As migrants wait at the border, they see health problems persist and worsen.

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CIUDAD JUAREZ, Mexico — Two days after arriving at a temporary refugee shelter on the border with the United States in June, Rosa Viridiana Cerón Alpizar’s 9-year-old daughter and 1-year-old son fell ill. Most of the kids in the converted gym had stomach aches after eating sausages and beans, she recalled.

Alpizar’s daughter recovered quickly, but her son did not. Jose had fever and diarrhea and was shaking. When the shelter’s nurses couldn’t help, Alpizar sought out a private doctor, who prescribed antibiotics.

In mid-June, Alpizar, her partner, her children and her brother moved Leona VicarThe former factory, which the Mexican government has turned into a home for migrants waiting to cross into the United States, says a doctor says her son is still not improving. “He showed me the chart again and said it’s still the same,” he said through an interpreter while at a market near the shelter. “He’s still malnourished.”

Three years ago, Mexico had few shelters. Immigrants to America Asylum seekers like Alpizar and her family have turned themselves in to US authorities and are often held in US facilities or released on parole while they await processing. Either way, they had access to the American health care system.

But the constellation of US immigration policies; An increasing number Asylum seekers and refugees and the Covid-19 pandemic. Mexican border towns have been turned into holding places For those who are waiting for and will change the policies Hoping to cross over and go north. Although the Biden administration has recently moved to address some policies, little is likely to change in the coming months. Now there is Alpizar and her family Thousands of people living in dozens of recently built shelters in JuarezIt is a few miles from El Paso.

keep out – This can last months – caused some refugees to develop health problems, such as Alpizar’s children; It got worse Human chronic diseasessuch as high blood pressure or diabetes; He left some uncared for in difficult situations; And it exacerbated the trauma of people fleeing their homes.

root Title 42, the Trump administration’s first public health emergency order In the year In March 2020, to stop the spread of Covid, Alpizar and her family will not be allowed to present themselves at a border checkpoint and ask for political asylum – they will immediately be deported to Mexico without screening.

He described the policy, just one of many that hold immigrants in Mexico, to protect people from Covid-19. KFF research.

Leona Vicario’s shelter has had outbreaks. Poultry disease And Measles In the year Since its opening in 2019, it is still considered one of the best shelters since it is managed by the Mexican government. Nonprofit and private shelters operate with little oversight, and their quality varies.

Some refugees sleep on the streets. Gabriela Muñoz, project manager at the Las Americas Migrant Advocacy Center in Juarez, said overall conditions are making people sick, and care is limited.

Alpizar decided A trip to the border She spoke after an attempted abduction of her children from Cuernavaca, a town south of Mexico City. That same day, her brother Angel and her partner Pablo Sandoval Arce were beaten up while returning home from work painting an apartment. She tells José’s father, Pablo, that it wasn’t an accident.

Alpizar said she reported the incidents to the local police, but was told nothing could be done. A few days later, they arrived in Juarez with money from Alpizar’s aunt in South Carolina, who had helped raise Alpizar and her brother after their mother died. Alpizar is now trying to get a Title 42 exemption that would allow her family to apply for asylum and join her aunt until their case is heard.

Las Americas gets about 4,000 calls a day, according to Cristal Sandoval, director of strategic initiatives at the El Paso center. Only about 100 responded. About 70% of callers need medical help – they need urgent cancer treatment, have an uncontrolled condition such as diabetes, or have anemia. Others have been sexually assaulted or experienced high-risk pregnancies. The group helps free 60 to 90 people a week, allowing them to apply for asylum and wait for their court dates in the US.

Immigration advocates say that Title 42 not only does more harm to public health than it does good, but that the law has been selectively enforced. U.S. Customs and Border Protection has stopped about 1.7 million immigrants in the current federal fiscal year, which began Oct. 1. About half of these stops result in deportation under Title 42. According to the agency. About 65% of them are Mexican, and most of the deportees are from El Salvador, Guatemala, and Honduras. But in April American authorities have temporarily allowed Ukrainians to stay in Mexican shelters to enter America

In many ways, the Alpizar family’s medical history is not so extreme. Other refugees have immediate, life-threatening needs. In the year In 2019, after five months of waiting in shelters, A Ugandan woman died in a hospital in Juarez – That same week, authorities processed her asylum request. She died of sepsis, pneumonia and tuberculosis. According to the investigation.

Alpizar’s situation reflects how U.S. immigration policy has increased the care of immigrants to Mexico, he said Jeremy SlackImmigration researcher at the University of Texas-El Paso, who initially met Alpizar during a weekly visit to Leona Vicario.

Federal courts have delayed or blocked the Biden administration’s attempts to roll back some immigration policies. In May, just days before Alpizar set out on her journey, A federal judge has blocked the Biden administration from ending the Title 42 order..

Some charities, on the other hand, want to help refugees get care during their border patrols. Hope Border Institute, a Catholic non-profit organization, has launched a fund to help see private doctors, pay for hospital stays, fill prescriptions and cover transportation to appointments.

When a doctor advised Alpizar to feed her son a special diet, the family went shopping to buy food that was not initially available at the shelter, which houses about 600 people. But later that day, when shelter residents checked their shared refrigerator, the fruit and yogurt were gone. Pablo shops three times a week, buying only small amounts to feed his son.

Then, in late July, a shelter doctor diagnosed Hossein with conjunctivitis and gave him antibiotic eye drops. Soon after, his sister Zoe contracts Covid, and the family is sent to the shelter’s isolation ward.

Dr. Julie Linton, chair of the American Academy of Pediatrics’ Council on Migrant Children and Families, said people with gastrointestinal issues, respiratory illnesses like Covid-19 and skin diseases are often confined to cramped quarters in gathering facilities like shelters. Health. During their journey, she treated many newly arrived children who had contracted multiple parasitic infections due to lack of clean water or unsanitary conditions.

Jose may have something more serious, but specialized care and testing are not available to refugees, said Dr. Bert Johansen, an El Paso pediatrician who volunteers at Mexico shelters.

Or maybe Jose needs a quiet place to recover.

Chronic stress weakens the immune system, making you more susceptible to infection and making recovery more difficult, Linton said. Marisa Lemon, senior director of advocacy and programming at the Frontiers of Hope Institute, said the long wait is causing or reinforcing existing damage. Mental health disorders are among the most common health problems for people in shelters and detention centers, Linton said.

In July, Las Americas officials told Alpizar that she would have to wait at least eight to 10 weeks to find out if her family would be freed.

Alpizar intends to cross illegally, but he doesn’t have the money. Desperation led to the refugees Take that dangerous journey.

Eddie Canales, director of the South Texas Center for Human Rights, said the lack of legal avenues to seek asylum “causes people to take more risks in more dangerous areas.” “The border is a graveyard.”

KN (Kaiser Health News) is a national news division that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three major work programs on the KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides information to the nation on health issues.

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