Teaching During a Crisis
TTUHSC El Paso Faculty Teach Students While Caring for Migrants
Urgent care provided at Doctors of the World USA clinic
EL PASO, Texas — The large influx of migrants and asylum seekers crossing the U.S.-Mexico border in the El Paso area has also resulted in a spike of medical emergencies.
To provide necessary health care, Texas Tech University Health Sciences Center El Paso and Texas Tech Physicians of El Paso have collaborated with Doctors of the World USA and Annunciation House to launch the Border Health Program. The program serves the migrant population through a three-way collaboration that places TTUHSC El Paso faculty and students in a Doctors of the World clinical program within Annunciation House facilities.
Through the border clinic, TTP El Paso specialists provide basic transitional and emergency health care, similar to what urgent care clinics offer. As the medical practice of the Foster School of Medicine, every TTP El Paso specialist holds a faculty appointment, where they teach and mentor the next generation of physicians, many of whom will go on to practice on the U.S.-Mexico border.
With more than 200,000 migrants – many with no access to health care – crossing per month, the Doctors of the World USA Border Health Program partnership with TTUHSC El Paso is critical to providing the proper medical resources necessary in this humanitarian crisis, said Glenn Fennelly, M.D., M.P.H. Dr. Fennelly is professor and chair of the Foster School of Medicine’s Department of Pediatrics and Doctors of the World USA board president.
In 2021, CBP recorded 557 Southwest border deaths. Dehydration and other heat-related risks are prevalent in the summer, and the cold can be unforgiving in the winter. Aside from seasonal illnesses and poor health, the clinic has helped migrants with physical ailments and getting proper prescriptions for both chronic illnesses and preventive care, Dr. Fennelly said.
“Many of them have chronic conditions such as diabetes, asthma or high blood pressure. In some cases, their medication was confiscated by CBP,” Dr. Fennelly said. “There may be worsening of these chronic diseases during their journey. Exposure to respiratory viral infections can be a setup for bacterial infections. And there is some level of malnutrition along with not being vaccinated that puts them at risk for severe viral illnesses, such as the flu or COVID-19.”
TTUHSC El Paso medical residents also provide care in the clinic, while Foster School of Medicine and Hunt School of Nursing students assist with intake and triage. Dr. Fennelly said the Border Health Program is here to stay and the migrant clinic will become part of the available rotations for students and residents going forward. The experience will prepare them for unique health issues they’ll encounter while training in the Borderplex region.
“Doctors of the World and our partners stay after the news cycle ends, past the first wave of the crisis. We want to contribute to long-term solutions for vulnerable populations,” Dr. Fennelly said. “The recent border crisis aside, El Paso’s always expected to have migrants crossing the border or reporting to CBP. We want to be prepared always for a humanitarian response to health care needs or medical emergencies that may arise.”
The clinic also aids with more immediate emergencies such as severe sprains from the journey and sexual assault injuries. According to a report from the UC Berkeley School of Law’s Human Rights Center, an estimated 24-80% of women suffer sexual violence en route to the U.S., along with 5% of men and 50% of gay and transgender persons. Additionally, the number of women migrating to the U.S. and crossing the border is growing: Women represented an estimated 24% of migrants in 2015, up from 14% in 2011.
For many migrants, and especially children, the entire process of relocating to a different country along with any unsettling events they have witnessed in their home country or on the journey, can leave lasting damage.
Cecilia De Vargas, M.D., associate professor and program director for the Child and Adolescent Psychiatry Fellowship Program, said many youth are diagnosed with anxiety, depression and post-traumatic stress disorder. Some have thought about or attempted to commit suicide.
“And just like any other injury, the longer they go untreated, the worse their problems get,” Dr. De Vargas said. “Although El Paso is likely not their final stop, our goal is to assist with the mental emergencies caused by the trauma they've endured. We work to provide continuity of care and referrals for mental health providers once they settle in a new community.”
Other injuries require complex surgeries. Some of the most serious are injuries from border wall falls, which have increased more than fivefold since 2019, according to an American Medical Association report. Most of the border wall injuries cause severe swelling, requiring pins and braces to stabilize the injury prior to surgery. In those cases, migrants are referred to emergency rooms or other TTP El Paso orthopaedic specialists.
The Border Health Program is more than just on-the-spot health care. The program’s six core objectives are intended to reduce health disparities faced by migrant populations. They are:
Direct Clinical Services: Develop the infrastructure for transitional care for migrants and asylum seekers in transit arriving to El Paso from government custody and shelters throughout the border region.
Education: Offer Foster School of Medicine and Hunt School of Nursing students, faculty, residents and staff hands-on learning experiences related to migrant health inequities and serving populations in transit.
Administration: Provide administrative oversight for the daily operations of the Border Health Program.
Data, Research and Dissemination: Provide data-driven decision making that will inform the development and growth of the Border Health Program and build a foundation for scholarship around migrant and refugee transitional care.
International: Promote bilateral and regional information exchange while establishing best practices to create a healthy future for migrants and asylum seekers.
Advocacy: Promote sound public health policy by conducting evidence-based advocacy for migrant and refugee transitional care
In the Borderplex, migrant health is part of the community’s health. As part of its mission to improve health care in the region, TTP El Paso and TTUHSC El Paso are rising to the challenge to provide bilingual care to those most in need and bilingual health care education for future generations. The Foster School of Medicine was one of the first medical schools in the country to integrate medical Spanish into its curriculum.
“Just seeing a smiling face, a reassuring voice, lets them know they’ve arrived and are welcome in this clinic,” Dr. Fennelly said. “That’s something we want to build on and let them understand we are trying to take care of their health care needs.”
About Doctors of the World USA
Doctors of the World USA (DotW) is the U.S. chapter of the global Médecins du Monde (MdM) network, an international health and human rights organization made up of 17 chapters around the world working on both domestic and international health projects. Founded in 2011, DotW provides emergency and long-term medical care to vulnerable people, wherever they are. They strengthen people’s access to quality medical services and fight for universal access to health care by advocating for sound, evidence-based public health policy.
About TTUHSC El Paso
TTUHSC El Paso is the only health sciences center on the U.S.-Mexico border and serves 108 counties in West Texas that have been historically underserved. It’s designated as a Title V Hispanic-Serving Institution, preparing the next generation of health care leaders, 48% of whom identify as Hispanic and are often first-generation college students.
TTUHSC El Paso was established to focus on the unique health care and educational needs of our Borderplex community. In 2023, TTUHSC El Paso celebrates its 10th anniversary as an independent university within the Texas Tech University System. In a decade, the university has graduated over 2,000 doctors, nurses and researchers, and will soon add dentists to its alumni.
About TTP El Paso
Texas Tech Physicians of El Paso is the region’s largest multispecialty medical group practice, with over 250 specialists providing world-class patient care right here at home. Our physicians are dedicated to excellence and committed to caring for Borderplex patients at convenient locations across the city so families never need to leave the region to find the latest medical and treatment opportunities.