The large influx of migrants and asylum seekers crossing the U.S.-Mexico border in the El Paso area has also resulted in a spike of medical emergencies.
To provide necessary health care, Texas Tech University Health Sciences Center El Paso and Texas Tech Physicians of El Paso have collaborated with Doctors of the World USA to launch the Border Health Program. The partnership has led to the creation of a clinic serving migrant patients locally.
Through the border clinic, TTP El Paso specialists provide basic transitional and emergency health care, similar to what urgent care clinics offer. As the medical practice of the Foster School of Medicine, every TTP El Paso specialist holds a faculty appointment, where they teach and mentor the next generation of physicians, many of whom will go on to practice on the U.S.-Mexico border.
With more than 200,000 migrants – many with no access to health care – crossing per month, the Doctors of the World USA Border Health Program partnership with TTUHSC El Paso is critical to providing the proper medical resources necessary in this humanitarian crisis, said Glenn Fennelly, M.D., M.P.H. Dr. Fennelly is professor and chair of the Foster School of Medicine's Department of Pediatrics and Doctors of the World USA board president.
In 2021, CBP recorded 557 Southwest border deaths. Dehydration and other heat-related risks are prevalent in the summer, and the cold can be unforgiving in the winter. Aside from seasonal illnesses and poor health, the clinic has helped migrants with physical ailments and getting proper prescriptions for both chronic illnesses and preventive care, Dr. Fennelly said.
"Many of them have chronic conditions such as diabetes, asthma or high blood pressure. In some cases, their medication was confiscated by CBP," Dr. Fennelly said. "There may be worsening of these chronic diseases during their journey. Exposure to respiratory viral infections can be a setup for bacterial infections. And there is some level of malnutrition along with not being vaccinated that puts them at risk for severe viral illnesses, such as the flu or COVID-19."
TTUHSC El Paso medical residents also provide care in the clinic, while Foster School of Medicine and Hunt School of Nursing students assist with intake and triage. Dr. Fennelly said the Border Health Program is here to stay and the migrant clinic will become part of the available rotations for students and residents going forward. The experience will prepare them for unique health issues they'll encounter while training in the Borderplex region.
Doctors of the World and our partners stay after the news cycle ends, past the first wave of the crisis. We want to contribute to long-term solutions for vulnerable populations. The recent border crisis aside, El Paso's always expected to have migrants crossing the border or reporting to CBP. We want to be prepared always for a humanitarian response to health care needs or medical emergencies that may arise."
Glenn Fennelly, Professor and Chair, Department of Pediatrics and Doctors, Foster School of Medicine
The clinic also aids with more immediate emergencies such as severe sprains from the journey and sexual assault injuries. According to a report from the UC Berkeley School of Law's Human Rights Center, an estimated 24-80% of women suffer sexual violence en route to the U.S., along with 5% of men and 50% of gay and transgender persons. Additionally, the number of women migrating to the U.S. and crossing the border is growing: Women represented an estimated 24% of migrants in 2015, up from 14% in 2011.
For many migrants, and especially children, the entire process of relocating to a different country along with any unsettling events they have witnessed in their home country or on the journey, can leave lasting damage.
Cecilia De Vargas, M.D., associate professor and program director for the Child and Adolescent Psychiatry Fellowship Program, said many youth are diagnosed with anxiety, depression and post-traumatic stress disorder. Some have thought about or attempted to commit suicide.
"And just like any other injury, the longer they go untreated, the worse their problems get," Dr. De Vargas said. "Although El Paso is likely not their final stop, our goal is to assist with the mental emergencies caused by the trauma they've endured. We work to provide continuity of care and referrals for mental health providers once they settle in a new community."
Other injuries require complex surgeries. Some of the most serious are injuries from border wall falls, which have increased more than fivefold since 2019, according to an American Medical Association report. Most of the border wall injuries cause severe swelling, requiring pins and braces to stabilize the injury prior to surgery. In those cases, migrants are referred to emergency rooms or other TTP El Paso orthopaedic specialists.
The Border Health Program is more than just on-the-spot health care. The program's six core objectives are intended to reduce health disparities faced by migrant populations. They are: • Direct Clinical Services: Develop the infrastructure for transitional care for migrants and asylum seekers in transit arriving to El Paso from government custody and shelters throughout the border region.• Education: Offer Foster School of Medicine and Hunt School of Nursing students, faculty, residents and staff hands-on learning experiences related to migrant health inequities and serving populations in transit.• Administration: Provide administrative oversight for the daily operations of the Border Health Program.• Data, Research and Dissemination: Provide data-driven decision making that will inform the development and growth of the Border Health Program and build a foundation for scholarship around migrant and refugee transitional care.• International: Promote bilateral and regional information exchange while establishing best practices to create a healthy future for migrants and asylum seekers.• Advocacy: Promote sound public health policy by conducting evidence-based advocacy for migrant and refugee transitional care.
In the Borderplex, migrant health is part of the community's health. As part of its mission to improve health care in the region, TTP El Paso and TTUHSC El Paso are rising to the challenge to provide bilingual care to those most in need and bilingual health care education for future generations. The Foster School of Medicine was one of the first medical schools in the country to integrate medical Spanish into its curriculum.
"Just seeing a smiling face, a reassuring voice, lets them know they've arrived and are welcome in this clinic," Dr. Fennelly said. "That's something we want to build on and let them understand we are trying to take care of their health care needs."
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