The Refugee Health Alliance: Sending Love Across the Wall (Doctors And Nurses Travel Across the Border)

Daniel Lichtenstein-Boris

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Trump made the wall, and defeating the ‘migrant caravan’ the issue of the midterms.  After sending troops to the border with shoot to kill orders, and a month long federal worker lockout, on February 15th Trump Declared a national military emergency.

The day after the start of the national military emergency I traveled to Tijuana with a team of healthcare professionals

Here is another one of their stories

Driving South on the Interstate

I left my house at five am, arriving to pick up a doctor in Long Beach at 5:30 in the morning.  It was still dark.  The apartment complex I pulled up next to was across from a parking lot where row after row of Humvees and military vehicles sat parked in what appeared to be a national guard facility, the camouflaged metal of truck hoods illuminated by yellow streetlights. 

There I picked up Walter, a tall lanky doctor in his early 30’s.  Black framed glasses rested on his nose, and a growing stubble of facial hair covered his chin.  He dressed in blue scrubs, and a light black jacket, wearing his hospital ID, a stethoscope wrapped around his neck and a black back in his left hand.  Walter voice was calm, monotone, and almost disinterested; it seemed it would take a lot to throw him off balance. 

Walter is a 32 years old family medicine doctor, a 2nd year resident at Long Beach Memorial Hospital.  After medical school at UC Davis, he began his residency in Long Beach.  He’s from San Jose, and didn’t want to be involved in tech.  If you aren’t working as a computer coder for a big tech firm, it’s almost prohibitively expensive to live in the bay area, even for a young doctor.

An attending physician at Long Beach Memorial told him about the Refugee Health Alliance.  So, on his day off, between weeks of hospital rounds, outpatient hours, and twenty-four hour on-call shifts, he signed up to head to provide healthcare in Tijuana

He has only done street medicine once, as a medical student at UC Davis, where he helped set up a pop-up clinic on the sidewalk to give check-ups for the homeless in Sacramento, the capital of the nation’s wealthiest state.

We exited in Santa Ana, where I parked my car; another volunteer would drive the rest of the way to the border. 

Cristina met us in a parking lot in Santa Ana, not far from the freeway.  A quiet, shy, but clearly excited UCLA nursing student, we met her in a chevron parking lot to travel together to the U.S.- Mexico border.  She smiled, greeting us and shaking hands; Cristina had green braces and a youthful demeanor, her expression bright and cheerful as the first traces of morning light splashed across the night sky.

A 3rd year nursing student at UCLA from Santa Ana, she has been living at the dorms on campus in Westwood, on Los Angeles’ posh west side.  She first got involved with international health work with a UCLA student club called the Flying Samaritans, a group of a hundred to two hundred health professionals from UCLA who sign up to staff two health clinics in Tijuana once a month.

She wanted to help out because she is bilingual, and so in that capacity she felt it was a good way to give back to her community.  To go out, cross the border, to do it for a good cause.  Plus, “I’m going to become a nurse. I want to see how outpatient works and see how the doctors, how they perform assessments and prescribe medicine.  I always learn something every time I go,” Cristina explained.

“It feels good to give back.  I feel privileged to be at UCLA.  If I was in their shoes, I’d love to have someone to come and help.  There is a lot of poverty.  It is the least I could do.  My family is from Santa Ana.  I have 8 sisters and 2 brothers; I’m the 5th oldest. “

Her parents are immigrants from Mexico.  Some of her siblings have Cerebral Palsy.

“One has a very severe form.  Can’t walk or talk.  When I was smaller, I questioned why she can’t be like us.  But I’ve realized she’s a blessing, she’s here for a reason, to help us.  She has taught us to learn how to be patient, and compassionate; to understand people, to love her, not to stigmatize people because of their disabilities, or to treat her differently.  We are grateful for her and her life.”

“Doctors are amazing too,” Cristina beamed, glancing back at Walter as she drove down the freeway while the sun slowly rose rays of light illuminating parting clouds dissipating after last night’s rain.  “But that’s why I wanted to become a nurse.  Plus, nurses have more patient interaction.  In hospitals it is nurses who make time with patients.  They provide holistic care to patients.  Also, if I want to become a Doctor, it’s a lot of work.  Maybe a nurse practitioner   But I’m scared of all the drugs, I’m taking pharma now. “

“Yeah, there’s a lot of drugs,” Walter added, “Over time you learn them.”

“What’s it like to be a medical student?” Cristina asked, “Do you have time to have fun?”

“You still have time to have fun.  As a third year with class and clinical rotations, it’s hard, but you find time,” Walter replied unenthused, in a dry level tone.  He was clearly still waking up.

“I’ve just started my clinical rotation now at UCLA Ronald Reagan Hospital’s telemetry and medical surgical unit.  It’s my first week.  I started Tuesday,” Cristina beamed proudly.

“Do you want to do impatient or outpatient?”  Walter asked.

“Inpatient first, then when I get experience, outpatient; to prevent people from going to the hospital,” she noted. 

“Inpatient and outpatient are tiring in different ways.  When you are on call you don’t know when there will be an admission, or an emergency.  It can be stressful,” Walter recalled, as if picturing the moments of anxious calm before the adrenaline surge of a critical admission.   “In outpatient there are a lot of patients in a day, though you develop a routine over time.”

Walter’s brother is also a doctor, a first-year resident in New York City.  His mom just moved with him to help in his first year of residency.  He doesn’t really know what to expect in Tijuana, he confessed. 

“My sister was going to come,” Cristina confessed, “but she said she isn’t feeling well, she had a stomach ache.  She is studying to be a medical assistant at a community college.” 

“I’ll be the first in my family to receive my bachelors,” she turned her head briefly and smiled.

“Did you do a gap year between college and medical school?”  Cristina asked Walter.

“I took five GAP years actually.” Walter chuckled.  “I was still figuring things out.” 

He continued, “College was a very stressful experience.  I went to Stanford, majoring in human biology.  I was stressed and burned out.  So, I signed up for AmeriCorps for two years, which is like the Peacecorp, but here in the U.S.   I worked at nonprofits in the bay area.   I worked with First 5, in early childhood education, as a preschool teacher for a year.  In my second year I worked at a food bank with underserved populations, visiting shelters, and distributing food.  I learned about food insecurity, and that I didn’t want to work in an office setting, a cubicle.  I enjoyed the close interaction I had with families.  So, I thought to myself, do I want to be a therapist, or a doctor, or something?  So, I said, I’ll try medicine.  The last two or three years was getting back into the mindset of going to medical school, jumping through hoops, applying again.  I was still figuring it out, make sure I did things for the right reasons.  I was involved in my church, and I taught gardening to 4th and 5th graders.  After school opportunity for kids, spend their time gardening, learning science, respect for nature and the environment, health, nutrition, and teaching skills to care for living things.” 

“What do your parents do?”  I asked them.

“My mom is, what do they say, a housewife,” Cristina replied.  “my dad works at my uncle’s recycling center, dealing with the accounts.  I guess you’d say he’s a cashier.”

Walter spoke next.  “My dad is a software engineer, he works at the US postal service.  My mom is a homemaker.”

“So, what do you all think about this national emergency they declared yesterday?”  I asked next.

“Mexico is accepting refugees, there is an emergency for his wall.  I don’t know what’s his problem.  What’s a wall going to do? It’s just going to divide us even more,” Cristina responded.

I asked Walter next.  He just smiled and chuckled.

“What?” I looked back at him. 

“I mean it’s just like I’m just counting down the days,” he grinned in a sly smile, ear to ear.  “The sad thing is that he could be re-elected.  His supporters are very narrow minded can’t see anything wrong about it, about what he’s been saying and doing.”

“I want a woman as president,” Cristina declared, almost interrupting Walter.  “I hope there is a woman, but I’m not sure if they country is ready for it.”

“Anyone but Trump,” Walter replied.  “So much harm he’s brought with his policies, and just his attitude.  It doesn’t just affect us, but other countries too, like pulling out of Syria.”

“What do you mean you don’t know if the country is ready for a woman president?”  I asked Cristina.

“Well look at Clinton,” Cristina replied.  “People weren’t ready for that.  She didn’t win.  A lot of things are male dominated.” 

“How so?” I asked.

“One is the school districts.  Those at the top are males, the Principals and heads of schools. Most teachers are women, but men are making all the decisions.  I work in a middle school tutoring six, seventh and eighth graders, Emerson middle school, a charter school.  I was talking to a teacher during the strike a few weeks ago.   The teacher, she was talking about there should be a new campaign, called ‘it’s our turn.’  It’s always males, males, males.  She had a job before teaching, and always hit this glass ceiling, couldn’t go higher because she was female.  The teacher’s went on strike.  It’s always men telling us what to do, she told me,” Cristina explained.

“There is bias in leadership.  They say, ‘she can’t handle it.’  We need a cultural change.  They got a few incentives [the teachers] not sure if it was all what they wanted.”

How did the strike impact them?

“During the strike kids were still allowed to go to school, but teachers weren’t there.“

“Right,” I replied.  “They were there outside the school, on the sidewalk with their signs.”

“Yeah,” Cristina affirmed.  “They just weren’t in the classroom.”

As morning light spread across the sky, sunlight streamed down from the east, through clouds departing with last night’s rain, radiating heat through the earth’s damp soil once desert bush and dirt now bright green fields of rolling green.  We passed strip malls and car dealerships, with their flashy signs and multicolored flags flapping in the wind driving south on Interstate five past downtown San Diego.  Turning a corner, one could see Mexico in the distance, beyond the border wall and river, a city of tightly packed tiny houses clustered haphazardly on the slopes of Tijuana a short distance across the valley.

We arrived at the California border at 7:45 am; the first of a dozen or so students and health professionals who would join the ranks of the Refugee Health Alliance that day. 

As we sat around drinking coffee, the volunteers straggled in.

Ivan, a recent college graduate in his early 20’s seemed eager to participate, he beamed smiling with a brown boyish face and muscular frame.  He grew up in California’s central valley in Linden.  Aaron Judge, the New York Yankees baseball player went to his high school, two years older than him.   After college he joined the red cross in Spain to care for refugees there. 

“If you are from a former Spanish colony,:” Ivan related, “if you make it to Spain, you can apply for asylum, and after living there two years, you become a Spanish citizen, and can get an EU passport.  Venezuelans are granted automatic asylum; I also saw a lot of Peruvians, and Bolivians.”  His short black hair was matted down, as he ate an apple, smiling.  He goes to a nearby university and is taking post-bac classes, preparing for medical school. 

Abby, a five-foot four white woman with long wavy blond hair, is a mental health professional, psychologist.  She’s been exploring developing a mental health program for the Refugee Health Alliance.  There are very few mental health services available.  Abby has mostly been assessing what is needed, to see what support the health alliance can provide. 

“They’ve been through a lot,” she explained.  “Trauma, depression, grief, separation, a lot of trauma; depression and anxiety.  There is so much unresolved grief; leaving home, leaving family.  Some are so resilient, some struggle with grief.  Teens leave because gangs threaten to kill them if they don’t join, family members are murdered, or forced into prostitution.   One teen girl fled in the night her uncle was abusing her.  A lot flee the gangs, in Honduras, especially. 

We got up to walk across.

Two or three border guards and private security officers milled about.

A masked Mexican officer checked tourists passports.  Two or three border guards and private security officers milled about.  The sun shined through the clouds warming the earth after last night’s rain. 

Cars passed by without hassle or incident, a steady stream of traffic. 

We walked across, through the border, and I first saw it, that at times sheet metal, grey concrete, red brick, or steel bar wall topped with curling spiked shining metal barbed wire that sliced the land between a clusters of densely packed homes on the Tijuana side and the green hill dotted with telephone poles and communications towers on the U.S. side. 

Crossing the pedestrian walkway into Tijuana one can see a mural, a hand coming up out of the earth, from beneath a painted border wall, the bare brown ground lined with little white crosses, like the lives lost scattered across the border, the hand was a tree trunk.

We passed over a bridge and down a few dark stairs.   Indents in the concrete filled with shallow puddles. 

It’s a calm Saturday morning, standing squinting in the bright sun blocks from the main pedestrian entrance to Tijuana, Calle Primera and Ave Madero, a big blue walking pedestrian sign that points the way to the USA, a truck rumbling slowly across the pedestrian walkway, its contents full of groceries, its diesel engine rumbling, growling at the Tijuana Wax Museum across the street, it’s neon purple and orange façade; a giant clock and  multicolored roof.

                Two black men speaking in in Haitian accents walked gesturing and exclaiming loudly walking down the pedestrian street.  As we waited for a cab to take us to our first location, a short indigenous woman, she looked as if from southern Mexico, approached us, carrying a tray with boxes of gum to sell, her baby slung across her back, holding the hand of a small boy, about two and a half years old, shuffling his feet slowly.  On her left a child a year older flanked his mother walking nearby.  A waiter slowly opened the restaurant down the block, setting out lawn chairs and umbrellas, music nearby blasted a high tempo hopeful pop song as a light breeze whipped around the corner and the sun warmed the asphalt. 

                We picked up medical supplies and split up, to travel to some of the shelters, encampments, and churches of Tijuana where thousands of refugees stayed, awaiting asylum, afraid to return home, praying for a safe place to call home, to work, to raise their children, to fall in love. 

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