CIUDAD JUAREZ – Since starting two months ago as a volunteer for weekend shifts at a clinic in one of this border town’s largest emergency shelters, Dr. Brian Elmore treated about 100 migrants for respiratory viruses and a handful of more serious emergencies.
But one issue he has not yet been able to address worries him most — the deepening trauma that so many migrants carry after long journeys north, often accompanied by witnessing murders and kidnappings and sexual assaults.
“Most of our patients have symptoms of post-traumatic stress disorder — I want to initiate screening for every patient,” said Elmore, an emergency room physician at Clinica Hope. It was opened this fall by the Catholic nonprofit Hope Border Institute with the help of Bishop Mark Seitz of El Paso, Texas, on the Juarez border.
Doctors, social workers, home administrators, clergy and law enforcement officials say a growing number of migrants are suffering violence amounts to torture and are arriving at the US-Mexico border in urgent need of trauma-informed medical and mental health treatment.
But the resources for this specialized care are so scarce and the shelter network so overwhelmed by newcomers and migrants has been stuck in the US asylum policy for months, that only the most severe cases can be treated.
“Like a pregnant 13-year-old who fled gang rape and therefore needs help with childcare and middle school,” said Zury Reyes Borrero, an Arizona case manager at the Center for Victims of Torture, who visited this girl when she gave birth . “We bring people into their most vulnerable form. Some don’t even realize they’re in the US.”
For the past six months, Reyes Borrero and a colleague have been helping about 100 migrants at Catholic Community Services’ Casa Alitas, a shelter in Tucson, Arizona, which in December was taking in about 700 people a day from different countries who were released by US authorities like Congo and Mexico.
Each visit can last for hours as caseworkers try to build a relationship with the migrants and focus on strengthening them, Reyes Borrero said.
“This isn’t a community that we’re talking about babbling brooks with… They may not have a secure memory,” said Sarah Howell, who runs a clinical practice and nonprofit that treats migrant torture survivors in Houston.
When she visits patients in her new Texas communities, she routinely introduces relatives or neighbors who also need help dealing with severe trauma but lack the stability and security needed to heal.
“The estimated need is at least five times greater than what we are supporting,” said Leonce Byimana, director of US clinical services for the Center for Torture Victims, which operates clinics in Arizona, Georgia and Minnesota.
Most migrants are traumatized by what they left behind as well as what they encountered along the way, Byimana said. They need “mental health first aid” as well as long-term care, which is even more difficult to arrange as they spread from shelters in border areas to communities across the country, he added.
Left untreated, such trauma can escalate to the point where it requires psychiatric care instead of therapy and self-help, said Dylan Corbett, executive director of the Hope Border Institute.
Jesuit Refugee Service/USA, the US branch of the worldwide Catholic refugee agency, plans to ramp up mental health resources in El Paso in the coming weeks. which has seen an increase in crossingssaid its director, Joan Rosenhauer.
Along the border, the most striking trend has been the increase in pregnant women and girls, some under the age of 15, becoming victims of assault and domestic violence.
Volunteers and lawyers encounter so many of these survivors that they have had to pool scarce legal, medical and shelter resources to help them, leaving hundreds of other victims of political violence and organized crime to fend for themselves.
Service providers and migrants say the most dangerous place in travel full of dangers at every turn is “la selva” – the Darien Gap jungle separating Colombia from Panama, traversed by increasing numbers of Venezuelans, Cubans and Haitians who first moved to South America and are now seeking a safer life in the United States.
Natural hazards like deadly snakes and rivers only add to the risks of an area teeming with bandits hunting migrants. Loreta Salgado was months after escaping Cuba when she crossed the Darien.
“We’ve seen a lot of dead people, we’ve seen people robbed, people raped. We saw that,” she repeated a few days before Christmas in a migrant shelter in El Paso, her voice cracking.
When asked about “la selva,” some women simply gasp — and only later reveal that they saved their daughters by pushing and raping them themselves, or endured strained relationships with their partners who witnessed the attack , said Howell.
“I don’t think it’s the first rape most women I’ve spoken to have experienced. But it’s most violent and shameful because it was in front of other people,” Howell added.
In many cases, forensic examinations at border clinics documenting psychological and physical abuse are also crucial for migrant asylum cases, since other evidence is often unavailable for court cases, Byimana said. Asylum is granted to those who cannot return to their country for fear of persecution for specific reasons, including sometimes very high levels of systemic violence against women.
but It takes years for asylum cases to be decided in US immigration courts, with a current backlog of more than 1.5 million people, according to Syracuse University’s Transactional Records Access Clearinghouse. And that’s with Restrictions from the pandemic period still in force enabling authorities to turn away or expel most asylum seekers.
A long wait for a solution, combined with a long journey across multiple countries, can add to the trauma migrants experience, advocates say.
“There’s a different tension and fear on their faces than I’ve ever seen before,” said Howell, who has researched trauma and forced migration for 15 years. “They don’t know how to stop running.”
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Associated Press writer Morgan Lee in El Paso contributed to this report.
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