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ER doctor: I see the cruelty of US immigration policy up close


Opinion by Brian Elmore

(CNN) — Hiking in the desert outside the city I call home, it’s not hard to find evidence of migrants who have traveled across the southern US border. In the shadows of boulders and rock faces, you can find abandoned water bottles, diapers and clothes.

These migrants make the perilous trek through the desert out of sheer desperation as US immigration policies have shut many of them out of our country.

As an emergency resident physician in El Paso, Texas, I’m used to treating migrant patients who have suffered the consequences of harsh border policies. But throughout the borderlands, there are new complications threatening the lives of those who seek refuge in our country — and they demand our immediate attention.

From mid-June until the end of July, El Paso experienced over 40 consecutive days of 100-plus degree heat, which meant that in addition to the usual tragedies my fellow doctors and I are accustomed to seeing, our emergency room had to contend with heat-related sickness. More than 100 migrants have died from heat along the southern US border this year, with 13 deaths and 226 rescues for dehydration and other heat-related issues in just one week in July, according to US Border Patrol chief Jason Owens.

Many of these migrants — when found alive — will end up in the emergency room, unconscious and clinging to life. One young patient was found in the desert next to her deceased son and husband. Others come with little signs of brain activity.

Texas Gov. Greg Abbott’s cruel escalation of border deterrence has only exacerbated the already dangerous conditions for migrants seeking refuge in our country. As part of “Operation Lone Star,” an alleged attempt to secure the border, he ordered that a buoy barrier be erected in the Rio Grande River, in addition to placing large swathes of razor wire on the banks.

According to an email from a Department of Public Safety trooper, a pregnant woman having a miscarriage got caught in the wire; in another instance, a young child passed out from heat exhaustion after she tried to pass through the wire and Texas National Guard soldiers pushed her back.

The email, written to a superior and reviewed by Hearst Newspapers, further alleges that DPS troopers were told not to give water to the migrants who they encountered. “I believe we have stepped over a line into the inhumane,” the trooper concluded.

Abbott has argued measures are needed to deter more migrants from crossing over and has stated he will not remove the floating barriers. The Justice Department isn’t buying it. In late July, it sued the state of Texas, alleging that the floating barriers violate the Rivers and Harbors Appropriation Act, since they were built in US water without the permission of the US Army Corps of Engineers. Abbott has claimed on Fox News that the cited law does not apply in this situation, but did not say why.

As the litigation inevitably plays out in court, it’s important to remember that the border has served as a macabre experiment in the ways that failed US immigration policy can maim and mangle men, women and children hoping to make a better life in America. Over the past several decades, politicians on both sides of the aisle have each left their own marks on the border, often surpassing each other in cruelty.

In the 1990s, then-President Bill Clinton pioneered a policy of “prevention through deterrence” by shutting off safer routes of migration and forcing migrants to travel through hostile terrain – namely a scorching desert where they would be exposed to extreme heat. That strategy has permeated US immigration policy ever since, contributing to the death toll of nearly 10,000 migrants who have lost their lives along the US-Mexico border in the past two-and-a-half decades.

When George W. Bush became president in the 2000s, his administration ordered many of the border barriers and walls that now surround El Paso to be built. Inevitably, desperation compels some to climb these walls, which can range in height from 18 to 30 feet. In the decades since they were built, hundreds of migrants have been treated in my emergency room for devastating lower extremity and back fractures incurred after falling from the wall. For many, these injuries will have life-long consequences.

Former President Donald Trump continued the construction of hundreds of miles of taller and more dangerous border wall. After the border wall was extended and raised to 30 feet in the area around San Diego, deaths and traumatic injuries among migrants falling from the wall soared.

The Trump administration’s approach to the southern border endangered the lives of thousands of people, from the family separation policy that resulted in more than 3,000 children being separated from their migrant parents at the border to Title 42, implemented during the Covid-19 pandemic under the guise of being a public health measure, that allowed authorities to expel migrants to their home countries or to Mexico. With many migrants being subjected to rape, kidnappings, torture and other violence after being expelled to Mexico under Title 42, it’s understandable why many of them chose to brave the desert or scale a wall.

President Biden, too, has fallen short of his promise to make the asylum system more humane. Title 42 didn’t expire until May of this year, and by first requiring asylum-seekers to make an appointment on an error-prone smartphone application, for example, the Biden administration has made life more difficult for many of the most vulnerable at our border.

Now Abbott has further contributed to this shameful legacy of anti-immigration policymaking.

Many of the injuries sustained along the border — heat stroke from the hot desert sun, fractured skulls or spines after falling off the border wall, flesh torn by razor wire along the banks of the Rio Grande — are what I call political pathologies, preventable injuries that are a direct result of border policies intended to enact a high cost on those who attempt to cross over. And every day I am confronted with the human costs of these pathologies.

I see and treat victims who are left permanently debilitated, with devastating injuries that will limit their ability to work and contribute to society and to their families.

Ironically, many of the victims are arguably those who have the most to offer our country. No person would make the treacherous journey to our border without firmly believing in the promise of America. At a time when many Americans are increasingly polarized and many seem to be losing faith in our ideals and values, it is encouraging to see hope and promise in the eyes of the migrants I treat.

In fact, this hope is contagious. It’s part of the reason why I continue to serve and treat migrants on both sides of the border. I want to work to live up to the America that my migrant patients believe in.

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