The Lancet is the world’s oldest medical journal. These days, its pages are almost as much about political/ideological advocacy as scientific/medical education.
An advocacy column published in its most recent issue continues this trend. It decries policies that deter desperate people from pouring across our southern border. In “Deterrence-Based Asylum Policies Exacerbate Health Inequities Among Women and Children Seeking Safety at the US–Mexico Border,” the authors state:
The past decade has seen a global spike in racist, anti-immigrant rhetoric. In the USA, intensifying militarization and restrictive asylum policies have created a public health emergency at the southern border. Years of policies explicitly designed to deter border crossings (e.g., Title 42, Migration Protection Protocols) have stranded asylum-seekers in Mexico, leaving families to wait indefinitely under inhumane conditions for limited opportunities to seek protection in the USA. Human rights organizations have documented at least 13,500 violent attacks and 1085 missing or dead migrants between 2021–22; and 4,000 children were separated from their families by border officials from 2017-2021.
I have no doubt that these effects are real — and it’s just awful — but the cause is not U.S. deterrence policies. Rather, poor people from all around the world know that the Biden administration opened the gates at the border. And they pay vicious human traffickers and Mexican drug cartels a lot of money to get them here, leading to all kinds of victimization.
For reasons beyond my ken, Biden apparently wants these millions to get in. Not only that, but these “migrants” are enabled by activist NGOs that teach them the magic words to say to claim refugee status, which allows them into the country to await a hearing that won’t be held for years — and at which most admittees will not appear. Each year now, millions of people from all around the world enter the country in this way, inducing millions more to make the journey.
The authors decry the conditions in which people who have had to wait in Mexico to get in are living:
Under asylum deterrence policies, women face deeply gendered security risks, with alarmingly high report rates of sexual and physical violence, harassment, torture, extortion, femicide, and other rights violations perpetrated by organized crime groups, US and Mexican officials, and intimate partners. Such violence amplifies pre-existing traumas endured before and during forced migration, contributing to heightened rates of posttraumatic stress, suicidality, anxiety, and postpartum depression.
Xenophobia, racism, and transphobia further drive stigma, abuse, and violence against LBGTQI+, Black, and Indigenous asylum seekers.
Again, the authors get the cause of this misery wrong. The promise of eventual entry into the U.S. is the problem, not the few, largely ineffective impediments to it.
And note, these authors do not care a whit about the crushing burden borne by our various infrastructures because of the hundreds of thousands of poor people ushered in by the government and left on the streets.
The answer? Open the borders!
As public health and legal scholars, we echo these calls and request that the Biden Administration immediately withdraw all asylum deterrence policies and uphold its international obligations to respect the fundamental human and reproductive rights of all persons, regardless of race, ethnicity, or country of origin. To curb this humanitarian disaster, humane reception structures, full access to asylum at all ports of entry, and trauma-informed medical and humanitarian aid must be implemented.
Good grief. That will only increase the stampede. If we want to reduce the misery, people have to believe that attempting to enter in this way will be futile so they never make the attempt.
By the way, one of the article’s three authors receives funding from the NIH. Another is the director of the Border Rights Project at the nongovernmental organization Al Otro Lado (On the Other Side).
This advocacy is not about medicine. It is about crumbling American sovereignty.