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Perspective | Magazine

I was a paramedic at the US border. Kids need doctors now.

US policy endangers the lives of desperate asylum seekers. We must send medical help immediately, especially for the children.

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What’s happening at the US border with Mexico is not a security crisis, but a humanitarian one, rooted in policies adopted decades ago. Its consequences won’t be fully understood for years, but we don’t have time to wait. Medics who treat the sick, injured, and dying on this civilian front line are calling for urgent action, and the government must heed that call.

I spent most of 2015 and part of 2016 in southern Arizona, where I worked with local fire and rescue departments and humanitarian aid groups. As an anthropologist who is also trained as a paramedic, I went with a National Science Foundation grant to learn how security buildup in the region affected those who live in the borderlands.


The teams I worked with carried the injured away from the US-Mexico border wall to ambulances, visited sick children locked in a Border Patrol processing facility, and cleaned the infected blisters of those who saw the walk across the desert as their best option. I can still hear the swooshing of the helicopters that took critical patients to the trauma center in Tucson, 75 miles away. I hear their pleas for water, too. But mostly what I remember is the eerie silence, an atmosphere of resignation, in which we cared for the wounded. As paramedics, we were called to deal with the inhumane consequences of our border enforcement policy, not to question it.

The physical and psychological trauma I witnessed along this section of the nearly 2,000-mile border is not new, but it is getting worse. So much so that on July 8 the UN high commissioner for human rights, a pediatrician by training, said she was “appalled” at the conditions in which migrants and refugees, including children, are being held in detention in the United States.


We know that at least 7,500 people have died trying to cross the border over the past two decades. Just last month, emergency responders found an unresponsive 47-year-old man lying on the ground on the US side of the 20-foot slatted steel wall, now topped by concertina wire, that divides Nogales, Arizona, from Nogales, Sonora, Mexico. The surgeons in Tucson could not save his life. The government has not released his name, but the Nogales International newspaper reported he had lived in Arizona and California since he was 2, before being deported to Mexico last winter.

Official statistics likely underestimate the number of lives lost in the pursuit of safety, jobs, and the American dream. We don’t know how many have been injured. More than two years ago, I filed a Freedom of Information Act request with Customs and Border Protection for the number of unauthorized border crossers whose medical condition warranted care in a medical facility. I’m still waiting. What we do know is that these deaths and injuries are an anticipated effect of a border enforcement strategy known as “prevention through deterrence.” Introduced in 1994, the strategy intends to make the journey so perilous that these migrants would give up trying. But it hasn’t dissuaded those who have no better alternatives.

Trauma surgeons, pediatricians, psychologists, and other health professionals in the border region have started noticing patterns in patient injuries and illnesses: fractured ankles and spinal injuries, severe dehydration and kidney failure, anxiety and depression caused by family separation. Although medical ethics requires them to provide care regardless of the patient’s legal status, and thus absolves them from taking sides in political conflicts, there is a point when silence means complicity with the status quo.


Physicians for Human Rights, formed in 1986 by a group of medical and legal professionals working in Massachusetts, released a report in January on the health effects of punitive immigration enforcement practices. The group criticizes Border Patrol for violating US and international law by “using hospitals as de facto detention centers,” vandalizing water supplies, and criminalizing volunteer first responders who are providing water and other lifesaving care to migrants. They urge Congress to exercise oversight of federal agencies operating at the border to ensure compliance with legal obligations. And they’re calling on Customs and Border Protection to improve training, investigate and sanction violations committed by its personnel, and work with outside groups to prevent fatalities and decrease health risks.

The Border Patrol’s failure to address the crisis is not surprising. Agents are not medical professionals or social workers. Facing intense public criticism, the Border Patrol has been hiring more agents trained in first aid and, after several widely reported cases of children dying while in their custody, has come under pressure to take medical complaints seriously. But these measures barely scratch the surface of the problem.

Despite the government’s attempt to suppress information about what is going on inside detention centers, doctors are speaking up. For more than a year, the American Academy of Pediatrics has been urging the Department of Homeland Security and the Department of Justice to end family separation. Since AAP leaders toured two CBP facilities in June, the group has been calling for pediatricians to be at every facility that holds children.


The body politic is ailing. We have the diagnosis. What we need now is an urgent intervention. We need to send doctors and nurses. We need pediatricians. And, perhaps above all, we need psychologists and psychiatrists who know how to help people who have fled violence, political unrest, and economic hardships—who have come seeking refuge, but instead have met with more trauma.

Ieva Jusionyte is the author of  “Threshold: Emergency Responders on the U.S.-Mexico Border.” Send comments to magazine@globe.com.