By Eileen Crespo, MD, FAAP, Pediatrician at Hennepin Healthcare and Vice President of Medical Services at Delta Dental of Minnesota
Eileen Crespo, MD, FAAP, recently returned from a trip to the United States – Mexico border to provide medical attention to migrants awaiting admission to the U.S. She offers this reflection of her experience to Minnesota Pediatrician.
I recently traveled to the Tijuana border shelters as part of the Minnesota Caravan Solidarity Group. The group was made up of three physicians (one pediatrician — yours truly — a med-peds physician and an adult neurologist), one nurse, two medical students, a diabetes clinic community health worker, and a retired child psychiatry nurse. It was a rag-tag team of volunteers who could get away on minimal notice for an intense, long weekend. Some in the group had done international medical volunteer work in the past but this was a unique situation. We’d seen reports that the Mexican people weren’t excited to “host” the group and there had been some backlash. So, we left feeling some anxiety about the conditions of the migrants and the general situation we might find ourselves.
We arrived in San Diego and were met by an amazing coordinator. Phil Canete is a math teacher during the week, but on weekends, he volunteers with San Diego Border Dreamers organizing medical volunteers, mostly from California. We were the first team from Minnesota. Phil communicates with the multiple shelters housing migrants and arranges the volunteer groups who are then deployed to provide care.
We saw common illnesses: coughs, colds, gastroenteritis, one likely case of influenza and a probable case of strep throat. The adult providers saw uncontrolled diabetes, hypertension, and headaches. The group saw a few unusual things, such as a severe eye infection in an adult, young siblings with a rare genetic metabolic abnormality (previously identified when the family had lived in California), and I saw one case of extensive varicella, something I haven’t seen since my University of Minnesota residency in the early 1990’s. And, we saw contagious conditions such as lice and scabies. The scabies issue was particularly vexing since it was already spreading at an encampment where environmental control was not possible.
We were most troubled, however, with the widespread mental health issues. This was reminiscent of what some in the group had experienced when we traveled to Puerto Rico in the aftermath of Hurricane Maria in 2017. In Tijuana, we saw stress and anxiety in both adults and children. One notable example was a little girl who refused to eat without her mother present for fear she might be separated and never see her mother again. It’s not difficult to imagine the pervasive stress and anxiety given the long, arduous journey from Honduras, mostly by foot, and the ongoing uncertainty that continues since they’ve arrived at the United States border. The entire trek is estimated to have been 2,700 miles and many had walked for three months or more to be met by a literal and figurative wall.
“…a little girl…refused to eat without her mother present for fear she might be separated and never see her mother again.”
We learned that claiming asylum is a human right through international law. Asylum seekers must have credible fear of persecution or torture in their home country that precludes their return. Asylum seekers can remain in the country where they are applying while their asylum application is processed. Migrants arriving at the border claiming asylum need to meet with an immigration judge. But we learned that immigration judges are overwhelmed by the sheer numbers, so migrants are waiting weeks to months. Many migrants shared harrowing stories about the conditions in their home country including gang violence, widespread corruption and a violent drug culture.
Our group was glad to get back safely. However, we are saddened by the ongoing negative characterization of the migrants and the injustice of delaying asylum claims. We are planning future missions and will tailor our teams to provide more psychologic resources based on our observations during this first trip. We will continue to monitor the situation as another migrant caravan is heading toward the U.S. border and is estimated at more than 10,000 people. They may need our help.