Challenges and Effects of the COVID-19 Pandemic on Asylum Seeker Health at the U.S.-Mexico Border

Christopher W Reynolds; Vidya Ramanathan; Elena Lorenzana; Porag J Das; Kyra M Sagal; Kristen M Lozada-Soto; Linda Camaj Deda; Anisa S Haque; Florian F Schmitzberger; Grecia Quiroga; Sarah A Raven; Michele Heisler

doi:10.1089/heq.2020.0110

Challenges and Effects of the COVID-19 Pandemic on Asylum Seeker Health at the U.S.-Mexico Border

Health Equity. 2021 Apr 13;5(1):169-180. doi: 10.1089/heq.2020.0110. eCollection 2021.

Authors

Affiliations

¹ University of Michigan Medical School, Ann Arbor, Michigan, USA.
² University of Michigan Asylum Collaborative, Ann Arbor, Michigan, USA.
³ Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
⁴ Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁵ Physicians for Human Rights, Ann Arbor, Michigan, USA.
⁶ Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic presents health care challenges to asylum seekers living in congregate encampments, including those along the U.S.-Mexico border. It is necessary to understand the impact of the pandemic among this population to address health care needs, reduce transmission, and diminish COVID-19-related morbidity. Methods: Thirty interviews were conducted with asylum seekers and health care professionals in a temporary camp in Matamoros, Mexico to determine challenges, perceptions, and effects of the COVID-19 pandemic. Interviews were coded in NVivo12 by using a team-based approach. Results: The pandemic caused significant mental health burdens but no perceived adverse physical effects, with the U.S. border closure and health care access barriers as more pressing concerns. Participants reported access to information about COVID-19 but had varied levels of knowledge and adherence to disease reduction strategies due to camp conditions. Most participants believed that they had special protection from COVID-19, including strong immune systems or from God. The nongovernmental organizations providing health care and sanitation faced multiple challenges to implement new policies to manage COVID-19. The institution of required temperature checks and quarantine of COVID-19 positive patients led to distrust, decreased seeking of health care services among asylum seekers, and possible underreporting of COVID-19 cases. Conclusion: Our findings among asylum seekers in a Matamoros camp highlight the challenges to implementing disease reduction policies in low-resource congregate camps. Policies to address disease outbreaks focusing on the social determinants of health, health care access barriers, and community engagement may be more acceptable to asylum seekers, suggesting the need for effective strategies to provide prevention information that complements such measures.

Keywords: COVID-19; U.S.-Mexico border; asylum health care; global health; health care services delivery; immigrant health.

Grants and funding

T32 GM007863/GM/NIGMS NIH HHS/United States