“Illegal” in the Hospital Bed

“Illegal” in the Hospital Bed:
The Experience of Undocumented Migrants in Mexican Medical Facilities

When Cesar was finally rescued from the train tracks where he had fallen and was bleeding from an open wound on his ankle, he thought the worst was over. As a Central American migrant traveling towards the United States, he had been risking his life ever since he crossed into Mexico – hiding from “migración” agents, trying to dodge thieving and kidnapping gang members, running from aggressive local police, and traveling on top of the northbound cargo train with its menacing steel wheels. Cesar had fallen from the train when the foreman had braked suddenly (and possibly intentionally), causing Cesar to lose his balance, fall, and watch as the train’s wheel sliced off his right foot.

Unfortunately, Cesar’s problems didn’t end with the arrival of the rescue crew. In the hospital where he was taken, he was operated on by inexperienced students who weren’t able to sew up his stump at his ankle and left him with an open wound. Rather than remedy their error by correcting the problem at the ankle, the hospital staff tried to get Cesar to consent to an amputation above the knee. They threatened that his whole leg would become infected and repeatedly attempted to get him to sign off on the surgery. Cesar, however, held out because he was certain that his knee and lower leg were still in good shape. He waited for 20 days with the open wound. No one would hear him out. Finally, the hospital director found out about the situation and ordered Cesar’s doctors to put a skin graft on his wound. With the graft, Cesar was able to heal and he regained full functioning of his knee and lower leg, which he uses to maneuver a prosthetic device he obtained through charity care. Cesar was correct that it had not been necessary to amputate above the knee. In fact, if the more drastic amputation had been performed, it would have been much more difficult for Cesar to adjust to a prosthetic leg than it has been with his small prosthetic foot.

The poor quality of care, unethical manipulation of consent, and delay of necessary medical attention that Cesar experienced in this Mexican hospital exemplify what many other migrants have faced in the Mexican hospital system. Just last spring, Amnesty International put out an urgent alert detailing the discriminatory treatment Nicaraguan Yasser Vilchez Grant Domingo received during a hospital stay in southern Mexico. Not only was Yasser’s treatment delayed, but the doctor involved actually physically and verbally abused him because he was a “damn migrant.” According to migrant rights advocates, medical negligence and abuses against migrants in Mexico’s hospitals are a widespread problem. Doña Olga Sanchez Martinez, who runs the Jesus el Buen Pastor migrant shelter in Tapachula, Mexico, and helps care for injured migrants after they are discharged from hospitals, says that she has been witnessing these types of occurrences for the past 15 years.

A recent story-gathering project at the shelter sought to document some of the difficult experiences of migrants in hospitals of Mexico with more detail and precision. The migrants in the shelter told stories about getting discharged in the middle of the night, being given painful operations without anesthesia, getting operated on without their consent, and being left without nurse support and forced to change their own sheets after receiving a serious operation. Other migrants spoke about being verbally abused and told that they deserved to be in pain because they were foreigners. The stories point out that, while some of the problems experienced can be attributed to the low economic capital of the migrants (a disadvantage shared by the poor of Mexico as well) the harsh treatment migrants receive is at times motivated by anti-migrant sentiment and discrimination on the part of the health care provider.

Although these abuses continue to occur, relatively little remedial action has been taken. The lack of consequences, combined with the long history of inconsistent and/or inferior care in Mexican hospitals, suggest that there are a number of systematic issues that need to be addressed in order to combat the problem of medical negligence and abuse of migrants. Given the difficult and dangerous situation migrants already face in Mexico, there is all the more reason for medical providers to stick to their professional commitment to heal the sick and injured by providing critical and unbiased medical attention and working to preserve the human rights and dignity of the migrants that they treat.