MATAMOROS, Mexico — It was June when the news began to spread among the rows of tents where thousands of asylum-seekers sleep on the banks of the Rio Grande across from Brownsville, Texas. After months of working tirelessly to fend off the virus from the Matamoros tent camp, health care workers confirmed the first case.
Jose, a 52-year-old Cuban asylum-seeker whose name has been changed, worried the virus would “wreak havoc” on the migrants living there. “I never thought it was a game,” he says.
Glady Cañas, who runs Ayudándoles a Triunfar (Helping People Succeed), a local nongovernmental organization, says she feared an impending crisis. “I thought, if one gets sick, they all will.”
Mileydis Tamayo Salgado, a Cuban nurse working in the camp, braced for the challenge ahead. “We’ve never confronted the coronavirus and we had heard that so many people were dying [around the world],” she says. “But we were prepared for what was to come.”
Throughout the pandemic, between 600 and 2,000 asylum-seekers from across Latin America have lived at the camp at any given time, as they await their court dates in the United States. Some have been there for more than a year under the Migrant Protection Protocols (MPP), a program that began sending asylum-seekers to dangerous Mexican border cities in January 2019 to await their court dates. Others were told to wait their turn on a so-called metering list that limits the number of cases U.S. border officials hear each day.
During the pandemic, the U.S. pushed back court dates for asylum-seekers in MPP and began turning back almost all border crossers, citing an obscure public health rule. It seemed inevitable that the squalid tent camp, often smelling of urine and crawling with mosquitoes, would become a petri dish for the coronavirus. But it wasn’t until June, three months after Mexico‘s first case, that a migrant at the camp tested positive.
Now, in December, as cities along the Texas border and across the U.S. report surging cases, the Matamoros tent camp has — seemingly miraculously — avoided the devastation predicted in the early days of the pandemic, with only a few dozen mild cases reported since June. Meanwhile, the border state of Tamaulipas — where Matamoros is located — has reported more than 37,000 cases. Aid workers and health officials working in the Matamoros tent camp say early preparations, listening to the community, and adapting to their needs were some of the keys to their success.
Educating About the Coronavirus
Global Response Management (GRM), an international NGO that works in conflict zones, first set up shop in Matamoros in September 2019. When news of the pandemic reached the camp in March, doctors and coordinators started to prepare for the new threat.
They took stock of the challenges: unsanitary conditions, close living quarters, distrust in authorities and overall poor health literacy. Full adherence to social distancing and isolation measures was going to be difficult given the living conditions and limited resources of the migrants there, according to Sam Bishop, GRM project manager in Matamoros.
So they started making their plans accordingly.
GRM prepared isolation areas, stocked the clinic with ventilators and other necessary equipment, and ramped up testing. It began building a 20-bed pop-up clinic to treat patients. Workers also started handing out Vitamin D tablets and masks, knowing the migrants themselves wouldn’t have the resources to buy them.
When the staff at GRM did all they could to medically prepare for potential cases, they turned to educating the population about COVID, the risks, and how to keep themselves safe. It was a tough task for a group of people who are “naturally mistrustful,” according to Bishop.
The migrants at the Matamoros tent camp have fled gang violence, political persecution and humanitarian crises in their home countries. They’ve traveled thousands of miles through jungles and deserts to try to reach safety. But under the administration of U.S. President Donald Trump, legal avenues to asylum have been cut off.
Before the Remain in Mexico policy, most would have been released to sponsors in the U.S. while their asylum cases were ongoing. Instead, they have been shunned to Mexico, where they are vulnerable targets to extortion, kidnapping and sexual violence by criminal groups. The migrants sent back started a camp at the port of entry in Matamoros, thinking it would give them some protection from violence and that Mexican and U.S. authorities couldn’t ignore them if they are camped out at the door. Even before the pandemic, attempts by Mexican authorities to relocate migrants caused an uproar in the camp and most refused to leave.
Building Trust With Vulnerable Populations
Because of their traumatic experiences and subsequent concerns over their personal safety, all asylum-seekers interviewed provided names other than their real ones.
“This is a population that has been systematically discriminated against, taken advantage of and manipulated,” Bishop says. So convincing them that the pandemic was not just a way to deny them entry to the U.S. and remove them from the camp was a major challenge for health care workers.
Many of the nurses and doctors working for GRM are themselves asylum-seekers who were trained as medical professionals in their home countries and have been stranded in Matamoros under MPP. This helps build trust between the migrants and the communities.
“They certainly can connect with them better than the gringo white guy doctor coming across the border trying to tell them things to do for their health,” Bishop says. “These are people who really understand what they’re in because they’re in the same circumstance.”
Jose, the Cuban migrant, says he respects all the health care workers in the camp. But the ones he most connects with are his fellow countrymen. “They never rest,” he says of two Cuban doctors in particular. “They are always giving talks, visiting the houses in the camp and fighting to maintain social distancing and hand-washing.”
When these doctors and nurses started talking to migrants in the camp about social distancing, mask use and other prevention measures, some migrants were quick to heed the advice.
“I always, always, always use my face mask,” says Helena, a 61-year-old asylum-seeker from Venezuela. She has a chronic condition that makes her more vulnerable to COVID-19. “They did a good job to make all the people here in the camp aware of how serious the sickness is and the consequences that it could have if each of us got infected.”
Others needed more convincing.
When Mexican asylum-seeker Alejandra heard of the first COVID case, she doubted whether it was real. She says she still doesn’t always wear her mask at the camp or with her family. But she does understand the need to use one in certain crowded settings. “We use it when we go to get things at the supermarket or when we go to the center to buy things.”
Prioritizing Individuals’ Needs
As more migrants tested positive, the GRM staff realized they were confronting another major challenge. Migrants did not want to isolate away from their families as local government protocol required. The trauma of their journeys translated into wanting to stick together.
After Mexican authorities began more closely monitoring who could enter the camp in an attempt to prevent community spread, some migrants didn’t want to leave the campgrounds to go to the clinic when they were feeling sick.
“Many stayed quiet because they were scared that they would isolate them and put them in a tent all alone,” Cañas says.
If the patients wouldn’t go to the clinic, then the clinic would go to them. “They told us who were the people showing symptoms and we assumed the responsibility of going to their tents to take them to the clinic and do the tests,” says Salgado. Most of the migrants she approached agreed to follow her advice.
She attributes the success of this approach to her ongoing relationship with the migrants in the camp, and the trust they have with her. Research shows that patients’ trust in their doctors can lead them to take more precautions when guarding their health and feel more satisfied with care.
Testing also met some resistance. When Mexican asylum-seeker Lorena noticed her 8-year-old son and infant daughter developed a runny nose and cough sometime in August, she knew getting tested was the responsible thing to do. But with so little control over her life in the past year since she fled Guerrero after her husband’s murder, she says she wanted to have some control over this experience.
“On the one hand, I understand them, but they should say, ‘Do you give me permission?’ the 33-year-old says. “They shouldn’t just make it obligatory.” Both tests came back negative.
Since facing this backlash, GRM has worked with Mexican officials to find a better way to handle potential COVID-19 cases that addressed the needs of the migrants. Isolation and testing is now optional. “We don’t want to compel anyone to do anything. That includes testing,” Bishop says.
Prioritizing the community’s needs over a one-size fits all approach has paid off with few cases and no deaths. “The doctors did a good job and they were always attentive to the health of the migrants,” Cañas says.
Other factors may have also helped the Matamoros tent camp avoid a disaster during the pandemic. Some working in the camp hypothesize that migrants who have made thousand-mile journeys may have stronger immune systems that protected them from catching severe cases, according to Bishop. They also wonder if living outside instead of in an enclosed space could have helped prevent transmission.
With new information and studies being published on COVID-19 on a daily basis, complete answers to just how and why some populations have fared better than others are likely years away.
But for migrants at the camp, the most important part of the COVID response is knowing that the health care workers who promised to take care of them have done everything in their power to guard their health. “They did everything they could,” Helena says.
Photojournalist Lexie Harrison-Cripps contributed reporting.
This story has been supported by the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems, http://solutionsjournalism.org.
More from U.S. News
Migrant Camp On Mexico’s Border Limits the Spread of COVID-19 originally appeared on usnews.com