The image is seared in my brain. The visibly nervous woman, speaking in hushed tones via WhatsApp from Mexico, shows me the sparse items in her tiny one-room dwelling: a sleeping bag on the cement floor and two plastic grocery bags filled with personal items. “This is all I own in the world,” she tells me in Spanish. As a medical expert with Physicians for Human Rights (PHR), I have seen much injustice around the globe. But this stark visual of a middle-aged asylum seeker’s entire possessions laid out in such a meager space – when she had a home and life that she was forced to flee – brings our work into sharp focus.
PHR clinicians provide pro bono medical and psychological examinations of asylum seekers to support their applications for protection in the United States. These examinations can corroborate narratives of the horrific violence that many asylum seekers have endured in their home countries. But in this time of COVID-19, when everything is vastly more challenging and the U.S. asylum system has essentially come to a halt, doing forensic examinations appears implausible. As it is, we expect people to tell their manifested worst nightmares to us, complete strangers, with little preparation. Now, in this era, we are required to establish this deepest human connection over the internet in a matter of moments. How does one hug a person via Zoom, when they reveal that their child was raped as an intimidation tactic? How does one offer support, when our usual comfort cues of touch and body language are rendered impotent over buffered video?
And yet we continue this work, in collaboration with immigration attorneys, because we understand that the alternative to asylum would likely be calamitous for these families. It would mean one of three fates for those coming through the U.S southern border: being imprisoned in Immigration and Customs Enforcement (ICE) detention facilities, being caught in the limbo of the Migrant Protection Protocols (MPP), which require people to wait in Mexico for their U.S. court date, or being deported back to extremely dangerous conditions in Central America.
The ICE detention facilities are a COVID-19 breeding ground. It is clear that we have a public health and humanitarian catastrophe on our hands, as the virus spreads through the crowded facilities. Many physicians from around the country have been writing about this issue, calling for the release of immigration detainees and community-based alternatives to detention. As of now, there are more than 750 positive cases out of more than 10,500 detainees tested. The fatality implications are clear. It is abject cruelty to keep them detained, when the vast majority of people there have not been convicted of any criminal offense.
People stranded across the closed southern border in MPP camps do not fare much better. They are also forced into crowded living spaces, with shared utensils and limited access to sanitation/hygiene. These are all contrary to U.S. pandemic public health guidelines. The worst scenario, getting deported back to Central America, is widespread. Apart from the real public health hazard of deporting potentially infected people, sending people back into the whirlpool of danger that they escaped is unfathomable for most.
Certainly, there are many social justice causes that require our attention, particularly now. Fellow Michigan pediatrician and child advocate Dr. Mona Hanna-Attisha has repeatedly made the case that children should not have to sacrifice their health just because of the zip code in which they were born. The pandemic has laid bare for us the dynamic interplay of race in the injustices running throughout our society. Domestic violence and child abuse experts know that the risks are multiplied during times of quarantine. Physical abuse is predictably rampant now in our own country.
Still, this doesn’t mean that our neighbors should be ignored. It is a fallacy to believe that our national attention can or should only be on ourselves. By feeding others, we are nourished. The means are discrete and easily accomplished: release people who are unnecessarily detained to avoid the risk of COVID exposure; provide adequate access to hygiene products and protocols for those who remain in detention and MPP, and allow avenues to appropriate medical care. More upstream, we need to process asylum claims more efficiently, and afford these families the due process they deserve.
If I had to fit my life into two grocery bags, what items would I choose? The majority of us are fortunate enough not to have to make that decision. At the very least, we should choose to make life possible for others. The pandemic has shown us that fortunes can change in the blink of an eye. Now is the time for us to keep our eyes open and live up to our national moral conscience.