The expansion of border crossings with the Mexico-US wall has been accompanied by an increasing number of serious injuries, with poor discharge care and a lack of adequate interpretation facilities contributing to a “humanitarian and health crisis”, researchers suggest in the open-access journal. Trauma Surgery & Acute Care Open.
Thirty-eight different nationalities and 21 languages other than Spanish were represented among those who tried to cross a section of the wall in 2021 and 2022, researchers say.
The US-Mexico border wall was extended by 50 miles and raised to a height of 30 feet in Southern California, the construction of which was completed in 2019, they explain.
Since then, trauma centers in Southern California have reported an increase in the number and severity of cerebrovascular, orthopedic and spinal injuries caused by boundary wall falls, they add.
To gain a clearer picture of the nationalities of injured migrants and what happens to them after hospital care, researchers retrospectively reviewed hospital and medical records of injured patients admitted to an academic Level 1 Trauma Center after attempting to cross a section of USA. -Mexico border wall in 2021 and 2022.
They identified 597 patients who were injured while crossing the San Diego section of the US-Mexico border wall from 38 different countries. Their average age was 32 years and 3 out of 4 (446, 75%) were men.
Just over two-thirds (405, 68%) were Mexican. Of the rest, nationals from Peru (23; 4%), India (17; (3%), El Salvador (14; just over 2%), Cuba (13; just over 2%), the Jamaica (12.2%), and Somalia (12.2%) were most represented, but immigrants also came from Europe, Asia and the Middle East.
“Multidisciplinary services are required to effectively treat patients presenting with complex borderline injuries. Patients often require multispecialty trauma care, multiple procedures, surgical interventions, and physical therapy—all of which require the use of significant hospital resources.” the researchers note.
However, despite the high level of care required during their hospitalization, many of these patients do not receive appropriate follow-up after discharge, they add.
“In San Diego, for example, most border fall patients are discharged with relatives or in border detention, despite significant disability that would typically require inpatient rehabilitation.
In El Paso, Texas, the trauma system noted a similar trend and described a simple follow-up of 12% of patients in the clinic despite the fact that more than 90% of these patients underwent surgery.”
The researchers found that most patients (74%) were discharged within the US. But the unloading destinations were scattered widely across the country.
California was the most common discharge state (49%), with just over 15% of all patients discharged in the San Diego area. New York was the destination for just over 5%, followed by Florida (just over 3%). Another 20% were released by law enforcement and 4% were released back to Mexico.
That means most (85%) of the immigrants were discharged outside the San Diego area, despite having an average injury severity score of 8, the researchers say, adding that follow-up rates were low even for those discharged in San Diego.
“This lack of post-operative care means that post-operative complications may go unrecognized and rehabilitation therapy may be delayed, all impeding recovery from potentially disabling injuries,” they point out.
“[It] highlights the need for careful clinical examination at discharge, with particular attention to detailed written and verbal instructions, discharge with all medications, and use of absorbable sutures when possible, given the challenges in postoperative follow-up,” they add.
They acknowledge that their analysis was limited to one trauma center serving a section of the US-Mexico border wall. Therefore, the findings cannot be extended to trauma centers serving different parts of the border wall, they say. And the data only records patients injured in 2021 and 2022.
But they conclude: “Overall, our study characterizes the global nature of the public health and humanitarian crisis unfolding at the southern border of the United States and demonstrates the diverse patient population associated with border fall injuries – represented by five continents, 38 countries, 22 languages and countries of exemption destinations.“
A linked article points to a tenfold increase in admissions for the fall of the border wall since 2017, adding traumatic injuries to the already established risks of immigration, such as exposure to heat and cold.
“Basically, these are preventable injuries. Current international politics and political conditions along with US immigration policy and border conditions drive migration and put immigrants at risk of harm during unauthorized border crossings. Interventions at all levels are necessary and appropriate for harm reduction“, the authors conclude.
Source:
Journal Reference:
Lagan, S., et al. (2024) From around the world – traumatic injuries are an international concern on the US-Mexico border wall. Trauma Surgery & Acute Care Open. doi.org/10.1136/tsaco-2023-001308.
