The deaths of migrant children at our southern border continue. In the past nine months, six have died — Darlyn Valle, 10, in September; Jakelin Caal Maquin, 7, and Felipe Gomez Alonzo, 8, in December; Juan de Leon Gutierrez, in April; and Carlos Gregorio Hernandez Vasquez, 16, in May. (In addition to those five, an unnamed 2 ½ year-old boy died last month.)

To put all of these deaths in context, before September, the last time a migrant child died in federal custody was in 2010; yet in the past nine months of the Trump Administration, half a dozen children have lost their lives.

Why is this tragedy happening? What can be done?

“The recent spate of deaths demonstrates the government’s inability to responsibly and humanely care for the children in their custody,” writes Katie Shepherd, National Advocacy Council for the Immigration Justice Campaign, a project of the American Immigration Council. “It also begs the question of how many children have suffered medical problems after being released from government custody as a result of inadequate medical care.”

We know that right now, the number of children and families crossing the border is overwhelming. In March, there were 103,000 apprehensions at the southern border. That rose to 109,000 in April, and, just-released May numbers have increased to more than 144,000. June could be higher still – immigration tends to peak in the early summer.

Vox Reporter Dara Lind, one of the nation’s best reporters on complicated immigration issues, puts it succinctly: children are dying in Customs and Border Patrol custody because more children are in CBP custody.

It is also possible, she says, that the children showing up on our southern border are more likely to have medical issues than those coming in the past. “The rise of quick bus smuggling routes through Mexico allows people to be brought to the U.S. more quickly and comfortably than before – potentially making it possible to someone to leave who might have been too sick to risk a dangerous journey on foot,” she writes.

Lind describes a CBP workforce that is simply overwhelmed by the challenges it faces – challenges that are exacerbated by migrants’ health issues. “It takes people, vehicles, and time to take people to the hospital,” she writes. “From December through February, agents spent a combined 57,000 hours at hospitals: at one point, a Border Patrol official said that half of all agents were on duty at hospitals with migrants seeking care. That results in fewer people checking on the migrants staying behind, and less ability to quickly respond if someone else is showing signs of illness as well.”

Lind does not view the cause of migrant children’s deaths as a matter of black and white but, rather, one with a canvas of gray.

“This doesn’t mean agents acted blamelessly or that none of the children could have been saved,” she writes. “It’s entirely possible that in some cases – for example, the ones where migrants spent little time in CBP facilities and were sent to the hospital shortly after their arrival in the U.S. – agents acted appropriately, while in others, more could have been done.”

Indeed: if the border agents were simply bad actors, the problem would be easier to fix.

“If it were the case that individual bad actions done by individual bad agents left to children’s deaths, the problem would actually be easier to solve: get rid of the bad agents,” she writes. “If the deaths are a symptom of a broader resource crunch at the border that makes it simply impossible for everyone to get the care and attention they need, however, it’s not as easy to fix.”

And maybe add to that the possibility that there is a lack of compassion in some quarters for migrant children.

Jennifer Podkul is Senior Director of Policy and Advocacy for Kids in Need of Defense (KIND). She’s an international human rights lawyer and an expert on child migration. She works to protect and advance the interests of children who arrive at the southern border without their parents.

After the latest death of a child migrant was announced, she blogged about how she felt in a piece headline, “We are all responsible when a child dies at the border.”

“Congress has allotted the Department of Homeland Security millions of dollars to provide humanitarian care to children and families arriving at our border seeking protection,” she writes. “Yet children keep dying. Why? Why has there been no accounting of this funding to ensure that DHS is spending it appropriately? The Administration has not hired specialized personnel with child welfare training to staff facilities holding children. The Administration has violated laws limiting prolonged detention in border patrol stations. This, as the number of child deaths continues to rise.”

How do we prevent migrant child deaths moving forward? It seems as though the answer to this question might take the form of many baby steps and one very large, very adult step.

Irwin Redlener, a pediatrician, academician, and President Emeritus of Children’s Health Fund, penned a May 23 op-ed in the Washington Post in which he makes three recommendations.

First, CBP agents need a standardized, but basic health-screening tool to help determine whether a child might need urgent medical attention. Second, there needs to be an organized system of medical response that includes rapid transfer of sick children from the border to hospital care. And third, we need a deployment of mobile clinics at strategic points along the border, combined with state-of-the-art telemedicine strategies to bring virtual medical specialty assessment to children anywhere there’s an Internet connection.

And the very large, very adult step?

“What the Border Patrol and those desperate to get to the United States really need — what the nation needs — is a coherent, effective and humane plan to manage immigration going forward,” Redlener writes. “Whatever the complexity of the policy challenges or the deeply frustrating partisan political battles, we need to respond to the humanitarian needs of people who end up on U.S. soil, no matter how or why they got here. This is not a message for just my medical colleagues, but for all Americans, especially elected officials. They have the power to change conditions and make sure that the policies they create — or tolerate — do not cause inadvertent harm to anyone, especially children.”

Anyone following the immigration debate knows of the complexities involved – political as well as logistical. In addition to comprehensive immigration reform, a humanitarian response demands that we take such steps as seeking alternatives to detention; improving conditions in the “Northern Triangle” countries, especially in Guatemala and Honduras, the main sources of the current flight, so that migrant families won’t need to leave in the first place; and making sure that when detention does occur, all facilities are properly staffed, including medical and pediatric staffing.

Shepherd, the immigration advocate at the American Immigration Council, warns that the deaths will continue unless action is taken. “Families looking to escape violence and instability in Central America and Mexico will not be deterred by the prospect of inadequate medical care in U.S. custody,” she writes. “But as long as the U.S. government fails to address the inadequate medical care in its detention centers and the abusive use of detention in general, children will continue to perish in government custody.”