Image: AP

There are currently thousands of people in Tijuana waiting to enter the United States so that they can apply for asylum. Because the Trump administration is tightly controlling the number of people who can cross the border to be processed each day—a policy called “metering,” which was also used by the Obama administration—that could take weeks, if not months or longer. The people attempting to seek asylum—mostly from Central America, many women and children—have already traveled long distances, fleeing violence and poverty. And so they wait, living in shelters and tents or sleeping outside.

Ronica Mukerjee, a clinical lecturer at Yale University School of Nursing and nurse practitioner, is one of the many medical professionals who have traveled to Tijuana in recent months to work in clinics serving the people caught in the limbo created for them by this administration. Mukerjee spoke to Jezebel about her time in Tijuana in January, the trauma that many people carry with them in migration, and trying to reduce harm in the face of a sprawling humanitarian crisis. This is that story, in her own words, as told to Jezebel.


MUKERJEE: On my first day in the clinic, one of the lawyers working there said this welcome: “Thank you for coming. You’re late.” I started seeing patients almost immediately: mainly families, a lot of mothers and their kids. Often people who had experienced violence and sexual violence in their lives, and yet those weren’t the reasons they said they had to leave their home country. It’s that they did not think they would survive, or that their children would survive. That was more often the breaking point.

People don’t leave their homes because they are safe where they are. They flee because they can’t eat and are scared their children will die of starvation. They travel that far and face that many dangers because they fear they will be killed and that their children will be killed. In some places we call that a refugee crisis, in some places we call it a migrant crisis, and in some places we don’t call it anything. But watching what was happening at the border, I felt like I could do some small thing about that lack of safety—to address some of the health outcomes that happen as a result of forced migration.

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There were people who hadn’t eaten for days before arriving in Tijuana. People had upper respiratory infections, both children and adults. Many were also arriving with heavy trauma. There were a lot of people I saw in the clinic who disassociated. I had multiple patients who I could not tell what was going on with them, and it was obvious they were not all present. There were some people who were angry for very understandable reasons. But most of what I saw, truthfully, was people being kind and generous. They were trying to make a pleasant environment because they had been in so many unpleasant environments. There are many different ways that we assimilate dealing with stress in our bodies, and one of them is that we try to decrease conflict. And I think trying to create a good situation for yourself and your children is a version of that.

One of my patients, a woman from Honduras, came in to talk about her upper respiratory infection. We had a conversation about her symptoms, and she said she had a cough. I asked her routine questions: how she felt at night, if she felt short of breath. As we were finishing, she made it clear that she had another issue she needed to discuss. She described being gang raped before leaving Honduras. I asked her if she had been STI- and HIV-tested, and then we arranged for that. She said that she was severely depressed, and that she had been experiencing fleeting thoughts of suicide. She didn’t know what to do with the fact that she wasn’t functioning the way she normally could.

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We talked some more, and I started her on medication. After a week had passed, she came in again and said she was beginning to feel better. It was such a short amount of time that it may have even been a placebo effect. But because of the way that people working in the clinics have to cycle in and out, she will have to see an entirely new set of people when she returns for another check-in. She is going to have to repeat that story.

It can often feel like that: putting a bandaid on a gaping wound that is the border crisis. How can you decrease the likelihood of harm in the time you have together? There is no choice but to do a harm-reduction approach. But we know the biggest harm is coming from the border.

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In the United States, we often don’t recognize what it means to be needed. And we think of this as a weakness, to have those needs. This is how a lot of migrants are seen: that they are greedy or wanting of something they don’t deserve. But Americans, we feel very justified in our needs—that we need a sweatshirt made in a Honduran sweatshop. That we need coffee and drugs and that we are entitled to those things. From the American perspective, those things are much more important than the people from those same places. That is how the American psyche has been constructed: to not recognize the humanity in the people trying to cross the border. When I look at things from that perspective, in terms of how we treat borders, I feel pretty strongly that we have never developed a border policy that is actually reflective of the relationships that the U.S. actually has to Latin America.

But the work happening in the clinics is just one small piece. It’s triage—the need is so great. The first thing I thought when I finished my last day there, reflecting on how many patients we had seen, was: “I don’t know how I could have physically done more.” And then my next thought was: “That was not enough.”