Places We Go: Borderland—El Paso, Las Cruces and Ciudad Juarez

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Metering out aid at the US/Mexico border.

On my return trip to El Paso this past July to continue helping migrants arriving from Central America, I decided to make it a broader effort in the Borderland.  The New Mexico Medical Reserve Corps put out a call seeking help at one of their shelter sites, the Armory located in Las Cruces.  I coordinated my time for the week by working mornings with them, then driving an hour back to El Paso at the Casa de Refugiado (CDR), the main center run by Annunciation House.


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Halfway through the week, I learned firsthand that many migrants were being “metered” in place—i.e., left on the Mexican side of the border and processed by their immigration services instead of reaching Texas.  So along with two native El Pasoans, Ramon (a medical student) and Luis (a social worker), a couple times that week, we brought medical supplies in bags and walked across the Paso del Norte Bridge and helped pass out food, diapers, water and render minor medical aid to migrants under the bridge.

These pictures represent the three sites.  Rather than write long paragraphs as I did in my prior Places We Go pieces, I am hoping the pictures tell the story of what we saw, did and who we helped.

Figure 1: Las Cruces


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a: Our facility, the Armory, was a former military base.  We had living quarters for migrants, a kitchen/dining hall, office space and several rooms for medical care.

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b: One of the back garages was used to store donations—shoes, clothes and belts for all ages.


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c: Belts and pillows were at a premium, so I used my military ID to purchase several items at the military clothing sales store on Fort Bliss.

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d: We had one intake room for vitals and this was one of our exam rooms—all the equipment was donated by local medical offices.  Each day a bus or two of migrants would get dropped off by ICE. I asked our team to screen them medically by simply taking a temperature after they had a chance to eat, drink and cool down from the heat.  I figured we could pick up febrile illnesses much faster that way as a way of triage.

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e: Our medication cabinet had basic over-the counter medications and we had a vault (literally, since it was an Armory!) full of donated medications from the community.

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f: One of the most important features in a volunteer, stand-up clinic with high turnover of patients and providers is establishing what local ERs/EMS services were available.  It was always challenging clinically to know where to draw the line and either treat in our small clinic or send someone to the ER for labs, IV medications, imaging, etc.  Many migrants would go get treated in the ER, come back with prescriptions they could not afford and then miss their bus or plane to their final destination.

Looking back, I wish we had the ability to keep just one to two antibiotics and inhalers, but because we had no pharmacy license, we could only give out over-the-counter treatments, per state regulations.  The solution I came up with was to post and exclusively use the $4 Wal-Mart list so we could save money with our limited budget when buying prescriptions for those needing antibiotics, inhalers, hypertension, seizure or diabetes medications.

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g: The Armory was unique among the sites I worked in because they set-up a quarantine area for those with febrile illnesses.  Basic, great public health concept, but was not replicated among the sites—communication between the sites and states was sparse and would definitely have helped outcomes.  The New Mexico site also had a standard history and physical form that I would have like to see the folks in Texas replicate.  The reality was that our patient turnover was so rapid, the medical documentation was sparse, at best.

Figure 2: El Paso

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a: We were asked not to take photographs of any migrants inside any of the facilities.  Many that had passed through for just one to three days took to beautifying the old warehouse of CDR with incredible, vibrant murals like this one —“Esperanza” or Hope.

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b: Each night, I had one to two students from Texas Tech medical school. This is Nikhil, a second year, who did an incredible job.  On his shift, we had a few Portuguese speaking migrants so he came up with the idea to use Google Translate to assist them—so creative!

 

Figure 3: Ciudad Juarez

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a: I took this picture as migrants were gathering under the main tent area.  The tents were set up under an overpass about 200 yards from the highway and 500 yards from the Paso Del Norte bridge that we crossed by foot from El Paso to Juarez.  After getting processed with papers and ID photographs by the Mexican Immigration services, migrants were led to chairs for briefings on their next steps.

The chairs held about 400 people. For the times I was there, they were about a third full.  The blue buckets are diapers to give out to moms and babies.  Off to the right, we had a table with sandwiches, snacks, water and shoelaces to give out.  All of those items were prepared daily by volunteers from Grupos Beta, a Mexican non-profit organization dedicated to helping migrants.

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b: Off to the side in the front of the tent was a smaller medical tent area.  Here, Luis is helping set-up a cot for a patient.  We met several Mexican medical professionals that were volunteering there and ended up leaving a few bags of extra Armory supplies so they could treat patients in Mexico (at this site and others inside the city).

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c: Juarez was so vibrant, colorful and festive! The red building to the middle-left is a border/customs museum.  It is where President Taft met Mexican President Porfirio Diaz in 1909.  The building beyond that is Our Lady of Guadalupe Cathedral, part of a religious complex that is over 350 years old.

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d: This is the famous “La Equis” sculpture.  Highly visible throughout the Borderland, the 197-foot monument represents mestizaje or the mix of Spanish and indigenous cultures that make up modern Mexico.PWG_Borderland Fig3e

e. Our final trek back to the States from Juarez. We paid a nominal fee to come and go and the lines were not too bad. Along the foot path were vendors and many folks carried packages of medications that were cheaper to buy in Mexico and bring back to the U.S.

ABOUT THE AUTHORS

Debjeet Sarkar is an attending emergency physician at Howard County General Hospital and Assistant Professor, USUHS SOM, Dept. of Military & Emergency Medicine.

Ramón Villaverde-Castañeda is a first-year medical student originally from the El Paso-Ciudad Juárez area. As a future physician from the US-Mexico border, he cares deeply about promoting patient-centered and humanistic medical care in the region.

Luis Enrique Jacquez is a social worker and graduate of UTEP.  He is currently employed by the Hope Border Institute as a border-coordinator in Ciudad Juarez.

2 Comments

  1. What medical volunteer organizations serve Juarez that a medical student from El Paso could volunteer with? Which organization did you work with when you were over there? Thanks for the info.

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