This article was published in The Brownsville Herald on April 16, 2020.
Update: Doctors at Global Response Management in Matamoros have isolated 17 fever-negative patients since preparations to mitigate the spread of COVID-19 began six weeks ago, said Andrea Leiner, the organization’s Director of Strategic Plans in a phone call on Thursday. Three of those patients qualified for testing with the health department in Matamoros. All three tests came back negative. “We encouraged their friends and neighbors to help so they weren’t walking around camp,” said Leiner.
“There were a few people the health department agreed fit the clinical picture that they wanted to test, and those tests all came back negative. Since then we’ve gotten our own testing capabilities that we’re currently working with the health department to validate with their PCR – so we’re double testing.”
PCR tests screen for antigens. Leiner, a nurse practitioner, said double testing is necessary to ensure the validity of the first one hundred or so tests. Anybody with COVID-19 symptoms is placed in an isolation area set up in collaboration with immigration officials in Matamoros. “We check every day with lung ultrasounds, we test, and we monitor them until we’re sure it’s safe for them to go back to the camp,” she said.
Leiner confirmed the NGO has been able to purchase enough testing material to screen the majority of the camp if necessary and said patients were isolated out of “an abundance of caution”.
In Matamoros, efforts to sustain the camp of an estimated 2,500 asylum seekers living past the Gateway International Bridge are ongoing after a plan to relocate residents fell through over the weekend, according to aid workers coordinating with officials from Mexico’s National Institute of Migration (INM, Instituto Nacional de Migración).
An organizer who spoke with the agency said construction on the new site in an abandoned stadium four miles into the city came to a halt when the state of Tamaulipas issued a stay at home order barring gatherings of more than 10 people.
Instead, all but one entrance to the camp will be cordoned off as a preventive measure against COVID-19. Residents will have their temperatures checked and are supposed to be allowed to move in and out freely. The situation is developing and plans to move the camp have not been terminated permanently.
Volunteers and staff with Team Brownsville, Angry Tias and Abuelas of the RGV, and Resource Center Matamoros have continued to coordinate the distribution of food, water, and supplies. Aid workers emphasized they have not abandoned camp residents in shifting to remote operations and are committed to supporting those in ongoing immigration proceedings seeking asylum at the U.S/Mexico border.
Global Response Management (GRM) has volunteer doctors and asylum-seeking staff operating full-time primary care services and a pharmacy in an enclave of temporary shelters on the levee. Services such as Lawyers for Good Government’s remote legal assistance program and the Resource Center’s medical referral program are still up and running.
“We’ve never stopped feeding people, we’ve never stopped providing clothing, shelter, and supplies. That’s our mission,” said Andrea Morris Rudnik, Team Brownsville’s volunteer coordinator in a phone call on Tuesday.
According to Rudnik, volunteers began to shift operations months ago when news of the virus broke. The team has been able to source goods in Mexico which are distributed to four tiendas, run by asylum-seeking families, who distribute the supplies as needed. “It’s broken up into four different areas and each store manager has about 200 tents they distribute to in that area,” said Rudnik.
Following the Trump administration’s March 20 decision to close the border to nonessential travel, reports described buses packed with deportees and newly-arrived asylum seekers departing from outside Repatriacíon Humana multiple times a day. The policy has essentially shut down the U.S. asylum system, though cases under the Migrant Protection Protocols (MPP, ‘Remain in Mexico’ program) are ongoing. Camp residents have reported continuances stretching through August.
Early this week, there appeared to be fewer people living in the camp, though aid workers are uncertain whether families seeking asylum under MPP have opted to leave on buses carrying deportees to Chiapas or are simply staying inside to practice social distancing.
According to Rudnik, some of the Mexican families living in the camp have left. Mexican nationals are not placed in MPP. Currently, anyone who is apprehended and claims asylum after crossing the border is deported immediately, according to administration officials who spoke during the March announcement.
Rudnik said that when INM began offering free rides to Tapachula, families troubled by the circumstances likely felt pressured to leave. “Prior to Easter, there were buses leaving every day. People were told they might as well not wait here because nobody is crossing into the United States. It costs to get from here to Tapachula. Some who knew they didn’t want to stay in Mexico and had cases that were not going well took advantage of that and self-deported,’ she said.
Team Brownsville has discontinued its Escuelita de la Banqueta for the time being but is providing educational videos children can watch on parents’ cell phones and monitors provided at each of the tiendas, Rudnik said. World Central Kitchen’s volunteers are no longer present and residents have been asked to stay out of the towering comedor set up by the organization.
A small restaurant down the road is now providing dinner service paid for by WCC in addition to a breakfast service they prepare and distribute for Team Brownsville, according to Rudnik.
Brendon Tucker, co-founder of the Resource Center, said the center’s asylum-seeker crew has added a few new members to bolster COVID-19 outreach and prevention. “We have two new guys sanitizing everything. That’s been going on for a few weeks now. The entire job is to spray sanitizer on all the sinks, faucets, inside and outside of the port-a-potties and changing stations,” he said.
“Anything that is communally used, we have someone sanitizing it every half hour to 45 minutes to mitigate the spread. We put sinks in the entrance to each free store and wherever they serve dinner so people can wash their hands before they eat.”
Tucker designed DIY hand-washing stations complete with running water and soap dispensers that have been scattered throughout the camp. Currently, there are 88. Staff is also refilling water cisterns and assisting with everyday activities.
The center’s director, Gaby Zavala said aid organizations are hoping the collaborative effort to protect the camp’s population from the virus will strengthen relationships with officials who have made prior attempts to take back the land. The work to support those who remain continues and is essential to protecting already-narrowed pathways to asylum.
At GRM, nurse practitioner Andrea Leiner said the NGO has struggled to set up its 20-bed field hospital. “We’ve spent the last six or seven days here in Mexico going in-between INM, customs, the mayor’s office, and the health department figuring out who needs to sign what for us to actually bring things over the border,” she said.
“It’s been one hassle after another. On the U.S. side, there’s a rule now that you can’t cross certain medical equipment. And we need tariff codes for everything even though it’s personal property and we’re not importing it to Mexico.”
Leiner said the NGO’s volunteer situation has “dried up significantly” because medical professionals working at home hospitals aren’t allowed to travel and are in high demand as the virus spreads through under-prepared communities across the country.
GRM recently put out an all-call for experienced MDs, DOs, PAs, NPs, RNs, and paramedics. The organization has a staff of doctors who are asylum seekers themselves, three of whom are from Cuba and work full-time in the clinic. “We’ve worked to shore up our staff locally — our pharmacist, our pharmacy assistant, and two translators,” Leiner said.
The organization’s executive director, Dr. Helen Perry, learned during a meeting with public health officials that Matamoros, a city of nearly half a million residents, has access to only 40 ICU beds and 10 ventilators. Figures given to Reuters by the government of Tamaulipas last month set the number at 25 ventilators and 11 ICU beds between the city’s five public hospitals.
GRM set up 24-hour hotline camp residents can call with questions or if they’re showing symptoms. Patients will be triaged and isolated. Those showing severe symptoms will be moved to the field hospital. The closure of the camp entrances may be an opportune time to begin administering COVID-19 tests, Leiner explained.
Medical staff has a planned treatment regimen including Cholroquine and Azithromycin but does not have the ability to intubate and place patients on ventilators. Doing so would also be an ethical dilemma, explained Leiner, because there is no higher level of care available to patients in Matamoros if the hospitals are at capacity. “Even though we can provide amazing service, we are still a tent in the middle of a muddy field with no electricity or running water. We can provide oxygen, we can provide medications, we can do a progressive level of treatment in a hospital setting, but we are not an American ICU,” she said.
“We’re working with local pastors to try to teach them how to put on and take off the protective equipment so if it comes down to it, they can give last rites, they can offer spiritual comfort.”
Leiner said staff has distributed vitamins to the entire camp population. Volunteers are asking anyone with underlying conditions like asthma, diabetes, and high blood pressure to identify these conditions to doctors so they can boost patients’ health and immunity to the highest extent possible.