Migrants Continue to Leave Federal Custody in Poor Health

January 6, 2019

By Gustavo Solis

SAN DIEGO –– Many migrants released from federal custody are in poor health and have not had access to medical care, according to doctors treating them in San Diego’s emergency shelter.

“We can tell that they have not necessarily had care anywhere along the road,” said Maria Carriedo-Ceniceros, chief medical officer for San Ysidro Health Center.

Most of the migrants arrive at the emergency shelter with weakened immune systems. They have mostly communicable diseases like the flu, cold, and respiratory infections — illnesses associated with living in close confinement for long times.

Additionally, doctors have treated pregnant women who have not been given prenatal vitamins, children with cavities, adults with tooth infections, and several cases of rashes, scabies, and fungus.

Although some young children with high fevers have been taken to hospitals, none of the migrants treated by San Ysidro Health Center providers have had to be hospitalized for extended times.

The federal government’s treatment of migrant children attracted national attention in December, when two Guatemalan minors died while in federal custody. An 8-year-old boy was had previously been diagnosed with a cold and fever died Dec. 25.

Even before the children’s death, doctors in San Diego were aware of the potentially fatal diseases some of the migrants have.

“It’s always on my mind,” said Carriedo-Ceniceros. “people forget that the common flu can be serious. People die from it.”

In response to the boy’s death, U.S. Customs and Border Protection ordered medical checks on every child in its custody.

However, local doctors have not noticed that migrants leaving federal custody are in any better condition.

“It’s probably too early to tell,” Carriedo-Ceniceros said. “I haven’t heard of any difference yet.”

The migrants in San Diego’s emergency shelter usually stay less than 48 hours. If they are given permission to live with relatives in the United States, they are released from federal custody until their immigration cases are resolved. The migrants stay in the San Diego’s emergency shelter until they can make travel arrangements to be with their families, most of which live east of the Mississippi, advocates said.

This dynamic presents healthcare providers with unique challenges. Specifically, doctors won’t always have the opportunity to do a follow up and they rarely know a patient’s medical history.

Doctors and nurses have to diagnose and immediately treat ailments while making sure the patients are safe enough to travel.

In one recent case, doctors struggled to find amoxicillin, an antibiotic, for a boy with an ear infection who was going to be on a five-day bus ride to New Orleans the next day.

Sometimes, the migrants are healthy but not fully prepared for their trips. One Central American woman destined for the Northeast refused to accept free coats until a doctor explained to her how cold it can get on the East Coast.

“One of our physicians said put your hands in cold water with ice. That is going to be how you feel,” said Ana Melgoza, vice president of external affairs for San Ysidro Health Center.

The woman ended up taking several coats after putting her hands in the cold water.

In another instance, a little girl bound for Philadelphia had never seen mittens before in her life.

“She’s 2 years old; I don’t think she knows what Philadelphia is,” Melgoza said.

There are limits to the care and travel advice doctors can provide. For example, mental health care providers cannot address some of the issues associated with the journey from Central America to the United States or the underlying issues of why migrants fled home in the first place.

“That is an area where we probably need more,” Carriedo-Ceniceros said. “We are not providing mental health at this point but that is an area that they are going to need. Long-term, with what they’ve been through, they will probably have some effect.”

Migrants being treated at the shelter operated by the Rapid Response Network are not part of the migrant caravan that has dominated the headlines in recent months.

They are people who left their countries to request asylum in the United States. Thousands of such migrants were in Tijuana before the caravan arrived and more have continued to arrive since then.

While migrants in the caravan have access to medical care, including dental care and pharmacies that distribute medicine and antibiotics, most non-caravan migrants do not. Many enter federal custody with already weakened immune systems from their long journey to the U.S.-Mexico border.

Advocates and doctors treating migrants on the U.S. side of the border continue to struggle to keep up with demand. They’ve asked state, county and local officials to help them find a shelter with capacity of more than 200 people.


©2019 The San Diego Union-Tribune

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