As the stretcher was wheeled into the room, my attention was drawn away from the patient chart by the sight of a burly man in the characteristic dark-green uniform of the U.S. Border Patrol. The patient, a young woman, shivered and struggled to maintain composure while a spinal collar immobilizing her neck suggested a possible fracture. I inquired if she had fallen from the wall and learned that she had fallen from the daunting height of 18 feet, and was found lying on the ground. The heavy rain and slick terrain during the monsoon season make it possible for she or any undocumented immigrant to climb the wall.
As a medical resident, in the past year, I have witnessed the consequences of U.S. border policies from both sides of the border. As co-founder of Clínica Hope in Juárez, I have treated migrant patients who have been turned away from the U.S. border and forced to endure unbearable conditions while waiting in Mexico. As an emergency-room resident at the University Medical Center in El Paso, Texas, I provide care to those who could not wait any longer at the border.
On inspecting the young woman fallen from the wall more closely, she appeared to be in her late 20s like myself. Her clothes were drenched with loose dirt and sand sticking to them, and a well-worn hoodie and sweatpants adorned her slender frame. I approached her to comfort her and noticed that she was trembling in fear. In fumbling Spanish, I introduced myself and reassured her that she was in safe hands; we would remove her wet clothes to make sure her injuries weren’t greater than immediately apparent.
With the assistance of the nursing staff, we removed the patient’s Converse sneakers and socks, revealing Mexican pesos cascading out of them onto the bed. Using trauma shears, we cut through her soaked hoodie and sweatpants to expose a Chicago Cubs jersey and jeans underneath, a prototypical American outfit. Upon cutting through the jeans, the patient winced, and we discovered a swollen and misshapen right-leg riddled with fractures. We found more pesos, some jewelry, and a soaked Colombian passport that the nursing staff carefully packed into a bag for the patient.
One policy that remains particularly alarming is Title 42, applied under emergency public health protocols to rapidly expel undocumented immigrants without due process or any future hearing. It is a measure that has led to dangerously high numbers of migrants waiting in unsafe border communities. According to Human Rights First, more than 10,000 migrants removed to Mexico under Title 42 experienced various forms of violence, including kidnapping, rape, torture, and murder.
Despite the high costs associated with asylum-seeking and illegal immigration, people, particularly women and children, are willing to pay incalculable costs for their chance at a better life. In the ICU of El Paso hospital, I encountered a woman grieving the loss of her 10-year-old daughter, who had perished on their journey across the border, hit by a car.
The demographics of migrants seeking asylum at the border are highly volatile. In September, most migrants were Venezuelan, crossing the Darién Gap by foot, a jungle between Panama and Colombia, notorious for bandits, inclement weather, and disease. The El Paso community, however, rose to the challenge, welcoming newcomers in shelters. In addition, the shift in U.S. government policy requiring asylum seekers to request asylum in the first “safe” country they reached outside their own has resulted in increased migrant populations at Juárez shelters. Despite this change, many asylum seekers lose hope and resort to attempting to climb over the wall, resulting in the rising number of injured and traumatized patients ending up in my emergency department.
Every time I cross the border to get from the Juárez clinic to the El Paso emergency department, I think about how simple it is for me, yet for so many others, it costs them everything to try. Sadly, the injuries and deaths of my patients are avoidable, but the costs are deemed acceptable by American society to those seeking a better life.
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