- Refugee Health Alliance
Life at the Border
Yesterday bore witness to how easy it still is to lose a child to dehydration.
Three hours from my home.
Twenty-five minutes from the Mexico-US border.
In a shelter bursting at the seams with families in search of a better life. Families who have lost everything. Families who have traveled for weeks in hopes of safety, welcome, refuge, maybe even a place for their children to sleep. They are fleeing extreme violence, corruption, and natural disasters- all of which have left many families fractured and devastatingly incomplete.
The young parents here are some of the most beautiful, resilient humans I have ever come across. Looking into their eyes is like looking into another world. They have witnessed more by their third decade than many here will in an entire lifetime.
The shelter, a local church, swells with well over 500 souls.
In all our advances in this world. In all our pursuits of more.
We still have children dying of dehydration. Up to 2.2 million per year. With the majority being children under 2 years of age.
We still, somehow, haven’t managed to put extraneous pursuits aside to address basic needs that are not being met for our fellow humans, for our brothers and sisters around the world.
We have to be better.
She came in completely limp, being carried by her father. Her arms dangling at her sides. Swaying lifelessly with every step her father took. She is two years old. She was 30 pounds a week ago. Now, barely 20. She hasn’t eaten in several days and has suffered significant water losses. A combination of the heat, lack of resources, and a viral illness tearing through this vulnerable population.
She has a pulse, thank goodness. Her heart is beating fast, working hard to supply her body with needed oxygen and nutrients.
She is breathing.
She is afebrile.
I pinch her fingers. And then her toes. Nothing.
“Please get me a glucometer now!”
Things begin moving quickly. As quickly as they can in a crowded shelter where the three volunteer providers have already taken care of over 120 people in the last 5 hours.
She doesn’t flinch with the stick of the needle.
Her sugar is 79.
As I’m inflating the blood pressure cuff around her thin arm, she begins to fight. Time slows down and it is as if we are witnessing the beginning of a miracle. Her arm moves and she begins to whimper. She opens her eyes. I breathe for the first time in what feels like eternity.
Her blood pressure is low.
We begin to arrange transport to the local hospital, knowing she will likely be turned away at the door. Many here have been turned away for this or more.
In the meantime, one of the other providers, begins to mix oral rehydration salts, in hopes she may be able to tolerate and buy us some time. We hand the small syringe to her father, and he administers the first 2cc of pink fluid. She closes her mouth around the syringe and swallows. We draw up another 3cc, and again, she swallows, now anticipating the next syringe. We continue this for another 25 cc. By this time, she is regaining muscle tone and wants to breastfeed. She latches. After 90 minutes, she is making tears, sitting up, interacting with her parents, even smiling.
The two-and-a-half-hour drive home after clinic was spent with that image in my mind. This limp, lifeless child.
What would have happened if we weren’t there?
The family had no transportation to a hospital. No money. No resources.
Perhaps someone would have been able to help.
I can’t imagine the alternative. I don’t want to.
She is a miracle, perhaps the third of my medical experience to date.
But what happens when there are no miracles?
It’s been two weeks
Two weeks since I’ve seen her
Two weeks of waiting
Wanting to see her with my own eyes
I’d asked about her
The small angel who was carried to my plastic table 14 days ago
Held lifeless in the arms of her father
The depth of his eyes revealing the trauma they had already witnessed
His eyes darkening further still
Shadowed by fear
When she didn’t flinch with the puncture of her small finger when we checked her glucose
He was so strong
Strong for his wife, for his two other beautiful daughters
and strong for her, the youngest of three.
I heard she was continuing to do better
Able to take in fluids
As much as I wanted them to have already crossed
Arriving in a new country
With a chance for a better life
A safer life
Where her and her family can simply be
Without fear of succumbing
to the hands of violence
As much as I wanted to hear they had made it safely across,
part of me wanted to see her.
We crossed the border in the morning,
met at one of the local clinics,
and drove to the shelters.
After making our way through the steep, winding streets
and then up the uneven dirt road,
traversing stray rocks, tires, plastic bottles, and a few thin roosters mulling about,
we make it to the shelter.
We grab our supplies and walk up the steps
standing at the door
is her father.
He is gleaming.
He is smiling.
He is so full of light, despite all that still is.
I can no longer contain my anticipation
¡¿Cómo está ella?!
How is she?!
He seems to smile from his very soul at the question
He tells me she is doing well
Eating and drinking
She is happy
A short while later, settled at our plastic tables and chairs set up for medical evaluations,
he calmly walks to the side of the table.
And there she sits, in his arms
Upright and looking directly at me
The most beautiful two-year-old girl.
It is hard to believe this is the same lifeless child we cared for just two weeks ago
Now, she is active, smiling
Her color is no longer ashen
She is bright
She is alive
She is alive
This miracle child
She is alive
She is the reason we do what we do.
The reason we are all here.
Borders mean nothing in the face of continued human suffering.
Within five days of first caring for her, on a day when we saw innumerable children and adults with moderate to severe dehydration, the Refugee Health Alliance (RHA) secured 106 large containers of potable water. These containers were divided amongst the local shelters, which are currently housing 2000 people. The goal being to prevent another case as severe as hers, or worse. In addition to water, RHA has also arranged sustainable access to healthy food by contracting with Food Not Bombs.
While this organization is amazing, help is needed.
106 containers, empty in 3 days
= $800/month for 1 shelter
$800 x4 shelters
= $3200/month for all 4 shelters.
= $0.0516 = $0.05 per person, per day for water
$3000/month for all 4 shelters
= $0.0483 = $0.05 per person, per day for food
Total cost: $0.10 per person, per day, for food and water.
Any and all help is appreciated
before I even lifted his shirt
I knew the moment I placed my hands on his tiny chest
and felt the skin being sucked in between his ribs with every breath
I knew there was no other place I needed to be
Nothing else in this moment mattered but keeping this 22-month-old boy alive
The last six weeks have felt as though there was no time to breathe
To just simply be
Mind on constant overdrive
Moving from one urgent task to the next
with no time to recuperate
I felt energy and patience waning at the end of my last shift
A state of mind I try hard to prevent
A state of being that always brings with it
a sense of defeat and shame
I met home by 1am
saw darkness by 2am
and awoke by 5am to make the drive to the border in time
Fatigue seemed to blur the morning
But the moment I felt his retractions
Everything was suddenly wide-awake
There was no other place I needed to be
His was the only soul we needed to focus on
All else had time to wait
Lifting his shirt further revealed the urgency of his condition
and accessory muscle use of his neck
All working to keep him alive
The oximeter took an eternity to register
With no supplemental oxygen in the interim
He was tiring
His body losing drive
The 911 equivalent never answered
The pastor of the shelter never answered
We began coordinating driving him directly to the closest Tijuana hospital
when one of our nurses was able to reach the red cross
They arrived within 30 minutes
saw what we saw
agreed to take him
I hope this innocent soul makes it
I hope the hospital accepts him
I hope there is enough oxygen
I hope a lot of things
Excruciatingly, his life is no longer in our hands