Places We Go: Matamoros, Mexico (Part 1 of 2)
“What has happened to us in this country? If we study our own history, we find that we have always been ready to receive the unfortunates from other countries, and though this may seem a generous gesture on our part, we have profited a thousand-fold by what they have brought us.
It may be that some of these very refugees may make discoveries which will bring us increased employment. Many of them represent the best brains of the countries from which they come…”
First Lady, Eleanor Roosevelt, “My Day”, January 1939
I came across this quote last night watching Ken Burns’ “The Roosevelts: An Intimate History”. The First Lady and her husband, FDR, uplifted the nation during the Great Depression and beyond with a daily newspaper column and fireside chats, respectively. There was no way they could know what the future would entail for the US, but they understood potential and believed our nation could overcome anything.
In times of trouble, history can guide us to a crossroads, an intersection of times. History is our past, but it can also explain the present and offer a glimpse to our future . Today, on this day in history, for example, we mark the 75th anniversary of the liberation of the Dachau concentration camp in WWII. That moment weighs heavy in any era. I cannot help but wonder how many of those Veterans were immigrants born elsewhere, during or after our last pandemic, survived the Great Depression and then were thrust into combat to save democracy?
It is said every generation has a calling. For me, history is repeating itself — uncertainty and fear leading to the election of demagogues and scapegoating — and now, an added layer, a global pandemic. For the last 4 years as I watched our country drift apart, I wondered what was my generation’s call? I used to think it was to fight the global war on terror, but that appears to have been just the tip of the iceberg. Personally, I vowed to match indecency and anger with respect and empathy— or as a mentor in the Army taught me: never mistake kindness for weakness. Kindness is in our genotype and phenotype. Look back at our nation’s history and you will see it.
Overview
Currently, I am a practicing emergency medicine physician in Maryland. I am also an Army combat veteran. I served as a Battalion Surgeon in OIF with the 2nd Infantry, 12th Cavalry Regiment, 1st Cavalry Division and again in OEF with the 82nd Airborne Division. My journey to restore decency the last 4 years has taken me to many places to help those in need — from post-Hurricane Maria medical care in Aguadilla, Puerto Rico, to treating patients from the Rohingya crisis in Bangladesh, to helping those in rural Haiti out of an Islamic farm we temporarily turned into a health clinic, to working with Syrian refugees in Jordan. In between, I spent 2 weeks in El Paso and Juarez at the US-Mexico border. Until now, I wrote about these trips in a column called “Places We Go” for Emergency Physicians Monthly (a play on the Dr. Seuss book “Oh the Places You’ll Go”). For my most recent trip in Jan 2020 to Matamoros, I wanted to provide a larger overview of my thoughts and journey, particularly now as we fight COVID-19, so I wrote this 2 part series.
Helping at the border is personal to me as I lived in Texas from 2006–2012. At one point, I was stationed at Fort Bliss and found El Paso to be one of the best hidden gems in the US — two nations, two cultures, incredible mountains, outstanding food with vibrant, kind people — so full of life and hope. Since PCS’ing from Bliss to Aberdeen Proving Ground in 2008, I had not returned to the area. When I learned about what the migrants had been going through, I decided I didn’t have to travel across the world to help those in need. What I needed to do was fight back and help right here, right now. I know my friends that died or were injured in Iraq would have wanted that because that is what we did every day in Ghazaliyah and Shula. So, I went to El Paso in April 2019 and again in July 2019 to help migrants from Central America.
About 3 years ago, there was a mass migration and exodus from Honduras, El Salvador and Guatemala as thousands fled violence and instability. After an arduous journey by train, bus and on foot with minimal supplies, migrants arrived at various US border crossings. Most were detained in overcrowded ICE facilities. Many were released to the Annunciation House which fed, clothed and sheltered thousands of people at various hotels and warehouses. In those locations, team of volunteers would help migrants contact and set up one-way journeys to their sponsors inside the US, where they would stay, pending an asylum hearing. In April and July, I’d helped with this process, but in 5 months much had changed. Tragically, right after I left in July, there was a mass shooting at a Wal-Mart in El Paso in early August. The senseless deaths of 22 (now 23) people added more pain, heartache and confusion to the situation at the border. Also, Homeland Security, in conjunction with the Mexican government, started MPP, or migrant protection protocols. Essentially, any asylum seeker that set foot in Mexico before hitting US soil was held there for processing (a.k.a., metering). As a result of MPP, fewer migrants came into El Paso (or the US, in general) and by late 2019, ~3,000 people, had amassed in Matamoros, Mexico. They were living in a large, open park next to the Rio Grande, yards away from Brownsville, Texas. I came across an article describing the awful living conditions there— cold, crowded, muddy and occasional flooding — which made me think of my time in other spots around the world. I had seen firsthand what those conditions did to vulnerable kids and so I reached out to the only on-scene medical aid group, GRM, signed up to volunteer and headed down for a week of shifts.
The Camp and The Clinic
I often don’t talk or write enough about the sensory portion of the work I (and others) have experienced — sights, sounds, smells. I have found over the years, smell becomes the second most indelible of senses, next to sight. Every camp or combat tour I’ve been on has a distinct smell — be it dirt, mud, urine, sewage, blood, smoke or gunpowder. My walk across the Gateway International Bridge into the camp was no different — dust. I could taste it as it rose from the streets hitting my face and penetrated deep into my nasal passages and lungs. A few hundred yards from the bridge is the park where thousands of asylum seekers have been living for nearly a year. They sleep on hard ground, hilltops, sidewalks in the town square and some, if they are lucky, have a 100 foot tall plastic roof structure arching over top their suffocatingly close tents. Inside these makeshift homes, they have air mattresses, tarps and blankets to protect them from the elements. Most are young and many are women with kids under the age of 10. Some have skillets and campfires. Everyone has access to a large shower facility and there are water filtration depots throughout the camp. Some of the men walk into town for construction/labor work to earn money. Most of the women tend to the children. Some NGOs provide dinner each night at the bridge (carted in via wheeled coolers from Brownsville) and others offer church services or teach kids reading and writing.
On my first day, I lugged across 2 duffel bags of children’s clothing donated by my nursing staff. Mexican border police hardly rifled through the bags. I think they realized by the appearance of our small group, we were simply there to help. We walk up a set of stairs with gorgeous mosaic tiles partially obscured by dust and traverse an elevated walking trail that is the main passage around the camp’s perimeter. As we go down the small hill, I see the medical trailer. Inside is a sink, fridge, couch and two tables with laptops for medical documentation. I set-up and quickly begin to see patients out of the back overhang while our team outside does triage —sorted by chief complaint and vital signs. Our pharmacy trailer is adjacent to us and houses both purchased and donated meds. Each day we see about 15–25 patients, mostly women and children.
As I often do on these trips, I find more work to do than practice emergency medicine. I find as a doctor, in a humanitarian crisis, people want to meet and talk to you to get a feel for how sick people are or what they can do to help with supplies. Often, those interactions seem to come at the worst times. An American and his colleague (they identify themselves as “witnesses”) approach me at the overhang. They are with a group called End MPP that protests at the Xeriscape Park every morning. They come up to me mid-thought (pondering over a child’s medication dosing) and ask me how I am doing. I am terse (as I often am when my clinical thinking is interrupted!), but I take a few seconds to slow down, chat and find we have visited and help at many of the same spots on the border. We may have different ways of going about it, but we just want migrants to be safe and healthy. I tell them about the work I have done with Annunciation House and Beto O’Rourke. The man tells me ‘get him down here so we can have the media show America what is happening — like he did in Clint and Tornillo!’. I tell him ‘I wish I had that kind of pull! But, I’ll pass along the message to his team next time I see them’.
During the week, I meet some of the lawyers, like Charlotte (name changed for privacy), who ask us to perform medical assessments on children needing a higher level of care than is available in Matamoros. One child, I examine, Dario (name changed for privacy), is autistic. His mother desperately pleads with me to help him. She says she left her small daughter at home and never expected to be gone so long. Dario is getting worse in the camp. He doesn’t talk, he barely eats and can’t be more than a foot away from his mom — at age 10. He is unable to sit still and is constantly needing redirection. I treat a foot infection the mom has and I send them to speak with Charlotte. Charlotte is a beacon — tough, smart and able to navigate the bureaucracy. Immigration lawyers at the border form a small circle — Charlotte knows a classmate of mine from Rutgers, Alma (name changed for privacy), who often comes to the border with her law students. Alma has been inside the ICE detention centers and testified in front of Congress about the awful living conditions. She is brave, conscientious and always charging forward. During the week, as I am walking home across the bridge at sunset, I see Charlotte and a few other volunteers stand in a long line in the heat and sun with 5 migrant children (most in strollers or infant car seats) with piles of papers ready to face CBP and present their case for asylum (on medical grounds or otherwise). Some kids are as young as 6 months and born in Mexico. MPP doesn’t apply to Mexican citizens. The babies become a way across for the parents. To echo Eleanor Roosevelt’s quote: what type of world do we live in — where a 6 month-old has to protect his parents?
Continued in Part 2.
