October 1, 2022

Homelessness: migrants see their health problems persist and worsen while waiting at the border

CIUDAD JUAREZ, Mexico — Two days after arriving at a temporary migrant shelter on the US border in June, Rosa Viridiana Ceron Alpizar’s 9-year-old daughter and one-year-old son fell ill. Most of the children in the converted gymnasium had stomach problems after being given a meal of sausages and beans, she recalls.

Alpizar’s daughter improved rapidly, but her son did not. José had fever and diarrhea and was vomiting. When nurses at the shelter couldn’t help her, Alpizar called in a private doctor, who prescribed her antibiotics.

In mid-June, Alpizar, his partner, children and brother moved to Leona Vicario, a former factory that the Mexican government had converted to house migrants waiting to cross into the United States. Weeks later, a doctor said her son still hadn’t improved. “He showed me the painting again and told me it was still the same,” Alpizar said in Spanish through an interpreter while at a shopping complex near the shelter. . “He is still undernourished.

People at a gate of the Leona Vicario migrant shelter in Mexico
People are seen at the Leona Vicario migrant center in Ciudad Juarez, Mexico, January 19, 2022.

Salwan Georges/The Washington Post via Getty Images


Three years ago, Mexico had few shelters for migrants heading to the United States. asylum, like Alpizar and his family, reported to U.S. authorities and were usually either held in U.S. facilities or released on parole pending trial. In both cases, they had potential access to the American healthcare system.

But a constellation of US immigration policies, a growing number of asylum seekers and refugees, and the Covid-19 pandemic have turned Mexico’s border towns into staging areas for people waiting for policies to change and hoping to cross over and head north. And despite recent efforts by the Biden administration to cancel some of these policies, not much seems likely to change in the coming months. Alpizar and his family are now among thousands of people living in dozens of newly built Juárez shelters a few miles from El Paso, Texas.

The wait – which can last for months – has led some migrants, like the children of Alpizar, to develop health problems; exacerbated chronic diseases, such as hypertension or diabetes; left some in dire conditions without care; and compounded the trauma experienced by those fleeing their homes.

Below Title 42an emergency public health order that the Trump administration first invoked in March 2020 to stop the spread of COVID, Alpizar and his family are not allowed to come to a border checkpoint and ask for permission. asylum – they would be immediately deported to Mexico without screening.

The policy, which is just one of many that have held back migrants in Mexico, is actually ‘counterproductive’ in protecting people from covidaccording to KFF research.

The Leona Vicario shelter has experienced outbreaks of chickenpox and measles since it opened in 2019. It is still considered one of the best shelters because it is run by the Mexican government. Nonprofit and private shelters operate with little oversight and vary in quality.

A man is tested for COVID-19 at the Leona Vicario shelter
A man is tested for COVID-19 at the Leona Vicario shelter in Ciudad Juarez, Mexico, before entering the United States on March 11, 2021.

PAUL RATJE/AFP via Getty Images


Some migrants sleep on the streets. In general, the conditions make people sick and care is limited, said Gabriela Muñoz, project manager for the Las Americas Immigrant Advocacy Center in Juárez.

Alpizar decided to travel to the border from Cuernavaca, a town south of Mexico City, she said, after an attempt to kidnap her children. On the same day, her brother Angel and his partner, Pablo Sandoval Arce, were beaten as they returned home from painting an apartment. She told Pablo, José’s father, that it was no coincidence.

Alpizar reported the incidents to local police, she said, but was told nothing could be done. A few days later, they arrived in Juárez with money from Alpizar’s aunt in South Carolina, who had helped raise Alpizar and his brother after their mother’s death. Alpizar is now trying to get a Title 42 exemption that would allow his family to file for asylum and join his aunt until their case is heard.

Las Americas receives about 4,000 calls a day, said Crystal Sandoval, director of strategic initiatives at the El Paso center. Only about 100 draw a response. About 70% of callers need medical attention – they need immediate treatment for cancer, have a condition like diabetes that is out of control, or have developed anemia. Others have been sexually assaulted or have high-risk pregnancies. The group helps 60 to 90 people a week obtain exemptions, allowing them to apply for asylum and wait in the United States for their court dates.

Immigration advocates say not only has Title 42 done more harm to public health than good, but the rule has been selectively enforced. U.S. Customs and Border Protection has detained migrants about 1.7 million times in the current federal fiscal year, which began Oct. 1. About half of those stops resulted in a Title 42 deportation, according to the agency. About 65% of them were people from Mexico, while the vast majority of the other deportations were people from El Salvador, Guatemala and Honduras. In April, however, US authorities temporarily allowed Ukrainians in Mexican shelters at enter the United States

In many ways, the medical history of the Alpizar family isn’t the most extreme. Other migrants have immediate, life-threatening needs. In 2019, after five months of waiting in a shelter, a Ugandan woman died in a hospital in Juárez – the same week authorities processed her asylum claim. She died of sepsis, pneumonia and tuberculosis, according to an autopsy.

Alpizar’s situation mirrors how U.S. immigration policy has outsourced migrant care to Mexico, said Jeremy Slack, an immigration researcher at the University of Texas-El Paso who first met Alpizar. during a weekly visit to Leona Vicario.

Federal courts have delayed or blocked attempts by the Biden administration to lift certain immigration policies. In May, a few days before Alpizar started its journey, a federal judge prevented the Biden administration to stop the Title 42 ordinance.

Some non-profit organizations, meanwhile, seek to help migrants access healthcare while waiting at the border. The Hope Border Institute, a Catholic nonprofit, has set up a fund to help them see private doctors, pay for hospital stays, fill prescriptions and cover transportation to appointments. .

When a doctor advised Alpizar to put their son on a special diet, the family first went shopping to buy him food not available at the shelter, which houses around 600 people. Later that day, however, when they checked a fridge shared by shelter residents, the fruit and yogurt were gone. Pablo now does his shopping three times a week, buying only small amounts to feed his son.

Then, at the end of July, a doctor at the shelter diagnosed José with conjunctivitis and gave him antibiotic drops. Shortly after, her sister, Zoe, tested positive for COVID and the family was sent to the shelter’s isolation ward.

Gastrointestinal issues, respiratory illnesses like COVID, and skin conditions are common in congregate settings, like shelters, where people are crammed into tight spaces, said Dr. Julie Linton, co-chair of the American Academy of Pediatrics Council on the Health of Immigrant Children and Families. She treated many newly arrived children who had multiple parasitic infections because they lacked clean water or access to sanitary conditions during their journey.

José could have something even more serious, but specialized care and testing is not available for migrants, said Dr. Bert Johansson, an El Paso pediatrician who volunteers at Mexican shelters.

Or maybe José just needs a stable place to recuperate.

Chronic stress suppresses the immune system, making infections more likely and recovery more difficult, Linton said. Long waits also cause or intensify existing trauma, said Marisa Limón, senior director of advocacy and programming at the Hope Border Institute. Mental health issues are among the most common health issues for people in shelters and detention centers, Linton said.

In July, Las Americas officials told Alpizar she would have to wait at least eight to 10 weeks before finding out if her family would receive an exemption.

Alpizar considered crossing illegally but did not have the funds. A sense of desperation led migrants to make this dangerous journey.

The lack of legal avenues to seek asylum “causes people to take more risks, in more dangerous areas,” said Eddie Canales, director of the South Texas Human Rights Center. “The border is a graveyard.”


KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.