Updated: Jul 21
Employment, access to healthcare, safety: these are three of many themes related to migration and health that Quarterly has so far explored this year. As we turn our attention to the Americas, we cannot deny the colonial and xenophobic influence that North American governments and immigration policies have had on the migrant experiences across Central and South America. Join us in this edition of Quarterly as we explore the state of migration in the Americas through the lens of discrimination and health with examples spanning from the notorious US-Mexico border, the Chilean Dream, and and the intersection of xenophobia and sexualisation in Peru.
New from Race & Health
New: Race & Health Podcast
Last Quarter, we released new episodes of the Race & Health Podcast. Learn more about how climate change impacts us unequally, and how justice in city planning, health system design, and legislation can alleviate the impact that climate change has on minoritised communities. Listen and subscribe here.
Air Pollution with Dr Anne Dorotheé Slovic, Ms Lilian Latinwo-Olajide and Dr Chetna Sharma.
This episode explores how unequal health outcomes for minoritised communities are influenced by air pollution.Touching on causes and sources of air pollution, city design, measurement and research, Dr Anne Dorotheé Slovic from the University of São Paulo, Ms Lilian Latinwo-Olajide from Impact on Urban Health, and Dr Chetna Sharma from Race & Health discuss how structural racism is a driving force behind these unequal outcomes, and what climate justice means for our climate action in this space.
Migration & Climate Change Dr Báltica Cabieses, Dr Maya Goodfellow and Dr Rita Issa
The relationship between climate change and migration is complex. In this episode of the R&H Podcast, we discuss these complexities from an anti-discrimination perspective. How does racism, xenophobia, and discrimination define health inequalities in migrant communities, when does migrant status matter, and what can the health community do about this? Explore these questions with our guests, Báltica Cabieses, Maya Goodfellow, and R&H rep, Rita Issa, who brings expertise about migrant access to healthcare, conceptualising the “climate migrant”, and the health inequalities migrants face amidst the climate crisis.
New Webinar Series:
Climate and health action are intrinsically intertwined. Discussions at the intersection of these topics are expanding, but without involving explicit ways that justice, anti-racism and decoloniality can be included in said discussions, future solutions will be unequipped to reduce the disproportionate health impacts that climate change has on minoritised communities.
If you are a health professional passionate about climate justice and health equity, join Race & Health over the next several months as we facilitate a professional webinar series that tackles how members of the health community can use justice-driven habits, methods, and strategies to combat climate change in their communities.
‘Deported, homeless, and into the canal: Environmental structural violence in the binational Tijuana River’
In this article, Calderon-Villarreal and colleagues discuss the nexus of post-deportation and homelessness-related vulnerability, police violence, and exposure to environmental harms through the lens of environmental structural violence. The article focuses on the residents of El Bordo, an informal settlement in the Tijuana River Canal on the Mexican side of the US-Mexico border. Much literature on US-Mexico migration focuses on the experiences of Mexicans in the US. By focusing on deportees in Tijuana, this article highlights the continued vulnerability and exclusion faced by migrants following forced removal from the US.
People living in El Bordo come into frequent contact with Tijuana River Canal water through daily use related to social exclusion from other water sources, and through crossing the river. This represents an intersection of environmental and structural violence as the Tijuana River poses an environmental health risk that El Bordo residents are forced into contact with due to violent social structures.
This intersection is demonstrated through a robust, transdisciplinary methodology. Water quality of the river was assessed using surface samples from seven sites during five water sampling campaigns, and diverse forms of testing were conducted, including measurement of levels of faecal indicator bacteria. Ethnographic methods were also employed, including semi-structured interviews, ethnographic fieldwork notes, photography, and videos. Finally, surveys were conducted with 85 participants to collect demographic information including information on migration history, and water-related health conditions and practices.
The study found that the water of the Tijuana River does pose an environmental health risk. For example, E. Coli levels were 40,000 times the Mexican legal limits for treated wastewater and for river water. Nevertheless, residents of El Bordo came into frequent contact with the river, despite perceiving it as a risk to their health. The most reported reason for immersion in the canal water was to flee the frequent police raids of El Bordo; imprisonment and police beatings were seen as a more acute health risk than the river water, and so residents were frequently forced to face environmental harms to escape state violence.
Drawing on these results, the authors develop the concept of environmental structural violence to highlight the role of environmental injustice in enacting structural violence and creating poor health outcomes for the residents of El Bordo. Many of these residents are deportees of the US who continue to face exclusion and violence following migration.
Alhelí Calderon-Villarreal et. al., (2022) ‘Deported, homeless, and into the canal: Environmental structural violence in the binational Tijuana River’, Social Science and Medicine, DOI: https://doi.org/10.1016/j.socscimed.2022.115044
‘Aquí viene una Veneca más’: Venezuelan migrants and ‘the sexual question’ in Peru
Venezuelan migrants fleeing the country’s political and socioeconomic crisis have faced xenophobic accusations of spreading infectious diseases to neighbouring Latin American countries. In Peru, Venezuelan migrant women are accused of importing HIV and other STIs, causing stigma that may limit their willingness and ability to access sexual and reproductive health (SRH) care. In this article, Irons situates these accusations within the status of Venezuelans as racialised others in Peru and the sexualisation of Venezuelan women. Irons argues that addressing the sexual and reproductive health (SRH) needs of Venezuelan migrants in Peru necessitates addressing the stigma that they face.
This article draws on qualitative research in Lima, Peru; 50 interviews were conducted with Venezuelan migrant women, their neighbours from Lima, and non-governmental organisation stakeholders. Thus, the perspectives of migrant women themselves are highlighted, foregrounding their own experiences of SRH stigma in Peru. Women in this study discussed their experiences of sexualisation in Peru, linking this to experiences of xenophobia. They also discussed perceived racial differences between themselves and Peruvians, highlighting the role of being a racialised other in discussions on SRH and stigma.
Through reference to ‘The Sexual Question’, Irons highlights that the blaming of racialised others for STIs in Peru is not a new phenomenon; through the 19th and 20th century, Asian, Black, Indigenous and Jewish people were blamed for STIs, depending on the context of the time. What is different in the present is that Venezuelan migrants do have real SRH needs. The crisis in Venezuela created a shortage of contraceptives, putting Venezuelan migrant women at high risk, and a shortage of HIV medication, forcing 8,000 people living with HIV to leave the country. As such, access to SRH services is extremely important for Venezuelan migrants in Peru and elsewhere. Increasing willingness and ability to access these services requires addressing the public health crisis of stigma.
Rebecca Irons (2022): ‘Aquí viene una Veneca más’: Venezuelan migrants and ‘the sexual question’ in Peru, Anthropology & Medicine, DOI: 10.1080/13648470.2022.2046700
Commentary: Shaping Transit: illustrations from work done with unaccompanied migrant minors
In 2021, nearly 150 thousand children arrived at the northern Mexican border unaccompanied by their parents. Most came from Central America, with hopes to work in the US and send money to their families; rejoin family in the US; or simply escape violence, discrimination and direct threats from gangs.
Aside from those who flee due to direct discrimination, such as LGBTQ youth who flee a homophobic family and/or environment, indirect discrimination and xenophobia are responsible for the structural violence which underlines regional migration management in Mexico and the United States. Policies such as Title 42 , under the guise of a pandemic response, or Migrant Protection Protocols , justified thousands of deportations and family separations. The exemption of Ukrainians to Title 42, whilst Haitians and Central Americans are turned back, can also be described as racist. The parallel militarisation of the southern Mexican and Guatemalan borders contributed to making this highly transited migration route one of the most dangerous. Thousands of families and children are forced to travel in harsh environmental conditions, paying high sums of money to smugglers with no guarantees, and vulnerable to be recruited, robbed or kidnapped by organised crime. The impact on physical integrity includes the risk of sexual violence and death, while the mental health impact of these experiences is long lasting – curbing the developmental potential of these youth.
The images below are illustrated pictures taken by migrant youth in the Cafemin shelter in Mexico City, in June 2021. They represent objects symbolic of the migration of the young people who took the photos. Objects are significant both because of their symbolic nature – which can give some solace during these harsh journeys – and because forced migration implies carrying as few belongings as possible. Sometimes, the few belongings are robbed. The images were used as prompts for subsequent interviews, and quotes from these interviews form the captions.
The images were created as part of a PhD project fieldwork conducted from October 2020 to October 2021 in Cafemin and FM4 shelters in Mexico City and Guadalajara. Drawing workshops were also conducted with migrant youth, and their drawings can be found in the Instagram page @shapingtransit. All images and quotes have consent to be shared and all names are pseudonyms. The project seeks to understand the perception these youths have of their migration transit and the impact on identity and resilience.
The project is led by Dr Susanna Corona Maioli, PhD candidate at the Institute for Global Health. If you wish to know more about the project or unaccompanied migrant youth migration more broadly, get in touch at firstname.lastname@example.org or follow @susannacoronam on Twitter
Acknowledgment to the illustrators: Mario Sandoval Rojas, Misael Naranjo Murillo, Pablo Rodrigo Fraustro
 Title 42 is a Covid-linked provision in place since March 2020 which allows to immediately return adults and families seeking asylum in the US. Unaccompanied minors are exempt from Title 42, although this exemption pushed many families to send their children over the border alone. The Biden administration’s plan to lift Title 42 in May 2022 was blocked by Louisiana Federal Judge Robert R. Summerhays, thus allowing the provision to remain in place.
 Migrant Protection Protocols, also called Remain in Mexico, is a policy implemented in January 2019 which required migrants requesting asylum in the US to be sent back to northern Mexico to wait for their court hearing. This exposed migrants to documented violence, including high levels of kidnappings on behalf of organized crime. In February 2021, the Biden administration ended the policy but it was put back in place by the US Supreme Court
Tenis - shoes
V: this one [tenis] well, it reminds me of all I walked, the blisters that one gets by walking with shoes and all that
S: Yes, did you walk a lot?
V: Honestly, yes
S: How many days walking?
V: Four days walking
S: And you were sleeping by the train tracks, in the woods…?
V: I didn’t sleep (…). Because I had to keep walking… and fear, a little, at night, of laying down on top of a snake
Violeta, 18, from Honduras
Mano - hand
V: (…) during my travel, when I was in the South of Mexico, I had a boyfriend who gave me two [bracelets] identical to these ones, honestly (…). Like these ones he put them on [my hand] (…)
S: And you still have them or not anymore?
V: Honestly, ehm, I have them
S: Are you still talking to him?
V: No, that was two years ago
S: Ah, ok. But you have a good memory of him?
V: Yes, I do
Violeta, 18, from Honduras
Rejas – wire fence
S: Is there any [image] that reminds you about your travel until now?
M: I think this one [rejas]
M: Because this almost seems like… let’s say like when Migración catches you, they really deprive you of [your] freedom. For safety, they say
Michael, 14, from Honduras
Santo – saint/cactus
E: I think this little saint catches my attention because in my room I used to always have a picture of my mom with a saint next to it and it was like... every day, ‘good morning, mother’, no? It was really nice
S: Of course. Do you still have it?
E: The picture? Yes. Even if I don’t know if she would have ever listened to me, but just [speaking to her] made me feel like she was still there
Estrella, 18, from Guatemala
Biblia - bible
R: Ehm... I proay a lot to God to help me
S: Mhj. And it helps you to pray, it makes you feel better?
S: Okay, and you still have this bible.
R: Yes, I still do. My grandfather gave it to me
Rosendo, 17 from El Salvador
Cubo - cube
E: I like this [cubo] (…). When I was little I used to de-stress with this (…), so it reminds me of my childhood
S: All these are images made from pictures that other young people took in a shelter I visited in Mexico City, of objects important for their migration
E: I like it
S: (…) all those in the shelter used this, the [Rubik’s] cube
E: Yes, it is a good anti-stress
Estrella, 18, from Guatemala
Cielo - sky
S: Is there any of these images that could remind you of a previous experience, something you have lived… or something you identify with?
A: Well, yes… this one (indicates tapping the table three times)
A: Well yes, sometimes it reminds me of when I took the train that sometimes we saw walls with crosses and… and… writings that migrants did
Alex, 15, from Guatemala
Reloj - watch
S: [You chose] the watch and hope. Why?
R: Well, hope of… achieving what I want and the watch because of waiting
Romeo, 14, from El Salvador
Peluche – stuffed animal
S: Among these images, is there one that reminds you of something you’ve lived?
L: This one [peluche], because... well, I’ve been alone, I’ve been abandoned like a dog…
S: But, do you think you have gone forward, that you have learned to take care of yourself?
Leslie, 18, from Mexico
Esperanza – hope/coin
H: This one caught my attention [esperanza/hope]
S: Mhm. Why?
H: Well because hope is a form of… Like you have to have hope in what you want, and maybe, if you want something, having hope one day you may achieve it. (…). Hope represents a lot
S: Yes, and also having a goal, right? Even if the road to get there isn’t so easy
H: Isn’t so easy, but always think that it is not easy to leave our country, and if one day I achieve something, well I should take into account everything I went through on the road
Héctor, 19, from Honduras
Pop Culture: Film and Podcast Reviews
Book review: The Land of Open Graves: Living and Dying on the Migrant Trail
De Leon’s debut, The Land of Open Graves (2015), chronicles the violence faced by people irregularly crossing the US-Mexico border in the vicious and sometimes lethal Sonora Desert. This violence, De Leon argues, is not inevitable or natural; it is set in motion by Prevention Through Deterrence (PTD). PTD is a US federal border enforcement policy that targets people illegally crossing from Mexico into the US. It is designed to funnel migrants into remote desert areas, intentionally exposing them to treacherous conditions while blaming their deaths on ‘natural’ environmental causes.
Through PTD, the US government plays an active role in migrant deaths around its southern border. The intentionality of the policy is highlighted by early federal government reports that cite the “mortal danger” and “hostile terrain” of the desert and measure the success of the policy in “deaths of aliens attempting entry”. The US government’s language on the policy has since become more sanitised. However, the violence this policy perpetrates against people migrating has only increased as crossing points have been pushed into more rural, perilous areas.
The harsh conditions of the desert are not only violent towards the living. The victims of PTD continue to face violence after their deaths. De Leon describes this as necroviolence; violence performed and produced through the treatment of dead bodies. Through descriptions of forensic science experiments, De Leon explains that, in the Sonora Desert, necroviolence is erasure; scavengers, intense sun, and other actors in the desert ecosystem eventually erase the remains of people who have passed away in the desert. Erasure also enacts further violence against the families of the deceased, creating states of ambiguous loss in which families are unable to mourn and engage with the process of grief.
While highlighting the violence and erasure enacted by the desert and PTD is important, the experiments, descriptions, and imagery that De Leon employs reproduce the very violence that he so vehemently critiques. His forensic experiments involved dressing dead pigs in clothing that he describes as typical of migrants crossing the desert, including t-shirts, bras, and worn-out tennis shoes, and recording the proceeding scavenging by vultures, dogs, and ants. Descriptions and photographs included in the text are gruesome and violent. It should not be necessary to recreate violence to demonstrate its harms.
Alongside engagement with theory and political context, The Land of Open Graves foregrounds experiences of migration at the US-Mexico border through ethnographic accounts of border crossing. Over several chapters, De Leon describes the lives of Memo and Lucho, two Mexican men who had not known each other before but became good amigos del camino. De Leon spent months with Memo and Lucho and chronicles their time living in Nogales, Mexico while preparing to cross the border, their failed crossing attempts, their final, successful attempt, and the continued impacts of trauma on their lives in the US. In portraying their final crossing, De Leon uses extensive excerpts from interviews, complemented by photos taken by Memo and Lucho on disposable cameras during their journey. Through this rare data, De Leon foregrounds their perspectives and experiences. The account of their crossing conveys the violence of the PTD policy and the environmental conditions that it intentionally exposes people to.
De Leon is reflective on his positionality throughout this book, providing nuanced insight into his role as an ethnographer and the access and limitations that his positionality creates. Through ethnography, he brings the people crossing the Sonora Desert to the fore, unmasking the human faces of people too often dehumanised by US immigration policies. Their journeys and struggles will stay with you, fostering a new perspective on the US border and those who cross it.
VICE Documentary Review: "Chile's migration boom has led to a major housing crisis"
Check out the 11 minute documentary here. This short VICE documentary sheds light on the “Chilean Dream”, the relationship between a growing migrant population facing extreme housing insecurity, and the political debates that form and reinforce these insecurities. The documentary is a great resource for students and individuals interested in learning more about the relationship between politics, housing, and xenophobia. It showcases relevant stories from residents in migrant communities, activists, and politicians to illustrate how these three dimensions serve as an echochamber that shapes migrant experiences.
As migration in Chile rises, public housing options remain limited and, with nowhere to go, migrants settle in informal housing settlements. These settlements lack standard and regulated infrastructure, meaning residents rely on solar power generators and water reserves to maintain their wellbeing. Facing severe financial constraints, residents of these communities are unable to afford rental costs if they want to continue accessing essential resources such as food and water. Water is often salty and difficult to drink, children lack access to school supplies, and families can be evicted at a moment’s notice.
Contrary to the stereotypes, these households include documented families with the required paperwork to live and work in Chile. Conservative discourse around these communities paint migration as something that must be limited, and have led to mass evictions of these communities. Liberal policymakers describe the importance of migration for Chile’s economy, highlighting the benefits of migration and the importance of supporting migrants’ livelihoods.
In sum, this short documentary provides a succinct overview of migration in and to Chile, with a special emphasis on housing security, financial corners, and political debates that migrants face in their experiences moving. It is a good watch for those eager to learn more about migrants’ access to resources, for students learning about urban development, and for on-the-go learners short on time.
VICE Documentary Review: Crisis Inside the Border's Largest Refugee Tent City
Check out the 25 minute documentary here.
The “Migrant Protection Protocol (MPP)” also known as the “Remain in Mexico” policy enacted under the Trump presidency added layers of restrictions for asylum seekers attempting to enter the US. MPP prevents individuals from across Central and South America from crossing into the US as their asylum cases process, leaving them stranded at the US-Mexico border. This Latin-XVICE documentary provides an inside look into the lives and realities of the families living in a large refugee camp situated at the US-Mexico border.
Handpicked stories following a pair of clinicians, an advocate and doctor duo, and a single mother whose son successfully crossed into the US illustrate the clear needs and humanitarian emergency taking place at the border, and the tangible impact that dehumanising rhetoric about migrants and refugees south of the US border has had on families fleeing dangerous socio political circumstances. Heavily story-focused, viewers will witness the unforgiving and dehumanising handling of migrants at the US-Mexico border as journalist Paola Ramos discusses the health, safety, and legal risks that migrants face as they wait for their case to process.
Taking place soon before the start of the COVID-19 pandemic, doctors explain how the settlement is not prepared for an epidemic, and that many of the families care for vulnerable children with pre-existing physical and mental health needs. Such conditions would have granted vulnerable children exceptions to the policy as they require special medical attention, however cases that plead exceptional circumstances are regularly denied by border patrol. Health hazards such as smoke from cooking, high dust levels, stagnant water, and insecure sleeping conditions add to the spread of respiratory diseases, parasites, and infections amongst children, and violence around the settlement is frequent.
For health professionals committed to learning about xenophobia’s impact on health, this documentary will demonstrate how xenophobic policymaking and stereotyping has a real impact on the health and wellbeing of migrants at the US-Mexico border. Seemingly designed to motivate action, this documentary will showcase the day-to-day needs of families undergoing these extreme conditions and inform your action towards health justice and human rights for migrants and refugees.