For hours before her collapse in US custody, a dying migrant child’s condition went unnoticed

Twenty-seven hours before she died at an El Paso, Texas, children’s hospital, 7-year-old Jakelin Caal walked across the U.S. border with her father and 161 other migrants outside Antelope Wells, New Mexico.

It was 9:15 p.m. on Dec. 6, and the small, remote U.S. border crossing was closed for the night. There were four Border Patrol agents on duty, and no medical staff.

The migrants skirted barriers and crossed into the United States. Like most Central American asylum seekers who have been arriving at the border in record numbers, they were not seeking to evade capture but to turn themselves in.

That night, as elsewhere when large groups of parents with children appear at remote border outposts, U.S. agents strained to accommodate the needs of those in their custody. The agents radioed the nearest Border Patrol station in Lordsburg, 90 minutes away, to request a bus, the only one available along that barren desert span of the New Mexico boot heel.

What unfolded over the next eight hours, as Jakelin's condition deteriorated but went unnoticed by agents and perhaps her father, is now the subject of an internal investigation at the Department of Homeland Security. And congressional Democrats are promising an inquiry of their own.

On Tuesday, three days after the child's death, Customs and Border Protection Commissioner Kevin McAleenan told the Senate Judiciary Committee that his agency's Border Patrol stations and their rudimentary holding cells were ill-suited to handle so many families and children. More medical staff and social workers were needed to handle the demographic change, he said.

McAleenan did not mention the girl's death, which was disclosed by CBP only after The Washington Post inquired about it Thursday evening. A DHS official said Friday the agency will review its policy on reporting deaths of migrants in U.S. custody.

Homeland Security officials have urged lawmakers to pass legislation addressing what they say are gaps in U.S. immigration and asylum laws that have induced more migrants to bring children in hopes of avoiding detention and deportation. Last month more than 25,000 members of family groups crossed the border this way, the highest one-month total ever recorded.

Yet Jakelin's death last week has put scrutiny on the surge - and the care of migrant families in U.S. custody - like no other recent event.

The girl's father, Nery Caal, 29, remains in the El Paso area but has not spoken publicly. According to Guatemalan consular officials, the family is from the Alta Verapaz department, one of the country's poorest, and the family's primary language is Q'eqchi', a pre-Columbian Mayan tongue.

Nery Caal has been granted a provisional release from CBP custody, according to consular officials, who said they are assisting with the repatriation of his daughter's body.

This account of the events leading up to Jakelin's death on Dec. 8 from dehydration, shock and liver failure is based on reports and interviews with consular officers as well as Homeland Security and Customs and Border Protection officials, who deny the agency is responsible for what happened.

White House and DHS officials Friday blamed the tragedy on the girl's father and the smuggling organizations that send busloads of people across the border in numbers officials say are designed to overwhelm U.S. agents.

Before reaching the border that night, Jakelin Caal had nothing to eat or drink for days, according to CBP, citing statements from her father. But though the girl's condition was worsening and her fever was soaring toward 106 degrees through the middle of the night, U.S. officials say her father did not tell agents.

"There were plenty of opportunities, if her father had noticed anything and brought it to agents' attention," said a CBP official who briefed reporters Friday, speaking on the condition of anonymity.

"There was no indication she had any health issues," the official said.

According to an account of Jakelin's death posted Friday on the Department of Homeland Security's Facebook page, the agency said the girl showed no sign of distress during a basic, routine check after the group of 163 was taken into custody by three agents.

"The initial screening revealed no evidence of health issues. During the screening, the father denied that either he or his daughter were ill. This denial was recorded on Form I-779 signed by the father," the DHS account said. The form was supplied in English, but CBP officials said agents provided a verbal translation.

"At this time, they were offered water and food and had access to restrooms," DHS said.

It's unclear whether Nery Caal attempted to feed his daughter or give her water during the middle of the night while the family waited with dozens of others in a loading bay next to the border crossing.

When the bus arrived from Lordsburg, border agents filled it with 50 children and other juveniles who had arrived with the group, following standard CBP procedures that require agents to prioritize children who arrive without an adult or guardian.

Jakelin and her father would have to wait longer.

It wasn't until around 5 a.m., nearly eight hours after crossing the border, that the bus returned to pick up a second load of passengers, which included the 7-year-old and her father.

It was at that time that Nery Caal told agents his daughter was sick, according to DHS, and agents called ahead to notify the station of her condition.

A few minutes into the 90-minute drive, the feverish child began vomiting. The bus continued on its route toward Lordsburg, which CBP officials insisted Friday was the fastest way for the girl to receive medical attention.

The bus arrived at the station shortly before 6:30 a.m. on Dec. 7. "At that point, the father notified agents that the child was not breathing," the DHS account states. "Border Patrol EMTs began medical care and requested an ambulance.

By then the girl's fever was 105.9 degrees. "Agents providing medical care revived the child twice," according to DHS.

The nearest major pediatric hospital, in El Paso, was a four-hour drive. Agents ordered a helicopter evacuation, and at 8:51 a.m. on Dec. 7, Jakelin arrived at Providence Children's Hospital. Border Patrol agents drove her father separately.

Jakelin died 15 hours later in the hospital's intensive care unit, according to DHS and consular officials. Her father was present.

Asked by a reporter Friday whether the administration is "taking any responsibility for the girl's death," White House spokesman Hogan Gidley said: "Does the administration take responsibility for a parent taking a child on a trek through Mexico to get to this country? No."

"If we could just come together and pass some common-sense laws to disincentivize people from coming up from the border and encourage them to do it the right way, the legal way, then those types of deaths, those types of assaults, those types of rapes, the child smuggling, the human trafficking, that would all come to an end," Gidley said. "And we hope Democrats join the president.

Senior Democratic lawmakers, including members who will soon chair the House Judiciary and Homeland Security committees, sent a letter Friday to the DHS inspector general urging an investigation, citing "the seriousness of this tragedy and the many questions that remain."

"The investigation should focus on policies and practices designed to protect health and safety, as well as policies and practices that may result in increased migration through particularly harsh terrain," the letter said.

CBP officials have faced criticism for their practice of metering, or what they call "queue management," that limits the number of people allowed to approach border crossings to seek asylum. The agency says its ports of entry have capacity limits and were not designed to process large volumes of migrant families requesting humanitarian assistance.

According to CBP records, the U.S. reported 281 deaths along the Mexico border during the government's 2018 fiscal year, which ended in September. The tally includes bodies and remains found in the desert or along the banks of the Rio Grande.

The figure was down from 298 in 2017 and a peak of 471 in 2012.

Guatemalan nationals accounted for the largest share of border arrests last month, surpassing Mexicans for the first time, according to CBP data.

"It's important to draw attention to the unfortunate reality that the places where migrants now enter are more dangerous and the distances they travel are greater, which exposes to greater dangers those who lack provisions like food and water," said Tekandi Paniagua, Guatemalan general consul in Del Rio, Tex.

The situation, she said, "is worsened in the case of children who are much more vulnerable to the kind of journey required to make these crossings into the United States."

In May, a Guatemalan toddler died after her release from U.S. immigration custody after crossing the border illegally with her mother. The family is seeking at least $40 million in damages, alleging negligent medical care.

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The Washington Post’s John Wagner in Washington and Robert Moore in El Paso, Texas, contributed to this report.