Before the opening of Driscoll Children’s Hospital in Edinburg last May, if you lived in Starr County and had a child who needed to see a pediatric specialist, the visit could involve a 160-mile drive to the nearest pediatric hospital in Corpus Christi.

That drive isn’t uncommon. According to researchers at Texas State University, before the new hospital opened over 75% of Texas children lived more than an hour from the nearest facility offering emergency services or specialized care to children.

But experts say more pediatric resources are still needed in the South Texas region. Border counties along the Lower Rio Grande have some of the highest percentages of children and adolescents in the state, and families face several challenges in getting pediatric care. There’s a shortage of providers in the area, many people lack transportation, and immigration status can also complicate trips to seek care due to interior border checkpoints.

According to Dr. Mandie Svatek, an associate professor of pediatrics and a pediatric hospitalist at University Hospital, living within 60 miles of a pediatric hospital is crucial to prevent complications and, in extreme scenarios, a patient’s death.

“Sixty miles is quite, quite wide,” said Svatek. “Ideally, you would want a major pediatric center so that those children have access to care.”

Children and adolescents make up about 25% of ER visits, and most end up in adult ERs where they are treated by nurses and doctors without specialized training.

“There is a stepping point where that becomes worrisome,” said Svatek, noting that conditions such as severe respiratory distress or an event involving numerous injuries could result in deaths or severe complications if a hospital isn’t prepared to treat children.

Across the country, hospital resources dedicated to children have declined over the last ten years. Only 10% of hospitals have pediatric ICU beds, and just under a third have pediatric inpatient beds, meaning that more children require treatment at specialized pediatric hospitals that are often far from their homes.

Undocumented families in South Texas face additional challenges traveling to access pediatric care, as border checkpoints deter those who would look for care outside the Valley.

Dr. Stanley Fisch, who first arrived in the Valley to work with the United States Public Health Service and stayed to open the region's first pediatric practice, said that until 9/11 he had no problem sending patients to Corpus Christi even if they were undocumented.

“If they didn't have legal status, I could write a note, a simple little note on a prescription pad, you know, saying, ‘Dear border patrol, this kid needs heart surgery. Please let him proceed to Driscoll Hospital', and they would say, 'Go, no problem.' That stopped 20 years ago,” he said. “That kind of message doesn't work, or patrol is no longer lenient or sympathetic.”

Driscoll Children’s Hospital opened in Edinburg in May and has 119 pediatrics beds. As the only children’s hospital designated by the Centers for Medicare and Medicaid Services south of Corpus Christi, it’s more accessible to families in the Valley and could decrease their chances of encountering an immigration checkpoint. But Stanley Fisch, a professor of pediatrics at the University of Texas Rio Grande Valley, says a trip to the hospital would still mean a day of driving and waiting for procedures.

“It is not something you can do at eight o'clock in the morning and be back in school or at work at nine. Unless it’s across the street, it’s always going to be a problem for somebody to get to the healthcare services,” Fisch said, adding that many families in the Valley have only one or no vehicle at all.

Research shows that about 5% of Texas households don’t have access to a vehicle. Of these, about a quarter live more than 60 minutes from a pediatric hospital. Many of these households are in rural South Texas counties such as Brooks, Starr and Zapata that offer fewer public transportation options.

Fisch is hopeful that the new pediatric hospital and University of Texas Rio Grande Valley’s School of Medicine, founded in 2014, will continue to increase access in the region by attracting medical personnel and providing specialists with an opportunity to teach and conduct clinical trials.

“The Valley is a nice place, nice place to live, and I suppose to work. And with Driscoll and the medical school, I think we're going to do OK eventually, but it's going to take a while,” said Fisch.

Svatek recommends that parents consult with their primary care pediatrician about which hospital they should take their child to in an emergency. Parents can also contact hospitals in the area and speak with a quality improvement director or pediatric emergency care coordinator.

This story was updated on September 27 to correct Dr. Mandie Svatek's title and to specify that Driscoll Children's Hospital is the only children’s hospital designated by the Centers for Medicare and Medicaid Services south of Corpus Christi.

Liza Kalinina is a graduate student at Texas State University and an intern with Texas Community Health News, a collaboration between the School of Journalism and Mass Communication and the university's Translational Health Research Center. TCHN stories, reports and data visualizations are provided free to Texas newsrooms.