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When Ana Melgoza, a representative from San Ysidro Health, walked into the old church – converted to a makeshift shelter for families seeking asylum in the United States – she saw children, coughing but smiling, playing soccer or coloring at tables in the dining hall. Families sat together.
For these families, the shelter was a welcome respite. After a difficult journey north – primarily from Honduras, El Salvador and Guatemala – and often days or weeks in a crowded immigration facility, they’d been released onto the streets of San Diego.
Volunteers had found them and brought them to the shelter, where, thanks to Jewish Family Service of San Diego, they’d receive food, clothing, a safe place to sleep, and legal advice. Because of two extraordinary local health centers, they’d also receive much-needed medical care.
Their journey was far from over. Soon, they’d depart for new lives in Washington, D.C., or Chicago or New Orleans, where they would await the court appearance that decided whether they’d be able to stay in the States.
But for the first time in a long time, “they were in an environment that was welcoming and festive,” explained Melgoza, San Ysidro Health’s Vice President of External Affairs. “Even to get their basic needs met meant the world to them.”
Dr. Javier Rodriguez, Chief Medical Officer at La Maestra Community Health Centers, saw something similar in the people he encountered at the shelter: “When they felt they were going to be treated with dignity and respect, with love even, they opened up, and this countenance of hope showed up on their face. You could see it.”
San Ysidro and La Maestra already serve more than 130,000 individuals per year in the San Diego area, and both health centers provide medical care to underserved patients regardless of their ability to pay. Caring for the families at the shelter was outside their scope of practice, but both organizations felt it was a moral imperative.
“To hear of the plight of the families and to know that they were just picked up from the streets of San Diego late at night…We just knew we couldn’t turn our backs on that,” Melgoza said.
In particular, these families were asylum seekers – people fleeing danger or persecution in their home countries and requesting legal protection from the United States government. Until October of last year, the federal government operated a Safe Release program designed to help asylum seekers travel to their “sponsors” – friends or relatives who would care for them while they awaited a court date.
Then the program ended. Individuals seeking asylum are now required to wait on the other side of the border, but families, who can remain inside the United States while they await their hearings, needed a place to go.
Working closely with the County of San Diego Health & Human Services Agency, Jewish Family Service stepped in to fill the gap. They immediately established a shelter where families released from federal custody safely stay while they make plans to join their sponsors. Volunteers help them arrange travel and navigate the legal process of requesting asylum.
And then, of course, there’s the medical aid. “A lot of these folks are not actually healthy when they’re leaving [facilities], even though they should have been cleared medically,” said Lea Bush, Senior Director of Family and Community Services for Jewish Family Service.
It hasn’t been without its challenges. The shelter has changed locations six times. Currently, it’s located in an unused courthouse. A judge’s chambers was converted into an exam room, complete with a portable sink. Arriving families are screened for health issues, treated onsite when possible, and transferred to a hospital if more complex care is needed.
Children arriving at the shelter have fevers, ear infections, and severe colds. Adults often have dental abscesses or painful skin conditions. Malnutrition and dehydration are frequent occurrences. There’s also psychological trauma.
A recent flu outbreak has caused additional challenges. Individuals at the shelter now undergo two separate health screenings, and anyone with flu symptoms is treated in isolation from the general population.
“We’re treating whatever was ignored on their way up, and whatever was developed or made more acute while they were in custody,” Melgoza said.
Patients receive primary and dental care, along with what Rodriguez calls “mental health first aid” – a consultation and discussion of available resources for patients who are, in many cases, depressed and anxious.
Other organizations are also lending their support. Direct Relief,for example, has provided Jewish Family Service, San Ysidro Health Center, and La Maestra Community Health Centers with financial assistance to help them defray the significant costs of providing shelter and medical aid. The organization has also provided medical supplies designed to meet the particular needs of the families seeking asylum.
According to Bush, the aid they’ve received has been indispensable. “There was just this sense that we were not without support,” she said. “We were going to be able to get support for all the different aspects of the shelter, the health component included.”
The courthouse is crowded, sheltering up to 200 people on any given night. Healthcare providers, who often go straight from their daytime work at the clinic to a night shift at the shelter, are tired. But La Maestra’s Dr. Rodriguez said the importance of what they’re doing carries them forward. “It’s a cost to their families and themselves, but they love it,” he explained.
Despite the crowded conditions – and the short window of time that asylum seekers spend at the shelter – all three organizations are committed to quality care. “We’re running it as though we were running a clinic here; it’s the same,” Rodriguez said. “They’re registered the same, they’re treated the same.”
Over time, the shelter has become a brighter space, decorated with butterfly ornaments and “welcome” signs. Volunteers and coordinators focus on warmth and comfort. Bush said the facilities where asylum seekers are held, nicknamed “hieleras,” or “iceboxes,” are famously cold. “We want them to be warm in all the different senses of the word,” she said.
It’s working, according to Rodriguez: “As we’ve gotten better collectively, the patients’ faces seem a little brighter.”