Arriving at the Mexican border this month, three days after the president’s Oval Office address calling members of this Central American caravan rapists and murderers, we weren’t sure what to expect.

The Minnesota Medical Coalition, part of the Minnesota Caravan Solidarity Coalition composed of physicians, psychologists and nurses, partnered with San Diego Border Dreamers, which coordinates volunteer efforts and performs needs assessments to the shelters serving as safe havens for families and individuals awaiting the process to request asylum in the U.S. We visited shelters for unaccompanied minors, mothers and children, and multiple shelters for families housed in local churches and community centers.

According to Honduran officials, there are approximately 2,500 migrants from the October caravan who remain in Tijuana. Lawyers working in Tijuana report that the U.S. government processes only 30 applications per day. We cared for more than 200 individuals over two days at various shelters and camps in and around Tijuana and carried more than 85 pounds of medicines and supplies to the area.

We made three main observations over the length of our stay.

First, the individuals and families for whom we cared reminded us of our own loved ones. Far from appearing criminal or violent, they had stories that were inspiring with respect to their courage, strength and fortitude in the face of impossible choices. We cared for an elementary-aged child and her mother at a Tijuana church providing refuge. The mother’s medical concerns were that her daughter did not eat when her mother was not present. The child’s father had been separated from them. When the child was apart from her mother, she refused to eat. The medical diagnosis was severe separation anxiety. We wondered about our own children and how they would respond to being separated from one of us. Would he eat? Would she be able to sleep? Would he act out?

At a women’s and children’s shelter, we were asked to evaluate a child who was causing trouble in the shelter. With intervention, introducing a game of cards and explaining the rules of the card game “War,” this child was able to make friends who wanted to join the game and model problem-solving, negotiation and even compassion among these elementary-aged children.

Additionally, there are young men and women we cared for who are eager to work. As we unpacked our medical supplies in duffel bags, a man in his 20s asked me if we had a hammer. He had been a carpenter in Honduras and saw plenty of projects in the church he could help with. He ultimately wanted to be able to work to earn some money while he waited for his family’s number to be called. Other young men at that shelter were hoping for some shoes so that they could begin to leave the shelter and seek work in the neighborhood.

Last, this inefficiency of the U.S. process is hitting Tijuana hard. Thirty applications per day against a need of 2,500. The local physicians, nurses and midwives in Tijuana were performing yeoman’s work to coordinate care and follow-up for patients from the caravan, and they need help. Many local agencies, physicians and clinics are in need of assistance. We were inspired by their commitment to care for patients crossing both ways — those desiring entry into America and those deported from the U.S.

From our personal experience caring for these patients, we would recommend:

1)  Increase capacity to process asylum applications. Surely with all of the emergency funding being poured into physical borders such as our existing walls, we could increase the number of immigration judges and personnel to review asylum claims.

2) Allow temporary work visas for these migrants who can help with jobs that are unfilled in this time of low unemployment.

3) Invest in aid to Central America to combat violence and grow those countries’ economies to improve the conditions that are leading these families to flee their homelands.

4) Support local on-site agencies that are connected in Tijuana and Mexicali to provide emergency care for these migrants.

We would recommend contacting congressional representatives to advocate not for a wall but for some of these long-term solutions that will more effectively address the humanitarian crisis.

There are real solutions to this crisis that involve neither completely opening up the border nor ignoring the sacred obligation we have in our global community to provide asylum-seekers a fair process and hearing. While we are no experts in immigration policy, we are experts in caring for children, women and men of all ages. We have borne witness to the devastating toll that this inefficient asylum process is having on multiple generations of Central Americans. They are like us — fathers, sons, mothers, daughters, grandparents and grandchildren — and all seek safety for their families.


Dr. Lynne Fiscus, Dr. Miguel Fiol and Jill Foss submitted this article on behalf of the Minnesota Medical Coalition.