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The Border Patrol–to–Emergency Room Pipeline

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What Sara’s family endured in detention certainly didn’t help. In addition to pneumonia, Sara’s 2-year-old also had an ear infection, and though she asked for antibiotics, she said immigration officials didn’t give them to her. About 70 migrants huddled on a freezing tile floor in the room where her family was detained, Sara said. They had floor mats to sleep on, but she said that for a time, not everyone had blankets. Each time a group of migrants was released, others claimed the blankets they left behind. “I wasn’t able to talk because of how cold it was,” she said.

The milk for babies smelled sour, she said, and her 1-year-old vomited and had diarrhea after drinking it—a complaint that Ramirez-Watson has recently heard from other families who have passed through Good Neighbor. Sometimes sandwich bread was moldy, and some of the children’s burritos had rotten beans, Sara said. One of the burritos appeared to have a bite mark. “They would pass around a container to put stuff we didn’t eat, and then the next day it seemed like they would give us the food that was thrown away,” she said. (When asked for a comment on the conditions Sara faced in detention, Border Patrol didn’t respond.)

She said three guards would look at her with disgust and push people, often harassing the children. “One of them would say ‘What the fuck’ and start saying stuff,” she said. “I don’t know English, but I know bad words.”


Dozens of migrants flow through the doors of Good Neighbor every day, and the nearby Catholic Charities respite center aids hundreds more in McAllen, Texas. While local respite-center directors say that most newly released migrants don’t require intensive medical care, sometimes they arrive so sick that they have to go straight to an emergency room.

Some respite centers, such as Catholic Charities, have volunteer doctors to treat minor ailments, and they send migrants to the emergency room for more severe problems. Ramirez-Watson of Good Neighbor says the shelter’s insurance company won’t let it distribute medications like Tylenol without hiring a medical professional, which it can’t afford now. So if migrants, especially children, arrive with a 101-degree fever or higher, she’ll call an ambulance.

Released migrants are almost always uninsured and usually can’t afford the cost of treatment. Hospitals likely pay for their care with federal and state dollars through a program called Emergency Medicaid, according to Anne Dunkelberg, the associate director of the Texas-based think tank Center for Public Policy Priorities, though that may not apply in all cases, and she said other supplemental funding sources, both federal and local, might also chip in.

From January to April, Good Neighbor sent about one to two people to the emergency room every week, though that frequency has dropped in recent weeks, according to Ramirez-Watson. “Mostly it’s children, babies that are very fragile and may have high fever,” says Sister Norma Pimentel, who runs the Catholic Charities respite center. “They may be dehydrated and unresponsive, so we definitely take them to the hospital right away.”

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