A joint report by the Boston College School of Social Work and Harvard Global Health Institute describes a serious public health crisis at the United States-Mexico border, where thousands of migrants seeking asylum in the U.S. are vulnerable to infectious diseases, chronic health problems, mental health risks, violence, and criminal activity.

Desperate scenes of hazardous living conditions are depicted in the study, co-authored by 51²č¹ŻSSW Assistant Professor Alejandro Olayo-MeĢndez, S.J: shelters with populations up to three times their capacity; encampments where thousands share a handful of outdoor showers and portable toilets; insufficient access to clean water, forcing some migrants to bathe in the contaminated Rio Grande; and people of all ages receiving little or no care for PTSD, depression, and other mental health problems.

In ā€œ,ā€ Fr. Olayo-MeĢndez and his co-authors call for ā€œa comprehensive responseā€ to the crisis, including changes in U.S. and Mexican polices regarding migrants and asylum seekers and coordinated health care efforts involving both governmental and non-governmental actors.

ā€œThe full extent of the health crisis at the border has yet to be documented,ā€ states the report, ā€œbut it is clear that it is growing. As such, sustainable solutions are needed now more than ever.ā€

Fr. Olayo-MĆ©ndezā€™s 51²č¹ŻSSW colleague Professor Thomas Crea was among those aiding in the ideation of the report.

While health concerns about migrants and asylum seekers have been given public exposure through advocates and media coverage, the HGHI-51²č¹ŻSSW report aims to provide a far-reaching basis for assessing needs and formulating responses. Its findings are based on data collected by international NGOs, reporters, and service providers, and augmented with testimonialsā€”including some collected by Fr. Olayo-MĆ©ndez last yearā€”from individuals on the Mexican border.

ā€œThe report is an effort to show the situation from different angles, and through different voices, as a humanitarian crisis rather than a ā€˜security crisis,ā€™ā€ said Fr. Olayo-MeĢndez, who has studied the intersection of humanitarian aid and migration, as well as questions regarding human rights, inequality, transit migration, meso-level structures, and the so-called ā€œMigration Industry.ā€Ģż ā€œWe wanted to stress the public health conditions, and especially the mental health implications for migrants, who have already endured so much to reach the border.

ā€œThere is an important role for the social work profession here, because of the big-picture perspective we bring: how to serve and advocate for migrants in a holistic way, and to work with the staff that serves this population on the ground.ā€

The more evidence we present, the more light we throw on the situation and, our hope is, the more voices will join together to demand a change . . . Above all, we want to make sure that people know what is going on at the border, to cut through the political dimensions and focus on the human aspect.
51²č¹ŻSSW Assistant Professor Alejandro Olayo-MeĢndez, S.J.


The health crisis at the U.S.-Mexico border has been building for the past two years, according to Fr. Olayo-MĆ©ndez and his co-authors, in the wake of policy changes and practices enacted or encouraged by the Trump administration that affect migrantsā€™ ability to seek asylumā€”a right guaranteed under U.S. law. One is ā€œmetering,ā€ which restricts the number of migrants requesting asylum each day at a U.S. point of entry, requiring them to remain in Mexico for their turn to state their claim for asylum. Another is the Migrant Protection Protocols, or MPP, where asylum seekers who have already been received and inspected by the U.S. government must wait in Mexico for their legal proceedings.

The result has been a logjam at entry points along the U.S.-Mexico border, according to ā€œA Population in Peril.ā€ Since January of 2019, under the MPP, the U.S. government has sent more than 64,000 individuals to Mexico to await legal proceedings; of these, 537 have been granted leave to stay in the U.S., and the average wait time for the initial immigration court date is almost 90 days. They have been joined by thousands more would-be asylum seekers idled by metering. The asylum process often takes three or more interviews before a decision is made. For now, during this time, asylum seekers have to wait in Mexico.

Meanwhile, the report notes, where in past years the typical U.S.-bound migrant was most likely to be a single adult, it is now persons in family units or unaccompanied minors who form the majority: The 64,000 people sent to Mexico under MPP included at least 16,000 children and 500 infants less than a year old. Increasing numbers of these migrants are fleeing poverty or violence, and given the arduous journey many takeā€”often facing personal as well as financial dangerā€”they are likely to arrive at the border physically and emotionally depleted. Some, such as mothers, pregnant women, and LGBTQI individuals, are at particularly high risk.

Entry points along the border where asylum seekers must wait are scarcely safe havens, given the spike in demand for essential services like food, shelter, water, and medical supplies. Casas de migrantesā€”shelters run by faith-based organizationsā€”are typically ā€œunderfunded and overburdened,ā€ often forced to ration food or charge for room and board, while rented rooms tend to be costly, overcrowded, and located in unsafe neighborhoods. The options for asylum seekers are to squat in abandoned buildings, sleep in the streets, or join makeshift, large-scale tent encampments.

The report was largely researched and compiled before the COVID-19 pandemic took hold, and thus does not address its impact. But Fr. Olayo-MĆ©ndez said the coronavirus has unquestionably put a further strain on services and contributed to the overall stress and anxiety among the migrants and those aiding them. [Read more in an opinion piece by the research team .]

 Alejandro Olayo-MĆ©ndez, S.J.

Alejandro Olayo-MĆ©ndez, S.J.

ā€œA Population in Perilā€ concludes with recommendations for the U.S. and Mexican governments, such as ending MPP and metering; allocating more resources to hire immigration judges; reinstating family case management systems; increasing federally supported accommodation capacity; and developing a long-term, strategic health care plan for asylum seekers. It proposes that NGOs, civil society organizations, and academic centers create educational materials for asylum seekers; empower religious leaders to deliver information on migrantsā€™ health care rights and services available to them; advocate against governmental policies and practices harmful to asylum seekers; and promote the needs of migrants in high-risk populations, such as the LGBTQI community.

Fr. Olayo-MĆ©ndez acknowledges that the current political situation in the U.S. or Mexico does not augur well for the reportā€™s recommendations, but believes the project has been worthwhile. ā€œThe more evidence we present, the more light we throw on the situation and, our hope is, the more voices will join together to demand a changeā€”and that the mounting voices will generate a response from both sides. Above all, we want to make sure that people know what is going on at the border, to cut through the political dimensions and focus on the human aspect.ā€

ā€œThe findings of this report make it abundantly clear that the human condition of migrants at our doorstep is precarious,ā€ said 51²č¹ŻSSW Dean Gautam Yadama. ā€œThese migrants are not only facing a health crisis but a crisis of declining social, economic, and legal rights. The result is a people on the move, a generation of children and families, robbed of their human dignity and life chances.

"I am pleased that the Boston College School of Social Workā€”and our colleague Alejandro Olayo-MĆ©ndez in particularā€”was able to contribute to this report on a very important humanitarian issue."

Sean Smith | University Communications | August 2020