Borderline Emergency

Keridwen CorneliusMarch 30, 2020
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Illustration by Jess Suttner
Illustration by Jess Suttner

Local nonprofits and medical professionals are working hard to address the staggeringly complex and ominous health care crisis on the border.

On a Saturday morning in South Phoenix, immigration officials drop off eight asylum-seeking families at a deserted-looking former elementary school, now a welcome center run by the International Rescue Committee. The parents walk in warily, carrying their belongings in garbage bags. A mom with an ankle monitor bulging from beneath her black leggings balances her baby on her hip. A father and son shuffle in wearing floppy sneakers after detention center staff confiscated their shoelaces to prevent suicides. Several kids spot the toy collection and beeline over to play.

Cecilia Garcia is excited to meet them all. As she shakes their hands and greets them warmly in Spanish, their uneasiness melts away. After an arduous trek from Mexico, Central or South America, plus weeks in detention and borderside tent camps, Garcia’s beaming smile must be a heartening sight.

“We’re the first friendly faces they encounter after a long journey,” says Garcia, founder of One Hundred Angels, a nonprofit that provides basic medical care to asylum seekers. “I feel it’s our responsibility to show the greatness of this country.”

She leads the families to One Hundred Angels’ pop-up station, where three volunteer medical students evaluate the families and give them over-the-counter medications. They hand lollipops and plush toys to the children, stack baby food into the parents’ arms, and give them letters of introduction to low-cost medical clinics in their destination cities, where they will stay with a sponsor family until their asylum hearing.

“Our professional medical community is eager to help,” Garcia says of her 200 or so intermittent volunteers. “They love coming over and being able to touch and hug and laugh and cry with these people.”

In 2019, their first full year of operation, One Hundred Angels assisted 15,598 asylum-seekers. Still, their efforts are a tiny Band-Aid on the enormous, open wound that is the border health crisis – one that especially deserves attention during this time of pandemic fears.

Due to a mix of budget shortages and deterrence policies, federal immigration detention centers are not providing adequate health care to asylum-seekers and other migrants, who often suffer from injury, illness and mental trauma. The lack of health screening, vaccinations and sufficient treatment makes disease outbreaks and other health disasters a constant threat.

One Hundred Angels, plus other grassroots organizations and churches, are trying to pick up the slack. But they are desperately under-resourced and overwhelmed. And it’s creating a precarious situation for immigrants and American citizens alike.

In February, a federal court found the conditions in Tucson Sector detention facilities to be unconstitutional, “presumptively punitive” and “substantially worse” than prison. According to court documents, Customs and Border Protection (CBP) fails to provide adequate health care, even when detainees experience symptoms such as heavy bleeding, heat stroke and pneumonia. Migrants are often kept in overcrowded, unsanitary, uncomfortably cold cells nicknamed hieleras (“iceboxes”). They are sometimes forced to sleep on the bare floor by the toilet. They are often denied showers, soap, sufficient toilet paper, food and potable water.

This creates “a perfect storm for infection to spread,” says Chandra Goff, a Phoenix physician assistant who volunteers with One Hundred Angels. “Even if these people are not at higher risk for bringing diseases to the United States, they’re certainly at higher risk for spreading them because they’re being forced to stay in such unhealthy conditions. So I think there are things we should be doing for Americans’ benefits… to make sure these people are not at higher risk for spreading infections once they come here.”

Last summer, following the death of three detained children due to complications from influenza, doctors from Harvard and Johns Hopkins university hospitals sent a letter to Congress requesting that CBP screen and vaccinate children for flu. CBP responded that it does not vaccinate detainees because they are in custody for only a few days (though immigration lawyers report that some are held for weeks).

Immigration Trends

In April and November 2019, Pew Research illustrated border issues in five charts. This one shows that immigration from Mexico has mostly been declining since 2000, but in 2019 there was a steep increase in families coming from Central America, largely due to severe violence and poverty.

Source: U.S. Customs and Border Protection.
Source: U.S. Customs and Border Protection.

In December, around 60 doctors and activists attempted to provide free flu shots for children at a detention center in San Diego, but CBP barred them from entering. A Department of Homeland Security spokesperson later tweeted, “Of course Border Patrol isn’t going to let a random group of radical political activists show up and start injecting people with drugs.”

One Hundred Angels avoids these roadblocks by traveling to the border and vaccinating families minutes before they enter detention. In recent months, the organization has conducted three such clinics in partnership with Lutheran Social Services of the Southwest, Lutheran Immigration and Refugee Service and the Mexican Red Cross.

In addition to infectious disease, asylum-seekers and other migrants also frequently suffer from severe physical and mental health issues. In a recent op-ed for the Tucson Sentinel, medical student Claire Lamneck wrote, “The real border crisis is what hospitals near the southern border see every day,” including people who break bones or lose fingers climbing over the border wall, and infants who develop pneumonia in the hieleras.

Garcia tells of a 5-year-old girl who fell from a train and got her hand caught in the wheels. Goff recalls a transgender man whose mother sold him to an old man who raped him and got him pregnant. A 2019 report from Physicians for Human Rights describes high rates of trauma among children fleeing the gangs that terrorize Central America. In the report, numerous asylum-seeking children recounted seeing family members riddled with bullets, bludgeoned and dismembered. The children themselves had been kidnapped, gang-raped and macheted.

If these migrants are granted a right to stay in the U.S., they bring these issues to Arizona and other states, as they visit hospitals and health care clinics, attend school and get jobs. “This is a humanitarian crisis that transcends our border,” observes Dr. Vicente Diaz-Gonzalez, a Goodyear pediatrician and internist, and One Hundred Angels’ medical director. “I don’t want to say it’s our responsibility, because it’s not my place to say it, but the problem is already here, and we’re not dealing with it.”

Diaz-Gonzalez says grassroots organizations try to help, but it’s difficult to get grants, resources or political support, because immigration is such a controversial issue. So they do what they can with what little they have. “I’m a doctor,” he says, “so my sense is to protect life. It’s about being compassionate and taking care of those in need.”