In the South Bronx, there is a center of hope for immigrant children arriving in the United States alone, without adult accompaniment. It is called Terra Firma (Latin for ‘solid ground’). 

Terra Firma is the first medical-legal partnership specifically designed for unaccompanied immigrant children in the community; as a programmatic partnership among Catholic Charities New York, Montefiore Medical Center, and the Children’s Health Fund, it operates out of a federally qualified health center that serves all patients regardless of their ability to pay, according to the program partners.   

Terra Firma is a patient-centered medical home located “within one of the poorest Congressional districts in the United States, and a community center and enclave for recently-arrived children with aspirations of fulfilling the American dream,” the partners said in a statement.

The work is all about providing medical, legal, and mental health advocacy for unaccompanied children. The original inspiration was “to break down silos in service delivery,” but it now extends to a wider array of community activities, including photography workshops, English classes, and soccer games. “Our work has taken us beyond the South Bronx, from detention centers in Texas to migrant shelters in Mexico,” the statement said. 

Mario Russell, director of Immigrant and Refugee Services for Catholic Charities New York, told The Good Newsroom that most of the arriving youths have been in their mid-teens, mostly from Central America. 

“It is a pathway to give children in need of support and who have experienced trauma and deprivation in their home countries,” Russell said in a Jan. 20 phone interview. “It gives them a home from which to begin a pathway to rebuild their lives.”

He said the youths “can’t really find a way to healing without all of these in place at the same time: psycho-social, case management, medical and legal. They are eventually reconnected with a sponsor or custodian; it could be a relative, either here in New York or anywhere else in the United States.”  

The Terra Firma stated mission is: “We believe that all children deserve healthcare and justice.” As a nationally-recognized medical-legal partnership, we work to facilitate access to medical care and enhance the role of medicine and mental health in legal services. By promoting the well-being of immigrant children through direct services and advocacy, we seek to strengthen local communities and inform public policy. Terra Firma aspires to empower immigrant children to develop resilience, attain stability and reach their full potential. 

The beginnings, as reported by Terra Firma: On Sept. 25, 2013, a small group of about 12 unaccompanied immigrant children gathered in a conference room at a pediatric clinic in the South Bronx. They had arrived with their lawyers and legal advocates to a room filled with balloons, welcome signs, snacks, and seating. It was the first-ever meeting of the “Immigrant Youth Clinic,” a new initiative designed to address the unmet medical, legal, and mental health needs of unaccompanied immigrant children, who had begun to arrive in the United States in historic numbers. These youth faced enormous challenges: at risk of deportation, acculturating to new environs, and processing traumatic histories as targets of persecution, torture, and abuse. 

Today, Terra Firma continues to serve recently arrived unaccompanied immigrant children in the South Bronx. From that first group of twelve has sprung a vibrant cohort of more than 500 children, adult caretakers, and family members that receive co-located medical, legal, and mental health services in an integrated, holistic setting.  

2014 saw the highest-ever number of unaccompanied immigrant children arrive in the United States, and yet it pales in comparison to the developments that followed: an onslaught of new attacks on our immigrant communities. 

“As a guiding principle, we at Terra Firma believe that lawyers, doctors, therapists, and advocates of all stripes must unite in our efforts to deliver life-saving and life-changing interventions to our new neighbors. For this generation of future Americans, we want to be part of the movement that lights the way,” Terra Firma co-founders Brett Stark, Esq., Alan Shapiro, MD, and Cristina Muñiz de la Peña, Ph.D., said in a statemen