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Caring for immigrant youth fleeing Central America -Crain's New York

A year before former President Barack Obama declared the waves of children crossing the Mexican border a humanitarian crisis, a Guatemalan teen showed up at Dr. Alan Shapiro’s mobile health clinic outside a drop-in homeless center in Harlem. The boy had accidentally washed his medication in the laundry. He could explain little of his situation, but he had a business card for Catholic Charities. The lawyer there told Shapiro the boy was seeking legal protection as an unaccompanied immigrant child.

“It made us think, Wow, how many kids have we seen whose situation we didn’t fully understand and we never thought of referring to lawyers?” he said. “Pediatricians and family medicine doctors might be seeing youth who have this way of winning legal relief. But if you don’t ask the right questions, you won’t know.”

A native of Queens, Shapiro recalls being affected by the poverty he glimpsed along the Cross Bronx Expressway on visits to his grandfather’s place in the Bronx. During medical school he spent time in the slums of Lima, Peru, but came to realize that many of the problems he worked on there were the same as those in poor neighborhoods at home in New York. He would go on to oversee a cluster of community health centers in the Bronx affiliated with Montefiore Medical Center and the Children’s Health Fund.

In 2013 Shapiro, along with a psychologist and the Catholic Charities immigration lawyer he met through that Guatemalan patient, opened Terra Firma, an innovative medical-legal practice serving youth who have journeyed alone—sometimes by foot or atop freight trains—from the world’s most dangerous places. The nonprofit partnership provides medical, mental-health and legal help as well as support groups and a summer enrichment program (English lessons, soccer and photography classes).

Terra Firma’s 300 clients hail mostly from El Salvador, Guatemala and Honduras. They have endured hardships and poverty, and have sometimes seen family and friends killed. “All the kids we see are resisting joining gangs,” which is why they are not safe in their home country, Shapiro said.

“I saw a kid who was run over by a car because he wouldn’t join the gangs,” he added. X-rays of the teen’s legs were successfully used as evidence in his immigration hearings. “Once they get legal status, the world opens up to them. They can start living a free life,” Shapiro said. “That’s what it’s all about.”

A version of this article appears in the May 15, 2017, print issue of Crain's New York Business as "Safe hands".

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