“Can you take us in your car to the next door?” asked the group of migrants. I was in Ciudad Juárez, along the US-Mexico border, with another doctor and members of my organization, Hope Border Institute. It was early May, and we were driving along the banks of the Rio Grande, providing what humanitarian aid and medical care we could to migrants detained by barbed wire set up by the Texas National Guard.
This group of migrants, three small children and several adults, was desperate. They looked exhausted and dehydrated. Their windswept faces looked at us for an answer. We look at each other uncomfortably. Every part of me wanted to give these desperate families a ride, but the reality was that it wasn’t safe, for us or for them. They said they had been walking along the barbed wire for four days. They had run out of water, and now they had run out of money. The day before, they said they had been robbed of all their money and material possessions by members of the cartel. Now, the National Guard was telling them they would have to continue walking several kilometers to find a processing point. Soldiers, dressed in desert camouflage and carrying assault rifles, watched as we spoke to the migrants.
Between here and the port of entry where they would be processed—wherever that was—another cartel operated. The migrants said they had nothing more to give and feared what the next cartel would do to them. But by collecting them, our group and theirs would become targets. So we gave them water, food, and the limited medical help we could provide, and off we went. A fear gnawed at my stomach as I watched them advance along the dusty banks of the Rio Grande, with the soldiers watching.
National Guard members on the other side of the barbed wire were brought to the border by Governor Abbott’s sweeping anti-immigration operation, called “Operation Lone Star.” This operation represents an escalation of deterrence policies by state officials. It has been an experiment in new ways to maim and destroy migrants and has exacerbated pre-existing patterns that contribute to migrant deaths.
As part of Operation Lone Star, the Texas National Guard has deployed more than 100 miles of razor wire along the banks of the Rio Grande. I have treated children whose flesh has been torn by barbed wire. Further down the river, the National Guard has also deployed floating buoys marked with serrated metal blades. Increasingly aggressive vehicular pursuits of migrants by Department of Public Safety officers have killed both Americans and migrants.
It is left to border organizations like mine, the Hope Border Institute, to grapple with the human costs of failed border policies. “Prevention through deterrence,” the United States’ strategy for making the border as dangerous as possible to cross, has spawned increasingly macabre policies, including family separation, Title 42, raising the border wall, and now the Governor Greg Abbott’s Operation Lone Star. These measures have created a growing public health crisis along the border.
In 2022, the US-Mexico border was the most dangerous land migration route in the world, according to the International Organization for Migration. Increasingly desperate migrants are forced to cross the desert where many will succumb to heat injuries and dehydration. Others will try to scale the wall, and many will inevitably fall. Those who survive will often have debilitating injuries. As an emergency physician in El Paso, I treat traumatic injuries for migrants who could no longer wait. As co-founder and medical director of Clínica Hope, I treat migrants in Juárez who have not yet crossed.
In response to this growing public health crisis, Clínica Hope was co-founded with Hope Border Institute in 2022 to provide shelter-based medical care to migrants trapped in Juárez. As policies have changed, so has our response, which is why we were walking the barbed wire.
The next group we encountered was also in trouble. Dozens of migrants crowded under the little shade offered by the sparse bush that bordered the River. In the midday heat, the groups moved slowly. They were apprehensive at first, but then they started approaching our vehicles. Other members of our group began distributing water while I began to see the patients.
Stories of violence and brutality emerged as weary migrants were eager to share their traumas with sympathetic Americans who did not point guns at them. Their bodies bore witness to the traumatic injuries they claimed had been inflicted on them. The reality of his desperation was made evident to me by his torn and bruised flesh. The Texas National Guard, Mexican immigration officials, and cartel members were now working together in this wicked game of deterrence, the goal of which was to inflict as much suffering as possible on these migrants. In my two years treating migrants in Juárez, I had never witnessed such desperation. Cornered by the cartel, barbed wire, and both US and Mexican security forces, these migrants were completely vulnerable to the depredations of each of these predators.
Texas soldiers have fired non-lethal projectiles at border crossers, Border Report reported, and migrants report beatings by Mexican immigration officials and cartel members.
A Venezuelan migrant approached me, his left arm bandaged in a disintegrating sling. He looked to be about thirty years old, dusty and beaten from his journey. His chest heaved in pain. He was on La Bestia, the train that takes migrants to the north of the country, when he was detained by Mexican immigration officials outside Juárez. The migrants scattered and immigration police chased them, beating anyone they could catch, he said. This beating had left the migrant with a fractured arm, on which a Mexican doctor had improvisedly put a splint.
Upon reaching the Rio Grande, he told me that he was pushed by National Guard soldiers while trying to climb the banks on the American side, after which he said he was hit with rubber bullets. His entire left breast seemed detached from his sternum and collarbone. The left side of his ribs moved independently of the rest of his chest. He needed to be evaluated at a hospital and would likely need urgent surgery.
The Texas Military Department did not respond to a request for comment from the Texas Observer about the use of non-lethal projectiles and physical violence.
We tried to convince the Venezuelan to come with us to a hospital, where he could be evaluated and treated. “I can’t,” he said. He did not want to miss the opportunity to cross the barbed wire and present himself to the authorities for asylum processing. I treated a few more injuries, including those of children whose flesh was torn by Texas barbed wire. We then reluctantly left the seriously injured migrant behind, exchanging contact information in case he changed his mind.
The next day, his pain became unbearable and he asked us to take him to a hospital. Crystal Massey, the humanitarian director of the Hope Border Institute, sprang into action, coordinating with our Mexican colleagues to pick him up and transport him to a hospital. Our Mexican partners arrived with an ambulance to safely extract the patient. We were told that an armed cartel member stopped the ambulance as it approached the barbed wire. All of this occurred while the National Guard watched, just a few feet away on Texas soil.
It occurred to me, in this twilight zone between borders, that the most basic right to life had ceased to exist. These human beings, desperately seeking security and a new future, were completely vulnerable to the cartel and the security forces of both nations. They all acted together to brutalize men, women and children. Each of these groups acts with impunity and with the same objective: extract their pound of flesh and make this border dangerous.
In mid-May, the body of a Honduran migrant was found along the river in Juárez, near where we had seen patients. According to the press, his face had been sunken by the attack that left him dead. A migrant who was with him said the beating was the work of US authorities.
(Brian Elmore is an emergency physician in El Paso. He co-founded Clínica Hope with the Hope Border Institute in Ciudad Juárez)
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