Mexico: Risks at Border for Those With Disabilities

(Ciudad Juárez) – Asylum seekers with disabilities waiting in Ciudad Juárez, Mexico for their United States asylum applications to be processed face obstacles to getting basic services, Human Rights Watch said today. Mexico’s government should identify and ensure services for people with disabilities and chronic health conditions.

Human Rights Watch research in Ciudad Juárez – a city across the border from El Paso, Texas – found that the Mexican government does not have a proper system in place there to screen and identify asylum seekers with disabilities and chronic health conditions. The authorities have not ensured physical accessibility in shelters, even new ones. Nor are they consistently providing information about and access to health care for asylum seekers with disabilities or chronic health conditions.   

“People with disabilities face significant challenges when they are forced to stay for many months in Mexico waiting for asylum applications to be processed in the US,” said Carlos Ríos Espinosa, senior disability rights researcher at Human Rights Watch. “If the government doesn’t identify people with disabilities, it won’t be able to adequately ensure their access to basic services including health care, food, and shelter.”

An increasing number of asylum seekers, mostly from Central America, have been marooned in Mexico since January 2019, when the Trump administration introduced a policy it calls the Migrant Protection Protocols, also known as “Remain in Mexico.” This policy forces asylum seekers to wait in Mexico while their US immigration claims are pending. Although US policy states that “individuals from vulnerable populations may be excluded on a case-by-case basis” from being sent back to Mexico, Human Rights Watch has found that US border agents’ identification of people with disabilities and decisions to exclude them from being returned have been inconsistent.

As of October 4, almost 50,000 people were in Mexico awaiting US asylum claim hearings under the program. The US government’s practice of limiting the number of new asylum applications to 15 to 30 per day also means that asylum seekers typically wait 3 to 4 months in Mexican border cities to even begin applying for asylum in the US.

In Ciudad Juárez in August and September, Human Rights Watch interviewed 10 asylum seekers with disabilities or chronic health conditions, their families, and officials from the National Migration Institute and the Chihuahua State Council for Population, state agencies responsible for migrants. Human Rights Watch also visited Ciudad Juarez’s one state-run shelter for migrants and asylum seekers and three private shelters.

None of the four shelters were fully accessible for people with disabilities. The federally-run Leona Vicario National Integration Center, which opened in August with a capacity of 3,000 people, has no bathrooms accessible for people with physical disabilities. When it opened, there were no beds and people slept on mats on the floor, including people with disabilities. There is no accessible transportation to and from the shelter.

Government screening for health conditions and disabilities of asylum seekers who enter shelters is inconsistent. A government official and some asylum seekers said that a doctor conducts a basic medical exam of every person moving into a public shelter. At the Leona Vicario shelter, an official said that 86 percent of asylum seekers entering the shelter are registered as having health problems.

However, the shelter’s screening failed to identify some people with disabilities. One resident said that her one-year-old son had been diagnosed with microcephaly and asthma while in Honduras. When she arrived at the shelter in May, the authorities did not ask questions about her son’s health and did not register him as having a disability.

Four adults with disabilities or chronic health conditions in a private shelter run by a religious organization similarly said that no one had identified their disabilities and health conditions when they arrived.

Human Rights Watch research in December 2018 in Tijuana identified many of the same barriers for asylum seekers with disabilities.

Some asylum seekers end up in private shelters because there is insufficient state-run accommodation for all asylum seekers returned to Mexico. Regardless of where they find shelter, under international law, the Mexican government has an obligation to protect the rights of asylum seekers with disabilities. This includes screening for health conditions and disabilities and taking action to prevent them from developing further disabilities, Human Rights Watch said.

Federal and state officials acknowledged that the screening was not sufficient. The head of the National Migration Institute in Chihuahua said that his agency only detected “visible disabilities” and did not do additional screening. “We still do not have an agreed concept as to what we should understand by disability,” he said.

Four asylum seekers with disabilities interviewed also said that officials did not provide enough information or facilitate their access to health care. Asylum seekers in Mexico are eligible for state health insurance for low-income people, yet Human Rights Watch interviewed asylum seekers who did not have information about the plan.

A 55-year-old man from Cuba who is hard of hearing purchased a hearing aid with his own funds. He spent 200 pesos (US$10), the full amount his family sends to him each month to support himself. Human Rights Watch later learned that he could have received a hearing aid at no charge under the government’s health insurance. No officials had informed him of this benefit.

In another case, a Honduran woman who said she has high blood pressure reported that no officials had given her information about state health insurance. She has not received any treatment or medication for her high blood pressure since arriving in Mexico in May.  

A man from Guatemala said that his son has a prosthetic eye which requires daily cleaning, yet officials did not share information with him about the medical insurance that would allow him to see a doctor. “We were in the dark, not knowing anything about health services,” he said. He secured a doctor’s appointment for his son nine months after arriving in Mexico after a nongovernmental organization informed him about the insurance.

Despite the fact that Mexican law establishes the right for asylum seekers who do not speak Spanish to have an interpreter without cost, the service is not always available. People with disabilities can face a disproportionate impact on their health if they don’t have timely access to an interpreter.

A 39-year-old man partially paralyzed in his right arm and leg from a stroke he experienced before fleeing violence in Cameroon said that during his three months in a private shelter in Ciudad Juárez, he had seen a doctor but had not been able to communicate effectively. “I have not been able to have an appropriate medical consultation because almost no one speaks English, and I cannot explain what happened to me,” he said. “I didn’t understand what the doctor was telling me.” Two days after the interview, he was hospitalized for a severe headache and high blood pressure.

Limited food options in shelters worsen some asylum seekers’ disabilities and health conditions. Food provided in three of the shelters visited by Human Rights Watch is primarily fatty meat and beans and is often spicy. An official responsible for providing food at the Leona Vicario shelter said that the shelter does not accommodate medical or other dietary needs.

A 29-year-old man from Uganda who had been in a private shelter for four months said he had an ulcer and back pain after alleged torture by the Ugandan military. “My condition here is very precarious,” he said. “I am very grateful to this shelter, but I am not well here. Every day they feed us the same food, and I need a fat-free diet because of my ulcer.”

Mexico’s Labor Ministry has a program to enable asylum seekers to find employment while their applications are being processed. But the Leona Vicario shelter manager said that this program has yet to ensure equal employment opportunities for people with disabilities.

Under the Convention on the Rights of Persons with Disabilities, ratified by Mexico in 2007, the government, including the National Migration Institute and the Labor Ministry, should identify and register asylum seekers with disabilities and ensure their equal access to shelter, employment, and health services through accessible information and communication.

“Mexico is obligated to protect everyone with disabilities and chronic health conditions, including those seeking asylum,” Ríos Espinosa said. “The government should strengthen procedures to identify and register their conditions and to ensure accessible information and other services.”