SAN DIEGO (AP) — The recent deaths of an 8-year-old Panamanian girl and 17-year-old boy from Honduras who were under US government supervision have again raised questions about how prepared authorities are to handle medical emergencies suffered by migrants arriving in the US, especially as agencies struggle with massive overcrowding at facilities along the southern border.

Anadith Tanay Reyes Alvarez became unresponsive on a what was at least a third visit to medics Wednesday at a Border Patrol station in Harlingen, Texas, and died later in a hospital, US Customs and Protection said. The girl had complained that day of vomiting and stomach pains.

She died on her family’s ninth day in custody; the most time allowed is 72 hours under agency policy.

The family told agents that the girl had a history of heart problems and sickle cell anemia, CBP acknowledged in its second statement on the death. She was diagnosed with influenza on the family’s sixth day in custody, which prompted them to be move to another station.

CBP published a detailed account on Sunday, confirming key aspects of what the girl’s mother said two days earlier in an interview with The Associated Press. It initially published only a brief statement.

Mabel Alvarez Benedicks told the AP that agents repeatedly ignored pleas to hospitalise her medically fragile daughter as she felt pain in her bones, struggled to breathe and was unable to walk. She said the daughter was finally taken in ambulance after falling limp and unconscious and bleeding from the mouth.

Agents said her daughter’s diagnosis of influenza did not require hospital care, according to the mother.

The girl’s death came a week after 17-year-old Ángel Eduardo Maradiaga Espinoza of Honduras died in US Health and Human Services Department custody. He was traveling alone.

WHY ARE SO MANY PEOPLE IN BORDER PATROL CUSTODY?

A rush to the border before pandemic-related asylum limits known as Title 42 expired brought extraordinary pressure. The Border Patrol took an average of 10,100 people a into custody a day the second week of May, compared to a daily average of 5,200 in March.

The Border Patrol had 28,717 people in custody on May 10, one day before pandemic asylum restrictions expired, which was double from two weeks earlier, according to a court filing. By Sunday, the custody count dropped 23 per cent to 22,259, still historically high.

Custody capacity is about 17,000, according to a government document last year, and the administration has been adding temporary giant tents like one in San Diego that opened in January with room for about 500 people.

Those who qualify to be released from custody to pursue asylum are processed for immigration court, which takes 90 minutes to two hours for a single adult and longer for families and creates severe bottlenecks.

By contrast, it takes only 20 minutes to release someone with instructions to report to an immigration office in 60 days, a common practice in 2021 and 2022. A federal judge in Florida who ordered an end to quick releases in March also blocked the administration’s attempt to resume them last week in what officials described as an necessary emergency response to overcrowding.