A look at how physicians and volunteers provide vital care for asylum seekers.
Two cities, dos ciudades, El Paso, Texas and Ciudad Juárez, Mexico are my home. They comprise one of the largest binational metropolitan areas in the Western Hemisphere and represent a rich, continuous interchange of language, people and culture. For me, this part of the US-Mexico border has always been a source of inspiration and pride.
I was born in El Paso to a family originally from Ciudad Juárez and I grew up crossing the border frequently to spend time with family and friends on both sides. My family continues to live in this border region. I am frequently in awe of how members of this community, by way of intermingled families (like my own) and friendships, work to make this a united region in spite of geopolitical barriers.
In challenging times, such as the recent horrific tragedy of a mass shooting with 22 deaths at the Cielo Vista Mall Wal-Mart on Aug. 3 and the ongoing humanitarian crisis from the Northern Triangle countries, this unity in both communities holds immeasurable strength. I feel incredibly fortunate to be a part of two cities that seek to show the world that no one is less human or less worthy of respect for being born on one side of a border.
The lessons of our shared common condition have come to the forefront of my life as I spent the spring and summer before starting medical school at UC-San Francisco back home in Texas. For the last five months, I had the privilege of volunteering at the various medical clinics for migrants that sprung up around El Paso.
These clinics, embedded in old 1970s motels, provided vital humanitarian care for thousands seeking asylum in the United States. The care was desperately needed given the arduous nature of the migrants’ journeys and the subsequent minimal care they received in detention at the southern border. Like many Americans, I read distressing reports of migrant children dying while detained and could not sit by idly. El Pasoans, Juarenses and volunteers from different parts of both countries responded to this in a massive effort to help those in need.
My particular role began in Spring 2019, where I helped arrange the space the future medical clinic would occupy at the largest shelter, Casa del Refugiado, run by Annunciation House. I was thrilled to have the chance to see the logistics and planning unfold and, ultimately, see the clinic fill its purpose as the first patients began to arrive in May. In July, I was able to sign up to work several volunteer shifts just prior to starting my medical school orientation.
The first patient I met was Angel, a little boy who was accompanied by his parents and sister. My responsibility at the clinic was to take an initial patient history, take basic vital signs, and assist within my role as a student with Dr. Debjeet Sarkar’s physical examinations.
Several of Angel’s family members had fevers that week and he was now also not feeling well. As I prepared to get basic vitals, I was immediately struck by the enthusiasm Angel displayed (even while sick) to let me listen to his heart and check his ears, nose and throat. He seemed fascinated by the stethoscope and eager to show his family he was a good patient.
After having received a sticker of a perrito (a dog, his favorite animal), he then supported his younger sister as it was her turn to see the doctor. It is amazing what children can do for each other and I could only imagine what the two of them had seen and been through on their journey—and what they would carry with them into childhood and beyond.
After examining the family, Dr. Sarkar and I recognized that three of them clinically had strep throat. In a close-quarters setting like the shelter, we were concerned the infection might spread to the nearly 300 others in the main sleeping quarters. Unfortunately, we did not have any access to antibiotics nor could we truly isolate the family of four given we only had one exam room. After a quick Google search, we found a Wal-Mart open late nearby. Dr. Sarkar called in three prescriptions of Amoxicillin and I went to pick them up. It took some time, but we were able to provide the family with medications they would otherwise potentially never have gotten.
Angel and his family’s story were common. Over the rest of that shift and the next night, we ended up replicating a similar process: vital signs and exam on 3-4 family members at a time and often finding the need for antibiotics or inhalers or other common prescriptions. As a student, it was interesting to see the steps to get a prescription filled—particularly since the migrants had no insurance or identification cards.
Also, several of the older migrants had all of their chronic medications confiscated by ICE, but they were not given back upon release to our facilities. We helped where we could with refills–particularly if we knew they had a long journey ahead or their fingerstick glucose tests or blood pressure were high in our clinic.
Being a migrant can mean facing an enormous amount of adversity and uncertainty. In spite of these roadblocks, many migrant families like Angel’s maintain optimism and strength and they form bonds with other families along the way.
These characteristics are the antidote to the ever changing circumstances in which they live. From my time working with migrants the last five months, I believe that a physician’s role in every circumstance should be to support those bonds and respect the dignity of all people and families. It is an immense privilege to study medicine, and I am grateful to have begun my path in a binational community that is, and will always be, my home.
Special thanks: Dr. Carlos Gutierrez, who mentored me this Spring and Summer and Dr. Debjeet Sarkar, who edited this article and who I worked with for my clinical shifts in July.