Posted by Elizabeth Losada, MD (a third year Pediatric resident from Kaiser Permanente, Oakland while on a…
Elizabeth, my co-resident, and I arrived late in the evening the night before our rotation started here in South Texas along the border with Mexico. Between finally finding our apartment for the month, settling in, and buying a few necessities, we did not get much sleep before orientation. Nonetheless, this week has been an eye-opening experience. Dr. Griffin, the program coordinator and creator of Community for Children, and Dr. Monserrat, the career development specialist and long time friend of Dr. Griffin welcomed us all with open arms. There are eight of us in the group, 5 residents and 3 fourth year medical students.
This first week has been about getting to know and understanding the issues facing children and the community at large here in the border region. For example, the first day, a local pediatrician very involved in the community, Dr. Fisch gave a talk on Children’s Rights and Border Pediatrics. It amazes me that not that long ago in the United States, a child had no rights and was essentially the property of the parents or guardians. No matter what they did to the child or did not do for the child, local law enforcement or other government agencies could not intervene. Obviously over the past several decades, that has changed, but defining the rights of any child is an important step when discussing minors who are not necessarily citizens and come into custody of the US government. This week has also been about border issues such as illegal immigration and what happens with unaccompanied minors. I had honestly never thought about unaccompanied minors crossing the border, and the issues associated with being alone in a foreign country where a child doesn’t speak the local language but must face a court alone to decide his or her fate. Nor had I taken the time for a detailed analysis of the reasons why a child or teenager would flee their home in Central America or Mexico, make a treacherous journey north with threats from other people (police, gangs, etc) and nature to then face a difficult border crossing and an uncertain fate. The reasons behind the migration, especially the recent surge in unaccompanied minors, was discussed by several groups. I thought Jennifer Harbury, an author and lawyer for Texas Rural Legal Aid (TRLA), had the most detailed answer, going back several decades into the history and relationship between Guatemala and the US government, and now with the Zetas moving southward to Central America due to the recent crackdown in Mexico. Jennifer Harbury’s adult life has been far more eventful than most people can even imagine their own to be. A less detailed version of what she imparted to us is easily found online, and while still unbelievable, the US government has released CIA documents to back it up. We met so many other amazing people through Dr. Griffin, including her husband Mike Siefert (formerly known as “Father Mike”), it was like a who’s who of the Texas-Mexico Border region.
We also visited the border wall, toured some of the detention facilities for unaccompanied minors, and visited the LegalAid office, which volunteers their time to teach the unaccompanied minors their rights and tries to have an adult representative accompany each minor to court. I would like to note that the border wall in this region is basically a really tall metal fence, is frequently interrupted (aka not continuous and has large gaps in the fence), and the fence is not necessarily right on the Texas-Mexico border. There are several parts that run through Texas, splitting people’s property, putting people’s livestock on the other side of the wall, and even placing part of the University of Texas Brownsville south of the border wall despite still being in Texas.
We also learned about the colonias, with a good summary I have borrowed from the state of Texas’ website: “The colonias has the largest concentration of people living without basic services in the United States. Colonias exist up and down the Texas side of the border. Texas is home to more colonia residents than any other state. Approximately 500,000 Texans live in 2,300 colonia communities along the 1,248-mile stretch from CameronCounty on the Gulf of Mexico to El PasoCounty in the west. The Colonias, which means neighborhood in Spanish, resulted when developers bought tracts of farm land and sold them unimproved to mostly poor, Mexican-Americans along the U.S.-Mexico border region. Most colonia people live without basic services taken for granted in the rest of the United States. These unincorporated, isolated settlements often lack water and sewer systems, electricity, health facilities, paved roads, and safe and sanitary housing.”
We learned that through local advocacy, people have improved local voter turnout and helped to get paved roads through some of the colonias, which then meant the mailman and garbage trucks could come residence to residence, providing their services.
We also chose our advocacy projects and had an initial meeting at our sites. Elizabeth and I are going to work with ARISE, a local nonprofit group based in the colonias aimed at empowering members of the community to improve their own lives. Many of the groups are for self-improvement, such as a health class aimed at healthy eating and exercise, especially for those with diabetes or hypertension, citizenship class, sewing group, driver’s license written test, get out the vote campaign, English classes for children and adults, cultural activities, and other groups and activities based on the needs of the community. It was amazing to talk to the leaders of the health class or “clase de salud” of each of the 3 sites in the colonias. One could immediately tell that these women, who started out as volunteers, were well versed in the importance of good nutrition and exercise, as well as other aspects of the organization and the community. We’re very excited to begin working with them. These advocacy projects are based on what the organization or community needs help with. The current plan is to interview abuelas or grandmothers in ARISE and the community regarding what they know about diabetes and how to prevent it in their children and grandchildren, given abuelas are often the ones caring for the children when others are at work. We’ll make a questionnaire to help guide conversations. Of course, this may be adjusted as we meet the participants in ARISE and focus our project to their specific issues / needs. We’re hopeful for the weeks to come, and all the Spanish we’ll get to practice, both in the daily morning