Webcast—Defending humanity: Caring for refugees and migrants trapped in danger

Avril Benoit:    

Good evening and thanks for joining today's discussion Defending Humanity: Caring for Refugees and Migrants Trapped in Danger. I'm Avril Benoit. I'm the executive director of Doctors Without Borders or as we're known in Mexico, Médicos Sin Fronteras. We're known that way also in all the Spanish-speaking countries of the world and internationally, though, it's Médecins Sans Frontières. And that's why tonight you might hear us using the acronym MSF for Doctors Without Borders. That's us.

As you may know, we're an international medical humanitarian organization. We work in more than 70 countries saving lives, alleviating suffering. The focus of our work in Mexico and in many other countries is to really look after people who are forced to flee and who suffer hardships because of the violence they've fled, perhaps, or other hardships, but also because of what they face along the route. So I've just come back from Nuevo Laredo a border zone hotspot that you may have heard about.

It's a hotspot for deportees, and for asylum seekers, and for violent criminals who prey upon them. Tonight we're going to tell you what it's like there. What it's like for them and what it's like for our teams that are trying to do the work of fighting against what is not just the impact of violence from criminal gangs and so forth, but also the impact of what we think of as a kind of bureaucratic or administrative violence.

Just one quick housekeeping note before we really get started with the panel. You can ask questions and we encourage it. If you're in the audience here at the Blanton Museum of Art in Austin, Texas, just write down on the note cards and you can pass it up to the crew that will be coming along the aisles to take your questions a bit later on. And if you're watching on the Livestream or on Facebook live, please send us your questions via the chat function and we'll send them up to the panel.

I'm honored today to introduce our moderator for this evening, Carlos Sanchez. He's the senior editor of Texas Monthly magazine, is 35 year career in journalism, has included leading the McAllen Monitor and the Waco Tribune Herald as executive editor. He wrote for the Washington Post and covered national and international stories, sensational stories, political stories, and stories of social crisis. He's been a steady force at a number of publications here in Texas from the Fort Worth Star-Telegram to the Austin American-Statesman. And on this topic in particular, he's covered just about every angle you can imagine from the wall and even the private wall to the border patrol holding facilities and the breakdown of due process for asylum seekers. So we're definitely in good hands tonight. Please join me in welcoming Carlos Sanchez.

Carlos Sanchez:

Thank you all. I'm very honored to be your moderator on such an important topic and I do want to jump right in. I'm going to give some abbreviated introductions of the panel itself and I would encourage you to go online to the MSF website for more detailed biographies. To my immediate left is Denise Gilman, who teaches and directs the immigration clinic at the University of Texas Law School where she works with students to handle a range of immigration cases.

To her left is Adriana Quiroga, who was born in La Paz, Bolivia, and moved to Austin at age 16 she joined RAICES two years ago, working directly with unaccompanied minors, immigrant, and refugee families.

To her left is Samuel Almeida. He is the MSF regional deputy head of mission and is responsible for the implementation and coordination of MSF's advocacy priorities in Mexico and Central America.

Finally, Gordon Finkbeiner, who's the field coordinator for MSF's migrant project in Mexico.

Before we begin our discussion, however, I felt it important that we introduce you to some of the members we're going to be talking about tonight. So we'd like to show you a brief video of the latest residents of Matamoros, Mexico.

 

Video Transcript: Waiting in Danger in Matamoros, Mexico

https://youtu.be/i-cPYJFLbOo

[Lower thirds] Nora Valdivia
MSF Mental Health Supervisor

NORA:
Today we are in Matamoros, at the border, at the bridge between Matamoros and Brownsville-Texas.

[TEXT] Entrance to Mexico-U.S. border

NORA:
As you can see, these are tents where people from different countries in Central America. Some are from Honduras, El Salvador, Guatemala. They are here trying to apply for asylum in the United States. They are waiting for their [court hearings].

[TEXT] In November, there were nearly 2,000 asylum seekers and migrants camped out in Matamoros by the international bridge. 

NORA:

Some of them have been exposed to violence, either in their countries or on the migration route: extortion, assault, kidnapping. Sexual violence, this happens, too.

[TEXT] In Honduras, Elena's young daughter witnessed another child being murdered by gang members. They had to leave their country immediately.

“ELENA”:
[My daughter's] life was at risk there. They wanted to kill her.

[Lower thirds] "Elena"
Asylum seeker from Honduras

“ELENA”:
That's why I immediately quit (my job with) the company where I had worked for 13 years, with my social security benefits. All those years of work were wasted. It was very sudden, from one day to the next. I had to quit my job in order to save her life. 

[Lower thirds] "Eduardo"
Asylum seeker from Honduras

“EDUARDO”:
In my country I have been hiding from criminals for the last 9 years because they wanted to kill me. ...They kidnapped me and told me that they were going to kill me. But often when you're asked for evidence of that, you don't have it because you can't make a complaint when the authorities are involved in crime.

[TEXT] MSF staff see the impact of this violence on people's mental health.

NORA:
It manifests as difficulty sleeping, lack of appetite, feeling worried, feeling scared all the time, reliving a violent act over and over again. And this leads to a type of post-traumatic stress or acute stress from having experienced a violent event.

[Lower thirds] Edwin
Asylum seeker from Honduras

“EDWIN”:
I had a problem with my daughter, there [when we were] in Tabasco [Mexico]. I can't talk about it. I can't work, I can't leave my daughter alone with anyone, with anyone.

NORA:
We see now that with the new migration policy things have changed. Waiting times are much longer. So we see changes in their emotional and mental health. There is more despair and anguish. They start out with a lot of hope, but as the months go by they lose that. [Getting asylum] is their reason to keep going, and realizing that it takes up to 10 months or a year, it makes them feel devastated and increases their suffering.

“EDWIN”:

... Never in my life have we suffered as we have suffered here. Because... I thought that after we entered the United States, it was the law that we would be able to remain in the United States.... It didn't matter if they would send me to a shelter, but I didn't want my daughter to be living in the condition we are living now.

[TEXT] Under U.S. and international law, people fleeing violence and persecution have the right to claim asylum.

But the U.S. has recently imposed a series of restrictions on access to asylum – including the so-called “Migrant Protection Protocols” that actually put people’s lives at risk.

The U.S. is now turning away vulnerable people seeking safety, and pushing them back into dangerous and precarious conditions in Mexico.

[Lower thirds] "Juan"
Asylum seeker from Honduras

“JUAN”:
The most shocking part was when I was detained [in the U.S.]. It was sad for me to be without my daughter. The food they gave us...they didn't let us sleep, they woke us up all the time. And that extreme air conditioning, they never turned it off. Sometimes they made it even colder. That was the worst part of it, which I will never forget.

[TEXT] U.S. policies to deter and discourage asylum seekers and migrants are having an impact.

However, nothing will stop people from trying to survive.

“ELENA”:

... If they don't give me asylum, I still won't go back, because I know that if I go back, they could kill my daughter.

[TEXT] Seeking safety is not a crime.

Learn more at doctorswithoutborders.org

 

Carlos Sanchez:                

It should be noted that Matamoros is in the state of Tamaulipas and if you don't believe these people and their stories earlier today, the State Department, in anticipation of travel over the Christmas holidays, issued travel advisories for various cities in Mexico. That advisory included the advice to stay away from the entire state of Tamaulipas because of crime and kidnapping. On that note, I'd like to ask Denise, I mean, the heart of tonight's discussion relates to something called Migrant Protection Protocols or MPP more commonly called Remain in Mexico. Could you tell us what that is?

Denise Gilman:                 

Right, so MPP, which we sometimes refer to, really, as Remain in Danger. I saw a couple of the law students that I work with who sort of coined that term here because they've been really thinking about what this program really means. What it does is it is an unprecedented change in policy by this administration. Unprecedented in the sense of using the law in a very different way than it's ever been used before for addressing the needs of asylum seekers in a way that is probably, in fact, unlawful and unprecedented in terms of its cruelty.

What it does is that asylum seekers who arrive at the U.S. southern border, after fleeing extreme violence and danger in their home countries, are processed in border facilities by U.S. authorities. That's the detention that was just described, in really miserable conditions, and they're put into immigration court proceedings in the United States, but then they are physically returned to Mexico, where they face extreme danger at the hands of cartels as well as incredibly difficult living circumstances. Then, they have to wait there and return, back and forth to the border multiple times to attend hearings in U.S. Immigration Court over a period of months and probably a year or so.

Carlos Sanchez:   

Now a lot of people confuse MPP with something called metering. What is that and what's the distinction?

Denise Gilman:                 

Yeah, that's really important because metering predates the Remain in Mexico or Remain in Danger program. What metering is, is sort of a wait list at the border, which is also something that is new under this administration and the very tail end of the Obama administration. Before that, if you presented at the U.S. Border and said you were seeking asylum, you were immediately processed into the U.S. And you were either sent to a detention center for some time or just allowed to go live with relatives and then have your asylum claim heard while you're living in the U.S. and you have your claim heard in the immigration courts.

Under metering, that still happened, but first you were required to wait in line at the border because U.S. authorities would only process in a few asylum seekers a day. So people were waiting for months and months before they would even get processed.

Now, metering is actually combining with the Remain in Mexico program, so that you have people who waited for months and months to get processed and then once they're finally processed, they're put in Remain in Mexico and returned back to Mexico to wait for their hearings.

Carlos Sanchez:                

Did you all get that? Well, as a matter of fact, MSF, over the weekend, did a social media poll to measure people's understandings of this very complicated topic. I'd like to run the poll by you and also see where you all stand with some of these questions. The first question that was asked is, "The Migrant Protection Protocols are U.S. policies that protect vulnerable migrants and asylum seekers. True or false?"

Audience:                          

False.

Carlos Sanchez:                

Well, let's see what they say up here. A lot of people are under misimpression that it is for their protection.

Audience Member:        

Who was asking?

Carlos Sanchez:                

This was asked on the MSF website via social media, both Facebook and Twitter. It was done over the weekend. Okay. Let's go to the second question. "MSF responds to which neglected medical need for migrants in Mexico?" A is malaria, B, antibiotic resistant infections and C mental health issues. What do y'all think?

Audience:                         

C.

Carlos Sanchez:                

C. What do we have up here? So it is mental health issues, but by just the slightest margin, so people don't understand what's going on. And then the final question, "The U.S. is sending vulnerable asylum seekers to places the State Department considers too dangerous for travelers?" I gave you that answer. So true or false?

Audience:                          

True.

Carlos Sanchez:                

And a lot of people got that one right. All right. Now that we have a basic understanding of Remain in Mexico, I'm trying to get a basic sense of the legal implications of this. Is there some violations of the law going on with regard to this policy?

Denise Gilman:                 

Oh, so I'm the only lawyer on the panel. I'll stop talking after this. There are really, really serious legal implications. One thing that's very important to understand is that in immigration proceedings, even though they are life or death decisions that are being made about whether somebody will be given asylum, and allowed to remain in the U.S., and receive protection, there is no right to a publicly appointed lawyer, to a government appointed lawyer.

In general, immigrants in removal proceedings in immigration court have a very hard time finding an attorney even though they really need one to be able to present a complicated asylum claim. In MPP, only about 2% of people in the Remain in Mexico, Remain in Danger program have an attorney, and that's because it is so difficult for attorneys to access these asylum seekers. They can't themselves travel safely to go work with the asylum seekers in Mexico. There are logistical hurdles and other hurdles, so that's one legal consequence.

Another is just that the entire system is set up to exclude. I think it's really important not to even think about this as just a different kind of court system or a different process for deciding asylum cases. This is really a sham court that is set up to keep asylum seekers out in every way. And so statistics have recently come out showing that only about 0.1% of asylum seekers in these proceedings actually win their asylum claims. And we know that some of these individuals, probably a very large percentage of those presenting at the U.S. southern border have very viable asylum claims. So those are some of the consequences.

In terms of whether it's lawful or not. There are some complicated legal arguments taking place in the federal courts right now, but it's pretty clear that the law that is being used that says that people can be returned to the contiguous territory, to a neighboring country during proceedings was never intended to apply to asylum seekers. It was really intended for entirely different kinds of cases. And of course the U.S. has obligations under the refugee convention, the UN refugee convention, to provide access to asylum and to grant asylum to those who need that protection. That's an obligation under international law and that we've brought down into U.S. Law that this program clearly violates.

Carlos Sanchez:

And for those of you, like me, who can't do math, 0.1% represents 11 asylum claims that had been processed out of 57,000 that had been requested. That came out in the Los Angeles Times yesterday. Tell me a little bit Samuel and Gordon about the human rights implications that this policy has.

Gordon F.:

Well as you know, Médecins Sans Frontières, Doctors Without Borders is not only a medical, but a humanitarian organization and this translates in not only a mandate for us to provide medical assistance or mental health assistance, but also to speak out when we see something that is going on that should not be going on in terms of human rights, for instance, violations.

We work with an array of organizations along the Northern Mexican border together and what we see is a wide range of shortcomings in terms of protection, mostly. In practical terms, the first thing that comes to mind is if somebody is being thrown back across the border into Mexico is, "Where do I go?" I mean, shelter.

Number two is protection because ... And here we go straight to one of the main denunciation points that we currently have is, just as an example, in one of the cities where we are working in Nuevo Laredo on the other side of Laredo, Texas, as of September this year, three out of four patients that we received in our mental health consultation room had been kidnapped in the seven days prior to the consultation. That is huge. That's three out of four people that came to us seeking mental health consultation had been kidnapped. It is a very strong message, it's very stark and we have been openly saying so. So there you go, this is deficit number two, protection.

And then there are a range of other issues that we're looking always into in the situation would be the water, sanitation and legal assistance, et cetera, but the main message from our side is, "It is too dangerous a place." Full stop.

Carlos Sanchez:                

And, Samuel, the medical implications. What are you seeing with these people in Mexico?

Samuel Almeida:             

Sure. I just want to highlight first, we don't only provide mental health care, we provide comprehensive care. Means physical care, mental health, health promotion and social work, which is a crucial part of our job in Mexico and Central America.

The main diagnosis we have for people, for example, in Matamoros it would be ... The physical health, would be related to respiratory problems, or gastro problems, or skin issues, which some of them are caused by the conditions they lived in. The sanitary conditions as you saw in the video.

For mental health, which is indeed the main gap we saw in terms of healthcare provision in Mexico and Central America. Then we're talking about extreme diagnoses like PTSD or post-traumatic stress disorder, acute stress, depression. I mean we have patients that have tried to suicide. There are several issues. And half of our patients, more or less are children. So, that also shows the vulnerability of these people trapped on the border.

Carlos Sanchez:                

And Adriana, for those who are fortunate enough to make it into the United States and seek your services, what types of mental or physical conditions are you seeing?

Adriana Quiroga:             

Yeah. I actually have a story I'd like to share. I spoke with a woman earlier this week who came in for consultation.

So at RAICES, we offer legal consultations to migrant children and families. I work in the advocacy department, so I work with a lot of people in the community. Our goal, or our greater goal is to really conduct outreach, empower people to understand the system, to know how to operate and navigate these really complex systems.

So, I met this woman and I resonated with her. I connected with her because she was around my age and she came to the United States to seek asylum when she was five months pregnant. She was seeking asylum because her child's father, in home country, was a police officer and was forcing her to have an abortion. So, she fled and she came to the United States to the border to seek asylum and she was returned to Mexico, to Matamoros, and she and a group of five to six other pregnant women found each other.

They all gathered the pesos that they had, the currency they had, and they bought a bag of churros. And that was the only solid food that she'd had in two weeks. And this is a woman that's five months pregnant. She said she had never experienced fear to that extent in her life.

She said she would wake up and the kids that she saw the day prior were missing. She talked to a lot of families there whose children had gone missing, were disappeared, kidnapped. So, she's someone that was actually ... When she came in to the United States for her court hearing, she was considered a high risk pregnancy and she was about to go into labor. So, she was paroled and allowed to be released to a sponsor. And that's when she came to seek our legal services.

I really connected with her just because she's a very young woman and the fear and the trauma that she's experienced as a result of being subject to MPP, Remain in Mexico, is going to stay with her for the rest of her life. And you can tell just by her sharing her story. So that's, that's an example I can think of.

Carlos Sanchez:                

Samuel, I was talking to a medical aid worker in Matamoros and she told me that several of the women in that camp have requested condoms, if they have any available. The idea being that when they're raped, they may be able to convince the rapist to put on a condom ahead of time. Are you seeing sexual assault as a huge issue among these people in Mexico?

Samuel Almeida:             

Absolutely. Either in the camp itself, or on the route, or in the home countries. We used to work in San Pedro Sula in Honduras. We did a short intervention with the returnees, people being deported from the U.S. to Honduras, and that was a common thing the women would ask for is these contraceptives, so they could go back on the route and feel safe that they wouldn't get pregnant.

We have seen a few cases ourselves in Matamoros in the past months. We do train the general hospital. We provide them with medicines, the PEP Kit, the post exposure prophylaxis to prevent HIV, up to 72 hours after the event. So yes, that's a reality.

Just to give another example, there's this patient of ours. She was in Matamoros. She was kidnapped in Reynosa and she was ... While being kidnapped, she was blindfolded, and she was touched, and they took photos. And that's just an example to show what kind of situations they're exposed to.

Carlos Sanchez:                

And I'm assuming that begins the process of lasting mental health implications. Gordon, is that something you're seeing as well?

Gordon F.:                          

This is true. Sometimes we have the unfortunate event of seeing the same person more than once. Because as you might know, the project that we run in Mexico and Central America attending to migrants and refugees, we have teams scattered all across the geography.

We have sometimes the case in which a patient that we're treating in the South, be it in Tenosique, on the border with Guatemala, might then appear again in a consultation room in Mexicali, which is across the border from Calexico in California. In the meantime, this person might have been exposed to a wide range of security incidents. Been traveling on the train, being assaulted, raped, kidnapped again, asked for money, made to work somewhere.

This is, unfortunately, very common and the mental health issues, they keep piling up on the migratory route all the way to the North. In the South, it's very often sexual violence, that someone just mentioned is very common as well, especially on the route that we are present in. But these issues, they keep adding up, keep adding up, they keep adding up. What keeps driving people is the hope, is this hope to get to the border.

Once that is cut out, that's when they usually, they face a drop. And that's when the mental health consultations are really, really important and add the value that they add. No? That's our mission here.

Carlos Sanchez:                

So I'd like to ... Go ahead [crosstalk 00:27:06]

Samuel Almeida:             

[crosstalk 00:27:06] If I can just compliment something. Of course, this is an issue in society, in general, sexual violence. But, this population these migrants, asylum seekers, they are particularly targeted by groups in Mexico, and on the border, that would kidnap, and assault them, and extort them, and so on. So, apart from the general inequality in society, this group is particularly vulnerable.

Carlos Sanchez:                

You know, it begs the question. Critics of these migrants who are coming into the United States, will often say, "Why would you dare expose your children to these kinds of conditions? To these dangers?" And from your experiences, what is the answer to that criticism? Anybody.

Denise Gilman:                 

Well, I think the reality is that most of these asylum seekers have already faced significant violence that has already happened, or has been threatened. And so, they're really, literally facing a decision of do I stay and be killed, or watch my child be killed? Or do I try to take the dangerous path to the United States and hope for protection. And maybe it won't work out, or maybe I'll be in danger there too, but it's better than the certainty that we'll be in danger and harmed here in our home country.

I think the other reality is that even though the U.S. government often suggests that U.S. policies are what determine whether people come or don't, that we can implement measures that will deter migration. In reality, people are making those decisions about the journey without really full information or understanding about what will happen. They're making it based on the danger they face at home. And so policies implemented by the U.S., frankly, have very little to do with that decision making process. Most believe that the U.S. is a country of laws. That if they arrive here, they will get the protection that they need.

Gordon F.:                          

The situation in certain places of Central America, from what we hear from our patients, is very often a high degree of extortion. And people living in modest dwellings, in places where every single little shop, business is being extorted. I mean, we're talking people who are just selling tacos on the street.

And what we also hear very, very often is that the moment of taking that kind of decision arise, or gets to a point of no return, when the family has a teenage son or daughter, because that is the age of recruitment by the gangs. That's very commonplace in Central America. And at that point, you either give up your child, they come and recruit the person, voluntarily or involuntarily, or else.

Carlos Sanchez:                

Go ahead, Adriana.

Adriana Quiroga:             

Yeah, and I would just mention, our video team was down in Matamoros and they met a young woman, a transgender woman, who left her home country because of the persecution she was facing. Her body was covered in scars. She was extorted. All the money that she'd made was stolen from her. And that's what ultimately drove her to make the decision to make the dangerous journey North.

She told our film director, she said, "Listen, I know that I'm at risk here. I know that Matamoros is incredibly dangerous, but I'd rather die here knowing that I have somewhat of a semblance of hope, rather than go back to my home country and be killed." So, she knows that she has the risk of potentially facing that kind of threat, facing death, but she doesn't have a choice, so that's where she is.

Carlos Sanchez:                

So, it's cold out tonight. Would you all agree? The last cold spell that hit Matamoros encouraged at least 20 parents to decide to send their children, alone, across the border to become unaccompanied minors. And I'm just wondering what kind of desperation that evokes that would prompt a parent to give up the child thinking, "They'll have a better chance without me." And I'm wondering if you could talk a little bit about what unaccompanied minors are and how that works.

Denise Gilman:                 

Yeah. So, that was another response I was going to give to your question about why do they do it, even though it's putting their kids potentially in danger.

I mean, a mom does what she can do, what she needs to do to protect her kids. And that's why they make the decision, based on what they're facing in their home country. And sometimes, it has gotten to such a horrific situation on the border with this program that some moms are deciding that, even though they know that it is not good for their kids to be apart from their parents, they're sending those children alone across the bridge. Little children, four year old children, with a piece of paper in their pockets that has a phone number of an auntie or somebody who will be able to sponsor them.

The idea is that it happens because unaccompanied children are currently under a separate law. Although, there are efforts by this administration, by this Congress, to change it. But, that law, for now, provides additional protections for kids who are by themselves when they appear at the border. And those kids cannot be put in the MPP program. And they will be detained. They'll be held in detention centers that are under Health and Human Services, so a little better than detention centers under ICE, but they will generally be processed out to go live with family members, more or less, quickly. And so, that's what some of those parents are trying to do.

I have to note though, there is another way in which MPP is making family separation happen that isn't even as voluntary is that. Although, there's a real question about whether what we just described is voluntary, right? But, there are also cases that we are seeing where it's not the same clear explicit policy as last summer of family separation, but where parents and children are processed together at the bridge and then somehow there's an unaccompanied minor that appears. And so we are seeing at least some instances of family separation. Whether the government is saying that the parent is unfit because of some vague tattoo that suggests gang affiliation, according to the government, or something like that. But we are seeing ongoing cases of separation.

The other thing we're seeing ... Our student team and I actually saw this in court, is situations where because of a kidnapping, a child ends up unaccompanied. And we know of at least one very clear instance where that happened. And the child was initially ... When she showed up in court that day without the parent and explained that the parent had been kidnapped ... Well, actually, another family brought her in and explained that the parent had been kidnapped. She was treated as an unaccompanied minor, temporarily, and then the records kind of go cold and show that, no, there was a determination that she was 18, which seems really unlikely. And seems as though government officials either made that up that she was actually 18, or pressured her into saying she was 18, so that she could go back and try to find her dad.

Carlos Sanchez:                

So, there is a case playing out right now in Chula Vista, California. It involves a 19 year old woman who's pregnant, having complications with her pregnancy, and was allowed into a U.S. hospital to deliver the baby. Border patrol has already made it clear that once the baby is delivered, she will be returned to Mexico. The baby will stay in the United States. Pregnancy involves a whole slew of new legal complications as it relates to this policy. Can you jump into this fray a bit and ...

Denise Gilman:                 

Yeah, I mean, so we just were talking about this case right beforehand. First, of course, it's extreme cruelty. There is no reason why the government couldn't just allow the mom to remain in the U.S. and pursue her immigration case in the U.S. with the child. So, that's the first thing that has to be absolutely clear. There's absolutely no law that requires that the mother be sent back.

And in fact, I would assert strongly that the law should require her to be allowed into the U.S. in this circumstance. But, it does create an interesting issue. The kid cannot be put into MPP, right? The child is a U.S. citizen. And so, if the government is going to insist that no matter what mom has to be returned to Mexico through the MPP program, then the government puts itself in this situation of saying that the family has to be separated.

Carlos Sanchez:                

Let's turn, now, to a really fundamental question with regard to ... It's up to about 60,000 people now in Mexico under the MPP program. Are they in refugee camps? Are these refugee camps that we're seeing along the border?

Samuel Almeida:             

There are different kinds of facilities they can stay along the border. Usually, their shelters in these cities. In Matamoros, specifically, there isn't one. People have an improvised camp. As you saw in the videos, they set up their own tents. Sometimes they get donations from volunteers, but it's improvised. There is no UN agency managing, or any authority managing those camps.

The situation has been improving, which is still awful, but, you have more latrines and showers now, and some kind of electricity. But winter, it's definitely an issue, as you mentioned. Temperatures in Matamoros go below zero and in these kinds of conditions, it's really affects them. And I guess, going back to your previous question, that's what force parents to send their children across the border or they just have no choice.

Carlos Sanchez:                

Now, I understand the political value of labeling these refugee camps, because it begins to force both the U.S. And Mexican government to confront something that perhaps they wouldn't. Is there a legal value in calling these refugee camps?

Denise Gilman:                 

I don't know if there's a legal value, but I do think it would be proper as a legal matter. When UNHCR runs a refugee camp in Turkey for Syrian refugees, it's not the case that everybody in that camp has already been determined to meet the full on definition of refugee and, therefore, has made themselves subject to all of the various international protections.

It's just a recognition that this is somebody who is fleeing from a situation that is absolutely a refugee producing situation, and that they have immediate needs that need to be taken care of in kind of a framework of refugee protection. And so I do think it would be appropriate under the international framework and under the law.

I'd like to be clear though that, even in that setting ,there are always questions about whether that will, in the end, just lead to kind of improvements in conditions in the camp as opposed to a more permanent solution of integration into the host society, or resettlement to a first world nation that would be willing to integrate the refugees.

And I do think it's a double-edged sword, regarding the description of the temporary camps set up on the border as refugee camps. On the one hand, there is a very clear need for basic human needs to be met in those camps that perhaps would be helped by that. And perhaps, it would even push the ball forward a little bit in recognizing that this is a true refugee crisis that needs to be addressed. But, the real answer I think would be that these asylum seekers need to be allowed to pursue their claims within the United States, not within Mexico.

Carlos Sanchez:                

Now, a couple of weeks ago, two members of Congress decided to go into the Matamoros camp unannounced. They didn't tell U.S. authorities. They didn't tell Mexican authorities. So, they saw the full unvarnished kind of truth of the situation.

When they returned ... Both of these members of Congress had visited refugee camps in Africa and in the Middle East. And they said what they were seeing in Matamoros was far worse than what they've ever witnessed in Jordan or in Africa.

And I'm wondering if by classifying them as refugee camps, there kicks in some international protocol that provides for infrastructure provides for healthcare needs. From your experience with MSF, have you seen, or is there a process that allows for these additional protections?

Gordon F.:                          

The term refugee camp is nothing that automatically trigger something. It would depend on if there's an active that actually is going to step in and do camp management. For instance, in other settings, what we do have as UNHCR, for instance, the RCU, some other organizations doing this. But I don't think this we should be concentrating much on that, really. I have no ... I can, myself, not for sure say that taking this step would actually help more.

What I would like to point out, though, is that the fact that this ... The reason why these people actually staying there, why they are starting to accumulating at the border is out of pure fear. That is the reason why they're staying there. I think this is something that we should not forget. They're not moving anywhere else out of pure fear of being kidnapped or something happening to them.

Denise Gilman:                 

Well, and to be clear, and because they have to keep showing up at that border bridge to show up for their hearings in these tent courts on the border. So, they can't really go further into Mexico beyond Matamoros or the very dangerous border cities because then they'll just have to come back into those cities, which is itself incredibly dangerous because the cartels control the bridge area and they control the bus stations. The entryways into these cities.

So, of the kidnapping stories that I know about and have been involved with, many of them took place right as the U.S. returned people across the bridge into Matamoros. Or in my case ... the ones that I know of more are in Nuevo Laredo. Or some cases where it's people coming into town after they had relocated to Monterrey to be safer, but they had to come back for their hearings and they were kidnapped on their way back into town.

Carlos Sanchez:                

Just a couple of weeks ago, there was such violence in Nuevo Laredo that they imposed a curfew, which was interesting because in order to show up for court hearing, what time do you have to show up?

Denise Gilman:                 

4:30 AM

Carlos Sanchez:                

So, in the midst of the curfew, they have to expose themselves to the situation like that.

At this time, I'd like to show you another video introducing a client of Adriana's, introduce you to a woman named Maria.

Adriana Quiroga:             

Yeah. Maria, she's actually not one of our clients, but she is somebody that our video team met down at Matamoros.

 

Video Transcript: Pregnant under the Migrant Protections Protocols

https://youtu.be/vhEdHfaFMCA 

[Lower thirds] “Maria”

“MARIA”:

I don’t understand why I’m here. They never explained.

[TEXT] Maria and her family fled gang threats in Honduras.

They asked for asylum in the U.S. but were dumped back into Mexico under Trump’s “Migrant Protection Protocols”.

“MARIA”:

I’m with my two children.  I recently found out I’m pregnant. I did all this to protect my family.

[TEXT] They have to wait months in Mexico for their asylum hearings in the U.S.

So they’re living in this makeshift refugee camp in Matamoros, Mexico.

“MARIA”:

On that first night here, we had to find cardboard to sleep on the street with our kids. No blanket, nothing. We were sleeping like that for 15 days.

[TEXT] Mexican authorities have also turned their backs.

Conditions at the camp are miserable.

“MARIA”:

When we first got here, we’d bathe in the river. We’ve found dead bodies in it. Their organs were removed. They were decapitated. That’s where we bathed. That’s why I have this infection on my skin. I’m worried my baby will be infected too.

[TEXT] People like Maria are often targeted by organized crime in Mexico.

“MARIA”:

It’s very hard to flee from your country only to end up kidnapped in another one. There were 175 of us kidnapped in that hotel. They demanded $4,000 from my father to let us go.

[TEXT] More than 55,000 people like Maria have been dumped back in Mexico.

This is being done in your name.

Help us stop this cruelty now.

Visit

Raicestexas.org/stopmpp

 

Carlos Sanchez:                

Last month there was a report issued in which they were able to independently verify at least 600 victims of kidnap, rape, and assault among the MPP participants, or those who were in that program. I'm just wondering what evidence you all see of predatory behavior, particularly as it relates to drug cartels, because everybody tends to blame the drug cartels on everything. And I'm just wondering if there is clear evidence to you all, from your experiences, that suggests that, yes, the cartel is very active in these situations.

Gordon F.:                          

Well, yes, we have to, unfortunately, perform our work under very harsh security conditions and security rules in one of the places, again mentioned, Nuevo Laredo. It applies to a lesser extent to the other areas we work as well, but in Nuevo Laredo, is a case in point. It gets to the extent that you can see handmade armor that was welded upon a pickup truck. What, two or three of them, with a half a dozen people armed to their teeth driving around Nuevo Laredo as if nothing happened. Five minutes later you see the military going down the same road.                                             

It's that level of obvious that, I mean it is very ... You can sense it. People ... Our beneficiaries, when we get to meet them, at the shelters in Nuevo Laredo. We work inside the shelters because of that same reason is these people they do not venture out. They're afraid of getting out.                                               

When you talk to them and say, "So, what do you do during the day in order to make time until you get to your court hearing date?" And they tell you, "The other day I went out, I saw a guy being kidnapped in front of me. There's no way I'm getting out of here. I'm staying put." That's very, very particular of Nuevo Laredo, and especially it's also the case amongst the other Northern towns here in Tamaulipas. In other areas we see other different ... We have different modalities. We work in a different way, but in Nuevo Laredo, we can only work inside the shelters.

Carlos Sanchez:                

Just ... Yeah.

Denise Gilman:                 

Can I just comment on that?                                               

You know, the U.S. knows that the cartels are extremely active and are targeting migrants in these Northern Mexican cities. So, it's a very clear decision on the part of the U.S. government to deliver people into that danger. And to do so knowing that, in fact, doing that will strengthen the cartels. Now, they have an entirely new kind of profit center for kidnappings and ransom collection. So, this policy is actually strengthening organized crime in Northern Mexico, I think it's fair to say.

Carlos Sanchez:                

Indeed, the governor of Tamaulipas has complained that it's also a place to recruit new workers because you don't do so voluntarily.

Samuel Almeida:             

Yeah. Just to add, I mean that's also a tactic they use, these organized armed groups. Forced recruitment when they kidnap someone that can't pay for the ransom. But, there's also deportations of Mexicans and they happen to Tamaulipas, to Nuevo Laredo, to Reynosa, to Matamoros. And in Reynosa, it happens at night.                                               

MSF is an organization that it's used to working in conflict zones. We know the risks. We mitigate the risks. We have very strict security protocols, but last week, in Reynosa, we suspended activities to receive these returnees, when we provide a psychological first aid. Because of the violence.                                               

There's a variety of groups in Reynosa. They're all fighting each other. On top of that, you have the military, you have state police, you have local police. And this population, what are the returnees, many of them lived in the U.S. for 30 years. Some of them don't even speak Spanish, don't have family members. The migrants going North, or waiting in the metering policy, or the MPP being returned to wait again. Those people are particular targeted. And when you're deported from the U.S., they all come with the same clothes, with the same bag, with the same shoes and that's how they are easily recognized and kidnapped by these groups. Those are the reports we hear from our patients.

Carlos Sanchez:                

Yeah. Go ahead, Adriana.

Adriana Quiroga:             

Yeah. Just to attest to also what Denise said about the U.S. acknowledging that they are handing people over into organized crime areas is this woman that I spoke to, she said when she was being returned to Mexico, she was with a group of other migrants who were also being returned.

And one of the men in the group asked the officer, "You're sending us back to Mexico. You're sending us into the hands of the cartels. You know that." And, and the officer just replied, "You need to be a man. You chose to come to the United States in the first place. You knew the risks. You need to be a man." And even when the man said, "You know, I have my five year old child with me. How are you all sending us back knowing that this is the danger that you're putting us in?" And the officer just shrugged and said, "There's no more questions after this." So that's, I mean, these are the interactions they're having with U.S. officials.

Gordon F.:                          

It's so bad. So that ... And this is an anecdote of early this morning, as of 6:00 AM when I was traveling up from Nuevo Laredo. This is something I had not known before, but every year at around this time, the Mexican government puts up a huge police force to accompany Mexican-Americans that are traveling back for Christmas. They cross the border with the cars. They line up and they're then escorted all the way out of the state of Tamaulipas. It's that bad. So, it's commonly known. It's not a secret. You cannot say it's a secret if it's so institutionalized. It was amazing to see this morning, really. The logistical work behind it.

Carlos Sanchez:                

Just as a reminder, those of you who would like to ask questions are encouraged to write them down. There's a gentleman over there who will gather your questions.

Those of you who are watching online are encouraged to post your questions online and they'll get to me eventually. Whether I ask them, I don't know is a different question.

We've been mentioning Matamoros and Nuevo Laredo a lot and I'm wondering why they kind of stand out from the four or five cities that the United States is sending MPP recipients to. What's unique about those two cities?

Denise Gilman:                 

Danger, but you guys know more.

Gordon F.:                          

Yes. I don't think we're going to do an open quarter context analysis here, but yes, the levels of danger and the kidnapping rates that are there are ... They go through the roof really. Again, I mentioned earlier on in September we had three out of four people walk into our mental health consultation room reporting that they had just been kidnapped in the last, in the prior seven days. This is high.

Carlos Sanchez:                

What about the tent courtrooms that exist on the U.S. side? How does that affect what's going on? I mean, in San Diego they have brick and mortar. El Paso, brick and mortar. In Laredo, it's massive tents. In Brownsville, it's massive tents. How does that affect this whole process?

Gordon F.:                          

We were told by some high up government official, U.S. Federal government official that the reason for setting up the tent court from Laredo was due to purely logistical reasons on the U.S. American side.

Denise Gilman:                 

So, I've been waiting for my opportunity to talk about the tents. Because this is where from the sort of legal perspective, any semblance of this being a court process an adjudication, a way to decide who gets asylum and who doesn't just completely falls apart.

Speaking of sort of comparisons, I have talked ... I've never been to Guantanamo, but I've spoken to lawyer colleagues who have, and when I describe the tent complexes they say that sounds just like Guantanamo.

And if you all will indulge me, I'll give just kind of a tiny quick visual, verbally, of what this looks like. Basically, when an asylum seeker who has court in Laredo or Brownsville reports to the bridge, they get checked off on a list at the midway point of the bridge. And they're sort of checking themselves into detention for the day, they really are, for their hearing.

And they get escorted. You can walk along with them as a lawyer up to a certain point. But then, the border patrol officials take them through this tunnel that goes straight away from the little booth where we present our passports when we come back into the U.S. And they head them into this court complex, which is courts, portable trailers, like you see when schools get too big for their physical building, and cargo containers.

The cargo containers are meeting rooms for attorneys and clients to meet. The portables are courtrooms where asylum seekers sit en masse, 20 or so, with their small children, and teenage children, and parents to appear by video to a judge sitting in a regular courtroom someplace else. For Laredo, the judge is sitting in San Antonio, Texas, four hours away or three hours away. In the Brownsville tent courts, the judge is sitting mostly in Harlingen, although judges are getting beamed in from elsewhere as well.

And so, the hearing that takes place is a hearing inside a portable building, by video, to a judge someplace else. And if you want to present evidence in support of your case, you have to either get one of the court officials ...

There's no court personnel in these tents. There are just sort of guards, private contractors, who will scan your evidence that has to be presented in English. Even though you're living in a Spanish speaking country and you're a Spanish speaker. Or your asylum application, which is a 15 page long form that has to be filled out in English with difficult legal questions. That has to be scanned in and sent to the judge who then checks his email and tries to look at the documents.

And if you want to meet with your attorney or perhaps, looking at it from the perspective of the attorney, if I want to meet with somebody there ... After the client, after the asylum seeker goes into the complex through the tunnel, the attorney has to go around to a separate entrance. And in Laredo it's this rickety wooden staircase that looks like it's sort of from an old boat dock that has isn't in use anymore where you might fall through. You're right on the river and you walk up these rickety wooden stairs to this big metal gate. It's kind of like this fortress and you knock on the door. Literally.

And hopefully, some guard listens and comes to get you and you say, "I have a client who has a hearing today in the tent." And they check their list. And they see whether that client is really appearing that day. And if so, then they check your identification and you go through x-rays, and a noisy waiting room, because it's all these tents with kind of air blowing and generators. And then you go into the cargo container to meet very briefly with your client. And then into the portable part of the tent court to actually attend the hearing.

Even attorneys are not allowed to stay in that hearing for more than their client's case, for the most part. They're ushered in and out only when their case is being heard. So, there's no sort of observation of these hearings. The press has tried to get in and has been denied. Congressmen have been trying to get in and have been denied. It just doesn't look or feel like a court at all.

Carlos Sanchez:                

I've been fortunate enough to actually go into the Harlingen courtroom and witness, at least from the perspective of the judge, these proceedings. One thing that struck out at me is the notion that the migrant, typically family, typically without a lawyer, would appear before the judge and the judge would go through the legal rigmarole, and then set a new court date. And these people seem distraught. Do they walk in with the impression that they're going to enter the United States that day forever?

Denise Gilman:                 

Many understand that at least their cases will be heard that day and, for the most part, their cases aren't even really started that first day. And the judges aren't even prepared.

If they miraculously get their asylum applications together, which is the first step, most of the time, the judges don't even have the time on their dockets, or are not prepared to even receive that asylum application. And so, in almost every case you're talking at least three hearings and most of the hearings are set two to three months apart.

We were involved recently with a family of asylum seekers who had been kidnapped when they first arrived in Nuevo Laredo. They have been struggling to try to get into the U.S. Because of that fear that they have of being kidnapped again and have been denied. They had their initial hearing. They came back for their next hearing with asylum applications ready to go in English. We had assisted them with those. And they were turned away.

They were not allowed to go into the court even to present their asylum applications to go on to the next stage of the case because some official decided that one of the four mom, dad, and two small children had lice, which it was later decided was not even the case. But so then, they just didn't even have their chance to present their asylum application and their case was set over to February. So, these cases are getting very drawn out in addition to just being faced with that difficulty of returning back to Mexico.

Carlos Sanchez:                

Go ahead, Samuel.

Samuel Almeida:             

Just to add, in terms of social work, the biggest need we see for our patients is information. They cross the border, they don't receive any information. They have no translation or anything. They get back and they don't know.

Some get appointments for one year. We have patients that have been returned now in November, and they have an appointment for November 2020. They don't know what to do. They have to fill this form in English, which is extremely long. But, they're not informed of their rights or they don't have access to legal counsel. And that affects a lot their mental health. Right? This adds a burden on an already vulnerable population. And then when they come from the second appointment, usually, yes, they're destroyed.

Carlos Sanchez:                

Onto a new topic. Denise mentioned lice. What other problems are you seeing medically among these people?

Samuel Almeida:             

We don't have a many cases of contagious diseases, such as spread in the media. That there are cases of epidemics of measles or ... That's not reflected in our data. We do not see those cases at the border.

Carlos Sanchez:                

Are you seeing cases of trauma?

Samuel Almeida:             

Oh, many. Psychologically, yes, but in terms of physical wounds, it's usually superficial wounds that comes to us. I'm generalizing, I'm just saying the main data. Of course, you have specific cases and it depends where the violence happened and how soon they came to us.

Gordon F.:                          

We have been until now mentioning mostly mental health because the mental health component is show to be the strongest one, the biggest one, the one with the biggest impact here in our missions in Mexico and Central America. But we also provide primary health care with the corresponding referrals to specialists, sub-specialists, and so on and so forth.

We do psychiatric detection of such psychiatric cases of what have you ... Sexual violence is a big issue that was mentioned earlier on. We have our team specialized on that. That is a general thing that we always try to address wherever we work, but in Mexico and Central America, it is very, very strong component.

And last but not least, we have center in which we treat victims of torture, extreme violence, and ill treatment in Mexico City. These are the very harsh cases. And if the patient then, together with families, or caretakers agree to move to Mexico City for a few weeks or months, then we treat them there in a more comprehensive way.

Carlos Sanchez:                

I'm sorry to inform you that the acting head of Homeland Security, the acting head of Customs and Border Protection declared MPP a success. Would you agree with that assessment? All at once.

Gordon F.:                          

I imagine he mentioned that out of his initiative. From his perspective, is the success is measured in terms of reduction of numbers, I imagine, then you can say that's the case. But that what costs is the question.

We have seen the number of kidnappings. I think we have mentioned quite a few times. End of November, the first case of somebody who had been returned under MPP program was killed in the city of Tijuana. Tijuana had 2,500 homicides in 2018. San Diego, which is just across the border had 34. I think it speaks for itself.

Denise Gilman:                 

And it ... Maybe it would be helpful, at this point ... Because I agree. I mean, if success is measured in terms of numbers of asylum seekers who are even accessing the U.S. asylum system, much less gaining protection in the asylum system, then those numbers are way down. And if that's the goal, then by that measure for the government, it's a success, but at what cost.

And it might be worthwhile to think about who these asylum seekers are exactly at this point. So I don't know. And I'd be interested to know exactly what nationalities you all are seeing and the like. But, most of the folks that I've seen are either from the Northern Triangle of Central America, Guatemala El Salvador, Honduras, which are countries with some of the highest murder rates in the world. And long-term strife and persecution of indigenous communities, gender violence, and the rest, that are bases for strong asylum claims.

And then we're seeing large numbers of people from Venezuela and Cuba. Venezuela being a situation of extreme repression that the U.S. government has denounced repeatedly. And so those fleeing that level of authoritarianism, one would assume have viable asylum claims. And the folks that I've spoken to absolutely did. In fact, pretty paradigmatic political opinion claims, in a lot of cases. Opposition activists who were detained for marching against the government and then fled with their families. Those kinds of situations.

And similarly in, in the cases of people fleeing Cuba, you see often cases that you would really think about as being just the most sort of classic kind of asylum case that you can imagine. And yet, they're being turned away.

I think in terms of what this looks like and, and others have made this comparison, so I don't feel too shy making it. Although, I'm always a little bit cautious, of course. But, this is where we're actually turning away people who need protection at our border.

We did so famously during World War II when we turned away the St. Louis ship full of Holocaust escapees who were trying to gain safety in the United States. We turned them back and most of the 900 passengers were killed. We are literally blocking people who need protection at our border. Putting them in danger in Mexico and putting them in extreme danger of being returned forcibly or out of desperation back to home countries where they also face extreme likelihood of harm or death.

Carlos Sanchez:

And this was in practice, which this is a terrific segue for questions from the audience. The first question being what the U.S. is doing right now, is that in compliance with international law? And if not, why isn't this a bigger issue with United Nations? Anybody.

Denise Gilman:

Sorry. Stop asking legal questions. It's boring. So, I would really strongly argue that it is not in compliance with international law and there have been statements from a number of international bodies. The Inter-American Commission on Human Rights was down at the border in August and stated their concern about the program. UNHCR, the refugee agency, has stated concern and other bodies have as well.

I think the bigger issue ... There's more that they could say absolutely. But, I think the bigger issue is whether or not the U.S. is willing to listen, as it should, but does not. And there is also an interesting question about whether Mexico is willing to listen. Because Mexico is complicit, because Mexico is accepting the returns and not providing for safety conditions, or other conditions of dignity and safety.

Carlos Sanchez:

Anybody else?

Samuel Almeida:

No, just to add, we see with great concern also the new agreements the U.S. have reached with Guatemala, Honduras, and El Salvador, which are clearly countries that first are not safe, and second don't have capacity to receive this population. So, yeah.

Adriana Quiroga:             

Yeah. And I would add, the safe third country rule, which is now pending litigation, but it's active for now, which essentially says if you are coming from the Congo and you travel to South America to travel by land to get to the United States to ask for asylum. If you pass through a third country, then you must try to seek asylum or make an attempt to seek asylum in that third country before arriving to the U.S. But, a lot of these places where they're, where they're passing through, there is no infrastructure to be able to provide them asylum in the first place. So, we're seeing things like this take affect.          

Gordon F.:                          

UNHCR has been funding most of the additional capacity that has been added to the Mexican agency and processes asylum claims in the year 2019, this year. Most of it has been funded by UNHCR. They're very transparent about it. It's not even a secret. Capacities are not there and that is true that this is a matter that goes across governments. The MPP wouldn't exist if the Mexican government hadn't agreed to it, number one.

And what is happening now with these supposed so-called third safe country agreements or similar. What de facto does is load responsibility on other countries, sending people back to countries that are at the origin of this. These are the countries that people are leaving from. Most of the nationals that ... The highest nationality that we have in the, for instance, in the VOT center. Sorry, the Victims of Torture Center that we run in Mexico City are mainly Hondurans at the moment and have been for a while. And the cases that we hear are very, very strong. It would never cross your mind to declare Honduras a safe country. Absolutely not.

Carlos Sanchez:                

This questioner visited the camp in Matamoros recently and said he was shocked or she was shocked to learn that mostly volunteers, nongovernmental organizations, religious based groups are providing most of the infrastructure needs for these people. To what extent is the Mexican government helping out in providing for care or security of these people?

Samuel Almeida:             

Okay, so it's a bit of a long story. I'll try to make short. But this camp began with the metering policy. Way before the MPP policy. So people are gathered there waiting on this waiting list across to the U.S. and seek asylum. Usually it was 50 people. Not huge numbers.

And then when the MPP started to be implemented, this camp, which is by the bridge that you saw, it grew exponentially. There was no international organization apart from ourself. The international committee for the Red Cross has some focal points with the Red Cross, the local Red Cross. So the local authorities had to, after a few months, decided to improve the situation and install latrines or showers and things like this. And now the federal government right next to the camp by the river, they have big tents and more latrines and more showers, but it's not ... There's no other presence.

The International Organization for Migration, it's present there. They do what they call voluntary repatriation, so people who allegedly are willing to go back to their home country or they just gave up from the waiting, they go back and they lose their right to seek asylum. I think the UNHCR, the UN refugee agency, has legal services, one or two social workers there, but there's not a huge presence of international organizations.

There are local NGOs, Mexican NGOs, they are doing the job they can in the conditions they can. We see volunteers coming from the U.S. and some small NGOs from the U.S. also crossing the border. Of course, they have legitimate security constraints, but there's nothing organized or a long-term solution for that matter. It's really on a daily basis.

Gordon F.:                          

Most ... The organizations that Samuel just mentioned, they operate in the Tamaulipas cities, the three of Nuevo Laredo, Reynosa, and Matamoros, out of Monterey. They have the offices based two and a half hours further South and only do field visits because of security concerns.

Denise Gilman:                 

Adriana.

Adriana Quiroga:             

Just an example of that. Our team met a man who was traveling with his 12 year old daughter. He had lost his wife. He came as an asylum seeker. He was sent back to Matamoros. His 12 year old daughter had been sick for weeks and he didn't know what to do. And he didn't know how to help her. And this is just an example of the lack of kind of coordinated effort.

They're relying really on cycles of different volunteers that come for a couple of weeks and then we'll leave. And he would keep going to up to the volunteers, to the medical volunteers, and ask for more medicine for his daughter because of a lack of understanding and also just desperation. He would continue to do that to a different group of volunteers. And these medicines started interacting negatively in her body and making her even more sick. But, because there's such a lack of kind of overall coordination, the volunteers groups weren't communicating about the medicine that was given to this young girl. So that's just kind of an example of the lack of structure.

Carlos Sanchez:                

So, just to be clear, the Mexican government promised to take care of these people. Are you seeing any evidence of them in terms of either monetary donations or infrastructure or other components of care?

Samuel Almeida:             

I mean, we have a variety of cities Matamoros being the most notorious one because of the horrific situation they're living in. They're ... If I recall correctly, when the Mexican government agreed to receive this population, they say they will do for humanitarian reasons, which for us it's really confusing because there is no conditions to receive this population humanely.

It's been improving. Mexico, it's a bit like the U.S. Each state has their own institutions and laws. The federal government just started doing a small intervention. The local authorities from the municipality also donated some latrines or showers. They're present with medics three days a week, but there is no long term solution. Basically there is some initiatives but there's not a proper solution for this issue. From the Mexican side.

Gordon F.:                          

What we are calling for is, this is not only wrong, but in the case of Tamaulipas it should never happen full stop. I mean you can put up shelters, whatever you like, but if you are escorting your own nationals that are driving in a car just for a few hours down the road? How on earth can you accept people to be just put there waiting for a court hearing?

We need to put ourselves into the minds of organized crime. Organized crime sees these people as merchandise. Whoever crosses through here is an irregular status, is a migrant, income. So if people are on this Migrant Protection Protocols, they are being sent back and they're not abandoning the process, but being seen and perceived as waiting for months along the border. What they think is they might have relatives in the United States. That's good. They have money, we can ... Let's kidnap them. And then so on so forth. And that's the business model. Kidnapping people because they think that they have relatives that have money behind.

Samuel Almeida:             

And the U.S. also, sending people to this place where their own Homeland Security classify it with the highest security risk. The same as Syria, as Yemen, the U.S. is sending people to this place they know it's highly dangerous. So it's both governments and now a few more in the Northern Triangle of Central America soon to be.

Carlos Sanchez:                

So, this questioner is asking, why then given what you all have described, is there not greater pressure being forced internationally either through the UN, through Amnesty International, through whatever international organizations exist, MSF, to pressure the situation? Obviously, it's a political question. You all provide humanitarian aid, which is a different beast altogether. But, where is the political will we're seeing internationally?

Samuel Almeida:             

I won't get in details of our bilateral meetings with members of government in the U.S. But I can assure you we have been ... They're extremely aware of how all of our data of what we're seeing. We have raised our concerns several times and we have seen little effort from the U.S. side to improve the situation.

Gordon F.:                          

If I might make a comment, and this is also geared towards the audience that is attending today. Thank you for coming, by the way, MSF has a very unique position and we are very, very fortunate to be counting on people like you that are supporting our work. This is one very clear example as to how important it is to be counting on independent funding.

And clearly, whenever we come across colleagues, even from other organizations that we would go into meetings and they sort of, they do the assist, we score. But we are the ones, I mean, we sometimes speak out messages they would like to pass, but they cannot because their funding is either state sponsored to a certain amount. They have percentages of large donations from institutional donors, et cetera.

MSF in this, I have to say, stands out and not only here, but this is a very good example of it. I think we can consider ourselves lucky to be able to denounce things very openly. The advocacy component of our work in Mexico is very, very strong. The press releases that we do update on a regular basis. Whenever we see something happening that we think we should speak out for, we do. This is something that is priceless if I might say.

Denise Gilman:                 

Yeah. Can I just chime in on that too?

Carlos Sanchez:                

Sure.

Denise Gilman:                 

I'm to go in a similar vein which is that I think we should not wait for international organizations to pressure. You should make the international organizations respond. And then when they do, you should take their words, their findings and bring them back and make them work to change the policy because this is not, in the U.S., an administration that is going to listen very well to international organizations. They may listen to an up-swelling, a real groundswell of resistance here in the U.S. Like they had to do with family separation last summer.

Carlos Sanchez:                

So we've identified mental health is kind of the number one issue affecting these people in MPP. This audience member wants to know what are the outcomes of the treatments? Are you all encouraged? Or are we in for a long dark road ahead?

Gordon F.:                          

Given the nature of the population we're assisting, we have developed over time something that we call a one shot sessions. And that is because migrants tend to be always on the move. It means that you cannot have subsequent sessions, generally speaking. It is ... We do sometimes see them more often and then if we know the person to stay there, then we can schedule maybe a few more sessions. But usually what we do is we open ... We provide the beneficiary with the tools that you can provide in a 45 minute session and then we close.

Are we seeing an improvement? Do we get the impression that we are relieving ... Alleviating, sorry, the suffering? Yes, of course. Do we do the full treatment? No, never Médecins Sans Frontières, Doctors Without Borders, what we always do is try and take a notch down of the most acute needs. That's our mandate in all settings.

But yes, if the answer is are we doing a good job and is it having a positive impact on people? The answer is yes. We believe so.

Samuel Almeida:             

That's ... Sorry, just to compliment. Mental health is the biggest gap we have seen in Mexico. Or it's not the traditional ... Although we've been in Mexico for over 30 years now. It's not the traditional setup of a conflict zone where there is no government or authority to provide this healthcare. Mexico does have a functioning healthcare system. We do provide training for the general hospital or donate medicine, but there is no particular attention of mental health care for victims of violence in particular. So yes, there are many needs, but this is a need that it's not covered.

Carlos Sanchez:                

Now, I've seen evidence of a fairly good organization with regard to lawyers doing pro bono work for these migrants in Mexico. This audience member wonders if there is something similar with you as doctors providing help in Mexico.

Samuel Almeida:             

Even locally, the Mexican doctors also, they try to provide care. It's beautiful to see the intentions of people and how civil society can mobilize even if they're not organized. There has been a few physicians or medics that crossed the border, particularly, especially at the beginning, let's say September, October. There are some U.S.-based small NGOs also providing this care, but mostly it's the local authorities and MSF.

Gordon F.:                          

And throughout our work on the border, we constantly come across organizations that are based on the U.S. side of the pool of talent. And will, and initiative on the U.S. side is huge and large and we obviously encourage people to join as much as they can allow themselves to. Not only contributing financially, but working for us eventually or supporting local organizations that are working in migration.

But, there is a lot of activity on the U.S. side for sure. We come across them in ... I was in Sonora three weeks ago, we came across a few very well-working organizations on the Arizona side that are attending to migrants that take the route through the desert, which is pretty dangerous, as well and always in company of certain dangerous elements. So yeah, there are many good organizations that are working in this area as well.

Samuel Almeida:             

Just to, sorry to be clear, I wouldn't encourage physicians from the U.S., romantics, to go and cross the border and provide direct care. I would encourage them to support organized organizations with expertise to do so.

Carlos Sanchez:                

Gordon, I'd like to start with you. This last question is a very simple one, but it's a very honest one. And I'd like for each of you to answer this question. How do you personally deal with this tragedy on a daily basis?

Gordon F.:                          

What an easy question to come last. The work that we do, the nature of the work is very grateful. I have to admit it's tough, but we put in many hours, we put up with certain constraints in our personal lives, but it's very, very rewarding I have to say. It is also ... and it's a teamwork. Everybody chips in. We are all aligned.

Yeah, it's almost like I say ... At the end of the day when, when you see, at our VOT center. Sorry, the center in which we treat victims of torture in Mexico City. When you do see people leaving the center, having improved, having stabilized, and being functional again in terms of trying to be standing on their feet again, and trying to look for work, or integrating social life again. That's pretty much the reward we're looking for. Not much more than that. And we see it on a constant basis and that's what keeps us going.

Carlos Sanchez:                

Samuel.

Samuel Almeida:             

Yeah, I mean I have little to add. I mean, we do have to be conscious in this sector. It does affect you somehow and you have to take responsibility for your own health and seek mental health counseling, but yet the reward, it's amazing. I don't ... It makes sense to me. I don't really see myself doing anything else.

Gordon F.:                          

Our clinical profilers, they receive a help the helpers session on a regular basis as well, in order to cope with all the stories that they hear.

Carlos Sanchez:                

Adriana

Adriana Quiroga:             

Yeah. At RAICES, what we say is that we live for the smallest of victories. We just ... That's our bread and butter. That's what we hold on to, especially on those really difficult days. I, personally, the reason I feel like I do this job and that it keeps me motivated is our Convivios. So, we started here in Austin. Convivios is what we call them, or community meetings, on a monthly basis where we invite RAICES clients that we worked with previously, or our current clients. We invite them out. We provide a space. And we provide food. And the idea really is to give them a platform to give them a space to say this is yours. Because at the forefront of this conversation, at the forefront of any change, really that's going to happen in United States, we need people who are directly affected to be at that table having those conversations.

Yes, we need allies. We need to all be a part of this conversation and care about it. But, they are at the forefront. So that's really the idea behind the Convivios that's giving people a space to feel empowered to, to educate, and provide resources about navigating United States in these complex systems. But also what can you do about it?

As an individual, as a person who's undocumented, you still have the same rights that we all do. You are a human being and this is why it's an important issue is because I think this becomes a heavily politicized conversation, a left or right conversation. But I think what's important to communicate is that it's a human issue and, and these people at their core, what they want is to live with dignity, to be able to provide for their families, to be able to live in a world that is just. Just like we all do. So, if we boil it down to that very essence of what this matter is really all about, then we should all care about it. That should drive us to action.

Carlos Sanchez:                

Denise.

Denise Gilman:                 

What gets me through these days truly, truly is talking to folks like those in this audience who are willing to learn about what's happening and take action to try to hold the government to task for what is happening so that change can be affected.

And that's you all here. It's the students that work with us in the clinic at the law school and all kinds of communities who come together around these issues and show how much that they care and are willing to be invested to force change. And that really truly is what kind of keeps me going.

I also recently have been working on some of those self-care strategies that people talk about. And the one that I've just recently learned that I'm really going to enact is a five minute dance party every night.

Carlos Sanchez:                

Good for you. And for those here who are wondering how they can help. Adriana, would you have any suggestions?

Adriana Quiroga:             

I do. And I would say, I think this is a really important point to drive home is that the mechanisms by which and the policies and the laws by which the government, the current administration is able to create policies like family separation and MPP. They've existed for a really long time.

It's just that this current administration is using all its force in order to create really brutal change, but they're using the same mechanisms that have existed for a really long time. So, what we need in this country is policy change. We need to revolutionize the way we think about our immigration system because it's a broken one that's backlogged. And that gives way to, to really harmful policies like MPP. So one of the things that RAICES is doing, we've created ... This is a little plug. We've created our Migrant Justice Platform is what we're calling it.

We've teamed with a bunch of different organizations and policy experts, both abroad and here locally to address what it would look like if we completely scrapped immigration as it is now and created a new system. So it's trans-nationally, like how would we reengage in these human rights mechanisms at the transnational level to address some of these push pull factors. At the border, how can we work to demilitarize the border. To remove these obstacles for asylum seekers. To increase humanitarian aid.

And then, internally, how do we create more opportunities for people to stay here legally. Undocumented folks, they generate billions of dollars in taxes. They buy into a system that it creates the remains, and that keeps, social security and Medicaid solvent, yet they don't benefit from it.

So understanding that we need to create stability for people who are here, the 11 million dreamers and TPS recipients here, a pathway to citizenship for them. So that's all our platform is laid out on this migrant justice platform. So I would encourage you to visit our website and learn more about it to understand really we ... What we need as radical policy change.

We also have a petition going on our website. It's a call really for Congress to defund the Migrant Protection Protocol or MPP. So, if you could go on our website and sign that petition, if that's something you're interested in doing.

Carlos Sanchez:                

And I've been asked to also encourage you to check on Doctors Without Borders on social media. Visit their website. It's doctorswithoutborders.org. You can also find them on Twitter at @msf_usa. On Instagram, you can find them at at @doctorswithoutborders. And on Facebook it's /msf.english.

And with that it's now eight o'clock. And I'd like to conclude our discussion tonight and ask you to join me in thanking this wonderful panel.