Theresa Cheng was volunteering with mutual aid groups at the US-Mexico border when she learned of a migrant on the US side of the wall with severe injuries. Cheng, an emergency physician, rushed to an encampment where asylum seekers wait to be processed by border patrol and pumped frantically on the chest of a 13-year-old boy bleeding on the ground while volunteers dialed 911.
It took 60 minutes – nearly as much time as Cheng and another migrant did CPR on the teen – for an ambulance and emergency medical services to arrive at the scene in eastern San Diego county. The boy, whom local media identified as Dario Zamudio, had suffered traumatic injuries in a car collision on the Mexican side of the border and had been taken to the border wall to receive quicker treatment.
Zamudio did not make it.
“His heart stopped while he was laying on the ground in the dirt,” Cheng said. “If EMS had arrived earlier, shortly after they were called, his heart wouldn’t have stopped in the field. He could have gone to a hospital and had much better comprehensive emergency care.”
Nearly two weeks later, Cheng’s frustration is palpable. She says she had to ask border patrol agents to help perform CPR, and that she asked multiple times to be allowed to accompany the child in the ambulance to the hospital, but was denied. She says she had tried previously to communicate to paramedics the gravity of the medical situation in the camps.
“That’s why I’m seething,” she said, “because I had this conversation with people on the ground expressing my concern that they aren’t responding appropriately. And then the very next day, a 13-year-old boy died.”
Cheng, who is also a lawyer, is part of a cohort of medical professionals and mutual aid providers along the US-Mexico border and in San Diego county who have been sounding the alarm about the dangers migrants face in open-air detention, especially the lack of medical care. Volunteers have been helping fill the gaps in medical and humanitarian aid in the camps in Jacumba Hot Springs and San Ysidro, where for several months migrants seeking asylum have been waiting to be processed.
When they are unable to use the government’s CBP One app, or present themselves to a US port of entry to request asylum, migrants cross deserts and climb walls to get on US soil. The injuries from wall falls can be gruesome, and when they arrive, asylum seekers have to wait for days in the dangerous outdoor conditions of the open-air detention sites, or OADs.
An 11 December complaint filed on behalf of immigrant rights organizations – including Al Otro Lado, Border Kindness, Southern Border Communities Coalition and the American Friends Service Committee – against the Department of Homeland Security’s office for civil rights and civil liberties, and Customs and Border Protection, explains how asylum seekers on the US side of the border are being held by patrol officers in freezing temperatures, with little food or water, and inadequate medical attention.
The complaint details violations of CBP’s custody standards and migrants’ human rights, like how border patrol provides migrants at four such locations with just one water bottle and one small snack a day, if that. It describes the dry, windy and cold desert locations where migrants are exposed to the elements with no shelter, as temperatures drop to 20F (-6.5C).
“It’s a recipe for disaster,” said Alexander Tenorio, another volunteer physician. “I do fear that if this does continue into the winter, and we keep exposing them to these conditions, there will be more injury, and I do fear there will be death.”
Tenorio said he had tended to pregnant women with stomach pain and bleeding, babies just months and days old, and people with traumatic injuries such as open wounds and possible bone fractures who desperately needed to be evaluated at a hospital. Cheng described seeing 75-year-old women and organ-transplant patients who had run out of medication, migrants with disabilities and those had experienced severe strokes. Individuals the volunteers encounter are already malnourished from their long trip north, and Tenorio says keeping them for days outside without adequate food leaves them at a high risk of developing a medical emergency, like hypothermia.
Jacqueline Arellano, the director of US programs for the mutual aid group Border Kindness, says she didn’t know what the volunteers would do if there were a mass hypothermia event. “Were we to call 911 if there are multiple people experiencing hypothermia, is that same delay going to be expected where possibly it’s going to have to be like an administrative or bureaucratic decision, how quickly they initiate mass emergency response? We’re unsure. They haven’t communicated that to us,” she said.
The corps of volunteer healthcare workers has to triage patients on the ground and can only escalate individuals with urgent medical needs to border patrol or San Diego county EMS. When they do call 911 to have someone taken to a hospital, Arellano said, they encounter major delays in response times and questions about who is responsible.
In some instances, volunteers say, emergency medical dispatch personnel ask for border patrol to confirm whether there is a medical emergency, or screen calls that come from the open-air detention sites. “There seems to be a delay that is specific to the fact that these are migrants,” said Arellano.
Customs and Border Protection said their agency was providing appropriate medical care and “humanitarian assistance as needed and by routinely coordinating with emergency medical services to assist individuals in need”. CBP did not respond to follow-up questions regarding the medical assistance they provide or the incidents provided to the Guardian at the time of publication.
Erika Pinheiro is the executive director of Al Otro Lado, which provides legal and humanitarian assistance to migrants in southern California. She said that while some border patrol agents do call 911, others deter migrants from accessing care by telling them they are faking their illnesses.
“It’s beyond not providing care. It’s malicious obstruction of care,” Pinheiro said.
She said volunteer medical providers have been told they can’t be on-site: “Border patrol claims people are not in custody, and so they do not have the obligation to provide medical services. But when we try to bring in medical services, the physicians have been asked for their credentials. They’ve been kicked out.”
Volunteers have observed multiple instances of border patrol agents telling migrants erroneously that their asylum process will be in jeopardy if they leave the camps for medical care, so migrants sometimes refuse to go to the hospital in emergency situations. Migrants are also refusing care to avoid being separated from their families.
In late November, Pinheiro witnessed a man having a heart attack at a camp in Jacumba. A border patrol agent called an ambulance, but when it arrived the man refused to go, because it would mean leaving his wife and son in the camp.
“I’m watching this guy’s face drooping in front of me, and I’m watching him double over in pain because of his chest pain,” Pinheiro said. “I thought he was going to die in front of me.” Pinheiro finally convinced him that her organization would help him reunite with his family – yet another service volunteers are providing as migrants are discharged with little help to the streets of San Diego.
“We are running a massive humanitarian disaster response on a shoestring budget, doing the best we can. But we’re exhausted and broke and frustrated, frankly, that we’re even still in this position,” she said
Jacumba, where three of the four open-air detention sites are located, has 600 residents, although Pinheiro says an average of 800 migrants circulate through the three camps each day. She said she knew of no additional resources that had been allocated by the county to address the increased need for medical care.
Border patrol, she said, had had an increase in resources commensurate with the increase in migrants in San Diego county this year: “There’s no justification for this. This is cruelty. This is abject and intentional cruelty. This is meant to create a political spectacle showing that the border is out of control so that they can lobby for additional asylum restrictions and additional funding for border patrol.”
In Washington, border security – including funding and asylum restrictions – is at the center of an end-of-year fight between Democrats and Republicans over military aid to Ukraine and Israel.
Meanwhile, volunteers on the ground in Jacumba and San Ysidro are left asking who will take responsibility for the medical emergencies happening at the border right now.
“No matter how you feel about immigration, I would hope that most people don’t want children dying in camps on the California border,” Pinheiro said.
