of medical
attention to the girl despite having available options, it would be direct violation of human
rights and serious consequences will be faced by the CBP agents. Also, the investigation
would also reveal, if the CBP indeed has a culture of cruelty towards migrants after their
arrest and if any forms of mistreatment were done to the arrested migrants during their
custodial time (Vera, 2019). Also, the accountability of the CBP agents will also be put under
scrutiny if any form of avoidance of responsibility is found on the part of the CBP agents. In
case of any allegation comes true after the investigation and any violation of human rights
and immoral behaviour is reported from the investigation, serious charges will be pressed
against the responsible CBP agents.
Alternatives for Action
Based on the scenario of the case study, it is evident that the child, Jackeline Caal, required
emergency medical treatment after she started getting sick and vomiting in the CBP custody.
Although, she received medical treatment after a long time when transported to Providence
Children’s Hospital in El Paso via air ambulance, it was already too late and she died after a
third cardiac arrest, swelling of the brain and liver failure despite the machine-aided breathing
provided by the hospital. In context to the decision makers in the case which are the CBP
agents, alternative ways to deal with the problem has been provided and they are justified
based on their usefulness in that situation.
Alternative 1
According to Democrat Congressman Raul Ruiz from California, stated that the duty of the
CBP agents are much more challenging as migrants are crossing the border in difficult to
reach areas where medical resources and ambulances are short in supply. This makes the
5| P a g e

availability of immediate medical treatment for sick illegal migrants a major issue. However,
he also stated that it is the legal responsibility of CBP to provide humanitarian and health
needs to the children in custody when detained for crossing border. It is quite evident, that the
girl had no meaningful observation or evaluation after her detention (Nytimes, 2019). This is
why, new policy changes should be made to provide standardized medical checks at the
border, so that migrants are immediately scanned for their health condition even though they
look completely well from outside. Had these policies been changed earlier, this tragic
incident could have been avoided.
Alternative 2
The second alternative is the lack of CBP’s serious accountability structure. With a budget of
$14 billion and 40,000 agents, it is the largest law enforcement agency in the US and one of
the largest in the world as well. However, despite its enormous size, its accountability
structure is very small and weak. This is why, if the accountability of the agents were more
under focus, they would have paid more attention to the health condition of the child and the
other detained migrants and the tragic incident could have been avoided.
Alternative 3
The third alternative is related to the problem in the US security agencies that fail to report
deaths in custody. It took almost a week to bring the death of Jackeline Caal into limelight.
Similarly, other custodial deaths are also unreported in many security agencies of the country.
If the authority is able to gain information of custodial death more often, it would be easier to
take preventive measures once the causes of these deaths are identified. In this case scenario,
if the custodial deaths were reported in the past, the CBP would have available forms of
medical treatment in emergency situation. Also, reporting of custodial deaths would prevent
any physical abuse to the detained migrants and no form of immoral activities could be
performed by the CBP agents.
Selection of Recommended Alternative
Of the three alternatives provided above, the best alternative is undoubtedly the first one. It is
clear that with proper standardised medical checks at the border would be the best way to
provide medical treatments to any illegal migrants trying to cross the border. The method,
criteria and recommendation for implementing this alternative has been provided below.
6| P a g e

Method
With a robust budget and staff capacity in the CBP, the company still lacks the investment for
a better infrastructure and staff power to provide service to all the detained migrants in their
custody. If the congress can pass a bill and a revised policy for the CBP accountability
structure, that would provide a standardized medical check team at every border outpost and
stations, that would allow them to provide a medical check-up for the migrants the moment
they are arrested and taken into the detained facility(News, 2019). Once they are cleared of
needing any medical treatments, then other legal policies will be conducted to deport them
back to their native country.
Criteria
The CBP and congress has clearly stated previously that the CBP will not be responsible for
any lives if they are previously sick when travelling through remote areas of the desert to
cross the border. However, once they are arrested and taken into custody, it is the legal and
moral duty of the CPB to provide them with all essentials like food and water and also any
form of medical treatment that they might need. Even if the migrants die during the custody
due to sickness prior to their arrest it will be held accountable against the CBP.
Recommendation
The best way to implement this alternative is by keeping an emergency medical technician
team with the border patrol agents, so that they can provide immediate medical treatment to
any migrant that would need any help. As providing medical care after reaching stations and
outposts might overlook any underlying medical condition of the migrants, and the CBP
would be unnecessarily held accountable for their deaths. A standardised check right after
arrest would allow them to report the medical condition of any migrant and the accountability
of the CBP agents can be shifted to the migrant itself.
Implementation of Recommended Alternative
Implementation Plan
To implement the discussed first alternative to avoid future deaths of migrants under custody,
it is necessary to follow a devised plan that would help to implement the alternative
successfully to prevent any similar death cases in the future. It is quite obvious that, to change
the accountability structure of the CBP it is necessary to pass a bill from the congress and
also make necessary policy changes based on past cases related to migrant death in CBP
custody. Once the bills are passed and necessary policy changes are made, it is also necessary
7| P a g e

to increase the budget and staff capacity of CBP. Providing a standardised medical check at
the security checkpoints and stations requires excess budget for medical equipment and tests
and also staff members for the CBP emergency medical technician (Americasvoice, 2019).
Once the budget and staff members are recruited, the CBP can implement their new system of
immediate health check up for all the detained migrants arrested for illegal border crossing.
Obstacles
Although a change in the CBP accountability structure is necessary as well as medical
treatment is absolute priority for the migrants, there are multiple obstacles that might delay
the process of implementation of the alternative discussed in the section 3. One of the major
obstacles are the increase of number of migrants over the last few years, would always make
it hard for the CBP agents to provide standardized medical checks as too many immigrants
would always make the number of CBP staff outnumbered. Also, with a budget of $14
billion, the CBP is assigned the highest budget of all security agencies in the country. Adding
to additional budget might not be practical and some congresspeople would be unwilling to
pass the bill. Also, as migrants tries to cross the border in hard to reach areas, it would be
tough to get them to nearest station for medical check up and long travel distance between the
location of arrest and CBP station might result in the death of a migrant who require
immediate medical attention. If they are able to overcome these obstacles, a standardised
medical check would be easily implemented successfully that would ensure prevention of any
future migrant deaths under CBP custody (Nbcnews, 2019).
Evaluation Plan
Based on the reports provided to the congress within 24 hours of death of a migrant, a total
estimation of the number of reported deaths under custody are made. As it is mandatory to
report within the first 24 hours after the death, reports can be generated on the number of
CBP deaths before implementing standardized check and after proper implementation. If the
number of custodial deaths is decreased significantly after implementing the recommended
alternative plan, it is a clear indication of successful implementation of the recommended
alternative plan.
8| P a g e

Reference List
Aclusandiego, (2019). ACLU Border Rights Center Statement on Child’s Death in Border
Patrol Custody. Retrieved from: https://www.aclusandiego.org/aclu-border-rights-
center-statement-on-childs-death-in-border-patrol-custody/
Americasvoice. (2019). Retrieved from https://americasvoice.org/press_releases/death-of-7-
year-old-girl-in-cbp-custody/
Gov. (2019). Retrieved from https://www.dhs.gov/news/2018/12/25/cbp-shares-additional-
information-about-recent-passing-guatemalan-child
Lind, D., (2019). The death of 7-year-old Jakelin Caal Maquin in Border Patrol custody isn’t
an isolated outrage. Retrieved from:
https://www.vox.com/2018/12/18/18144434/child-died-jakelin-caal-seven-border-
patrol
Nast, C. (2019). A 7-Year-Old Died in Border Patrol Custody. Retrieved from
https://www.teenvogue.com/story/7-year-old-jackeline-caal-died-border-patrol-
custody-migrant-guatemala
Nbcnews. (2019). Retrieved from https://www.nbcnews.com/news/latino/accountability-
medical-care-critics-cry-serious-reform-border-agency-n950046
News, A. (2019). Border Patrol defends handling, medical care of 7-year-old girl who died in
custody. Retrieved from https://abcnews.go.com/Politics/year-girl-dies-custody-us-
border-patrol/story?id=59818607
Nytimes. (2019). Retrieved from https://www.nytimes.com/2018/12/26/us/felipe-alonzo-
gomez-customs-border-patrol.html
Ray Sanchez, C. (2019). 7-year-old Guatemalan girl who died in Border Patrol custody is
identified. Retrieved from https://edition.cnn.com/2018/12/14/us/guatemalan-girl-
death-ice/index.html
Sant, S. V., (2019). Autopsy For 7-Year-Old Migrant Who Died In U.S. Custody Shows She
Died Of Sepsis. Retrieved from: https://www.npr.org/2019/03/30/708388844/autopsy-
for-7-year-old-migrant-who-died-in-u-s-custody-shows-she-died-of-sepsis
9| P a g e

Theguardian, (2019). Why did a little Guatemalan girl die after crossing the US border?
Retrieved from: https://www.theguardian.com/us-news/2018/dec/17/guatemalan-girl-
jakelin-caal-maquin-death-crossing-us-border
Vera, A., (2019). Autopsy determines 7-year-old Guatemalan girl died from sepsis while in
US custody. Retrieved from: https://edition.cnn.com/2019/03/29/us/guatemala-
jakelin-caal-maquin-autopsy/index.html
10| P a g e