An hour and a half east of San Diego in late October, surrounded by haphazard makeshift tents, an asylum seeker lies in the desert with his leg propped up. Our team of volunteer physicians and medical students learned that he sustained a serious foot injury on his perilous journey to the United States. By the look of his swollen and seeping wound, the antibiotics he has been taking for the last 10 days are not warding off infection. He’s been taking half the prescribed dose of antibiotics because he’s not sure how long he’ll be traveling and doesn’t want to run out.
While we dress his wound, a doctor on our team steps away, motioning for the rest of us to follow. We find ourselves conflicted over the limited options, not knowing when this patient will next access medical care. Moreover, once he is transferred from this site to an official detention facility, his medications, including antibiotics, may be confiscated. After considering these factors, we all come to the same conclusion: If he does not receive proper care, this injury could cause permanent damage, or worse, a fatal blood infection. So what happens next?
For the last two months, we have mobilized local healthcare providers to help asylum seekers in rural San Diego County. A handful of uninhabitable places around the small town of Jacumba Hot Springs have become open-air detention sites for hundreds of asylum seekers. Migrants wait in the desert to be transferred to an official detention facility for processing. While some are transported within a few hours, many spend days without consistent access to food, water or medical care, with no shelter from increasingly harsh environmental conditions.
Migrants have been told by Border Patrol agents that if they leave the sites to seek medical care, their asylum process may be significantly delayed or endangered. Yet since Jacumba is not an official detention center, these asylum seekers are denied the basic resources and services required by Border Patrol policy for those in custody.
We see a medical crisis unfolding. People are suffering from deep tissue infections and ulcers, acute appendicitis, seizures, heart attack symptoms and pregnancies with complications. We provide services with whatever donated supplies we can get our hands on. We wash dust-filled eyes with saline, hand out Vaseline for cracked skin and provide face masks to limit the spread of upper respiratory infections that overwhelm the sites. Plastic spoons serve as splints for broken fingers, children are examined in makeshift tents and cough drops are handed out by the hundreds.
On any given day, volunteers in different fields are providing critical services for hundreds of migrants in Jacumba, supported by donations, mutual aid groups and nonprofit teams including Border Kindness and Al Otro Lado.
As temperatures approach freezing and winter rains fall, we are increasingly concerned about frostbite, hypothermia and exacerbations of chronic health conditions such as asthma and diabetes. At least one preventable death has been reported at an open air site along the border. We fear that the next one could occur in Jacumba.
International and U.S. laws recognize seeking asylum as a human right. We have a responsibility to provide safe conditions for migrants when they exercise that right.
To ensure that no further harm is done, local, state and federal authorities need to stop utilizing loopholes, or sidestepping legal responsibility, to detain migrants in “unofficial” camps where they are experiencing dehumanizing, preventable suffering. If hundreds of people are being kept by our country at a site, that location should be acknowledged as a detention center with the obligation to meet detainees’ basic needs.
As our day at the site comes to a close, we rejoin the migrant with the leg infection and our colleagues who have finished changing his dressing. We share our concerns and coach him through communicating with medical staff at his next destination, most likely an official detention center. A minute in, we pause — this is too much information to remember. Someone produces a marker, and one physician begins writing on the waterproof tape. She scrawls out a note to Border Patrol and instructions for the next medical team, signing her name at the bottom as she would a prescription. Right now, this is the best we can do out here.
Sadie Munter and Karyssa Domingo are second-year medical students in San Diego, where Weena Joshi is a practicing pediatrician.
This story originally appeared on LA Times
